NR 451 Week 2 Discussion

Student Name

Chamberlain University

NR-451: RN Capstone Course

Prof. Name

Date

Week 1: Types of Nursing Models and Frameworks of Evidence-Based Practice (EBP)

In Week 1, students are introduced to various nursing models and the fundamental frameworks that guide Evidence-Based Practice (EBP). These models form the foundation for clinical decision-making and enhance the integration of research findings into patient care. Nursing frameworks such as the Iowa Model, Johns Hopkins EBP Model, and Stetler Model provide structured approaches that enable nurses to critically evaluate evidence and apply it within practice settings. Understanding these models is crucial because they help bridge the gap between research and clinical application, ultimately improving patient outcomes.

Additionally, these frameworks emphasize the importance of interdisciplinary collaboration, systematic inquiry, and outcome measurement. By becoming familiar with different EBP models, nurses are better equipped to identify problems, evaluate evidence, implement interventions, and assess the results of their practice changes.

Week 2: The Clinical Question

The capstone change project begins in Week 2 with the identification of a clinical practice issue requiring improvement. This issue must align with a systematic review from the approved list provided in the course guidelines (Week 3 Capstone Project: Milestone 1 assignment page). The selection of a systematic review is essential, as it ensures that the proposed project is grounded in credible and current evidence.

Once a review has been chosen, the next step is to formulate a clinical question that serves as the foundation of the project. The question should clearly address a practice concern relevant to nursing and demonstrate how evidence can improve outcomes. It is important to explain how this question was developed and its significance within your professional context—whether from past experiences, current responsibilities, or anticipated future roles.

A research–practice gap often emerges when there is a discrepancy between what evidence suggests should be done and what is actually practiced in clinical settings. Identifying and addressing this gap is vital for ensuring that nursing interventions remain evidence-based and patient-centered.

NR 451 Week 2 Discussion – Example 1

There was some confusion in framing the initial clinical question, as it appeared to lean more toward a medical rather than a nursing focus. However, highlighting nursing interventions, such as ensuring compliance with Surgical Care Improvement Project (SCIP) protocols, underscores the role of nurses in promoting patient safety. Nurses often serve as the final checkpoint, ensuring that key practices, such as the administration of prophylactic antibiotics, are followed.

One possible PICO-based clinical question is:

Question: Does the use of antimicrobial dressings and topical antibiotics compared to traditional sterile gauze dressings on surgical sites lead to a decrease in surgical site infections (SSIs)?

This question emphasizes a nursing-related intervention—dressing application—that is directly within the scope of nursing care. By focusing on wound management strategies, nurses can play a critical role in reducing postoperative complications.

NR 451 Week 2 Discussion – Example 2

Another potential clinical issue relates to misconceptions held by patients and families about recovery practices after surgery. While many believe rest is the most beneficial approach, research suggests that early ambulation and nutritional support are more effective in restoring bowel function and reducing hospital stays.

Question: In patients undergoing bowel surgery, how does early and frequent ambulation with nourishment compare to conventional recovery methods of rest and bowel rest, in terms of return of bowel function and hospital length of stay within the first 72 hours postoperatively?

This clinical question directly relates to nursing practice, as nurses play a central role in mobilizing patients, encouraging early ambulation, and supporting nutritional interventions. By implementing evidence-based strategies, nurses contribute significantly to enhanced recovery protocols (ERPs) and improved surgical outcomes.

References

American Nurses Association. (2021). Nursing: Scope and standards of practice (4th ed.). ANA Publishing.

Iowa Model Collaborative. (2017). Iowa model of evidence-based practice: Revisions and validation. Worldviews on Evidence-Based Nursing, 14(3), 175–182. https://doi.org/10.1111/wvn.12223

NR 451 Week 2 Discussion

Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Wolters Kluwer.

Stevens, K. R. (2013). The impact of evidence-based practice in nursing and the next big ideas. Online Journal of Issues in Nursing, 18(2), 4. https://doi.org/10.3912/OJIN.Vol18No02Man04