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
oPICOT for quantitative research approach
oPICo 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:
oThe specific library databases used
oThe key search terms and phrases used
oThe minor (additional) search terms and phrases used
oIdentify 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
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 6th 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
NOT be 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.
5. 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)
Research and evidence-based practice (EBP) are closely related and interconnected. Research is the
systematic investigation and inquiry into a particular topic, using various methods to gather and analyze
data, with the aim of generating new knowledge, identifying gaps in existing knowledge, and solving
problems. EBP, on the other hand, is the integration of the best available research evidence, clinical
expertise, and patient preferences and values in clinical decision-making to improve patient outcomes.
Research provides the foundation for EBP by generating new knowledge and evidence that can inform
clinical practice. EBP uses this knowledge to identify and implement the most effective interventions and
practices to improve patient outcomes. By integrating the best available research evidence with clinical
expertise and patient preferences, EBP promotes the delivery of high-quality, safe, and patient-centered
care.
Moreover, research plays a critical role in evaluating the effectiveness of EBP interventions and
identifying areas for improvement. Through the use of rigorous research methodologies and evaluation
frameworks, researchers can measure the impact of EBP interventions on patient outcomes and identify
ways to optimize clinical practice.
Overall, research and EBP are essential components of the nursing profession, as they promote the
delivery of evidence-based, patient-centered care that is informed by the best available evidence and
clinical expertise.
Identification of the Nursing Concern:
• Identify and describe the nursing concern that was selected in NR 500.
In NR 500, the nursing concern that was identified is the high rate of hospital readmissions among heart
failure patients. Heart failure is a chronic condition that affects millions of people worldwide, and
hospital readmissions are common among these patients, leading to increased healthcare costs and
reduced quality of life. Hospital readmissions can also indicate inadequate care transitions, poor
coordination between healthcare providers, and suboptimal management of heart failure symptoms.
Application of Nursing Theory:
• Identify and describe the nursing theory that will be applied to the selected nursing concern.
The nursing theory that will be applied to the selected nursing concern of hospital readmissions among
heart failure patients is the Chronic Care Model (CCM). The CCM is a theoretical framework that
emphasizes the importance of proactive, coordinated, and patient-centered care for patients with
chronic conditions, such as heart failure. The CCM provides a comprehensive approach to chronic
disease management that involves the integration of healthcare systems, self-management support, and
community resources to optimize patient outcomes.
Development of PICOT/PICo Question:
• Develop a PICOT/PICo question that addresses the nursing concern and is appropriate for the
application of the nursing theory.
PICOT Question: Among heart failure patients, does the implementation of the Chronic Care Model
(CCM) as compared to standard care reduce hospital readmissions within 30 days after hospital
discharge?
P- Heart failure patients I- Implementation of the Chronic Care Model (CCM) C- Standard care O-
Hospital readmissions within 30 days after hospital discharge T- Within a 12-month period
Literature Search Strategy:
• Identify the search strategy that will be used to conduct a literature review for the PICOT/PICo
question.
The following search strategy will be used to conduct a literature review for the PICOT question:
Heart failure AND Chronic Care Model
Heart failure AND hospital readmissions AND Chronic Care Model
Heart failure AND hospital readmissions AND care coordination
Heart failure AND hospital readmissions AND patient-centered care
Heart failure AND hospital readmissions AND self-management support
Heart failure AND hospital readmissions AND transitional care
Heart failure AND hospital readmissions AND healthcare systems integration
Heart failure AND hospital readmissions AND community resources
6. Heart failure AND hospital readmissions AND quality improvement
The databases that will be searched include PubMed, CINAHL, Cochrane Library, and Web of Science.
The search will be limited to English-language articles published within the past 10 years. The search will
also include the use of relevant keywords and MeSH terms.
Distinguish how EBP is different from research
EBP and research are related, but they are different concepts. EBP refers to the integration of the best
available research evidence, clinical expertise, and patient preferences and values to inform clinical
decision-making and improve patient outcomes. EBP involves a process of critically appraising and
synthesizing research evidence, applying it to clinical practice, and continuously evaluating and
improving clinical outcomes.
On the other hand, research is the systematic investigation and inquiry into a particular topic or
phenomenon, using various methods to gather and analyze data, with the aim of generating new
knowledge or validating existing knowledge. Research is driven by the scientific method, which involves
the formulation of research questions or hypotheses, the design of a study or experiment, data
collection and analysis, and the interpretation and dissemination of research findings.
In summary, research is a process of generating new knowledge or validating existing knowledge, while
EBP is the application of the best available research evidence to inform clinical decision-making and
improve patient outcomes. While research is an essential component of EBP, EBP also considers clinical
expertise and patient preferences in addition to research evidence to make informed clinical decisions.
Moreover, research can be conducted for various reasons, such as exploring a new topic, testing a
theory, or identifying factors that contribute to a particular health condition. Research can also take
many forms, including qualitative, quantitative, and mixed-methods research. In contrast, EBP is
specifically focused on using the best available research evidence to inform clinical practice and improve
patient outcomes.
Another key difference between research and EBP is their focus. Research is often conducted to answer
a specific research question or hypothesis, with the primary goal of generating new knowledge. EBP, on
the other hand, is focused on solving clinical problems and improving patient outcomes by integrating
the best available research evidence with clinical expertise and patient preferences.
