Assignment
pRe-assignment instructions
Identify a nurse-driven topic of interest related to a current challenge in nursing or your workplace and explain why it is a nursing problem. This topic will be used to complete the remainder course assignments.
Evidence-based practice uses the PICOT model for formulating a searchable question. Follow the guide below to answer the questions that will help you develop your PICOT question.
P = Population: How would you describe the group of patients in question?
I = Intervention: What main nursing intervention within your scope of practice are you considering implementing to improve patient outcomes?
C = Comparison: Is there an alternative to compare with the intervention?
O = Outcome: What do you hope to accomplish, improve or affect from the implementing the nursing intervention?
T = Timeframe: What would be the timeframe for data collection or time to measure the outcome?
Based on your responses, use the sample below to develop your clinical PICOT question. State your clinical question.
In elderly patients (P), does a fall risk assessment tool (I) compared to none (C) affect fall rates (O) by hospital discharge (T)?
Support your response by citing and referencing either the course lesson or assigned textbook
Pre assignment discussion summited by me
In the post-anesthetic care unit, the encounters with patients who wake up post-hip surgery to discover a large, conspicuous wedge between their legs or individuals who undergo Anterior Cervical Discectomy and Fusion ACDF surgery only to express frustration about the necessity of wearing a neck brace reveal a recurring challenge in perioperative care (Yen & Leasure, 2019). Furthermore, experiences with patients who demand immediate postoperative mobility without awareness of the associated risks underscore the pressing issue of patient education during this critical period. It is particularly exasperating when patients appear ill-prepared for the realities of their recovery journey, emphasizing a concerning gap in preoperative education. This gap not only results in patient dissatisfaction but also potentially jeopardizes their postoperative outcomes (Yen & Leasure, 2019).
The nurse-driven topic of interest related to the current challenge in nursing is implementing a nurse-led prehabilitation program for patients undergoing elective orthopedic surgery. This is a nursing problem because nurses play a critical role in the comprehensive care of surgical patients, from preoperative preparation to postoperative recovery. The challenge lies in optimizing patient outcomes and satisfaction during the postoperative period, which can be impacted by factors such as pain management, physical function, and the patient’s understanding of the recovery process.
Using the PICOT model, I can formulate a clinical question based on this topic:
P = Population: Patients undergoing elective orthopedic surgery
I = Intervention: Implementation of a nurse-led prehabilitation program
C = Comparison: No prehabilitation program (standard care)
O = Outcome: Improved physical function and reduced postoperative complications
T = Timeframe: Within the first 30 days post-surgery
The clinical PICOT question would be:
“In patients undergoing elective orthopedic surgery, does the implementation of a nurse-led prehabilitation program compared to no prehabilitation lead to improved physical function and reduced postoperative complications within the first 30 days post-surgery?”
This question addresses the need for proactive nursing interventions to enhance patients’ physical readiness for surgery and their ability to recover effectively, ultimately aiming to improve patient outcomes and satisfaction. Nurses can play a pivotal role in educating patients about the importance of prehabilitation and managing their expectations regarding the surgical and recovery processes.
References
Developing the PICO Question. (n.d.). Files.galencollege.edu. https://files.galencollege.edu/media/BSN/NSG4000/Developing_the_PICO_Question/presentation_html5.html
Yen, P. H., & Leasure, A. R. (2019). Use and Effectiveness of the Teach-Back Method in Patient Education and Health Outcomes. Federal Practitioner : For the Health Care Professionals of the VA, DoD, and PHS, 36(6), 284–289.
