NR 505 Week 2: Refinement of a Nursing Concern into an Evidence-based Practice Proposal Using the Research Process
Sample Answer for NR 505 Week 2: Refinement of a Nursing Concern into an Evidence-based Practice Proposal Using the Research Process Included After Question
NR 505 Week 2 Refinement of a Nursing Concern into an Evidence-based Practice Proposal Using the Research Process
Purpose
This assignment provides the opportunity for the student to continue work on a previously
identified area or phenomenon of interest related to their MSN specialty track. Week Two's
assignment builds upon the identified area of interest by developing an overview of the evidence-
based practice (EBP) project and the PICOT/PICo question. This assignment initiates the
evidence-based practice proposal that is continued throughout the entire course with each
assignment adding components of the research process.
Course Outcomes
This assignment enables the student to meet the following course outcomes:
CO#1 Integrate evidence-based practice and research to support advancement of holistic nursing
care in diverse healthcare settings. PO 1
CO#2 Integrate knowledge related to evidence-based practice and person-centered care to
improve healthcare outcomes. PO 2, 5
CO#4 Develop knowledge related to research and evidence-based practice as a basis for
designing and critiquing research studies. PO 1, 2, 3, 5
Due Date: Sunday 11:59 PM MT at the end of Week Two
Total Points Possible: 150 points
Requirements
Description of the Assignment
This assignment builds on the identification of a nursing concern from NR 500 and the
application of a nursing theory to the selected concern from NR 501. For this course, the selected
concern and nursing theory then serve as a foundation to the identification of PICOT/PICo.
Identification of the literature search strategy is also required.
Criteria for Content
1. Overview of Selected Evidenced-based Practice Project: This section provides a foundation to
the MSN EBP scholarly project. It should contain the following elements:
Explain the relationship between research and evidenced-based practice (EBP)
Distinguish how EBP is different from research
Explain the contribution of EBP to professional nursing
Identify your MSN Program Specialty Track and practice focus
Explain how EBP promotes change within your future practice setting
2. Identification of the Nursing Concern to be Improved: This section provides a comprehensive
discussion of the selected nursing concern. It should contain the following elements:
Explain the selected nursing concern in detail
Identify how frequently the selected concern occurs within your specialty track setting
Identify the stakeholders impacted by the concern
Identify the consequences of the selected concern
Identify your proposed solution to the selected concern
Identify a purpose statement for this EBP proposal
3. PICOT/PICo question and Literature Search Process: This section identifies the PICOT/PICo
question that will used for this EBP proposal. The literature search parameters will also be
identified. It should contain the following elements:
Identify the question in correct format with all required elements
o PICOT for quantitative research approach
o PICo for qualitative research approach
Identify how the expected outcome will be useful to your future practice setting
Discuss the purpose of conducting a literature review and the contribution it will provide to this
EBP proposal
Identify the steps used to conduct a literature review for this EBP proposal by including:
o The specific library databases used
o The key search terms and phrases used
o The minor (additional) search terms and phrases used
o Identify any specialty organization that is relevant to this EBP proposal
4. Theoretical Framework: This section presents the theoretical framework that will used in this
EBP project. It should contain the following section:
Explain the theoretical framework to be used in this EBP proposal
Describe how the identified theoretical framework is applied to this EBP proposal
A Sample Answer For the Assignment: NR 505 Week 2: Refinement of a Nursing Concern into an Evidence-based Practice Proposal Using the Research Process
Title: NR 505 Week 2: Refinement of a Nursing Concern into an Evidence-based Practice Proposal Using the Research Process
Preparing the Assignment
Criteria for Format and Special Instructions
1. The paper (excluding the title page and reference page) should be at least 5, but no more than 8
pages. Points will be lost for not meeting these length requirements.
2. Title page, running head, body of paper, and reference page must follow APA guidelines as
found in the 6 th edition of the manual. This includes the use of headings for each section of the
paper except for the introduction where no heading is used.
3. A minimum of 6 (six) appropriate research-based scholarly references must be used. Required
textbook for this course, dictionary and Chamberlain College of Nursing lesson information
may NOTbe used as scholarly references for this assignment. For additional assistance
regarding scholarly nursing references, please see "What is a scholarly source" located in the
Course Resources tab. Be aware that information from .com websites may be incorrect and
should be avoided. References are current – within a 5-year time frame unless a valid rationale
is provided and the instructor has approved them prior to submission of the assignment.
4. Ideas and information from scholarly, peer reviewed, nursing sources must be cited and
referenced correctly.
