great work on time
As a way of introdu
c
ing yourselves to the instructor and your peers, please post the following:
· Your name and a description of your current position (If not employed, what are your expectations when you complete your program?)
· How do you see yourself applying knowledge from this course?
· Post a photo of yourself (self-portrait, family, or action photo).
Next, please read and respond to the following questions:
· Visit the library website and conduct a search of the literature for at least one ‘best practice’ relative to your specialty track of NE, NLA, FNP, AGPCNP, AGACNP, or PMHNP (BSN students, choose one specialty track of interest).
· Briefly describe the ‘best practice’ recommendation.
· Discuss how you envision implementing the ‘best practice’ recommendation in your future role as a NE, NLA, FNP, AGPCNP, AGACNP, or PMHNP.
· Correlate and describe how best practices facilitate certification success.
Responses need to address all components of the question, demonstrate critical thinking and analysis and include peer-reviewed journal evidence to support the student’s position.
Please be sure to validate your opinions and ideas with citations and references in APA format.
Estimated time to complete: 2 hours
Discussion Peer/Participation Prompt [Due Sunday]
Please respond to at least 2 of your peer’s posts. To ensure that your responses are substantive, use at least three of these prompts:
· Compare your peers’ responses about the application of EBP to certification success to yours; how are they different, how are they the same?
· Respond to their ideas to expand the conversation and/or give additional perspective.
· Ask for clarification if needed.
· Present new references that support your opinions.
Please be sure to validate your opinions and ideas with citations and references in APA format.
c
Discussion Question/Prompt [Due Friday]
According to the American Association of Colleges of Nursing, the Masters prepared nurse “recognizes that the master’s-prepared nurse applies research outcomes within the practice setting, resolves practice problems, works as a change agent, and disseminates results.” Many research ideas emerge from practice and/or the educational environment. Formulating a well-built research question is challenging. Asking the right question facilitates the search process when conducting a review of the literature.
· Read the article “
Asking the clinical question: A key step in evidence-based practice (Links to an external site.)
.”
· After reading the article, create your own PICOT question around the topic you selected that will be used for your Unit 2 Introduction to an Evidence-Based Practice Problem. In your discussion post, complete the following:
1. Describe your selected topic and its significance
2. Share and discuss your created PICOT question.
Responses need to address all components of the question, demonstrate critical thinking and analysis, and include peer reviewed journal evidence to support the student’s position.
Please be sure to validate your opinions and ideas with citations and references in APA format.
Please review the rubric to ensure that your response meets the criteria.
Estimated time to complete: 2 hours
Discussion Peer/Participation Prompt [Due Sunday]
· Respond to at least two other student’s postings with substantive comments.
· Substantive comments add to the discussion and provide your fellow students with information that will enhance the learning environment.
· References and citations should conform to the APA standards.
· Remember: Please respect the opinions of others, even if their views differ. In other words, disagree professionally and respectfully.
· Plagiarism is never acceptable – give credit when credit is due – cite your sources.
Please be sure to validate your opinions and ideas with citations and references in APA format.
Unit 2 Discussion [Due Wednesday]
Research Design
It is anticipated that the initial discussion response should be in the range of 250-300 words. Response posts must demonstrate topic knowledge and scholarly engagement with peers. This is not the only criteria utilized for evaluation; substantive content is imperative. All questions in the topic must be addressed. Please proofread your response carefully for grammar and spelling. Do not upload any attachments. All responses need to be supported by a minimum of one scholarly resource. Journals and websites must be cited appropriately. Citation and reference must adhere to APA format.
Classroom Participation
Students are expected to initially address the discussion question by Wednesday of each week. Participation in the discussion forums is expected with a minimum total of three (3) substantive postings (this includes your initial posting and posting to two peers) on three (3) different days per week. Substantive means that you add something new to the discussion, you aren’t just agreeing. This is also a time to ask questions or offer information surrounding the topic addressed by your peers. Personal experience is appropriate for a substantive discussion and should be correlated to the literature.