Response by instructor Hello,Great topic. You developed an excellent clinical question. Out of my curiosity, what is meant by a nurse-lead prehabilitation program, compared to a rehab program?I appreciate you adding to my knowledge. Response to my instructor In the context of perioperative care, it is essential to differentiate between prehabilitation and rehabilitation. Prehabilitation, as discussed in the article by Engel et al. (2023), refers to proactive interventions and preparations undertaken before surgery to optimize a patient’s physical and psychological condition. It involves activities aimed at enhancing a patient’s baseline health, such as exercise regimens, nutritional guidance, and psychological support. In contrast, rehabilitation occurs after surgery and focuses on helping patients regain lost physical function and mobility through physical therapy and targeted exercises (Engel et al., 2023). This distinction underscores the preventive nature of prehabilitation, aiming to reduce postoperative complications and enhance overall outcomes, while rehabilitation addresses the recovery phase following surgery. I believe this field has promising career prospects in the future for nurses.
References:Engel, D., Testa, G. D., McIsaac, D. I., Carli, F., Santa Mina, D., Baldini, G., Scheede-Bergdahl, C., Chevalier, S., Edgar, L., Beilstein, C. M., Huber, M., Fiore Jr., J. F., & Gillis, C. (2023). Reporting quality of randomized controlled trials in prehabilitation: a scoping review. Perioperative Medicine, 12(1), 1–15. https://doi.org/10.1186/s13741-023-00338-8 Links to an external site.
Assignment part one and rubric
Use this template: Dissemination of Evidence Paper Template.docx
Download Dissemination of Evidence Paper Template.docx
Finalize your nurse-driven intervention clinical question and create keywords to complete a literature search using the Galen library database.
The clinical question should be written using the format: In elderly patients (P), how does the implementation of a fall risk protocol (I) compared to none (C), affect the number of falls (O) within hospitalization (T)?
Find and save the full text (PDF) of 3 research articles dated within the past 5 years to your computer.
Consider the levels of evidence as you select articles that show your nursing intervention is effective in achieving your desired outcome stated in your clinical question. For example, if you plan to implement yoga as a nursing intervention to enhance weight loss, all 3 studies must find (reported under the results/findings section) that yoga is an effective weight-loss strategy. If you cannot find studies to support your intervention and outcome, consider the need to edit your intervention and outcome within the clinical question. Then, repeat the literature search using the revised keywords.
Use a total of 4 sources, including the 3 research articles and the assigned course textbook.
Use 1 to 2 short, direct quotes and multiple paraphrases as supportive evidence throughout the paper with in-text citations and matching references formatted in APA style.
Each short, direct quote should contain less than 20 words.
Each paragraph should contain a minimum of 4 sentences and a maximum of 6 to 8 sentences.
Complete a 3 to 4-page APA formatted paper (excluding the title and reference pages) to include the following:
1. Introduction (1 paragraph): Use the selected articles as sources as you:
Identify and introduce a nurse-related topic of interest.
Describe your interest in the topic.
Include a purpose statement.
2. Clinical Question (1 sentence): State your nurse-driven intervention clinical question. Do not discuss the PICOT components.
3. Justification of the Topic (1 paragraph): Discuss two reasons why this topic should be investigated and provide in-text citations to support your claims for each reason.
4. Findings (3 paragraphs): Paraphrase the 3 research articles with in-text citations to report a summary of the findings. Do not use direct quotes. Summarize each article in one paragraph by identifying the:
Type of study or design.
Purpose of the study.
Description of the sample (describe the sample and state the number of participants).
Methods (describe the data collection and data analysis procedures)
Results (Explain the findings and include statistical significance such as p value or numerical data for quantitative results and themes/concepts for qualitative results).
State how the study connects to your topic.
5. Recommendations (1 paragraph): Based on your findings, use evidence from the articles with in-text citations to discuss two recommendations for enhancing clinical practice (bedside and patient care). Support each recommendation with evidence.
6. Conclusions (1 paragraph): Provide a concise summary of the evidence on the topic and state how the evidence you found supports your clinical question. Do not include new information.
Submission:
Adhere to page limit and utilize available resources as needed including Grammarly, Academic Writer, and Smarthinking Tutoring Services.
Save your assignment as a Microsoft Word document.
Submit your paper and review your Turnitin report and score.
If needed, edit your paper per the Turnitin Guidelines, and upload the revised version for grading before the due date.