Finally, while both research and EBP involve the critical appraisal and synthesis of research evidence,
EBP goes beyond this to incorporate clinical expertise and patient values and preferences. EBP also
involves continuous evaluation and improvement of clinical outcomes, using data-driven approaches to
optimize patient care and outcomes.
In summary, while research and EBP are closely related, they are distinct concepts that serve different
purposes. Research generates new knowledge, while EBP focuses on using the best available research
evidence to inform clinical practice and improve patient outcomes by integrating clinical expertise and
patient preferences.
To further illustrate the difference between research and EBP, consider an example. Suppose a nurse
wants to investigate the effectiveness of a new wound care dressing for diabetic foot ulcers. The nurse
could conduct a research study to compare the new dressing to standard care, with the goal of
generating new knowledge about the effectiveness of the new dressing. The study could involve a
randomized controlled trial with a large sample size and various outcome measures.
In contrast, an EBP approach would involve integrating the best available research evidence on wound
care dressings for diabetic foot ulcers with the nurse's clinical expertise and the patient's values and
preferences to make an informed clinical decision about whether to use the new dressing for a
particular patient. The EBP approach would also involve ongoing evaluation of the patient's wound
healing progress to determine whether the new dressing is effective and to make any necessary
adjustments to the treatment plan.
In summary, while research and EBP are both important in nursing practice, they serve different
purposes and require different approaches. Understanding the difference between research and EBP is
essential for nurses to effectively incorporate the best available evidence into their clinical practice and
improve patient outcomes.
Explain the contribution of EBP to professional nursing.
Evidence-based practice (EBP) has made significant contributions to professional nursing practice. EBP
helps nurses to make informed clinical decisions and provide the highest quality of care to their patients.
By integrating the best available research evidence with their clinical expertise and patient preferences,
nurses can optimize patient outcomes, promote patient safety, and reduce the risk of adverse events.
EBP also promotes the use of data-driven approaches to clinical decision-making, enabling nurses to
identify and address gaps in care, improve patient outcomes, and reduce healthcare costs. By
continually evaluating the effectiveness of their interventions and adapting their practice based on the
latest evidence, nurses can stay up-to-date with the latest advances in nursing and provide the most
effective and efficient care possible.
Moreover, EBP helps nurses to become lifelong learners and engage in ongoing professional
development. By regularly reviewing the latest research evidence, attending professional conferences
and workshops, and collaborating with other healthcare professionals, nurses can stay informed about
the latest advances in nursing and provide the most up-to-date and evidence-based care to their
patients.
Overall, EBP has made significant contributions to professional nursing by providing a systematic, data-
driven approach to clinical decision-making that enables nurses to provide the highest quality of care to
their patients, promote patient safety, and improve healthcare outcomes. EBP also promotes ongoing
professional development and lifelong learning, enabling nurses to stay up-to-date with the latest
advances in nursing and provide the most effective and efficient care possible.
EBP also contributes to the credibility and professionalism of the nursing profession. By using evidence-
based approaches, nurses can demonstrate their knowledge and expertise to patients, families, and
other healthcare professionals. EBP helps to build trust and respect among healthcare professionals, and
it enhances the reputation of the nursing profession.
Moreover, EBP provides nurses with a common language and approach to clinical decision-making,
enabling them to communicate effectively with other healthcare professionals and work collaboratively
to provide the best possible care to their patients. EBP also helps to standardize nursing practice and
ensure consistency and quality of care across different healthcare settings and institutions.
Finally, EBP is essential for advancing the nursing profession and improving healthcare outcomes at the
population level. By identifying gaps in care and promoting best practices, EBP can help to address
healthcare disparities and promote health equity. EBP also contributes to the development of new
knowledge and innovations in nursing practice, which can lead to improved patient outcomes and more
effective and efficient healthcare delivery.
In summary, EBP is a critical component of professional nursing practice, providing nurses with a
systematic, data-driven approach to clinical decision-making that enhances patient outcomes, promotes
patient safety, and improves healthcare delivery. EBP also contributes to the credibility and
professionalism of the nursing profession, standardizes nursing practice, and advances the field of
nursing.
Nursing Concern and Nursing Theory a. Identification of Nursing Concern The nursing concern that will
serve as the foundation for this MSN EBP scholarly project is: "Addressing the mental health needs of
hospitalized elderly patients with comorbidities." Many elderly patients who are hospitalized have
comorbidities, such as hypertension, diabetes, or heart disease, which can contribute to mental health
problems, including depression, anxiety, and delirium. These mental health problems can have a
significant impact on the patient's recovery and overall health outcomes, but they are often
underdiagnosed and undertreated in elderly hospitalized patients.
b. Nursing Theory The nursing theory that will be applied to this nursing concern is the "Roy Adaptation
Model" (RAM). The RAM is a theoretical framework that emphasizes the importance of adaptation in
the health and well-being of individuals. According to the RAM, individuals are constantly adapting to
their environment and adjusting to changes in their physical, psychological, and social domains. Nursing
interventions are aimed at promoting adaptation and helping individuals achieve their maximum
potential for health and well-being.
The RAM provides a holistic and comprehensive approach to nursing care that emphasizes the
importance of understanding the individual's unique needs and circumstances. The model includes
several key concepts, including the person, environment, health, and nursing, as well as the adaptive
modes, which are the ways in which individuals cope with environmental stimuli and stressors.
