NP 505 Week 1 Area of Interest in Nursing Practice Assignment

NP 505 Week 1 Area of Interest in Nursing Practice Assignment

NP 505 Week 1 Area of Interest in Nursing Practice Assignment

Week 1: Area of Interest in Np

Overview
Over the course of the next eight weeks, we will be examining concepts related to nursing research and the translation of evidence to practice. To help you better understand the process, you will be identifying a practice issue for nurse practitioners. You will develop a PICOT question (SEPSIS) associated with the issue, find evidence to support a change in practice, and present your recommendations for change to your peers. This week, we will work on helping you refine your area of interest so that you will be able to develop a concise question for next week’s assignment. You are encouraged to use the area of interest you chose for the project in NR500NP and/or NR501NP; however, you may choose a different area if you wish.

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Select an issue in nurse practitioner (NP) practice that is of interest to you and in which you would like to see a practice change occur. Conduct a review of literature to see what is currently known about the topic. In 1-2 paragraphs, describe the scope and relevance of the issue and your recommended change. Provide reference support from at least two outside scholarly sources to support your ideas. Please pick something you can do as a NP in your practice. Please avoid anything that would require a policy or law change, such as full-practice authority.

1. Application of Course Knowledge: The student\’s initial post contributes unique perspectives or insights gleaned from personal experience or examples from the healthcare field.. Two resources must be used in your initial post. One from the weekly reading or lesson and one outside source.

2. Integration of Evidence: The post provides support from a minimum of one scholarly in-text citation with a matching reference AND assigned readings OR online lessons, per discussion topic per week. Two resources total and to count must be an in-text citation in your initial post.
a. What is a scholarly resource? A scholarly resource is one that comes from a professional, peer-reviewed publication (e.g., journals and government reports such as those from the FDA or CDC).
 Contains references for sources cited
 Written by a professional or scholar in the field and indicates credentials of the author(s)
 Is no more than 4 years old for clinical or research article
b. What is not considered a scholarly resource?
 Newspaper articles and layperson literature (e.g., Readers Digest, Healthy Life Magazine, Food, and Fitness)
 Information from Wikipedia or any wiki
 Textbooks
 Website homepages
 The weekly lesson
 Articles in healthcare and nursing-oriented trade magazines, such as Nursing Made Incredibly Easy and RNMagazine (Source: What is a scholarly article.docx; Created 06/09 CK/CL Revised: 02/17/11, 09/02/11 nlh/clm)
c. Can the lesson for the week be used as a scholarly source?
 Information from the weekly lesson can be cited in a posting; however, it is not to be the sole source used in the post.
d. Are resources provided from CU acceptable sources (e.g., the readings for the week)?
 Not as a sole source within the post. The textbook and/or assigned (required) articles for the week can be used, but another outside source must be cited for full credit. Textbooks are not considered scholarly sources for the purpose of discussions.
e. Are websites acceptable as scholarly resources for discussions?
 Yes, if they are documents or data cited from credible websites. Credible websites usually end in .gov or .edu; however, some .org sites that belong to professional associations (e.g., American Heart Association, National League for Nursing, American Diabetes Association) are also considered credible websites. Websites ending with .com are not to be used as scholarly resources
Discussion Rubric
Category Points Description
Application of Course Knowledge 15 Answers the initial discussion question(s)/topic(s), demonstrating knowledge and understanding of the concepts for the week by Wednesday at 11:59pm MT.
Engagement in Meaningful Dialogue With Peers and Faculty 10 Responds to a student peer AND course faculty furthering the dialogue by providing more information and clarification, adding depth to the conversation
Integration of Evidence 15 Assigned readings OR online lesson AND at least one outside scholarly source are included. The scholarly source is:
1) evidence-based, 2) scholarly in nature, 3) published within the last 5 years
Total content points = 40 points
Grammar and Communication 5 Presents information using clear and concise language in an organized manner
Reference Citation 5 References have complete information as required by APA
In-text citations included for all references AND references included for all in-text citation
Total format points = 10 points
Discussion total points = 50 points

After assignment add
• Reflection: write 1-2 paragraphs reflecting on your learning for the week. Guiding questions are provided or you may write about what you felt was most significant to you for the week.
• What experiences have you had with EBP or QI in your practice area (Long-term care)?
• What factors in your practice area support EBP? What barriers to EBP do you see?
• What do you think your role in research will be as an NP?