All discussion boards will be evaluated utilizing rubric criterion inclusive of content, analysis, collaboration, writing and APA. If you fail to post an initial discussion you will not receive these points, you may however post to your peers for partial credit following the guidelines above. Due to the nature of this type of assignment and the need for timely responses for initial posts and posting to peers, the Make-Up Coursework Policy (effective July 2017) does not apply to Discussion Board Participation.
Discussion Question/Prompt [Due Wednesday]
Please review the Unit 2 Introduction and Required Resources regarding qualitative and quantitative research design. Then, consider your selected evidence-based practice problem/topic from unit 1 and the unit 2 assignment. Then, respond to the following question(s):
1. Compare and contrast qualitative and quantitative research designs. Think about this in terms of methodology and outcome.
2. If you were to actually conduct your own research study, would your selected evidence-based practice problem/topic lend itself to a qualitative or quantitative design? (Describe specifics around the topic to support your findings.)
Responses need to address all components of the question, demonstrate critical thinking and analysis, and include peer reviewed journal evidence to support the student’s position.
Please be sure to validate your opinions and ideas with citations and references in APA format.
Please review the rubric to ensure that your response meets the criteria.
Estimated time to complete: 2 hours
Discussion Peer/Participation Prompt [Due Sunday]
· Respond to at least two other student’s postings with substantive comments.
· Substantive comments add to the discussion and provide your fellow students with information that will enhance the learning environment.
· References and citations should conform to the APA standards.
· Remember: Please respect the opinions of others, even if their views differ. In other words, disagree professionally and respectfully.
· Plagiarism is never acceptable – give credit when credit is due – cite your sources.
Responses need to address all components of the question, demonstrate critical thinking and analysis, and include peer reviewed journal evidence to support the student’s position.
Please review the rubric to ensure that your response meets the criteria.
Unit 2 Discussion [Due Friday]
Sampling
It is anticipated that the initial discussion response should be in the range of 250-300 words. Response posts must demonstrate topic knowledge and scholarly engagement with peers. This is not the only criteria utilized for evaluation; substantive content is imperative. All questions in the topic must be addressed. Please proofread your response carefully for grammar and spelling. Do not upload any attachments. All responses need to be supported by a minimum of one scholarly resource. Journals and websites must be cited appropriately. Citation and reference must adhere to APA format.
Classroom Participation
Students are expected to initially address the discussion question by Wednesday of each week. Participation in the discussion forums is expected with a minimum total of three (3) substantive postings (this includes your initial posting and posting to two peers) on three (3) different days per week. Substantive means that you add something new to the discussion, you aren’t just agreeing. This is also a time to ask questions or offer information surrounding the topic addressed by your peers. Personal experience is appropriate for a substantive discussion and should be correlated to the literature.
All discussion boards will be evaluated utilizing rubric criterion inclusive of content, analysis, collaboration, writing and APA. If you fail to post an initial discussion you will not receive these points, you may however post to your peers for partial credit following the guidelines above. Due to the nature of this type of assignment and the need for timely responses for initial posts and posting to peers, the Make-Up Coursework Policy (effective July 2017) does not apply to Discussion Board Participation.
Discussion Question/Prompt [Due Friday]
How do the sampling methods and sample sizes vary for the different types of quantitative and qualitative research?
·
· Hypothetically, what sampling method would you use to conduct a study of your selected evidence-based practice problem/topic? Why?
· How would you determine the sample type and size?
Responses need to address all components of the question, demonstrate critical thinking and analysis, and include peer reviewed journal evidence to support the student’s position.
Please be sure to validate your opinions and ideas with citations and references in APA format.
Please review the rubric to ensure that your response meets the criteria.
Estimated time to complete: 2 hours
Discussion Peer/Participation Prompt [Due Sunday]
· Respond to at least two other student’s postings with substantive comments.