5. Rules of grammar, spelling, word usage, and punctuation are followed and consistent with
formal, scientific writing.
Rubric
Week 2: Refinement of a Nursing Concern into an Evidence-based Practice Proposal Using
the Research Process
Week 2: Refinement of a Nursing Concern into an Evidence-based Practice Proposal Using the Research Process
Criteria Ratings Pts
This criterion is
linked to a Learning
OutcomeOverview of
Selected Evidence-
based Practice Project
25.0 pts
Presentation of
information
was exceptional
and included all
of the following
elements: •
Explain the
relationship
between
research and
evidence-based
practice (EBP) •
Distinguish how
EBP is different
from research •
Explain the
contribution of
EBP to
professional
nursing •
Identify your
MSN Program
Specialty Track
and practice
22.0 pts
Presentation of
information
was good, but
was superficial
in places and
included all of
the following
elements: •
Explain the
relationship
between
research and
evidence-based
practice (EBP) •
Distinguish how
EBP is different
from research •
Explain the
contribution of
EBP to
professional
nursing •
Identify your
MSN Program
20.0 pts
Presentation of
information was
minimally
demonstrated in
the all of the
following
elements: •
Explain the
relationship
between research
and evidence-
based practice
(EBP) •
Distinguish how
EBP is different
from research •
Explain the
contribution of
EBP to
professional
nursing •
Identify your
MSN Program
Specialty Track
10.0 pts
Presentation of
information in
one or two of
the following
elements fails to
meet
expectations: •
Explain the
relationship
between
research and
evidence-based
practice (EBP) •
Distinguish how
EBP is different
from research •
Explain the
contribution of
EBP to
professional
nursing •
Identify your
MSN Program
Specialty Track
0.0 pts
Presentation of
information is
unsatisfactory in
three or more of
the following
elements: •
Explain the
relationship
between research
and evidence-
based practice
(EBP) •
Distinguish how
EBP is different
from research •
Explain the
contribution of
EBP to
professional
nursing • Identify
your MSN
Program
Specialty Track
and practice
25.0 pts
focus • Explain
how EBP
promotes
change within
your future
practice setting
Specialty Track
and practice
focus • Explain
how EBP
promotes
change within
your future
practice setting
and practice
focus • Explain
how EBP
promotes change
within your
future practice
setting
and practice
focus • Explain
how EBP
promotes
change within
your future
practice setting
focus • Explain
how EBP
promotes change
within your
future practice
setting
This criterion is
linked to a Learning
OutcomeIdentification
of the Nursing
Concern to be
Improved
25.0 pts
Presentation of
information was
exceptional and
included all of
the following
elements: •
Explain the
selected nursing
concern in detail
• Identify how
frequently the
selected concern
occurs within
your specialty
track setting •
Identify the
stakeholders
impacted by the
concern •
Identify the
consequences of
the selected
concern •
Identify your
proposed
solution to the
selected concern
• Identify a
purpose
statement for
22.0 pts
Presentation of
information was
good, but was
superficial in
places and
included all of
the following
elements: •
Explain the
selected nursing
concern in detail
• Identify how
frequently the
selected concern
occurs within
your specialty
track setting •
Identify the
stakeholders
impacted by the
concern •
Identify the
consequences of
the selected
concern •
Identify your
proposed
solution to the
selected concern
• Identify a
20.0 pts
Presentation of
information was
minimally
demonstrated in
the all of the
following
elements: •
Explain the
selected nursing
concern in detail
• Identify how
frequently the
selected concern
occurs within
your specialty
track setting •
Identify the
stakeholders
impacted by the
concern •
Identify the
consequences of
the selected
concern •
Identify your
proposed
solution to the
selected concern
• Identify a
purpose
10.0 pts
Presentation of
information in
one, two or
three of the
following
elements fails to
meet
expectations: •
Explain the
selected nursing
concern in detail
• Identify how
frequently the
selected concern
occurs within
your specialty
track setting •
Identify the
stakeholders
impacted by the
concern •
Identify the
consequences of
the selected
concern •
Identify your
proposed
solution to the
selected concern
• Identify a
0.0 pts
Presentation of
information is
unsatisfactory in
four or more of
the following
elements: •
Explain the
selected nursing
concern in detail
• Identify how
frequently the
selected concern
occurs within
your specialty
track setting •
Identify the
stakeholders
impacted by the
concern •
Identify the
