response D
Ask a probing question, substantiated with additional background information, evidence or research.
Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
Validate an idea with your own experience and additional research.
Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
Discussion
When conducting a doctorate of nursing practice (DNP) project, a conceptual framework may be a helpful part of the process because it helps identify and categorize the project’s various components (Moran et al., 2020). When considering this framework, performing literature reviews will help determine what research is pertinent to the project’s interest. A literature review is an interpretive, organized, and written interpretation of what the researcher has read (Gray et al., 2017). Literature entails all of the written sources that the researcher finds relevant to the selected topic, and this may include newspapers, encyclopedias, conference papers, scientific journals, textbooks, other books, theses, dissertations, and clinical journals (Gray et al., 2017). For this discussion, four research articles about safe, effective, and affordable prescribing of psychotropic medications were found and interpreted.
The first article that was reviewed suggests that the framework of public health psychopharmacology (PHP) should be considered a practice discipline (Barbui et al., 2018). This framework is suggested based on the lack of availability, affordability, and rational prescribing practices for mental health disorders (Barbui et al., 2018). This article strengthens the merit of my selected practice problem by providing a thorough review of evidence-based research data. This data supports the use of regulatory science, health services research, and implementation science to improve prescribing practices by increasing rational prescribing, improving access, and providing more affordable medication options (Barbui et al., 2018).
The second article reviewed safety and prescriber’s perceptions of off-labeling prescribing. The authors identified a lack of awareness or understanding of the regulatory process and labels, a perception that labels are not meaningful guidelines for practice, and recognition of alternative processes for ensuring safe and rational prescribing (Ghinea et al., 2016). This article did strengthen my research because it supports the notion that there are safety guidelines for prescribing medications backed by evidence.
The third article that was reviewed considered the access and use of psychotropic medicines in low-resources settings. This article supports my practice problem by identifying availability, distance, and cost as the main barriers to effective psychotropic medicines in low-resource settings (Barbui, 2015). This article was especially helpful for researching in my community because I practice in a location that does much telehealth to reach out to people all over the state that are unable to access care in person.
The fourth article that was reviewed covered the prevalence of psychotropic medication prescribed to children and adolescents. This article was more specific to the child and adolescent population, and I am more interested in the psychiatric population as a whole, involving all ages. However, it still strengthens my research because it provides global estimates of pediatric psychotropic medications prevalence and the trends occurring (Piovani et al., 2019).
The level of evidence most prevalent in these articles was level one. Level one evidence consists of evidence from a systematic review, meta-analysis of randomized-controlled trials, or evidence-based clinical practice guidelines based on systematic reviews of randomized-controlled trials, or three or more randomized-controlled trials (Winona State University, 2020). I think this is the most prevalent level of evidence in my practice problem because it is a well-known practice problem. Since it is such a well-known practice problem, much research has been conducted surrounding this topic. Also, my research topic is fairly broad, covering several factors that affect prescribing quality in mental health care, making this topic easier to find high-quality evidence instead of a more condensed topic.
Barbui, C. (2015). Access and use of psychotropic medicines in low-resource settings. Epidemiology for Clinical
Psychopharmacology, 24, 206-209. doi:10.1017/S20457960015000268
Barbui, C., Ostuzzi, G., & Godman, B. (2018). Public health psychopharmacology: A new research discipline comes of age?
Epidemiology and Psychiatric Sciences, 27, 24-28. doi:10.1017/S2045796017000464
Ghinea, N., Kerridge, I., Little, M., & Lipworth, W. (2016). Challenges to the validity of using
medicine labels to categorize clinical behavior: An empirical and normative critique of
“off-label” prescribing. Journal of Evaluation in Clinical Practice, 23, 574-581.
doi:10.1111/jep.12673
Gray, J.R., Grove, S.K., & Sutherland, S. (2017). Burns and Grove’s the practice of nursing research: Appraisal, synthesis, and
generation of evidence (8th ed.). St. Louis, MO: Saunders Elsevier
Moran, K., Burson, R., & Conrad, D. (2020). The doctor of nursing practice scholarly project: A framework for success (3rd ed.).
Burlington, MA: Jones & Bartlett Learning
Piovani, D., Clavenna, A., & Bonati, M. (2019). Prescription prevalence of psychotropic drugs in
children and adolescents: An analysis of international data. European Journal of Clinical
Pharmacology, 75, 1333-1346. https://doi.org/10.1007/s00228-019-02711-3
Winona State University. (2020). Evidence based practice tool kit. Retrieved on October 3, 2020, from
https://libguides.winona.edu/c.php?g=11614&p=61584
Moran, K. J., Burson, R., & Conrad, D. (2019). The doctor of nursing practice project: A framework for success (3rd ed.). Jones & Bartlett Learning.
Strøm, T., Martinussen, T., & Toft, P. (2010). A protocol of no sedation for critically ill patients receiving mechanical ventilation: A randomised trial. The Lancet, 375(9713), 475–480. https://doi.org/10.1016/s0140-6736(09)62072-9
Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.