Rubric
Evidence Paper Grading Rubric 2023.03
Evidence Paper Grading Rubric 2023.03
References I found to support my question
My question may have to drop nurse-led?
Only use 3 of the below
De Klerk, B., Dounavi, D., Hamilton, D., Clement, N., & Kaliarntas, K. (2023). SYSTEMATIC REVIEW E ects of home-based prehabilitation on pre-and postoperative outcomes following total hip and knee arthroplasty A SYSTEMATIC REVIEW AND META ANALYSIS Aims. Bone Jt Open, 4(5), 315–328. https://doi.org/10.1302/2633-1462.45.BJO-
Dominique Engel, Giuseppe Dario Testa, Daniel I. McIsaac, Francesco Carli, Daniel Santa Mina, Gabriele Baldini, Celena Scheede-Bergdahl, Stéphanie Chevalier, Linda Edgar, Christian M. Beilstein, Markus Huber, Julio F. Fiore, & Chelsia Gillis. (2023). Reporting quality of randomized controlled trials in prehabilitation: a scoping review. Perioperative Medicine, 12(1), 1–15. https://doi.org/10.1186/s13741-023-00338-8
Khalid, T., Ben-Shlomo, Y., Bertram, W., Culliford, L., England, C., Henderson, E., Jameson, C., Jepson, M., Palmer, S., Whitehouse, M. R., & Wylde, V. (2023). Prehabilitation for frail patients undergoing total hip or knee replacement: protocol for the Joint PREP feasibility randomised controlled trial. Pilot and Feasibility Studies, 9(1). https://doi.org/10.1186/s40814-023-01363-6
Punnoose, A., Claydon-Mueller, L. S., Weiss, O., Zhang, J., Rushton, A., & Khanduja, V. (2023). Prehabilitation for Patients Undergoing Orthopedic Surgery. JAMA Network Open, 6(4), e238050. https://doi.org/10.1001/jamanetworkopen.2023.8050
Must use
The below reference as stated below
Text book to be used Melnyk, B., & Fineout-Overholt, E. (2023). Evidence-based practice in nursing and healthcare (5th ed.). Wolters Kluwer.
Outline
Evidence Paper
Your Name
College
Application of Evidence-Based Research
Instructor’s Name
Assignment Due Date
Delete all yellow highlighted text from this template and replace them with your content.
Evidence Paper
Start your paper with your introduction here. Do not use introduction as a heading. In one paragraph, introduce your nurse-related topic of interest, describe your interest in the topic, and include the purpose of the paper. Use evidence from the articles to introduce the topic. Throughout this paper, each paragraph must contain a minimum of four sentences and a maximum of six to eight sentences. This paper should be three to four pages long and have a maximum of two direct quotes with multiple paraphrases cited in APA format.
Clinical Question
State the clinical question in one sentence.
Justification
In one paragraph, discuss two reasons why this topic should be investigated and provide in-text citations to support your claims for each reason.
Findings
Paraphrase the three research articles to report a summary of the studies. Do not use direct quotes within the summaries. Paraphrase each article using your own words with in-text citations. See the assignment directions and grading rubric for what content should be included. This section should contain a total of three paragraphs (one for each study), and each paragraph should have six to eight sentences.
Recommendations
In one paragraph, consider the findings from the two articles and discuss two recommendations for enhancing clinical practice at the bedside. Support each recommendation with evidence from the articles by providing in-text citations.
Conclusion
In one paragraph, provide a concise summary of the paper and state how the evidence you found supports your clinical question (do not include new information and no in-text citations). Write this section using your own words, and do not use sources. Review the assignment directions and grading rubric to ensure that you have met all criteria for this paper.
References
Provide the full reference for the required four sources (3 articles and course textbook) in APA format. The references page will include a hanging indentation for each source. Ensure that each reference has a corresponding in-text citation. See your APA Manual and the APA resources posted to the course for reference formatting.