By applying the RAM to the nursing concern of addressing the mental health needs of hospitalized
elderly patients with comorbidities, nurses can develop interventions that are tailored to the individual's
specific needs and circumstances. The RAM emphasizes the importance of promoting adaptation and
maximizing the individual's potential for health and well-being, which is particularly relevant for elderly
patients with comorbidities who may be vulnerable to mental health problems.
PICOT/PICo a. PICOT Question
Population: Elderly patients (aged 65 and above) with comorbidities who are hospitalized Intervention:
Implementation of a mental health screening and assessment tool Comparison: Usual care without a
mental health screening and assessment tool Outcome: Improved identification and management of
mental health problems Time Frame: Within the hospitalization period
PICOT Question: In elderly hospitalized patients with comorbidities, does the implementation of a
mental health screening and assessment tool improve the identification and management of mental
health problems compared to usual care without a mental health screening and assessment tool during
the hospitalization period?
b. PICo Elements
Population: Elderly patients (aged 65 and above) with comorbidities who are hospitalized Intervention:
Implementation of a mental health screening and assessment tool Comparison: Usual care without a
mental health screening and assessment tool Outcome: Improved identification and management of
mental health problems Context: Hospitalization setting
Identify your MSN Program Specialty Track and practice focus
Some common MSN Program Specialty Tracks include:
Adult-Gerontology Nurse Practitioner: This track focuses on providing primary care to adults and elderly
patients, including diagnosing and treating common illnesses and managing chronic conditions.
Family Nurse Practitioner: This track focuses on providing primary care to individuals and families across
the lifespan, including diagnosing and treating common illnesses, managing chronic conditions, and
promoting health and wellness.
Nurse Anesthesia: This track focuses on providing anesthesia care to patients in a variety of settings,
including surgical and obstetrical procedures.
Nurse Educator: This track focuses on preparing nurses to become educators in academic or clinical
settings, teaching and training the next generation of nurses.
Nurse Executive: This track focuses on preparing nurses to become leaders and managers in healthcare
organizations, overseeing operations and managing staff.
Psychiatric-Mental Health Nurse Practitioner: This track focuses on providing primary care and mental
health services to patients with psychiatric and mental health disorders.
The practice focus of an MSN program can vary depending on the specialty track chosen. However,
some common practice focuses for MSN-prepared nurses include:
Direct patient care: Providing hands-on care to patients in a variety of settings, including hospitals,
clinics, and long-term care facilities.
Clinical education: Teaching and training the next generation of nurses in academic or clinical settings.
Healthcare management: Overseeing operations and managing staff in healthcare organizations,
including hospitals, clinics, and nursing homes.
Research and evidence-based practice: Conducting research and utilizing evidence-based approaches to
inform nursing practice and improve patient outcomes.
Public health: Promoting health and preventing disease at the population level through community-
based interventions and policy advocacy.
Explain how EBP promotes change within your future practice
setting
Evidence-based practice (EBP) promotes change within a future practice setting by integrating the best
available evidence with clinical expertise and patient values and preferences to inform decision-making
and improve patient outcomes. By utilizing EBP, nurses can provide the most effective and efficient care
to their patients based on the most current and relevant evidence.
EBP can promote change in a variety of ways in a practice setting. For example, it can:
Improve patient outcomes: By using the most up-to-date evidence to inform clinical decision-
making, nurses can provide care that is most likely to lead to positive patient outcomes.
Increase efficiency: By utilizing evidence-based interventions and treatments, nurses can
improve patient care while minimizing unnecessary procedures and treatments.
Reduce healthcare costs: By implementing evidence-based interventions and treatments, nurses
can avoid unnecessary and costly procedures and treatments, ultimately reducing healthcare
costs.
Improve patient satisfaction: By incorporating patient values and preferences into care
decisions, nurses can improve patient satisfaction with their care.
Enhance professional development: By incorporating EBP into practice, nurses can continually
update their knowledge and skills, improving their professional development and providing
more informed and effective care.
In my future practice as a Family Nurse Practitioner, I plan to use EBP to guide my clinical decision-
making and promote positive patient outcomes. By utilizing EBP, I can provide the most effective and
efficient care to my patients, ultimately improving their health and well-being.
Additionally, incorporating EBP into my practice can help to identify areas for improvement and
promote change within my practice setting. By critically evaluating the available evidence and applying it
to my clinical practice, I can identify areas where my practice may be falling short and make changes to
improve patient outcomes. For example, if I notice that my patients with a certain condition are not
responding well to a particular treatment, I can use EBP to identify alternative treatments that may be
more effective.
Moreover, using EBP can also help me to stay up-to-date with the latest developments in healthcare and
identify new and innovative approaches to patient care. By continually updating my knowledge and skills
through ongoing education and research, I can ensure that my practice is always at the forefront of
evidence-based practice.
Overall, EBP promotes change within my future practice setting by providing a framework for evaluating
and improving the quality of care that I provide to my patients. By integrating the best available
evidence with clinical expertise and patient values, I can optimize patient outcomes and provide the
highest quality of care possible.
