RESPONSE DIS

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.

Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

Discussion

Physical restraint use in the ICU is a current practice problem and warrants exploration through literature review. Despite supporting evidence against the use of restraints, they continue to be routinely used in the ICU setting (Mitchell et al., 2018). The Stetler Model of research utilization is comprehensive and can be adapted to the institution or individual level (Gray et al., 2017). This model consists of five phases which can be tailored to meet the objectives of the identified practice problem and evidence-based practice goals. It is imperative to locate literature that aligns with the clinical concern and summarize the available research (Gray et al., 2017). For example, there is a high level of evidence that suggests the use of physical restraint in ICU patients worsens delirium and patient outcomes, and a decrease in restraint use is correlated with improved patient outcomes (Pan et al., 2018). The Stetler Model identifies cognitive and instrumental application when translating evidence into practice (Gray et al., 2017). As nurses analyze their practice dynamics and utilize new evidence regarding physical restraint use, it will allow them to improve their knowledge, modify their way of thinking, and develop new solutions. Development in nurses’ knowledge will likely lead to instrumental application of research evidence in the form of updated practice protocols and guidelines (Gray et al., 2017).

Evidence-based practice is a blend of research and theory, synthesizing knowledge in a meaningful way to establish best practices for improved patient outcomes. Clinical research alone does not constitute an evidence-based practice. Clinical research must be validated and tested using different modalities so that it can be synthesized into a thoroughly reviewed evidence-based practice. PhD-prepared nurses pioneer clinical research that will support or refute global practice problems in healthcare. Numerous studies supporting similar outcomes with high-quality research designs are necessary to develop evidence-based practice (Gray et al., 2017). Evidence-based practices are not experimental; they are proven and tested guidelines to advance patient care. DNP nurses are uniquely prepared to synthesize clinical research, apply theoretical concepts from multiple ways of knowing, and develop evidence-based practice that are meaningful to the holistic care of patients (Fitzpatrick, 2010).

References

Fitzpatrick, J. J. (2010). Connecting or disconnecting the dots between research and evidence-based practice. Applied Nursing Research, 23(1), 1. https://doi.org/10.1016/j.apnr.2009.10.001

Gray, J. R., Grove, S. K., & Sutherland, S. (2017). Burns & grove's the practice of nursing research: Appraisal, synthesis, and generation of evidence (8th ed.). Saunders Elsevier.