consequences of
the selected
concern •
Identify your
proposed
solution to the
selected concern
• Identify a
purpose
statement for
25.0 pts
this EBP
proposal
purpose
statement for
this EBP
proposal
statement for
this EBP
proposal
purpose
statement for
this EBP
proposal
this EBP
proposal
This criterion is
linked to a Learning
OutcomePICOT/PICo
question and
Literature Search
Process
20.0 pts
Presentation of
information
was exceptional
and included all
of the following
elements: •
Identify the
question in
correct format
with all
required
elements o
PICOT for
quantitative
research
approach o
PICo for
qualitative
research
approach •
Identify how
the expected
outcome will be
useful to your
future practice
setting • Discuss
the purpose of
conducting
literature
review and the
contribution it
will provide to
18.0 pts
Presentation of
information
was good, but
was superficial
in places and
included all of
the following
elements: •
Identify the
question in
correct format
with all
required
elements o
PICOT for
quantitative
research
approach o
PICo for
qualitative
research
approach •
Identify how
the expected
outcome will be
useful to your
future practice
setting • Discuss
the purpose of
conducting
literature
review and the
16.0 pts
Presentation of
information was
minimally
demonstrated in
the all of the
following
elements: •
Identify the
question in
correct format
with all required
elements o
PICOT for
quantitative
research
approach o PICo
for qualitative
research
approach •
Identify how the
expected
outcome will be
useful to your
future practice
setting • Discuss
the purpose of
conducting
literature review
and the
contribution it
will provide to
this EBP
8.0 pts
Presentation of
information in
one or two of
the following
elements fails to
meet
expectations: •
Identify the
question in
correct format
with all
required
elements o
PICOT for
quantitative
research
approach o
PICo for
qualitative
research
approach •
Identify how the
expected
outcome will be
useful to your
future practice
setting • Discuss
the purpose of
conducting
literature review
and the
contribution it
0.0 pts
Presentation of
information is
unsatisfactory in
three or more of
the following
elements: •
Identify the
question in
correct format
with all required
elements o
PICOT for
quantitative
research
approach o PICo
for qualitative
research
approach •
Identify how the
expected outcome
will be useful to
your future
practice setting •
Discuss the
purpose of
conducting
literature review
and the
contribution it
will provide to
this EBP
proposal •
20.0 pts
this EBP
proposal •
Identify the
steps used to
conduct a
literature
review for this
EBP proposal
by including: o
The specific
library
databases used
o The key
search terms
and phrases
used o The
minor
(additional)
search terms
and phrases
used o Identify
any specialty
organization
that is relevant
to this EBP
proposal
contribution it
will provide to
this EBP
proposal •
Identify the
steps used to
conduct a
literature
review for this
EBP proposal
by including: o
The specific
library
databases used
o The key
search terms
and phrases
used o The
minor
(additional)
search terms
and phrases
used o Identify
any specialty
organization
that is relevant
to this EBP
proposal
proposal •
Identify the steps
used to conduct a
literature review
for this EBP
proposal by
including: o The
specific library
databases used o
The key search
terms and
phrases used o
The minor
(additional)
search terms and
phrases used o
Identify any
specialty
organization that
is relevant to this
EBP proposal
will provide to
this EBP
proposal •
Identify the
steps used to
conduct a
literature review
for this EBP
proposal by
including: o The
specific library
databases used o
The key search
terms and
phrases used o
The minor
(additional)
search terms
and phrases
used o Identify
any specialty
organization
that is relevant
to this EBP
proposal
Identify the steps
used to conduct a
literature review
for this EBP
proposal by
including: o The
specific library
databases used o
The key search
terms and
phrases used o
The minor
(additional)
search terms and
phrases used o
Identify any
specialty
organization that
is relevant to this
EBP proposal
This criterion is 20.0 pts 18.0 pts 16.0 pts 8.0 pts 0.0 pts 20.0 pts
linked to a Learning
OutcomeTheoretical
Framework
Presentation of
information
was exceptional
and included all
of the following
elements: •
Explain the
theoretical
framework to
be used in this
EBP proposal •
Describe how
the identified
theoretical
framework is
applies to this
EBP proposal
Presentation of
information was
good, but was
superficial in
places and
included all of
the following
elements: •
Explain the
theoretical
framework to
be used in this
EBP proposal •
