[Answered] NR439Week 3 Assignment: Problem/PICOT/Evidence Search (PPE) Worksheet

Assignment Practice Scenario

Your Chief Nurse Executive (CNE) recognizes you are pursuing your BSN and has asked you to be a member of the nursing evidence-based practice (NEBP) committee. She has advised the members that the purpose is to conduct nursing research studies involving clinical practice problems. Increasing nurses’ awareness of quality and safety concerns will help develop an attitude of inquiry and asking questions (Sherwood & Barnsteiner, 2017). Baccalaureate nurses “collaborate in problem identification, participate in the process of search, retrieval, and documentation of evidence, and integrate evidence using credible databases and internet resources” (AACN, 2008, pp. 16-17).

The CNE has advised all members of the following areas of quality and safety clinical practice that each committee member needs to consider and choose only one    as a priority area for conducting a research study. Sources of research problems come from nursing clinical practice (Houser, 2018):

Quality Safety
  • Patient satisfaction
  • Patient education
  • Falls
  • Non-pharmacological pain management
 Errors. Examples include:

  • Medication
  • Patient identification
  • Communication
  • Readmissions
  • Length of stay
  • Costs
 Healthcare Associated Infections (HAIs).
Examples include:

  • Central Line Associated Blood Stream Infections (CLABSI)
  • Catheter Associated Urinary Tract Infections (CAUTI)
  • Ventilator Associated Pneumonia (VAP)
  • Surgical Site Infections (SSI)
  • Sepsis (Screening or Prevention)
  • Discharge Teaching/Coaching
  • Transitions of Care/Level of Care
  • Pressure Ulcers
  • Skin Integrity

Your CNE has requested that you select ONLY one topic area and complete the PPE Worksheet using only one topic area. The committee will collaborate and decide as a team which nursing clinical problem area will be the priority focus of their next research study. Thank you for your valuable contributions to this important NEBP committee.

Best Practices

  • For questions about this assignment, please contact your instructor.
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Directions

  1. Read over each of the following directions.
  2. You must read the Assignment Practice Scenario below before completing the PPE Worksheet.
  3. Download and use the required PPE Worksheet (Links to an external site.).
  4. Review the information provided in our library of how to search for journal articles here (Links to an external site.).
  5. Review the information provided in our library of how to locate and copy a journal permalink (Links to an external site.).
  6. You are required to complete the worksheet using the productivity tools required by Chamberlain University, which is Microsoft Office Word 2013 (or later version), or Windows and Office 2011 (or later version) for MAC. You must save the file in the “.docx” format. Do NOT save as Word Pad. A later version of the productivity tool includes Office 365, which is available to Chamberlain students for FREE by downloading from the student portal at http://my.chamberlain.edu (Links to an external site.). Click on the envelope at the top of the page.
  7. Complete each section of the Problem/PICOT/Evidence (PPE) Worksheet. For the Clinical PICOT Question, use the NR439_Guide for writing PICOT Questions and Examples.N439_Guide for writing PICOT Questions and Examples (Links to an external site.) Use one of the templates/guides to write your Clinical PICOT Question using all of the PICOT elements. Be sure to include the PICOT letters in your question.
  8. Be sure to use the rubric to make certain you are meeting all grading criteria of the PPE Worksheet.
  9. Submit the completed PPE Worksheet on the Week 3 Assignment page.
  10. Students, A short tutorial with tips for completing the Week 3 Problem/PICOT/Evidence Search (PPE) worksheet assignment may be viewed here.

 

Solution

Criteria The safety concern identified is patient falls,particularly, among elderly adults in hospice care. This is a priority concern mainly because it has significant implications on patient safety, quality of care, and health outcomes. This problem affects all levels, from local to national organizations. The Agency for Healthcare Research and Quality (AHRQ) (2018) reported that 3 to 5 patients experience falls per 100 bed-days, leading to 700,000 to 1million patients falling per annum. Patients in long-term care, including nursing homes, have a higher risk of falls with approximately 1.6 U.S nursing home residents experiencing a fall every year.Besides the health implications, falls are linked to huge financial implications. About specific data on elderly adults, the U.S. Centers for Disease Control and Prevention (CDC) (2019) has it that every 1 in 4 elderly American adults aged 65 and above experience falls per year. More so, every 11 seconds, the emergency room receives an emergency case related to fall and every 19 minutes, 1 elderly patient in the U.S dies from a fall.  This leads to the accumulation of total falls and deaths per annum. Falls lead to 2.8 million and more injuries cared for in the emergency unit every year. This number includes the 800,000+ admissions and 27,000+ deaths from falls (Burns & Kakara, 2018). This has been supported by the CDC (2019) which reports that approximately 30 million elderly adults fall per year, causing around 30,000 deaths/ year. Falls among the elderly patients are the leading causes of fatal injuries and the most common cause of non-fatal hospitalizations due to trauma among elderly patients. In 2015, the approximate costs of treating injuries caused by falls were $50 billion. The Medicare and Medicaid covered for 75% of these costs. As put forward by the National Council on Aging (NCOG) (n.d), the financial burden of falls is expected to increase to $67.7 billion/ year in 2020. The complications of falls among elderly adults can range from mild to severe. The CDC (2019) has it that 1 in every 5 falls among the elderly adults causes severe injuries such as broken bones and head injury. 95% of the total hip fractures are due to falls, mainly sideways falls. I chose this problem because, being a nurse, I am aware of the complications of elderly patient falls to the health outcomes. I am obligated to ensure the safety of our patients by protecting them from any harm. With the increase in life expectancy, the number of elderly adults is anticipated to increase and so is the rate of elderly patient falls and associated costs. Falls, including those that do not lead to life-threatening injuries, can lead to psychological problems such as anxiety, distress, fear of falling for the patients, and their families which may ultimately affect their willingness to participate in physical activities of daily living, leading to poor health outcomes and quality of life. Falls are preventable health problems that can be prevented through the implementation of evidence-based interventions. Among the common causes of falls among elderly patients is the lack of musculoskeletal strength and stability due to the aging process. According to Alshammari et al. (2018), physical exercise is linked to an increase in one’s physical health, (including musculoskeletal strength and stability), mental health, and cognitive health. In this regard, nurses can implement nurse-led physical exercise programs, particularly, nurse-led physical exercise in hospice care to enhance the elderly patients’ musculoskeletal strength and stability, leading to a reduction in falls.
Clinical Nursing Practice Problem

 

Select and identify ONLYone quality or safety clinical priority area from the assignment guidelines practice scenario. Summarize why youbelieve the nursing practice problem/issue is the most important.  Summarize your rationale (why) for choosing the problem.

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