· Substantive comments add to the discussion and provide your fellow students with information that will enhance the learning environment.
· References and citations should conform to the APA standards.
· Remember: Please respect the opinions of others, even if their views differ. In other words, disagree professionally and respectfully.
· Plagiarism is never acceptable – give credit when credit is due – cite your sources.
Responses need to address all components of the question, demonstrate critical thinking and analysis, and include peer reviewed journal evidence to support the student’s position.
Please review the rubric to ensure that your response meets the criteria.
Unit 3 Discussion [Due Wednesday]
Study Review of Ethics
It is anticipated that the initial discussion response should be in the range of 250-300 words. Response posts must demonstrate topic knowledge and scholarly engagement with peers. This is not the only criteria utilized for evaluation; substantive content is imperative. All questions in the topic must be addressed. Please proofread your response carefully for grammar and spelling. Do not upload any attachments. All responses need to be supported by a minimum of one scholarly resource. Journals and websites must be cited appropriately. Citation and reference must adhere to APA format.
Classroom Participation
Students are expected to initially address the discussion question by Wednesday of each week. Participation in the discussion forums is expected with a minimum total of three (3) substantive postings (this includes your initial posting and posting to two peers) on three (3) different days per week. Substantive means that you add something new to the discussion, you aren’t just agreeing. This is also a time to ask questions or offer information surrounding the topic addressed by your peers. Personal experience is appropriate for a substantive discussion and should be correlated to the literature.
All discussion boards will be evaluated utilizing rubric criterion inclusive of content, analysis, collaboration, writing and APA. If you fail to post an initial discussion you will not receive these points, you may however post to your peers for partial credit following the guidelines above. Due to the nature of this type of assignment and the need for timely responses for initial posts and posting to peers, the Make-Up Coursework Policy (effective July 2017) does not apply to Discussion Board Participation.
Discussion Question/Prompt [Due Wednesday]
Locate a research study (2015 or later) on your topic of choice. Explore the research study and review the participants, procedures (methods section) of the article. Then, answer the following questions related to your selected article/study (Be sure to cite the article in APA format and provide a link to your article on the discussion board for your classmates).
· Describe the participant protections provided by the researchers for participants.
· How were the participants selected? How might this impact ethical principles within the study?
· Would the participants in this study be considered “vulnerable”? Why or why not?
· Were participants subjected to any physical harm or discomfort or psychological distress as part of the study? What efforts did the researchers make to minimize harm and maximize good?
· Does the report discuss steps that were taken to protect the privacy and confidentiality of study participant?
Responses need to address all components of the question, demonstrate critical thinking and analysis, and include peer reviewed journal evidence to support the student’s position.
Please be sure to validate your opinions and ideas with citations and references in APA format.
Please review the rubric to ensure that your response meets the criteria.
Estimated time to complete: 2 hours
Discussion Peer/Participation Prompt [Due Sunday]
· Respond to at least two other student’s postings with substantive comments.
· Substantive comments add to the discussion and provide your fellow students with information that will enhance the learning environment.
· References and citations should conform to the APA standards.
· Remember: Please respect the opinions of others, even if their views differ. In other words, disagree professionally and respectfully.
· Plagiarism is never acceptable – give credit when credit is due – cite your sources.
Responses need to address all components of the question, demonstrate critical thinking and analysis, and include peer reviewed journal evidence to support the student’s position.
Please review the rubric to ensure that your response meets the criteria.
T
o fully implement evidence-
based practice (EBP),
nurses need to have both
a spirit of inquiry and a culture
that supports it. Inour first article
in this series (“Igniting a Spirit of
Inquiry:AnEssential Foundation
for Evidence-Based Practice,”
November 2009),we defined a
spirit of inquiry as “an ongoing
curiosity about the best evidence
toguide clinical decisionmaking.”