Describe how
the identified
theoretical
framework is
applies to this
EBP proposal
Presentation of
information was
minimally
demonstrated in
the all of the
following
elements: •
Explain the
theoretical
framework to be
used in this EBP
proposal •
Describe how the
identified
theoretical
framework is
applies to this
EBP proposal
Presentation of
information in
one of the
following
elements fails to
meet
expectations: •
Explain the
theoretical
framework to be
used in this EBP
proposal •
Describe how
the identified
theoretical
framework is
applies to this
EBP proposal
Presentation of
information is
unsatisfactory in
two of the
following: •
Explain the
theoretical
framework to be
used in this EBP
proposal •
Describe how the
identified
theoretical
framework is
applies to this
EBP proposal
This criterion is
linked to a Learning
OutcomePaper
Specifications
10.0 pts
This section
included all of
the following: •
Paper meet
length
requirements of
5 to 8 page. •
Minimum of 6
(six) scholarly
nursing
references •
Dictionary,
required
textbook for this
course and
Chamberlain
College of
Nursing lesson
information,
were NOT used
as scholarly
references. • All
references are
current – within
a 5-year time
frame unless a
valid rationale
9.0 pts
This section
included three
of the following:
• Paper meet
length
requirements of
5 to 8 page. •
Minimum of 6
(six) scholarly
nursing
references •
Dictionary,
required
textbook for this
course and
Chamberlain
College of
Nursing lesson
information,
were NOT used
as scholarly
references. • All
references are
current – within
a 5-year time
frame unless a
valid rationale
8.0 pts
This section
included only
two of the
following: •
Paper meet
length
requirements of
5 to 8 page. •
Minimum of 6
(six) scholarly
nursing
references •
Dictionary,
required
textbook for this
course and
Chamberlain
College of
Nursing lesson
information,
were NOT used
as scholarly
references. • All
references are
current – within
a 5-year time
frame unless a
4.0 pts
This section
included only
one of the
following: •
Paper meet
length
requirements of
5 to 8 page. •
Minimum of 6
(six) scholarly
nursing
references •
Dictionary,
required
textbook for this
course and
Chamberlain
College of
Nursing lesson
information,
were NOT used
as scholarly
references. • All
references are
current – within
a 5-year time
frame unless a
0.0 pts
This section
included none of
the following: •
Paper meet
length
requirements of
5 to 8 page. •
Minimum of 6
(six) scholarly
nursing
references •
Dictionary,
required
textbook for this
course and
Chamberlain
College of
Nursing lesson
information,
were NOT used
as scholarly
references. • All
references are
current – within
a 5-year time
frame unless a
valid rationale
10.0 pts
was provided
and the
instructor
approved them.
was provided
and the
instructor
approved them.
valid rationale
was provided
and the
instructor
approved them.
valid rationale
was provided
and the
instructor
approved them.
was provided
and the
instructor
approved them.
This criterion is
linked to a Learning
OutcomeAPA Style
25.0 pts
APA guidelines,
as per the 6th
edition of the
manual, are
demonstrated
for the • title
page, • running
head, • body of
paper (including
margins,
headings, font
etc.), and
reference page
One deduction
for each type of
APA format
error 0 to 1 APA
error was
present
22.0 pts
APA guidelines,
as per the 6th
edition of the
manual, are
demonstrated
for the • title
page, • running
head, • body of
paper (including
margins,
headings, font,
etc.), and
reference page
One deduction
for each type of
APA format
error 2 – 3 APA
errors were
present
20.0 pts
APA guidelines,
as per the 6th
edition of the
manual, are
demonstrated
for the • title
page, • running
head, • body of
paper (including
margins,
headings, font,
etc.), and
reference page
One deduction
for each type of
APA format
error 4 – 5 APA
errors were are
present
10.0 pts
APA guidelines,
as per the 6th
edition of the
manual, are
demonstrated
for the • title
page, • running
head, • body of
paper (including
margins,
headings, font,
etc.), and
reference page
One deduction
for each type of
APA format
error 6 – 7 APA
errors were
present
0.0 pts
APA guidelines,
as per the 6th
edition of the
manual, are
demonstrated
for the • title
page, • running
head, body of
paper (including
margins,
headings, font,
etc.), and
reference page
One deduction
for each type of
APA format
error 8 or
greater APA
errors were
present
25.0 pts
This criterion is
linked to a Learning
OutcomeCitations 10.0 pts
There were 0-1
errors in the
crediting of
ideas, and
information that
contributed to
knowledge.
9.0 pts
There were 2-3
errors in the
crediting of
ideas, and
information that
contributed to
knowledge.