In addition to the benefits of EBP for patient care, it also contributes to the overall advancement of the
nursing profession. As nurses continue to use EBP in their practice, they contribute to the growth of the
body of nursing knowledge and contribute to the development of new evidence-based practices.
EBP also helps nurses to become more knowledgeable and confident in their practice. By using EBP to
inform their clinical decision-making, nurses can be more confident in the care they provide to their
patients. Furthermore, by continually updating their knowledge and skills through ongoing education
and research, nurses can become better equipped to provide the highest quality of care possible.
Finally, incorporating EBP into practice can also contribute to increased collaboration and teamwork
within healthcare settings. By using a common framework for clinical decision-making, nurses and other
healthcare professionals can work together more effectively and efficiently to provide the best possible
care to patients. This ultimately leads to improved patient outcomes and a more positive healthcare
experience for all involved.
Overall, EBP is essential to the future of nursing practice, as it promotes positive patient outcomes,
contributes to the advancement of the nursing profession, and encourages collaboration and teamwork
within healthcare settings. As a future Family Nurse Practitioner, I am committed to using EBP to guide
my clinical practice and promote positive change within my practice setting.
To summarize, EBP is a vital component of professional nursing practice and is essential to improving
patient outcomes, promoting professional development, and advancing the nursing profession. By
incorporating the best available evidence with clinical expertise and patient values, nurses can provide
the highest quality of care to their patients while contributing to the growth of the nursing knowledge
base.
In my future practice as a Family Nurse Practitioner, I will use EBP to guide my clinical decision-making
and promote positive patient outcomes. By continually updating my knowledge and skills through
ongoing education and research, I can stay up-to-date with the latest developments in healthcare and
identify new and innovative approaches to patient care. Furthermore, by promoting the use of EBP
within my practice setting, I can contribute to the growth of the nursing profession and help to improve
the quality of care provided to patients.
To achieve this goal, I will need to have a strong foundation in EBP and develop the necessary skills to
effectively apply it to my clinical practice. This includes understanding how to formulate clinical
questions, conduct literature searches, critically appraise research studies, and integrate the best
available evidence into my practice. I will also need to develop effective communication and
collaboration skills to work with other healthcare professionals to promote the use of EBP within my
practice setting.
In addition, I will need to identify and prioritize nursing concerns within my practice setting to develop
evidence-based interventions to address them. By using a PICOT/PICo framework to guide my research
and practice, I can ensure that my interventions are well-structured and grounded in the best available
evidence.
Overall, I am excited about the opportunities that EBP offers for improving patient outcomes, promoting
professional development, and advancing the nursing profession. As a future Family Nurse Practitioner, I
am committed to using EBP to guide my clinical practice and promote positive change within my practice
setting.
7. 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
The selected nursing concern for this project is the high incidence of pressure ulcers among hospitalized
patients. Pressure ulcers, also known as bedsores, are a serious and common problem in healthcare
settings, particularly among elderly, immobile, or critically ill patients. Pressure ulcers are caused by
prolonged pressure on the skin, which can lead to tissue damage, infection, and other complications.
They can be difficult to manage and can significantly impact patient outcomes, including prolonged
hospital stays, increased healthcare costs, and decreased quality of life.
Pressure ulcers are a significant concern for nurses and other healthcare professionals, as they can
develop quickly and can be difficult to prevent and manage. Effective prevention and management of
pressure ulcers requires a multifaceted approach that includes regular skin assessments, appropriate
positioning and turning, and the use of specialized support surfaces and dressings. Nurses play a critical
role in identifying patients at risk for pressure ulcers and implementing evidence-based prevention and
management strategies.
Despite the availability of evidence-based guidelines for the prevention and management of pressure
ulcers, they remain a significant concern in healthcare settings. Factors contributing to this problem
include inadequate staffing levels, poor communication and collaboration between healthcare
professionals, and inadequate training and education on pressure ulcer prevention and management.
Therefore, addressing this nursing concern requires a coordinated and collaborative approach that
involves all members of the healthcare team.
In summary, pressure ulcers are a common and serious nursing concern that require a comprehensive
and evidence-based approach to prevention and management. Nurses and other healthcare
professionals play a critical role in identifying patients at risk and implementing effective strategies to
prevent and manage pressure ulcers. Addressing this concern requires a multifaceted approach that
includes adequate staffing levels, effective communication and collaboration, and ongoing education
and training.
To effectively address the issue of pressure ulcers, it is essential to have a deep understanding of the
underlying causes and risk factors associated with this condition. Some of the most common risk factors
for pressure ulcers include immobility, malnutrition, advanced age, incontinence, and decreased
cognitive or sensory function. Patients who are admitted to hospitals or other healthcare settings with
one or more of these risk factors require close monitoring and appropriate interventions to prevent the
development of pressure ulcers.
Pressure ulcers can have a significant impact on patient outcomes, including prolonged hospital stays,
increased healthcare costs, and decreased quality of life. Furthermore, they can also lead to serious
complications such as infection, sepsis, and even death. As such, prevention and management of
pressure ulcers are essential for ensuring optimal patient outcomes and reducing healthcare costs.
Effective prevention and management of pressure ulcers require a coordinated and multidisciplinary
approach that involves all members of the healthcare team. This includes regular skin assessments,
appropriate positioning and turning, and the use of specialized support surfaces and dressings. In
addition, nurses and other healthcare professionals must also work closely with patients and their
families to provide education and support to help prevent the development of pressure ulcers.
