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Significance Of Identified Practice Problem

Maureen

Significance Of Identified Practice Problem

Identifying a problem is only the first step; the problem must be addressed once identified. We need answers to effectively solve the problem. The first step in determining the best solution to our problem is to ask a question, not just any question; it must be relevant and answerable. Various frameworks are available to guide the process of asking questions to obtain the best answers supported by clinical judgment and patient input; this is the application of Evidence-Based Practice (EBP) (Polit & Beck, 2017). This paper aims to determine whether or not the issue of allowing pediatric patients to visit is relevant and researchable.

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Growing Hurdles

I currently work in a 295-bed facility that is undergoing renovations. We are currently pursuing Magnet status, and the nursing staff continues to be heavily involved in the implementation of change, which, as the ANA points out, benefits both nursing staff and patients (Blum, 2014). In the last five years, the hospital has received certification as a Primary Stroke Center and accreditation as a Chest Pain Center (http://www.lakecumberlandhospital.com/about-us). We recently became a formal teaching facility, complete with a family medicine and internal medicine residency program, and we are expanding the pediatric department to include inpatient care. We treat acute childhood illnesses and schedule and emergent surgical procedures like tonsillectomies, appendectomies, and orthopedic procedures. Throughout this process, we are revising existing policies and developing new ones for the treatment and care of this new patient population. The nursing staff identified a problem with the hospital’s standard visitation policy. Visitors under 12 are currently not permitted on any inpatient unit except postpartum. When the family unit is disrupted for an extended period, the staff has identified a problem.

The Importance of Nursing Practice

Patient and Family Centered Care (PFCC) is the gold standard of care in the pediatric patient population (American Nurses Association [ANA], 2008). (American Academy of Pediatrics Committee on Hospital Care, Institute for Patient and Family-Centered Care, 2012). When a child is ill, the entire family unit suffers. When a parent is in the hospital with an ill child and has other young children at home, they may feel torn. The staff and parents are responsible for protecting these vulnerable patients, but nurses must also support parents and siblings throughout the process. We must consider whether there is a reduction in readmissions when parents can interact with all of their children during a hospital stay. In order to practice PFCC, input from the patient and family must be considered. Nurses must adhere to PFCC as the gold standard and monitor the effects. Is the patient outcome improved, is it measurable in these situations, and is any improvement dependent on the intervention? Steps must be taken to avoid rushing home solely to reassemble the family unit. Does research show that allowing enhanced visitation with home support systems improves patient outcomes when appropriate and does not interfere with patient care?

The Tough Questions

I posed the questions and provided a description of how I assessed their feasibility. The inquiries:

The analysis: During the evaluation of the problem, I had to determine if the problem is significant, if the problem is something that I will be able to research if I have the time, experience, and resources available, and if this problem interests and affects me in my practice (Polit & Beck, 2017, Chapter 4). The problem meets all four criteria for being an appropriate research problem for me.

PICOT Question and Key Terms with Rationale

All the questions I generated were either too general or too specific to be researched effectively; they did not meet the criteria of any framework presented in the literature (Davies, 2011). I developed my question by plugging the data into the framework provided. My initial PICOT question: In pediatric patients, what is the effect of increasing visitation to allow appropriately screened siblings visitation versus not allowing visitors under 12 to decrease readmission over 30 days (Walden Student Center for Success, 2012)? This question addresses the population, intervention, comparison, outcome, and timetable specified in the framework (Walden Student Center for Success, 2012).

At least ten keywords that could be used to conduct a literature search for information related to my PICOT question would be:

Summary

When we ask the right questions, we can move closer to a solution to a problem. Using tools to ensure that the best evidence is returned is part of implementing Evidence-Based Practice. Any change in practice should be based on rigorous research and facts. Incorporating change in nursing practice allows individual staff and entire units to benefit from the learning process during changes. Following the framework as a guideline can increase the likelihood of forming a relevant answerable question, which leads to a relevant answer or intervention.

Other Related Post: Ethical Decision Making

References

American Academy of Pediatrics Committee on Hospital Care, Institute for Patient and Family-Centered Care. (2012). Patient- and family-centered care and the pediatrician’s role. Pediatrics, 129, 394-404. http://dx.doi.org/org.ezp.waldenulibrary.org/10.1542/peds.2011-3084

American Nurses Association. (2008). Pediatric nursing scope and standards of practice. Silver Springs, MD: Author.

Blum, C. A. (2014). Practicing self-care for nurses: A nursing program initiative. The Online Journal of Issues in Nursing, 19(3). http://dx.doi.org/10.3912/OJIN.Vol19No03Man03

Davies, K. S. (2011). Formulating the evidence-based practice question: A review of the frameworks. Evidence-Based Library and Information Practice, 6(2), 75–80. Retrieved from https://ejournals.library.ualberta.ca/index/php/EBLIP/article/viewFile/9741/8144

Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing practice (10 ed.). Philadelphia, PA: Wolters Kluwer.

Walden Student Center for Success. (2012). Clinical Question Anatomy. Retrieved August 29, 2016, from https://academicguides.walenu.edu/content.php?pid=183871&sid=2950360

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Question 

Purpose of Assignment:

Professional nurses must be able to identify relevant practice issues, appraise literature, and integrate credible evidence into innovative, evidence-based practice solutions for positive outcomes.

Significance Of Identified Practice Problem

Course Competency:

Propose an evidence-based solution aligned with an evidence-based practice question.

Explain the relationship between research, theory, and evidence-based practice.

Instructions:

Content:

Applying The Iowa Model Revised: Evidence-Based Practice to Promote Excellence in Health Care, create a written proposal for these components of a proposal for an evidence-based practice solution.

Describe interprofessional and interprofessional team members you would select to assist with gathering and appraising evidence.

Include rationales supporting your choices for team members

Discuss the search strategy to locate evidence related to the practice issue

Summarize and synthesize the body of evidence found in the search to establish the significance of the practice issue and support the proposed evidence-based practice solution

Format:

Template for the Course Project.

Resources

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