A spirit of inquiry is the founda-
tionof EBP, andonce nurses pos-
sess it, it’s easier to take the next
step—toask the clinical question.1
Formulating a clinical question
in a systematicwaymakes it pos-
sible to find an answermore
quickly and efficiently, leading to
improved processes and patient
outcomes.
In the last installment,wegave
an overviewof themultistepEBP
process (“The Seven Steps of
Evidence-Based Practice,” Janu-
ary). Thismonthwe’ll discuss
step one, asking the clinical
question. As a context for this
discussionwe’ll use the same
scenariowe used in the previous
articles (see Case Scenario for
EBP: Rapid Response Teams).
In this scenario, a staff nurse,
let’s call herRebeccaR., noted
that patients on hermedical–
surgical unit had a high acuity
level thatmay have led to an in-
crease in cardiac arrests and in the
number of patients transferred
to the ICU.Of thepatientswho
had a cardiac arrest, four died.
Rebecca sharedwith her nurse
manager a recently published
study onhow the use of a rapid
response teamresulted in reduced
in-hospital cardiac arrests andun-
planned admissions to the critical
Asking the Clinical Question: A Key Step in
Evidence-Based Practice
A successful search strategy starts with a well-formulated question.
This is the third article in a series from the Arizona State University College of Nursing and Health Innovation’s Center
for the Advancement of Evidence-Based Practice. Evidence-based practice (EBP) is a problem-solving approach to the
delivery of health care that integrates the best evidence from studies and patient care data with clinician expertise and
patient preferences and values. When delivered in a context of caring and in a supportive organizational culture, the
highest quality of care and best patient outcomes can be achieved.
The purpose of this series is to give nurses the knowledge and skills they need to implement EBP consistently, one
step at a time. Articles will appear every two months to allow you time to incorporate information as you work toward
implementing EBP at your institution. Also, we’ve scheduled “Ask the Authors” call-ins every few months to provide a
direct line to the experts to help you resolve questions. Details about how to participate in the next call will be pub-
lished with May’s Evidence-Based Practice, Step by Step.
Case Scenario for EBP: Rapid Response Teams
You’re a staff nurse on a busy medical–surgical unit. Overthe past three months, you’ve noticed that the patients on
your unit seem to have a higher acuity level than usual, with
at least three cardiac arrests per month, and of those patients
who arrested, four died. Today, you saw a report about a
recently published study in Critical Care Medicine on the use
of rapid response teams to decrease rates of in-hospital car-
diac arrests and unplanned ICU admissions. The study found
a significant decrease in both outcomes after implementation
of a rapid response team led by physician assistants with spe-
cialized skills.2 You’re so impressed with these findings that
you bring the report to your nurse manager, believing that a
rapid response team would be a great idea for your hospital.
The nurse manager is excited that you have come to her with
these findings and encourages you to search for more evidence
to support this practice and for research on whether rapid re-
sponse teams are valid and reliable.
58 AJN � March 2010 � Vol. 110, No. 3 ajnonline.com
care unit.2 Shebelieved this could
be a great idea for her hospital.
Based onher nursemanager’s
suggestion to search formore evi-
dence to support theuseof a rap-
id response team,Rebecca’s spirit
of inquiry ledher to take thenext
step in the EBPprocess: asking
the clinical question. Let’s follow
Rebecca as shemeetswithCar-
losA., oneof the expertEBPmen-
tors from the hospital’s EBP and
research council, whose role is to
assist point of care providers in
enhancing their EBPknowledge
and skills.
Types of clinical questions.
Carlos explains toRebecca that
finding evidence to improve pa-
tient outcomes and support a
practice change depends upon
how the question is formulated.
Clinical practice that’s informed
by evidence is based onwell-
formulated clinical questions
that guide us to search for the
most current literature.
