RESPOND TO THIS DISSCUSION: Remember that a substantive response is one that adds value to the discussion – see syllabus for full description.
Writing a research problem is one key learning I will take with me in my nursing practice. I will do that through writing PICO (Population, Intervention, Comparison, Outcome) questions for quality improvements. There have been some issues where I work that could improve. For instance, I feel like our leadership is always emphasizing trying to prevent falls and pressure injuries. Lately there have been a few falls with serious injuries, as well as some deep tissue pressure injuries in some of our patients. Some of these could have and should been prevented if appropriate nursing interventions had been in place. By writing a PICO question I could try to see which interventions could help prevent some of these events.
Searching for peer reviewed articles on CINAHL and PubMed is the second key learning I will take with me in my nursing practice. PubMed is a great public resource that could help in adopting evidence-based practices (EBPs) to improve outcomes. This class helped me learn how to navigate PubMed and CINAHL which will help me find the latest research available on the issues I mentioned before. By knowing which terms to enter, how to set certain limits, and narrowing or expanding the search I will be able to focus on those papers that best help with whatever quality improvement I would like to tackle.
Critically analyzing papers is the third key learning I will take with me in my nursing practice. The assignment for week 6 (writing a critique of a research paper) was perhaps one of the most challenging assignments but also one of the most helpful for discerning whether the research has validity or if the data presented supports adopting the interventions mentioned on that particular research paper. Learning how to read quantitative research papers and understanding what the data means was very helpful. This will help me understand research papers on topics that are relevant to my practice, such as what interventions are the most effective at preventing falls and pressure injuries or to see if other interventions could be used in addition to the ones that are already in place.
Evidence-based practice (EBP) in nursing, as I understand it, means adopting and changing the way nursing interventions are carried out based on the best available evidence. EBP also means taking into consideration the patient’s beliefs and values and accepting their decisions to allow or reject nursing interventions even if rejecting those interventions means having a worse outcome. EBP builds on previous knowledge and research and takes into consideration the patient’s cultural and spiritual background and integrates those believes so long as they are not harmful. EBP can be adopted by using information obtained from both quantitative and qualitative research to improve outcomes (Schmidt & Brown, 2022). It is important because striving to get the best outcomes possible should be every nurse’s goal.
Many of the things the unit where I work could improve on are some of the same things other institutions also struggle with, among them: falls, hospital acquired pressure injuries, and readmission rates. A lot of the issues are multifactorial and very complex. However, I believe improving on those issues is possible. On the other hand, convincing nurses to adopt those EBP changes can be quite challenging. The unit where I work has a culture of adaptability and embracing cooperation which is why I still work there since I first started three years ago.
As Schmidt and Brown (2022) put it, some of the barriers at the individual level to implement EBP can be lack of knowledge, confidence, and skills. Other barriers can come from the organization’s culture, administration, and nurse leaders. Therefore, to introduce new EBPs to my colleagues, I would have to first research the literature myself, and then find evidence that shows clearly why certain interventions should be implemented, especially when it comes to falls and pressure injuries which are two of the most pressing issues on my unit.
I can employ the help of nurse educators and clinical nurse specialists. I could present to them the evidence I found to help reduce the incidence of falls and pressure injuries. In fact, I recently gave a copy of a peer-reviewed research paper to the clinical nurse specialist on my unit. The paper was on fall prevention technology which yielded amazing results. It was the use of “Smart Socks”, a type of technology that uses socks equipped with pressure sensors that warn staff when someone is trying or has gotten up unassisted. I asked the clinical nurse specialist if we could pilot the use of these socks on our unit and she said she would bring it up to the “higher ups” on their next meeting. To evaluate if the changes are happening, I could ask the clinical nurse specialist or the nurses on the fall and skin committees to do chart reviews. I could also get involved on these committees myself, reviewing charts to see if our unit is improving on these issues.