8.0 pts
There were 4-5
errors in the
crediting of
ideas, and
information that
contributed to
knowledge
4.0 pts
There were 6-7
errors in the
crediting of
ideas, and
information that
contributed to
knowledge
0.0 pts
There were 8 or
greater errors in
the crediting of
ideas, and
information that
contributed to
knowledge
10.0 pts
This criterion is
linked to a Learning
OutcomeWriting
Mechanics 15.0 pts
1–2 errors or
exceptions to the
rules of
grammar,
spelling, word
usage,
punctuation and
other aspects of
formal written
work as found
in the 6th
edition of the
APA manual
13.0 pts
3 – 4 errors or
exceptions to the
rules of
grammar,
spelling, word
usage,
punctuation and
other aspects of
formal written
work as found in
the 6th edition
of the APA
manual
12.0 pts
5 – 6 errors or
exceptions to the
rules of
grammar,
spelling, word
usage,
punctuation and
other aspects of
formal written
work as found in
the 6th edition
of the APA
manual
6.0 pts
7 – 8 errors or
exceptions to the
rules of
grammar,
spelling, word
usage,
punctuation and
other aspects of
formal written
work as found in
the 6th edition
of the APA
manual
0.0 pts
9 or greater
errors or
exceptions to the
rules of
grammar,
spelling, word
usage,
punctuation and
other aspects of
formal written
work as found in
the 6th edition of
the APA manual
15.0 pts
Total Points: 150.0
PreviousNext
Submission
Submitted!
May 14 at 10:18am (late)
Submission Details
Download NR505 Week 2 Paper –Reducing Falls in Longterm Care Facilities.docx
Grade: 150 (150 pts possible)
Graded Anonymously: no
View Rubric Evaluation
Comments:
Hi Fride! Thank you for your fine work on this interesting topic. Overall writing/apa look great, too! Awesome! I look forward
to ongoing work! Dr. L
FNPs Role in Reducing Falls in Long-term Care Facilities
Fride Wandji
Chamberlain College of Nursing
NR505: Advanced Research Methods: Evidence-Based Practice
May 2017
Overview of Selected Evidenced-based Practice Project
Research is typically conducted to explore and discover new knowledge or to validate
existing information about a specific subject. Specifically, nursing research is form of scientific
investigation meant to explore and explain a variety of clinical experiences, outcomes, and
phenomena that is vital to the scientific and professional foundation of nursing (Baker, 2016).
The goal of nursing research is to drive the practice to meet a high level of patient care outcomes
(Baker, 2016). Nursing research also sets out to identify the links or gaps between published
research and current clinical practice (Baker, 2016). Research is based on collected opinions, but
it is also built upon a framework of scientific inquiry to avoid bias as much as possible (Baker,
2016). In contrast, evidence-based practice (EBP) is founded on collected scientific and medical
research, but it is also an expert opinion built on professional, clinical, and patient experiences.
The goal of EBP is to translate or utilize current knowledge, research, and other pertinent
medical data into everyday clinical practice to provide the best care possible for patients. FNPs
and other nurses who utilize this approach should study recent healthcare research to determine
the best course of patient care and treatment (Baker, 2016).
Evidence-based practice and research take different approaches to identifying quality
nursing data and expert/clinical opinions. The difference between EBP and research is that FNPs
can use evidence-based practice to make connections between conducted research and clinical
experiences (Echevarria, Teegarden, & Kling, 2017). Evidence-based practice is not focused on
research first but about employing traditional or alternative care and treatment methods then
sharing that information in a published format (Echevarria et al., 2017). EBP urges nurses to
consider the “why” and “how” behind existing nursing methods and applications in an effort to
improve clinical outcomes (Echevarria et al., 2017). Lastly, EBP seeks to challenge and add to
the traditional body of nursing knowledge.
The contribution of EBP to professional nursing is vast. Since its professional inception,
nursing has evolved the way nurses provide optimal patient care and the way in which they are
educated. Over the past decade, EBP has been garnering more attention from nursing
professionals and has slowly emerged as an excellent standard by which to provide clinical care
(Mick, 2017). Evidence-based practice has transitioned to the classroom setting, influencing
undergraduate and graduate nursing programs (Mick, 2017). EBP nursing coursework increases
nursing students’ overall knowledge base as it teaches them the importance of professional
accountability and fosters critical thinking skills (Stevens, 2013). EBP also makes an invaluable
contribution to the field of nursing because it considers the nurses role in nurturing interpersonal
relationships between patients and nurses (Stevens, 2013). EBP shows the relevance of
respecting and seeking better understanding of how patients’ clinical, cultural, religious and
socioeconomic backgrounds relate to scientific research and suggested treatments (Mick, 2017).