There are two types of clinical
questions: backgroundquestions
and foregroundquestions.3-5 Fore-
ground questions are specific and
relevant to the clinical issue. Fore-
groundquestionsmust be asked
in order to determinewhich of
two interventions is themost ef-
fective in improving patient out-
comes. For example, “In adult
patients undergoing surgery, how
does guided imagery compared
withmusic therapy affect anal-
gesia usewithin the first 24hours
post-op?” is a specific,well-
defined question that can only
guides her in formulating a fore-
groundquestionusing PICOT
format.
PICOT is an acronym for the
elements of the clinical question:
patient population (P), interven-
tion or issue of interest (I), com-
parison intervention or issue of
interest (C), outcome(s) of inter-
est (O), and time it takes for the
intervention to achieve the out-
come(s) (T).WhenRebecca asks
why the PICOTquestion is so
important, Carlos explains that
it’s a consistent, systematicway
to identify the components of a
clinical issue. Using the PICOT
format to structure the clinical
question helps to clarify these
components,whichwill guide the
search for the evidence.6, 7 Awell-
built PICOTquestion increases
the likelihood that the best evi-
dence to informpracticewill be
foundquickly and efficiently.5-8
To helpRebecca learn to for-
mulate a PICOTquestion,Car-
los uses the earlier example of a
foregroundquestion: “In adult
patients undergoing surgery, how
does guided imagery compared
be answered by searching the
current literature for studies
comparing these two interven-
tions.
Background questions are
considerably broader andwhen
answered, provide general knowl-
edge. For example, a background
question suchas, “What therapies
reduce postoperative pain?” can
generally be answeredby looking
in a textbook. Formore informa-
tion on the two types of clinical
questions, see Comparison of
Background and Foreground
Questions.4-6
Ask the question in PICOT
format. Now thatRebecca has
an understanding of foreground
andbackgroundquestions,Carlos
Comparison of Background and Foreground Questions4-6
Question type Description Examples
Background
question
A broad, basic-knowledge question
commonly answered in textbooks.
May begin with what or when.
1) What is the best method to pre-
vent pressure ulcers?
2) What is sepsis?
3) When do the effects of
furosemide peak?
Foreground
question
A specific question that, when
answered, provides evidence for clin-
ical decision making. A foreground
question includes the following ele-
ments: population (P), intervention or
issue of interest (I), comparison inter-
vention or issue of interest (C), out-
come (O), and, when appropriate,
time (T).
1) In mechanically ventilated pa-
tients (P), how does a weaning
protocol (I) compared with no
weaning protocol (C) affect venti-
lator days (O) during ICU length
of stay (T)?
2) In hospitalized adults (P), how
does hourly rounding (I) com-
pared with no rounding (C) affect
fall rates (O)?
The PICOT question is a consistent,
systematic way to identify the components
of a clinical issue.
By Susan B. Stillwell, DNP, RN, CNE, Ellen Fineout-Overholt, PhD,
RN, FNAP, FAAN, Bernadette Mazurek Melnyk, PhD, RN,
CPNP/PMHNP, FNAP, FAAN, and Kathleen M. Williamson, PhD, RN
ajn@wolterskluwer.com AJN � March 2010 � Vol. 110, No. 3 59
also not always required. But
population, intervention or issue
of interest, and outcome are es-
sential to developing any PICOT
question.
Carlos asksRebecca to reflect
on the clinical situation onher
unit in order to determine the
unit’s current intervention for ad-
dressing acuity. Reflection is a
strategy to help clinicians extract
critical components from the clin-
ical issue to use in formulating
the clinical question.3 Rebecca
andCarlos revisit aspects of the
clinical issue to seewhichmaybe-
come components of the PICOT
question: the high acuity of pa-
tients on the unit, the number of
cardiac arrests, the unplanned
ICUadmissions, and the research
article on rapid response teams.