In summary, pressure ulcers are a significant nursing concern that requires a coordinated and evidence-
based approach to prevention and management. By addressing this concern, healthcare professionals
can improve patient outcomes, reduce healthcare costs, and promote overall patient satisfaction.
Application of Nursing Theory to the Selected Concern: This section applies a nursing theory to the
selected nursing concern. It should contain the following elements: • Identification and discussion of the
nursing theory that will guide the project
The nursing theory that will guide this project is the Orem's Self-Care Deficit Theory. This theory
emphasizes the importance of individual self-care in promoting and maintaining health. According to
Orem, individuals have a natural inclination towards self-care, and they are capable of identifying and
meeting their own healthcare needs. However, when individuals are unable to meet their own self-care
needs, they develop a self-care deficit that can lead to health problems and the need for nursing care.
In the context of pressure ulcers, the Orem's Self-Care Deficit Theory is particularly relevant, as it
highlights the importance of patients taking an active role in their own care. Patients who are at risk of
pressure ulcers, such as those who are immobile or have decreased sensory or cognitive function, may
have difficulty identifying and meeting their own healthcare needs. In these cases, nursing care is
essential to prevent and manage pressure ulcers.
By using the Orem's Self-Care Deficit Theory, nurses can work with patients to identify their self-care
deficits and provide education and support to help them meet their own healthcare needs. This may
include teaching patients how to perform regular skin assessments, providing instruction on proper
positioning and turning, and working with patients and their families to develop a comprehensive care
plan.
Overall, the Orem's Self-Care Deficit Theory provides a framework for promoting patient self-care and
empowering patients to take an active role in their own healthcare. By applying this theory to the issue
of pressure ulcers, nurses can help to prevent and manage this serious nursing concern while also
promoting overall patient health and well-being.
Identification of PICOT/PICo: This section identifies the PICOT/PICo question for the EBP project. It
should contain the following elements: • Identification and discussion of the PICOT/PICo question
PICOT Question: In adult patients with limited mobility and sensory function, does the implementation
of a comprehensive pressure ulcer prevention program (intervention) compared to standard care
(comparison) decrease the incidence of pressure ulcers (outcome) during hospitalization (timeframe)?
Population: Adult patients with limited mobility and sensory function Intervention: Implementation of a
comprehensive pressure ulcer prevention program Comparison: Standard care Outcome: Decreased
incidence of pressure ulcers Timeframe: During hospitalization
The PICOT question identifies the key elements of the proposed EBP project, including the population,
intervention, comparison, outcome, and timeframe. By answering this question, the project aims to
determine whether the implementation of a comprehensive pressure ulcer prevention program can
effectively reduce the incidence of pressure ulcers in adult patients with limited mobility and sensory
function during hospitalization.
This PICOT question is relevant to the nursing concern of pressure ulcers as it focuses on identifying a
comprehensive approach to prevention and management. By implementing a pressure ulcer prevention
program, nurses and other healthcare professionals can work to address the underlying risk factors
associated with this condition and provide appropriate care to prevent the development of pressure
ulcers in at-risk patients.
Overall, the PICOT question serves as a foundation for the proposed EBP project, providing a clear and
concise focus for the study and guiding the selection of appropriate research methods and data analysis
techniques.
Identification of Literature Search Strategy: This section identifies the literature search strategy to be
used in the EBP project. It should contain the following elements: • Explanation of the literature search
strategy
To identify relevant literature for this EBP project, a comprehensive search strategy will be employed.
The search will be conducted using electronic databases, including PubMed, CINAHL, and Cochrane
Library, as well as manual searches of relevant journals and reference lists. The following keywords and
MeSH terms will be used in the search:
Pressure Ulcers
Decubitus Ulcers
Bedsores
Prevention and Control
Self-Care
Nursing Theory
Orem's Self-Care Deficit Theory
Hospitalization
Immobility
Sensory Impairment
Comprehensive Programs
The inclusion criteria for the literature search will be studies that:
Are conducted in adult patients
Focus on pressure ulcer prevention
Use the Orem's Self-Care Deficit Theory as a guiding framework for the intervention
Include a comparison group or standard care group
Are published in English language
Are published between 2010 and 2023
The exclusion criteria for the literature search will be studies that:
Focus on pediatric patients
Do not include a comparison group or standard care group
Use a different nursing theory or framework as a guiding framework for the intervention
Are published before 2010
Are published in a language other than English
The search results will be reviewed and evaluated for relevance and quality by two independent
reviewers, and only studies that meet the inclusion criteria and have a low risk of bias will be included in
the final analysis. This comprehensive search strategy will ensure that all relevant literature is identified
and included in the EBP project, providing a strong foundation for the proposed intervention and
allowing for effective evidence-based practice in the prevention and management of pressure ulcers in
adult patients with limited mobility and sensory function.
Identify how frequently the selected concern occurs within your specialty track setting
Based on available literature, pressure ulcers are a common concern within the specialty track of Adult-
Gerontology Acute Care Nurse Practitioner (AG-ACNP) setting, especially in patients with limited
mobility and sensory function. In acute care settings, pressure ulcers have been identified as a significant
issue, affecting up to 15% of hospitalized patients, with the prevalence being even higher in long-term
care settings, reaching up to 30%. AG-ACNPs work with critically ill and complex adult and older adult
patients, who often have multiple comorbidities, immobility, and sensory impairment, putting them at a
higher risk of developing pressure ulcers. Therefore, identifying effective prevention and management
strategies is crucial in improving patient outcomes and reducing healthcare costs.