NP 505 Week 1 Area of Interest in Nursing Practice Sample

Area of Interest in Nursing Practice

In week 1, we learned about the essentials of nursing research, including the tenets of evidence-based practice, steps of quantitative and qualitative research, research ethics, and approaches to reading and critiquing research articles. Out of these aspects of nursing research, setting research questions and selecting topics emerge as the primary steps for informing the overall research process. According to Polit & Beck (2018), nursing researchers are responsible for setting clinical questions consistent with workplace scenarios that can derive insights from the current literature. In this sense, asking clinical questions that are answerable by research evidence, searching for and retrieving relevant evidence, appraising and synthesizing the evidence, and integrating the evidence into local contexts form the basis of evidence-based practice. It is possible to ask and explore contextualized questions by utilizing the PICO framework, which enables researchers to establish the characteristics of a population of patients (P), define interventions (I), compare alternatives (C), and set identify the desired outcomes of implementing the intervention (O).

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An Area of Interest

As a long-term care facility nurse, I have witnessed many scenarios where older adults succumb to sepsis-related concerns such as septic shock and multiple organ dysfunction. One concern is the absence of a comprehensive framework for diagnosing and managing sepsis. Despite the knowledge of potential causative and contributing factors for this condition, our organization is yet to establish guidelines for the early detection and management of sepsis. I know that the current literature provides insights into effective interventions for detecting and managing sepsis. As a result, I have a justifiable reason for utilizing nursing research to obtain information and recommendations from scholarly evidence sources to develop contextualized quality improvement initiatives for reducing the sepsis prevalence and subsequent adverse ramifications, including increased mortalities, prolonged hospitalization, and increased care costs, and compromised quality of life. Consequently, I endeavor to explore this topic using the PICO framework.

Integration of Evidence

Sepsis poses multiple health and economic ramifications to older adults and healthcare institutions. It is essential to note that older adults grapple with various health concerns, including cardiovascular diseases (CVDs), diabetes, musculoskeletal disorders, and mental health issues that compromise their immunity, exposing them to other health concerns such as sepsis. Branco et al. (2020) define sepsis as “a systematic inflammatory response to the presence of inflammatory mediators, which the host produces in response to microbial agents or toxins” (p. 2). The immediate consequences of sepsis are multiple organ dysfunction and septic shock. Further, this condition has long-term effects such as increased mortality rate, prolonged hospitalization, increased care costs, and compromised quality of life. As a result, it is essential to integrate evidence-based practice in addressing risk factors for sepsis and ensuring effective management of the condition.

The current scholarly literature provides insights into sepsis concepts, including risk factors and evidence-based prevention and management interventions. Branco et al. (2020) contend that sepsis is an inflammatory response to microbial agents and represents an acute condition that can progressively lead to septic shock and multiple organ dysfunction. In this sense, sepsis is a profound health concern resulting in adverse ramifications, including high mortality rates, significant treatment costs, prolonged hospitalization, and negative medical outcomes. According to Lee & Levy (2019), approximately 30 million people are hospitalized for sepsis, resulting in about 5.3 million deaths annually. Often sepsis-related mortalities emanate from life-threatening organ dysfunction due to a dysregulated host response to infection.

Older adults in long-term care facilities are susceptible to sepsis due to the interplay between multiple risk factors. According to Cheng et al. (2018), the number of older adults with severe sepsis and septic shock is increasing due to the increased prevalence of chronic illnesses, comorbidities, frailty, and functional impairment. Further, constant exposure to infections, prolonged admission to the intensive care unit, and invasive devices such as intravenous catheters and breathing tubes increase the likelihood of sepsis in older adults. Consequently, it is essential to embrace measures that address these risk factors and avert the consequences of sepsis among older adults.

