NURS FPX 5005 Assessment 3 Evidence-based Practice in Nursing

Student Name

Capella University

NURS-FPX 5005 Introduction to Nursing Research, Ethics, and Technology

Prof. Name

Date

Evidence-Based Practice Application

Nurses devote a significant portion of their time to critically assess and evaluate the quality of patient care. Operating within a dynamic healthcare environment, nurses continually adapt to evolving patient circumstances and stay current with advancements in medicine, treatments, and literature. The framework employed to assess and evaluate recent innovations, best practices, and emerging literature in order to establish state-of-the-art inpatient care is known as Evidence-Based Practice (EBP).

EBP integrates external evidence, clinical expertise, patient values, and critical evaluation. Any new and pertinent approach to nursing practice is appraised based on external evidence, personal experience, and patient feedback. External evidence encompasses clinically substantiated and contemporary literature, while personal experience reflects the clinical proficiency gained through patient care (Alatawi et al., 2020).

Analysis of Criteria and Process for Implementing EBP

In the course of their daily responsibilities, nurses encounter recurring problems that their prior experiences can resolve. However, they occasionally confront novel issues that demand further investigation. To address such challenges, Evidence-Based Practice (EBP) follows a four-step process:

1. Assessment of the patient’s clinical problem.
2. Thorough exploration of related and reliable literature.
3. Appraisal of pertinent articles.
4. Execution and dissemination of gathered information.

Initially, nurses compile information based on initial assessments or diagnoses to formulate a clinical problem statement. This statement serves as a foundation for database searches, encompassing relevant studies, journal articles, and related literature. Rigorous scrutiny is applied to assess the credibility and relevance of these sources, given the constant evolution of medical practices and procedures. Based on this comprehensive review of the literature, nurses proceed to implement the identified treatment protocols (Alatawi et al., 2020).

According to Alatawi et al. (2020), barriers to the adoption of EBP are both individual and organizational in nature. Individual barriers relate to the professional competence of healthcare providers, including their experience and attitudes. In certain cases, nurses must communicate and understand the needs of patients who are unable to articulate their concerns, making effective communication critical. Organizational barriers pertain to the resources and budgets available within healthcare institutions. These factors influence the extent to which organizations prioritize the delivery of optimal patient care. Any modifications to clinical practices within an organization may raise concerns related to budget allocation, database access, and logistical considerations.

Importance of Scholarship for EBP Research

Solving complex healthcare problems requires significant investments of time and resources, which may be beyond the means of individual nurses. Programs such as Magnet® support evidence-based nursing practice and research (Wentland & Hinderer, 2020). Clinical nurses play a distinct role in driving problem-focused research and scholarship, contributing to staff development and enhancing healthcare capabilities (Whalen et al., 2020).

Inclusion and exclusion criteria for conducting evidence-based nursing practice, as outlined by Saunders et al. (2019), encompass the following considerations:

• Addressing biases during the selection of literature in EBP research.
• Evaluating the methodological quality of studies.
• Ensuring a focus on multiple outcomes.

Clinical Questions Related to Evidence-Based Practice

Speroni et al. (2020) conducted a survey involving 127 out of 181 nursing research leaders from various Magnet-recognized hospitals across the United States. Magnet recognition evaluates the implementation of strategic nursing goals by nursing leaders. The study revealed that over 90% of these hospitals utilize the EBP model, with the Iowa Model of Evidence-Based Practice being the most commonly employed. EBP has demonstrated its ability to enhance patient care and create a conducive work environment for nurses.

Clinical Question: “Which Interventions, Along with Patient Care Technologies, Control Fever Based on EBP in the ICU?”

Chiwaula et al. (2021) introduced the Iowa Model of Evidence-Based Practice in the ICU of Kamuzu Central Hospital (KCH). Fever management is a significant concern in the ICU, given the vulnerability of patients in this setting. Discrepancies in fever management protocols necessitate the use of temperature monitoring devices with connected sensors (patient care technology) in the ICU. This approach has empowered frontline nurses to systematically manage the ICU, ensuring efficient, competent, and optimal patient care.

The model’s purpose is to establish guidelines for routine practice. Data analysis employed STATA 12.0 software, utilizing statistical tools such as paired t-tests, and spearman correlation to correlate temperature changes with clinical interventions. Additionally, Liu et al. (2020) assessed the use of AI technology in the wearable wireless device iThermonitor WT705, which facilitated continuous temperature monitoring for surgical ward patients. The device proved effective in capturing more instances of fever compared to intermittent observations, with the potential for further improvement through advanced algorithm development.

Knowledge Gap in Study

A significant knowledge gap in the study conducted by Chiwaula et al. (2021) pertains to patient consent. Due to the unconscious state of many ICU patients, obtaining their consent was unfeasible. This represents a critical area of uncertainty, as EBP relies on patient input and participation.