Moreover, pressure ulcers are also a concern within the AG-ACNP specialty track setting because they
can lead to a range of negative outcomes, such as pain, decreased mobility, infections, and prolonged
hospital stays. In addition, pressure ulcers can also lead to legal implications, negatively affecting the
reputation of the healthcare facility and healthcare professionals involved in the patient's care.
Therefore, identifying effective prevention and management strategies for pressure ulcers is critical in
providing high-quality care to patients and ensuring optimal outcomes within the AG-ACNP specialty
track setting.
To address the concern of pressure ulcers within the AG-ACNP specialty track setting, various evidence-
based interventions have been proposed, such as frequent repositioning, skin care, use of pressure-
relieving devices, and patient education. However, despite the availability of guidelines and protocols,
pressure ulcers continue to be a common concern, indicating the need for further research and
implementation of effective strategies.
In this project, the focus will be on implementing a comprehensive pressure ulcer prevention and
management protocol within an acute care setting, specifically targeting patients within the AG-ACNP
specialty track. The project aims to identify effective prevention strategies that can be implemented in
clinical practice to reduce the incidence of pressure ulcers, improve patient outcomes, and decrease
healthcare costs. Additionally, the project aims to improve nursing practice by promoting the use of
evidence-based interventions, enhancing the knowledge and skills of nurses, and facilitating
interdisciplinary collaboration to provide comprehensive and coordinated care to patients with pressure
ulcers.
Identify the stakeholders impacted by the concern
The stakeholders impacted by the concern of pressure ulcers within the AG-ACNP specialty track setting
include:
8. Patients: Patients with limited mobility and sensory function are at a higher risk of developing
pressure ulcers, which can lead to pain, decreased mobility, infections, and prolonged hospital
stays. Effective prevention and management of pressure ulcers can improve patient outcomes
and enhance their overall quality of life.
9. Nurses: Nurses play a critical role in the prevention and management of pressure ulcers. They
are responsible for implementing evidence-based interventions, monitoring patients' skin
integrity, and providing patient education. Effective prevention and management of pressure
ulcers can enhance nursing practice and promote the use of evidence-based interventions.
10. Healthcare organizations: Pressure ulcers can lead to increased healthcare costs, prolonged
hospital stays, and legal implications, negatively affecting the reputation of healthcare
organizations. Therefore, effective prevention and management of pressure ulcers can reduce
healthcare costs and improve the overall quality of care provided by healthcare organizations.
11. Interdisciplinary team members: Effective prevention and management of pressure ulcers
require interdisciplinary collaboration, involving healthcare professionals such as physical
therapists, occupational therapists, wound care specialists, and nutritionists. Therefore,
interdisciplinary team members are also stakeholders impacted by the concern of pressure
ulcers within the AG-ACNP specialty track setting.
12. Healthcare administrators: Healthcare administrators play a critical role in developing policies
and protocols for pressure ulcer prevention and management. Effective prevention and
management of pressure ulcers can reduce healthcare costs and improve patient outcomes,
which can be beneficial for healthcare administrators.
13. Insurance companies: Pressure ulcers can lead to increased healthcare costs, which can affect
insurance companies. Effective prevention and management of pressure ulcers can reduce
healthcare costs and improve patient outcomes, which can be beneficial for insurance
companies.
14. Regulators: Regulators such as state and federal health departments and accrediting bodies
require healthcare organizations to have policies and protocols for pressure ulcer prevention
and management. Therefore, effective prevention and management of pressure ulcers can
ensure compliance with regulations and accrediting bodies.
Identify the consequences of the selected concern
The consequences of pressure ulcers within the AG-ACNP specialty track setting can be significant and
include the following:
Pain: Pressure ulcers can cause significant pain and discomfort to patients, leading to reduced mobility
and decreased quality of life.
Infections: Pressure ulcers can become infected, leading to further complications and prolonged hospital
stays.
Prolonged hospital stays: Pressure ulcers can lead to prolonged hospital stays, which can increase
healthcare costs and negatively impact patients' mental and physical health.
Delayed wound healing: Pressure ulcers can take a long time to heal, which can lead to additional
healthcare costs and prolonged recovery times.
Increased healthcare costs: Pressure ulcers can increase healthcare costs due to prolonged hospital
stays, additional medications, and treatments required for wound healing.
Legal implications: Pressure ulcers can lead to legal implications if patients or their families feel that
appropriate care was not provided.
Negative impact on reputation: Pressure ulcers can negatively impact the reputation of healthcare
organizations if they are not managed effectively. This can lead to reduced patient satisfaction and
decreased referrals.
Reduced quality of life: Patients with pressure ulcers may experience a reduced quality of life due to
pain, discomfort, and limited mobility.
Mental health impacts: Patients with pressure ulcers may experience depression, anxiety, or other
mental health conditions due to prolonged hospital stays and decreased quality of life.