Incorporating EBP nursing concepts and findings throughout a nurse’s education and clinical
experiences develops decision-making skills as nurses are better able to adapt to situations,
utilize informatics, and work together in collaborative teams (Stevens, 2013). When EBP
narratives are shared in the classroom, utilized to create health and nursing legislation, and
accepted by nursing organizations and theorists, nurses gain a greater sense of confidence and
pride in their work. Furthermore, EBP has led nurses to become more interested and invested in
nursing research (Stevens, 2013). Additionally, when relevant EBP is used in a clinical setting,
nurses have a working approach to managing complications associated with illness or disease.
This patient centered approach helps lower costs of care as it eliminates unnecessary costs
associated with testing and treatment plans (Stevens, 2013).
MSN Program Specialty Track and Practice Focus
My MSN specialty track is FNP, and my practice focus is reducing falls in long term
care. I am interested in this topic to assess the current level of involvement of FNPs in activities
related to preventing falls and managing fractures in long-term care (LTC) setting. EBP
promotes change in an LTC setting because it has problem-solving approach (Echevarria,
Teegarden, & Kling, 2017). Published evidence-based practice concepts becomes a viable
literature resource for LTC nurses. This EBP knowledge is founded on best practices,
information gathered from nursing and scientific studies, nurses’ expertise, and patients’ desires
and beliefs—all of which improve patient outcomes; thus, nurses are more willing to implement
EBP into care practices (Echevarria et al., 2017).
EBP also promotes change in an LTC setting because it empowers FNPs to practice
autonomy and gives them the confidence to share and implement their, and other nurses, clinical
expertise in their goal to improve patient outcomes (Specht, 2013). LTC nursing managers can
refer to EBP to restructure their organizations’ care plans and LTC nursing roles (Specht, 2013).
Implementing EBP practice in an LTC setting will embolden FNPs to find alternatives to
traditional clinical treatment options. There are multiple barriers to promoting change in an LTC
setting, yet there is clear evidence of the benefits that evidence-based practices have on LTC
residents and to the health care system (Specht, 2013). The goal of patient centered change
supports LTC based nursing research and the integration of best practices in LTC organizations
(Specht, 2013).
Identification of the Nursing Concern to be Improved
As an LTC nurse, I am familiar with the issues associated with residents/patients falling
and fracturing bones, especially their hips. Falling is a painful and humiliating experience,
especially for elderly patients. After suffering a fall in an LTC setting, patients may experience a
decline in their quality of life. Kaasalainen, Papaioannou, Burgess, and Van der Horst (2015)
state fractures can be a significant source of pain, anxiety, agitation, depression, disability, and
decreased pulmonary function. Also, fracture rates are four to eight times higher in an LTC
setting than in any other medical setting (Kaasalainen et al., 2015). In a mixed method study
conducted on managing falls in an LTC setting, Kaasalainen et al. (2015), states NPs reported
they overly familiar with caring for patients who received a fracture while in an LTC setting.
NPs in this study also report, they have participated in multiple fall reduction initiatives
(Kaasalainen et al., 2015). I believe NPs set the tone and expectations for nursing staff. NPs can
assist nurses with applying learned fall prevention techniques, taking risk assessments,
implementing balance and strengthening exercises, and ensuring all patients have taken an
adequate amount of calcium and vitamin D.
NPs can also integrate new information and practices that will benefit existing fall
prevention practices. Harrison (2017), states two primary reasons the NPs contribution to fall
prevention strategies in an LTC setting are necessary: NPs have the clinical knowledge and skills
to establish and lead fall prevention programs in community and LTC settings; FNPs are
qualified to teach evidence-based education courses on fall risk factors. The stakeholders
impacted most by my concern are patients and families, along with FNP nurses and nursing
leaders who practice in LTC settings. Additional impacted stakeholders include nursing
administrators, scientific and nursing researchers, physicians, nursing instructors, legislative
bodies who create LTC laws, nursing professional associations, and nursing accrediting agencies.
Each of these stakeholders are responsible for promoting LTC patient care and ensuring that a
high quality of care is provided to patients. The consequences of not utilizing or introducing
LTC evidence-based data in an LTC setting is that it hinders or limits the treatment options
provided to FNPs nurses. Another negative result is that it delays the advancement of the LTC
and causes traditional LTC nursing treatment methods to become outdated instead of expanding
upon them. My proposed solution is to advocate for evidence-based practice LTC methods to be
implemented in LTC settings and within the classroom.
Purpose Statement
The purpose of this qualitative study is to determine FNPs clinical experiences in
providing EBP centered care to patients who have fractured bones in an LTC setting. The goal is
to take the information gathered and use it to create fall prevention programs and/or implement
fall prevention strategies, which raises patient safety and satisfaction and lessens LTC
malpractice and negligence suits.