Once the issue is clarified, the
PICOTquestion can bewritten.
withmusic therapy affect analge-
sia usewithin the first 24 hours
post-op?” In this example, “adult
patients undergoing surgery” is
thepopulation (P), “guided imag-
ery” is the interventionof interest
(I), “music therapy” is the com-
parison intervention of interest
(C), “pain” is the outcomeof in-
terest (O), and“the first 24hours
post-op” is the time it takes for
the intervention to achieve the
outcome (T). In this example,
music therapy or guided imagery
is expected to affect the amount
of analgesia used by the patient
within the first 24hours after sur-
gery.Note that a comparisonmay
not be pertinent in somePICOT
questions, such as in “meaning
questions,”which are designed
to uncover themeaning of a
particular experience.3, 6 Time is
Templates and Definitions for PICOT Questions5, 6
Question type Definition Template
Intervention or
therapy
To determine which treatment leads to the
best outcome
In _____________________ (P),
how does ______________ (I)
compared with ___________ (C)
affect __________________ (O)
within __________________ (T)?
Etiology To determine the greatest risk factors or
causes of a condition
Are ______________________________ (P)
who have ________________________ (I),
compared with those without ________ (C),
at ____ risk for ____________________ (O)
over _____________________________ (T)?
Diagnosis or
diagnostic test
To determine which test is more accurate and
precise in diagnosing a condition
In ______________________________ (P),
are/is ___________________________ (I)
compared with ___________________ (C)
more accurate in diagnosing _______ (O)?
Prognosis or
prediction
To determine the clinical course over time
and likely complications of a condition
In ___________________ (P),
how does _____________ (I)
compared with ________ (C),
influence _____________ (O)
over _________________ (T)?
Meaning To understand the meaning of an experience
for a particular individual, group, or commu-
nity
How do ______________ (P)
with _________________ (I)
perceive ______________ (O)
during _______________ (T)?
A well-built PICOT question increases the
likelihood that the best evidence to inform
practice will be found.
60 AJN � March 2010 � Vol. 110, No. 3 ajnonline.com
BecauseRebecca’s issue of in-
terest is the rapid response team—
an intervention—Carlos provides
herwith an“interventionor ther-
apy” template to use in formu-
lating the PICOTquestion. (For
other types of templates, see Tem-
plates and Definitions for PICOT
Questions.5, 6) Since the hospital
doesn’t have a rapid response
teamanddoesn’t have a plan for
addressing acuity issues before a
crisis occurs, the comparison, or
(C) element, in the PICOTques-
tion is “no rapid response team.”
“Cardiacarrests”and“unplanned
admissions to the ICU”are the
outcomes in the question.Other
potential outcomes of interest to
the hospital could be “lengths of
stay” or “deaths.”
Rebecca proposes the follow-
ing PICOTquestion: “In hospi-
talized adults (P), howdoes a
rapid response team (I) compared
with no rapid response team (C)
clinical question that’smost ap-
propriate for each scenario, and
choose a template to guide you.
Then formulate onePICOTques-
tion for each scenario. Suggested
PICOTquestionswill be pro-
vided in the next column. �
Susan B. Stillwell is clinical associate
professor and program coordinator of
the Nurse Educator Evidence-Based
Practice Mentorship Program at Arizona
State University in Phoenix, where Ellen
Fineout-Overholt is clinical professor and
director of the Center for the Advance-
ment of Evidence-Based Practice, Ber-
nadette Mazurek Melnyk is dean and
distinguished foundation professor of
nursing, and Kathleen M. Williamson is
associate director of the Center for the
Advancement of Evidence-Based Prac-
tice. Contact author: Susan B. Stillwell,
sstillwell@asu.edu.
REFERENCES
1.MelnykBM, et al. Igniting a spirit of
inquiry: an essential foundation for
evidence-based practice. Am J Nurs
2009;109(11):49-52.
2.DaceyMJ, et al. The effect of a rapid
response teamonmajor clinical out-
comemeasures in a community hos-
pital. Crit Care Med 2007;35(9):
2076-82.