EBP holds the potential to serve as a valuable guide for patients with specific conditions. However, it is crucial to recognize that patient circumstances and symptoms can vary significantly. Implementing EBP guidelines requires careful consideration to ensure that they align with individual patient needs and characteristics (Chiwaula et al., 2021).

Evaluation of Ethical and Regulatory Concerns for EBP

Ethical concerns related to patient-doctor confidentiality and ethical codes necessitate full disclosure to patients regarding the study’s objectives and the potential health implications. Informed consent must be obtained when conducting investigations involving patients (Chiwaula et al., 2021). Ethical considerations for evidence-based practice emphasize adherence to the ethical principles articulated in the Belmont principles, which encompass respect for autonomy, beneficence, and justice (Tu & Gao, 2021). Regulatory considerations mandate compliance with all recommendations set forth by the FDA in the use of evidence-based technology. These ethical and regulatory considerations significantly influenced the implementation of the wearable wireless technology device iThermonitor WT705 for continuous temperature monitoring in hospital intensive care units.

Patient safety and privacy are paramount concerns, particularly when implementing interventions, such as fever management in the ICU (Chiwaula et al., 2021). EBP often necessitates structural changes within healthcare organizations, technological upgrades, and associated financial considerations, which may pose policy challenges (Chipps et al., 2020).

Conclusion

Evidence-Based Practice holds the potential to address emerging challenges in healthcare, provided that nurses are afforded opportunities and support for scholarly research efforts. Nurses engaged in Evidence-Based Practice must uphold rigorous standards when evaluating literature and ensuring methodological quality. Moreover, maintaining patient confidentiality and anonymity is imperative when conducting EBP studies.

References

Alatawi, M., Aljuhani, E., Alsufiany, F., Aleid, K., Rawah, R., Aljanabi, S., & Banakhar, M. (2020). Barriers of implementing evidence-based practice in nursing profession: A literature review. American Journal of Nursing Science, 9(1), 35. https://doi.org/10.11648/j.ajns.20200901.16

Chipps, E., Tucker, S., Labardee, R., Thomas, B., Weber, M., Gallagher-Ford, L., & Melnyk, B. M. (2020). The impact of the electronic health record on

moving new evidence-based nursing practices forward. Worldviews on Evidence-Based Nursing, 17(2). https://doi.org/10.1111/wvn.12435

Chiwaula, C. H., Kanjakaya, P., Chipeta, D., Chikatipwa, A., Kalimbuka, T., Zyambo, L., Nkata, S., & Jere, D. L. (2021). Introducing evidence-based practice in nursing care delivery, utilizing the Iowa model in the intensive care unit at Kamuzu Central Hospital, Malawi. International Journal of Africa Nursing Sciences, 14, 100272. https://doi.org/10.1016/j.ijans.2020.100272

Liu, Y., Liu, C., Gao, M., Wang, Y., Bai, Y., Xu, R., & Gong, R. (2020). Evaluation of a wearable wireless device with artificial intelligence, iThermonitor WT705, for continuous temperature monitoring for patients in surgical wards: A prospective comparative study. BMJ Open, 10(11), e039474. https://doi.org/10.1136/bmjopen-2020-039474

NURS FPX 5005 Assessment 3 Evidence-based Practice in Nursing

Saunders, H., Gallagher‐Ford, L., Kvist, T., & Vehviläinen‐Julkunen, K. (2019). Practicing healthcare professionals’ evidence‐based practice competencies: An overview of systematic reviews. Worldviews on Evidence-Based Nursing, 16(3), 176–185. https://doi.org/10.1111/wvn.12363

Speroni, K. G., McLaughlin, M. K., & Friesen, M. A. (2020). Use of evidence‐based practice models and research findings in magnet‐designated hospitals across the united states: National survey results. Worldviews on Evidence-Based Nursing, 17(2), 98–107. https://doi.org/10.1111/wvn.12428

Tu, J., & Gao, W. (2021). Ethical considerations of wearable technologies in human research. Advanced Healthcare Materials, 10(17), 2100127. https://doi.org/10.1002/adhm.202100127

Wentland, B. A., & Hinderer, K. A. (2020). A nursing research and evidence-based practice fellowship program in a magnet®-designated pediatric medical center. Applied Nursing Research, 151287. https://doi.org/10.1016/j.apnr.2020.151287

Whalen, M., Baptiste, D.-L., & Maliszewski, B. (2020). Increasing Nursing Scholarship Through Dedicated Human Resources. JONA: The Journal of Nursing Administration, 50(2), 90–94. https://doi.org/10.1097/nna.0000000000000847

NURS FPX 5005 Assessment 3 Evidence-based Practice in Nursing