Morbidity and mortality: In severe cases, pressure ulcers can lead to complications such as sepsis,
cellulitis, and osteomyelitis, which can be life-threatening. Additionally, patients with pressure ulcers are
at increased risk for mortality compared to those without pressure ulcers.
It is important to note that the consequences of pressure ulcers can be significant not only for patients
but also for healthcare organizations and the healthcare system as a whole. Effective prevention and
management of pressure ulcers can help reduce these consequences and improve patient outcomes.
Decreased patient satisfaction: Patients with pressure ulcers may be less satisfied with their care,
leading to decreased patient satisfaction scores.
Decreased staff satisfaction: Staff members involved in the care of patients with pressure ulcers may
experience increased stress and decreased job satisfaction.
Increased workload: Effective prevention and management of pressure ulcers requires significant
resources, including staff time and equipment, which can increase the workload for healthcare
organizations and staff members.
Reduced reimbursement: Hospitals and healthcare organizations may experience reduced
reimbursement if pressure ulcers are not managed effectively, as this can be considered a preventable
complication.
Negative impact on healthcare system: Pressure ulcers can have a negative impact on the healthcare
system as a whole by increasing healthcare costs, reducing patient outcomes, and decreasing the overall
quality of care.
Identify your proposed solution to the selected concern.
The proposed solution to the selected concern of pressure ulcers is the implementation of a pressure
ulcer prevention program that includes evidence-based interventions aimed at preventing the
development of pressure ulcers in at-risk patients. This program will involve a multidisciplinary team
approach to pressure ulcer prevention, including nursing staff, physical therapists, wound care
specialists, and other healthcare professionals.
The pressure ulcer prevention program will include the following evidence-based interventions:
Pressure redistribution surfaces: The use of pressure redistribution surfaces, such as specialized
mattresses, cushions, and overlays, can help reduce pressure on bony prominences and prevent the
development of pressure ulcers.
Repositioning: Regular repositioning of patients can help relieve pressure on bony prominences and
prevent the development of pressure ulcers.
Skin care: Adequate skin care, including cleaning, moisturizing, and protecting the skin, can help prevent
the development of pressure ulcers.
Nutritional support: Adequate nutrition, including adequate protein and calorie intake, can help
promote skin health and prevent the development of pressure ulcers.
Education and training: Education and training for staff members and patients can help promote
awareness of pressure ulcer prevention and ensure that evidence-based interventions are implemented
effectively.
The pressure ulcer prevention program will be implemented using a quality improvement approach,
with regular monitoring and evaluation of outcomes to ensure that the program is effective in reducing
the incidence of pressure ulcers in at-risk patients.
To support the implementation of the pressure ulcer prevention program, the following strategies will
be used:
Establishing a multidisciplinary team: A team of healthcare professionals, including nursing staff,
physical therapists, wound care specialists, and other relevant staff members, will be established to
oversee the implementation of the pressure ulcer prevention program.
Providing education and training: Staff members will receive education and training on pressure ulcer
prevention, including the evidence-based interventions included in the prevention program.
Developing policies and procedures: Policies and procedures will be developed to ensure that evidence-
based interventions are implemented consistently and effectively.
Monitoring and evaluation: The pressure ulcer prevention program will be regularly monitored and
evaluated to ensure that it is effective in reducing the incidence of pressure ulcers in at-risk patients.
Providing feedback: Feedback will be provided to staff members and the multidisciplinary team to
promote continuous quality improvement and ensure that the pressure ulcer prevention program is
implemented effectively.
Overall, the implementation of a pressure ulcer prevention program that includes evidence-based
interventions and a multidisciplinary team approach has the potential to significantly reduce the
incidence of pressure ulcers in at-risk patients and improve patient outcomes.
Using technology: Technology can be used to support the prevention program by providing staff with
tools such as electronic risk assessment forms, reminders for repositioning, and alerts for high-risk
patients.
Collaborating with patients and families: Patients and families can be included in the prevention
program by educating them on the importance of pressure ulcer prevention and providing them with
information on how they can participate in prevention efforts, such as encouraging patients to report
discomfort or changes in skin condition to their caregivers.
Establishing a culture of prevention: The prevention program will be supported by establishing a culture
of prevention that prioritizes proactive efforts to prevent pressure ulcers, including regular risk
assessments and interventions to reduce pressure, friction, and shear.
By implementing these strategies, the pressure ulcer prevention program can be effectively integrated
into practice, reducing the incidence of pressure ulcers in at-risk patients and improving patient
outcomes.
Identify a purpose statement for this EBP proposal
The purpose of this EBP proposal is to implement a pressure ulcer prevention program in a clinical
setting using evidence-based interventions and a multidisciplinary team approach to reduce the
incidence of pressure ulcers in at-risk patients and improve patient outcomes.
15. 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
oPICOT for quantitative research approach
oPICo for qualitative research approach
Here is an example of a PICOT question for a quantitative research approach:
PICOT Question: In adult patients admitted to the hospital with an expected length of stay of more than
3 days, does implementing a pressure ulcer prevention program using evidence-based interventions and
a multidisciplinary team approach compared to standard care without the program reduce the incidence
of pressure ulcers in at-risk patients within a 6-month period?
And here is an example of a PICo question for a qualitative research approach:
PICo Question: What are the perceptions and experiences of healthcare providers regarding the
implementation of a pressure ulcer prevention program using evidence-based interventions and a
multidisciplinary team approach in adult patients admitted to the hospital with an expected length of
stay of more than 3 days?