PICOT/PICo question and Literature Search Process
My PICo question is: “What are NP’s experiences in providing care to patients who have
fallen in an LTC and fractured bones in the United States?” The expected outcome of this query
is that implementation of quality fall prevention programs and strategies will enrich the health
and quality of life of LTC patients. Examining EBP fall prevention programs will circumvent
patient falls and promote best patient outcomes. I hope to also prove that participation in fall
intervention programs decrease LTC residents’ fears of falling, particularly for elderly patients.
A literature review is useful in that it examines and analyzes scholarly literature (books
and articles) that are relevant to a health model or an area of research theory. When done
correctly, literature reviews summarize research on a given subject and critically evaluate
research publication sources. Within my practice focus and setting, literature reviews illustrate to
long term care FNPs how EBP and research fit within a larger field of study (Maggio, Sewell &
Artino, 2106). The systematic format of a literature review allows researchers to connect
traditional explanations of dated research material with new interpretations of the same material
(Maggio et al., 2016). The goal of a literature review is to summarize a body of valuable
information and identify any disparities in research and to eliminate unrelated information
(Maggio et al., 2016). A literature review will contribute to this EBP proposal because it assists
with categorizing possible publication sources that I may need to use to construct the body of my
final proposal. A literature review will also allow me to compare related research and connect
my findings with traditional or EBP based practices, as well as investigate and apply my
experiences with fall prevention programs in the LTC settings in which I have been employed.
I will use the following library databases: PubMed (Medline), CINAHL Plus, ERIC
(EBSCOhost), JSTOR, and Google Scholar. Key search terms and phrases used are: LTC fall
management programs, elderly falls in the LTC, falls and fall risks in LTC, EBP fall care, FNP
narratives on fall care in LTC, evidence-based nursing fall interventions. Additional search
terms used are minimizing fall risks in long term care facilities, strategies for reducing falls in
long-term care, risk assessment and prevention in long term care. Specialty organizations
relevant to this proposal are the American Nurses Association (ANA), American Healthcare
Association (AHCA), The American Association of Directors of Nursing Services (AADNS),
American Association of Retired People (AARP), National Association of Directors of Nursing
Administration in Long Term Care, Americans for LTC Security, Long Term Care Partnership
Program.
Theoretical Framework
Falls suffered in an LTC setting have lasting psychological and physical consequences.
They lead to fractures and slow the healing process down. Furthermore, patients lose confidence
in walking, which diminishes mobility and hastens health decline. Falls in the LTC lead to a
decline in the services provided by an LTC facility and its nursing staff, raise healthcare and
malpractice insurance costs of the facility, and decrease the quality of life for residents. The
theoretical framework used for this EBP proposal is the Deliberative Nursing Process model
developed by the theorist, Ida Jean Orlando. Her theory allows nurses to create effective,
practical, and adaptable nursing care plans (Nursingtheory.org, 2016). These plans can be used to
eliminate falls, prevent complications arising from patients not wanting to participate in fall
prevention programs, and minimize barriers with FNPs and LTC administrators not wanting to
integrate fall prevention strategies. Orlando’s theory suggests that patients with acute illnesses or
needing long term care must satisfy their physiological needs and eliminate fears if they want to
heal (Nursingtheory.org, 2016). When these needs are not met, patients do not have a positive
LTC or acute care experiences. Orlando’s theory is useful to create initial fall risk assessments
and critical intervention plans. The theory promotes individualize care plans and interventions
(Nursingtheory.org, 2016). In relation to eliminating falls in the LTC, Orlando’s theory posits all
patient behavior is a cry for help (Nursingtheory.org, 2016). Thus, falling is the patient’s way of
saying “pay attention to me.” The FNP must interpret this behavior and determine the needs of
the patient (Nursingtheory.org, 2016). Orlando’s Deliberative Nursing Process includes five
stages: assessment, diagnosis, planning, implementation, and evaluation (Nursingtheory.org,
2016).