Despite the current knowledge of the pathophysiology of sepsis and advances in treatment options, there is no effective treatment for this condition. However, there is a high probability of preventing it by embracing pharmacological and non-pharmacologic interventions, including maintaining hygiene when caring for older adults, antimicrobial therapy, obtaining blood cultures before initiating antimicrobial treatment, early sepsis screening, and staff training to enhance their knowledge and awareness of vital sign monitoring and proper preventive and management interventions (Branco et al., 2020). Regarding pharmacological interventions for managing sepsis, Lee & Levy et al. (2019) support the rationale for measuring lactate levels and administering broad-spectrum antibiotics and crystalloids for hypotension or lactate. While these interventions can demonstrate varying effectiveness in preventing and managing sepsis, it is possible to explore their contextual application using nursing research guidelines.

Reflection

Undoubtedly, I have acquired knowledge regarding the dimensions and fundamentals of nursing research through the week one learning activities. For instance, I am now conversant with profound requirements for nursing research, including frameworks for selecting research questions and topics, awareness of various research methods under the qualitative and quantitative research paradigms, the processes of selecting, critiquing, and synthesizing research evidence, and guidelines for translating knowledge to practice. I felt that the lesson about the PICO format for developing research questions and approaches for critiquing research articles were the most significant aspects of the week one learning because they provided the foundational knowledge of developing contextual topics and leveraging credible sources to inform decisions and solve clinical problems.

My experience with EBP or Quality Improvement (QI) initiatives in the Long-term Care

Our organization has yet to achieve the desired objectives in promoting evidence-based practice (EBP) tenets. Although we aim to provide quality care to patients, we rely massively upon conventional guidelines and protocols, with less emphasis on external evidence sources, including scholarly articles. It is vital to argue that the over-reliance on conventional clinical guidelines compromises the ability to provide quality care by depriving healthcare professionals of opportunities to leverage the best available evidence to support clinical decisions and solve problems.

Facilitators and Barriers to EBP in my Practice Area

Although our facility is yet to adhere to all the prerequisites for evidence-based practice, there are prospects of positive trajectories toward embracing EBP. In this sense, the institution has a functional computer laboratory, internet connection, and leadership commitment to training employees on EBP. These factors are profound facilitators of evidence-based practice and enhance opportunities for utilizing the best available evidence to support nursing practice. However, some constraints that compromise EBP include time pressure, staff shortage, limited knowledge of EBP, negative beliefs, and increased workload. According to Matheison et al. (2018), these barriers prompt healthcare organizations to develop policies and procedures for eliminating the restraining factors for implementing evidence-based practice. Therefore, a contingency plan consisting of staff training and education alongside cultural transformation can address these constraints.

My Research Role as a Nurse Practitioner

As a nurse practitioner in a long-term care facility, I spearhead research activities to investigate topics and problems of concern within the context of my scope of practice. This role encompasses various steps of nursing research, including using clinical scenarios to develop research questions and topics, searching for and retrieving evidence consistent with the issue of concern, appraising and synthesizing the evidence, and incorporating the evidence into clinical practice local context. Finally, I can play a forefront role in implementing quality improvement (QI) projects that entail protocol changes consistent with recommendations from scholarly evidence sources.

References

Branco, M. J. C., Lucas, A. P. M., Marques, R. M. D., & Sousa, P. P. (2020). The role of the nurse in caring for the critical patient with sepsis. Brazilian Journal of Nursing, 73(4), 1–7. https://doi.org/10.1590/0034-7167-2019-0031

Cheng, H.-H., Chen, F.-C., Change, M.-W., Kung, C.-T., Cheng, C.-Y., Tsai, T.-C., Hsiao, S.-Y., & Su, C.-M. (2018). Difference between elderly and non-elderly patients in using serum lactate level to predict mortality caused by sepsis in the emergency department. Medicine, 97(13), e0209. https://doi.org/10.1097/md.0000000000010209

Lee, J., & Levy, M. M. (2019). Treatment of patients with severe sepsis and septic shock: Current evidence-based practices. Rhode Island Medical Journal (2013), 102(10), 18–21. https://pubmed.ncbi.nlm.nih.gov/31795528/

Mathieson, A., Grande, G., & Luker, K. (2018). Strategies, facilitators, and barriers to implementation of evidence-based practice in community nursing: A systematic mixed-studies review and qualitative synthesis. Primary Health Care Research & Development, 20(20). https://doi.org/10.1017/s1463423618000488

Polit, D. F., & Beck, C. T. (2018). Essentials of nursing research: Appraising evidence for nursing practice (9th ed.). Wolters Kluwer.