Identify how the expected outcome will be useful to your future practice setting
here's an example of how the expected outcome can be useful to a future practice setting:
The expected outcome of the EBP proposal, which is to reduce the incidence of pressure ulcers in at-risk
patients within a 6-month period through the implementation of evidence-based interventions and a
multidisciplinary team approach, can be useful to my future practice setting in several ways. First, it can
improve patient outcomes by reducing the incidence of pressure ulcers, which can lead to pain,
discomfort, and longer hospital stays. Second, it can improve patient satisfaction by ensuring that they
receive high-quality, evidence-based care that is tailored to their individual needs. Third, it can improve
the efficiency of care delivery by reducing the need for costly and time-consuming interventions to treat
pressure ulcers. Finally, it can enhance the reputation of the practice setting by demonstrating a
commitment to providing high-quality, evidence-based care that prioritizes patient safety and well-
being.
Discuss the purpose of conducting a literature review and the contribution it will provide
to this EBP proposal
Here's a discussion of the purpose of conducting a literature review and its contribution to this EBP
proposal:
The purpose of conducting a literature review is to identify and evaluate existing research and evidence
related to the selected nursing concern and proposed solution. It provides a comprehensive
understanding of the current state of knowledge in the field and identifies gaps in the evidence that
need to be addressed through further research. Conducting a literature review is an essential step in the
EBP process because it helps to ensure that interventions and approaches are evidence-based and
grounded in the best available research.
In the context of this EBP proposal, the literature review will contribute to the development of a
comprehensive understanding of the current evidence related to pressure ulcer prevention and
management. It will identify the most effective interventions and approaches that have been successful
in reducing the incidence of pressure ulcers in at-risk patients. The literature review will also identify any
gaps in the evidence or limitations of existing research, which will inform the development of research
questions or areas for future investigation. Additionally, the literature review will help to identify
potential barriers or challenges to the implementation of evidence-based interventions and approaches,
which can inform the development of strategies to overcome these challenges. Overall, the literature
review is an essential component of the EBP process that ensures that interventions and approaches are
based on the best available evidence and have the greatest potential for success in improving patient
outcomes.
Identify the steps used to conduct a literature review for this EBP proposal by including:
oThe specific library databases used
oThe key search terms and phrases used
oThe minor (additional) search terms and phrases used
oIdentify any specialty organization that is relevant to this EBP proposal
To conduct a literature review for this EBP proposal, the following steps were used:
The specific library databases used were: PubMed, CINAHL, and Cochrane Library.
The key search terms and phrases used were:
Anxiety
Pediatric
Music therapy
Nursing
Hospital
Randomized controlled trial
The minor (additional) search terms and phrases used were:
Pediatric anxiety
Music intervention
Pediatric nursing
Hospitalized children
Anxiety reduction
Music and nursing
The specialty organization that is relevant to this EBP proposal is the American Music Therapy
Association (AMTA). The AMTA is a professional association that advocates for the use of music therapy
in healthcare and provides resources for music therapists and healthcare professionals.
16. 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
The theoretical framework that will be used in this EBP proposal is the Roy Adaptation
Model (RAM). This model was developed by Sister Callista Roy and is based on the
assumption that individuals strive to maintain a balance between various physiological and
psychological needs and the demands of the environment. The model is composed of four
major components: person, environment, health, and nursing. It describes the
interrelationships between these components and how they influence the individual's
adaptation to the environment.
The Roy Adaptation Model is particularly relevant to the selected nursing concern because it
focuses on the individual's adaptation to stressors and how nurses can assist in promoting
adaptation. This model provides a holistic perspective on patient care, emphasizing the
importance of addressing the patient's physical, psychological, and social needs. It also
emphasizes the role of the nurse in assessing the patient's adaptive responses and
intervening to promote adaptation.
Using the Roy Adaptation Model as a theoretical framework for this EBP proposal will help
to guide the development and implementation of interventions that promote the patient's
adaptation to the selected nursing concern. It will also help to ensure that the interventions
are focused on addressing the patient's individual needs and are tailored to their unique
circumstances.
• Describe how the identified theoretical framework is applied to
this EBP proposal
The identified theoretical framework for this EBP proposal is the Roy Adaptation Model (RAM),
which emphasizes the importance of adaptation in response to environmental stimuli for
maintaining an individual's health and well-being. In this proposal, the RAM will be applied by
considering how patients adapt to the selected nursing concern and the interventions
implemented to improve patient outcomes.
The RAM includes several key concepts, including the individual, the environment, adaptation,
and nursing. The individual is seen as a holistic being with physical, psychological, and social
needs. The environment includes all internal and external stimuli that can impact the
individual's adaptation process. Adaptation is the process by which individuals respond to these
stimuli to maintain their health and well-being. Nursing is seen as the discipline that supports
individuals in this process by promoting their adaptive abilities.
Applying the RAM to this EBP proposal will involve assessing how patients are adapting to the
selected nursing concern and identifying the environmental factors that may be influencing their
ability to adapt. Interventions will then be implemented based on the patient's individual needs
and the identified environmental stimuli. The RAM will provide a framework for understanding
how patients respond to the nursing interventions implemented and how their adaptation
process may influence their health outcomes.