References
Baker, J. D. (2016). Nursing research, quality improvement, and evidence‐based practice: The
key to perioperative nursing practice. AORN Journal, 105(1), 3-5. Retrieved from
https://doi.org/10.1016/j.aorn.2016.11.020
Echevarria, L. M., Teegarden, G., & Kling, J. (2017). Promoting a culture of evidence-based
practice through a change request process. Nurse Leader, 15(4), 281-285. Retrieved from
https://doi.org/10.1016/j.mnl.2017.02.004
Harrison, B. E. (2017). Fall prevention program in the community: A nurse practitioner’s
contribution. The Journal for Nurse Practitioners, 13(8), e395–e397. Retrieved from DOI:
https://doi.org/10.1016/j.nurpra.2017.06.017
Kaasalainen, S., Papaioannou, A., Burgess, J., & Van der Horst, M. L. (2015). Exploring
the nurse practitioner role in managing fractures in long-term care. Clinical Nursing
Research, 24(6), 567–588. Retrieved from http://doi.org/10.1177/1054773815577577
Maggio, L. A., Sewell, J. L., & Artino, A. R. (2106). The literature review: A foundation for
high-quality medical education research. Journal of Graduate Medical Education, 8(3),
297-303. Retrieved from https://doi.org/10.4300/JGME-D-16-00175.1
Mick, J. (2017). Call to action: How to implement evidence-based nursing practice.
Nursing2017, 47(4), 36-43. Retrieved from DOI-
10.1097/01.NURSE.0000513603.03034.5c
Nursingtheory.org. (2016). Ida Jean Orlando – Nursing Theorist. Retrieved from
Specht, J. K. (2013). Evidence based practice in long term care settings. Journal of
Korean Academy of Nursing, 43(2), 145-153. Retrieved from DOI:
10.4040/jkan.2013.43.2.145
Stevens, K. R. (2013). The impact of evidence-based practice in nursing and the next big
ideas. The Online Journal of Issues in Nursing (OJIN), 18(2), Manuscript 4. Retrieved
from DOI: 10.3912/OJIN.Vol18No02Man04
Grading Rubric
| Performance Category | 100% or highest level of performance
100% 16 points |
Very good or high level of performance
88% 14 points |
Acceptable level of performance
81% 13 points |
Inadequate demonstration of expectations
68% 11 points |
Deficient level of performance
56% 9 points
|
Failing level
of performance 55% or less 0 points |
| Total Points Possible= 50 | 16 Points | 14 Points | 13 Points | 11 Points | 9 Points | 0 Points |
| Scholarliness
Demonstrates achievement of scholarly inquiry for professional and academic topics. |
Presentation of information was exceptional and included all of the following elements:
|
Presentation of information was good, but was superficial in places and included all of the following elements:
|
Presentation of information was minimally demonstrated in all of the following elements:
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Presentation of information is unsatisfactory in one of the following elements:
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Presentation of information is unsatisfactory in two of the following elements:
|
Presentation of information is unsatisfactory in three or more of the following elements
|
| 16 Points | 14 Points | 13 Points | 11 Points | 9 Points | 0 Points | |
| Application of Course Knowledge
Demonstrate the ability to analyze and apply principles, knowledge and information learned in the outside readings and relate them to real-life professional situations |
Presentation of information was exceptional and included all of the following elements:
|
Presentation of information was good, but was superficial in places and included all of the following elements:
|
Presentation of information was minimally demonstrated in the all of the following elements:
|
Presentation of information is unsatisfactory in one of the following elements:
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Presentation of information is unsatisfactory in two of the following elements:
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Presentation of information is unsatisfactory in three of the following elements
|
| 10 Points | 9 Points | 6 Points | 0 Points | |||
| Interactive Dialogue
Initial post should be a minimum of 300 words (references do not count toward word count) The peer and instructor responses must be a minimum of 150 words each (references do not count toward word count) Responses are substantive and relate to the topic. |
Demonstrated all of the following:
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Demonstrated 3 of the following:
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Demonstrated 2 of the following:
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Demonstrated 1 or less of the following:
|
||
| 8 Points | 7 Points | 6 Points | 5 Points | 4 Points | 0 Points | |
| Grammar, Syntax, APA
Points deducted for improper grammar, syntax and APA style of writing. The source of information is the APA Manual 6th Edition Error is defined to be a unique APA error. Same type of error is only counted as one error. |
The following was present:
AND
AND
|
The following was present:
AND/OR
AND/OR
|
The following was present:
AND/OR
AND/OR
|
The following was present:
AND/OR
AND/OR
|
The following was present:
AND/OR
AND/OR
AND/OR
|
The following was present:
AND/OR
AND/OR
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| 0 Points Deducted | 5 Points Lost | |||||
| Participation
Requirements |
Demonstrated the following:
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Failed to demonstrate the following:
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| 0 Points Lost | 5 Points Lost | |||||
| Due Date Requirements | Demonstrated all of the following:
A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT. |
Demonstrates one or less of the following.
A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT. |
Read Also: NR 505 Week 1: Identification of Area of Interest