dicussion response

Peer response:

Evidence-based practice is the integration of the best current evidence, clinical expertise, and patient preferences to improve patient outcomes. Evidence based practice helps nurses to formulate informed decisions that are supported by scientific research rather than routine practice. According to Melynk et al., (p.1) evidence-based practice can reduce costs while also improving job satisfaction amongst staff members. PICOT questions are used in evidence-based practice to help develop focused clinical questions that guide research and improve the quality of evidence gathered.

PICOT stands for Population, Intervention, Comparison, Outcome, and Time. Each of these components helps to narrow down the focus of research. One issue encountered on my labor and delivery unit is prolonged labor in woman who have received epidural anesthesia. Prolonged labor can increase risks for maternal exhaustion, birth complications, and cesarean delivery rates. Often labor and delivery nurses use various repositioning techniques to promote labor progression. My PICOT question is: while women are in labor and receiving epidural anesthesia (P) does the use of a peanut ball (I) compared to repositioning without a peanut ball (C), reduce the length of labor and lower cesarean delivery rates (O) during hospitalization (T)? This PICOT question describes a therapy type of PICOT question as it questions if a nursing intervention can improve maternal outcomes during their labor and delivery stay. Implementing the use of a peanut ball is beneficial because it is evidence based. A peanut ball can help progress labor, decrease cesarean delivery rates, and directly improve maternal and fetal outcomes.

References

Melynk, Fineout-Overholt, , & Williamson. (2010). Evidence-based practice: step by step: the seven steps of evidence-based practice. American Journal of Nursing, 10(110), 51-53.

RTP: Click reply on your peer's initial posting. Begin your peer post by addressing your peer by name.

Your RTP should not focus on the "med-surg" aspects of your peer's posting. For example, if your peer's PICO(T) question is related to bed alarms and fall rates, your response should not be related to bed alarms or fall rates. Keep the focus on an aspect of EBP. For example: discuss the steps in EBP, benefits and barriers of EBP, where your peer can find evidence, the important of appraising evidence, hierarchy of evidence, randomized control trials, systematic reviews, meta-analysis, meta-synthesis, clinical practice guidelines, evidence-based practice models, etc. Again, keep the focus of your RTP on EBP.

The articles posted in each unit in the syllabus are to facilitate your understanding of the topic and help you meet the identified learning objectives. They are not to be used as references for your course work. Such articles must be obtained from the BC online library. HOWEVER, FOR THIS WEEK ONLY: I want you to use the two journal articles below, which are posted in the Unit 1 module. Use one for the IP and the other one for the RTP (in addition to your course textbook). Although these two articles are several years old, they remain quite relevant today. No other journal articles are needed.

Melynk, Fineout-Overholt, Stillwell, & Williamson. (2010). Evidence-based practice: step by step: the seven steps of evidence-based practice. American Journal of Nursing, 10(110), 51-53.

Stevens, K. (2013). The impact of evidenced-based practice in nursing and the next big ideas. Online Journal of Issues in Nursing, 18(2).

Before you begin writing: Read the guidelines below, the rubric for Discussion postings, and the announcement in the Content section entitled, "A MUST READ: Writing Info. and Other Tips."

The maximum number of references for DQs is three.

Both postings are to be in APA format on the discussion board. In addition to posting to the discussion board, upload the IP as an APA formatted word document. APA format includes, but is not limited to, a running head, separate title and reference pages, pagination, in-text citations, and references. Be sure to include the page or paragraph number(s) you found the paraphrased info. on, in all in-text citations. (While APA does not require a running head on student papers or the page/paragraph number in in-text citations, I do require them).

Do not use direct quotes--paraphrase instead. Quotes do not demonstrate understanding of the material. Papers that include quotes will not be graded until they are revised/resubmitted.

Evidence-based practice (EBP) is an essential component of professional nursing practice because it promotes safe, effective, and high-quality patient care. Nurses use EBP to combine the best current research evidence with clinical expertise and patient preferences when making healthcare decisions. According to Polit and Beck, EBP allows nurses to make informed clinical decisions based on evidence rather than tradition or routine practice (Polit & Beck, 2022). Evidence-based practice improves patient outcomes, enhances patient safety, and supports quality improvement within healthcare organizations. Stevens (2013) explained that EBP has transformed nursing practice by improving healthcare quality, reducing costs, and decreasing preventable patient complications. Because nurses play a direct role in patient care, the use of evidence-based interventions is important in preventing adverse events and improving overall patient outcomes.

One significant issue encountered in hospital settings is catheter-associated urinary tract infections (CAUTIs). CAUTIs are among the most common hospital-acquired infections and can lead to increased patient discomfort, prolonged hospitalization, increased healthcare costs, and serious complications such as sepsis. Patients with indwelling urinary catheters are at higher risk for infection, especially when catheters remain in place longer than medically necessary. This problem is appropriate for an EBP project because current research supports interventions that can reduce CAUTI rates and improve patient safety outcomes.

Evidence-based practice questions are commonly written in PICO(T) format because the framework helps healthcare providers develop focused and researchable clinical questions. Melnyk et al. (2010) stated that the PICO(T) format helps clinicians identify the patient problem, intervention, comparison, outcome, and timeframe, which improves the efficiency of searching for evidence and applying findings to practice (pp. 51–52). The initials in PICO(T) stand for patient population/problem (P), intervention (I), comparison intervention (C), outcome (O), and timeframe (T). Using this format helps nurses clearly define a clinical issue and identify evidence-based interventions that may improve patient outcomes.

The PICO(T) question developed for this EBP project is: In hospitalized adult patients with indwelling urinary catheters (P), does implementation of a nurse-driven catheter removal protocol (I), compared to standard physician-directed catheter removal practices (C), reduce the incidence of catheter-associated urinary tract infections (O) during hospitalization (T)? This question focuses on improving patient outcomes by decreasing the occurrence of hospital-acquired infections through evidence-based nursing interventions.

This PICO(T) question is classified as a therapy/treatment question because it evaluates the effectiveness of an intervention intended to improve patient outcomes. The intervention being studied is the implementation of a nurse-driven catheter removal protocol to decrease CAUTI rates in hospitalized patients. According to Polit and Beck (2022), therapy questions examine whether specific interventions produce better outcomes for patients. Research supports that reducing unnecessary catheter use and encouraging timely catheter removal are effective strategies for decreasing infection rates and improving patient safety.

The use of EBP is essential in modern nursing practice because it encourages nurses to critically evaluate research and apply evidence-based interventions to clinical problems. Stevens (2013) emphasized that EBP strengthens nursing practice by promoting safer care and improving healthcare outcomes for patients. By addressing the problem of CAUTIs through an evidence-based intervention, nurses can help reduce preventable infections, improve patient experiences, and contribute to higher standards of care within healthcare organizations.

References

Essentials of Nursing Research: Appraising Evidence for Nursing Practice Polit, D. E., & Beck, C. T. (2022). Essentials of nursing research: Appraising evidence for nursing practice (10th ed.). Wolters Kluwer.

American Journal of Nursing Melnyk, B. M., Fineout-Overholt, E., Stillwell, S. B., & Williamson, K. M. (2010). Evidence-based practice: Step by step: The seven steps of evidence-based practice. American Journal of Nursing, 110(1), 51–53.

Online Journal of Issues in Nursing Stevens, K. (2013). The impact of evidence-based practice in nursing and the next big ideas. Online Journal of Issues in Nursing, 18(2).