3.Fineout-Overholt E, JohnstonL.
TeachingEBP: asking searchable, an-
swerable clinical questions. World-
views Evid Based Nurs 2005;2(3):
157-60.
4.NollanR, et al. Asking compelling
clinical questions. In:MelnykBM,
Fineout-Overholt E, editors. Evidence-
based practice in nursing and health-
care: a guide to best practice.
Philadelphia: LippincottWilliams
andWilkins; 2005. p. 25-38.
5.Straus SE. Evidence-based medicine:
how to practice and teach EBM. 3rd
ed. Edinburgh;NewYork: Elsevier/
Churchill Livingstone; 2005.
6.Fineout-Overholt E, Stillwell SB.Ask-
ing compelling questions. In:Melnyk
BM, Fineout-Overholt E, editors.
Evidence-based practice in nursing
and healthcare: a guide to best practice
[forthcoming]. 2nd ed. Philadelphia:
WoltersKluwerHealth/Lippincott
Williams andWilkins.
7.McKibbonKA,Marks S. Posing clini-
cal questions: framing the question
for scientific inquiry. AACN Clin
Issues 2001;12(4):477-81.
8.Fineout-Overholt E, et al. Teaching
EBP: getting to the gold: how to search
for thebest evidence. Worldviews Evid
Based Nurs 2005;2(4):207-11.
affect the number of cardiac ar-
rests (O) and unplanned admis-
sions to the ICU (O) duringa
three-month period (T)?”
Now thatRebecca has formu-
lated the clinical question, she’s
ready for thenext step in theEBP
process, searching for the evi-
dence. Carlos congratulates
Rebecca ondeveloping a search-
able, answerable question and
arranges tomeetwith her again
tomentor her in helping her find
the answer to her clinical ques-
tion. The fourth article in this
series, tobepublished in theMay
issue of AJN, will focus on strat-
egies for searching the literature
to find the evidence to answer
the clinical question.
Now that you’ve learned to
formulate a successful clinical
question, try this exercise: after
reading the two clinical scenarios
in Practice Creating a PICOT
Question, select the type of
Practice Creating a PICOT Question
Scenario 1: You’re a recent graduate with two years’ experi-
ence in an acute care setting. You’ve taken a position as a
home health care nurse and you have several adult patients
with various medical conditions. However, you’ve recently
been assigned to care for hospice patients. You don’t have
experience in this area, and you haven’t experienced a loved
one at the end of life who’s received hospice care. You notice
that some of the family members or caregivers of patients in
hospice care are withdrawn. You’re wondering what the fam-
ily caregivers are going through, so that you might better un-
derstand the situation and provide quality care.
Scenario 2: You’re a new graduate who’s accepted a position
on a gerontology unit. A number of the patients have demen-
tia and are showing aggressive behavior. You recall a clinical
experience you had as a first-year nursing student in a long-
term care unit and remember seeing many of the patients in
a specialty unit for dementia walking around holding baby
dolls. You’re wondering if giving baby dolls to your patients
with dementia would be helpful.
What type of PICOT question would you create for each of
these scenarios? Select the appropriate templates and formu-
late your questions.
ajn@wolterskluwer.com AJN � March 2010 � Vol. 110, No. 3 61
#1
My name is Makamah; I go by Kamah. I am currently working as an LPN; I’ve been an LPN for three years; I currently work in a long-term care facility. Before that, I worked on the Family Medicine and Pediatric floors in a Clinic setting; I love everything I do; I’m very grateful for the opportunity and experiences I’ve had in all departments and locations as they all provide different learning abilities. After this program, I plan on working as an RN for a while, but later, my dream is to become a Family Nurse Practitioner. This year is my last semester as a BSN student at Herzing. I will be graduating in Fall; fingers crossed. I love traveling and enjoy spending time with families and friends. I also love listening to music and outdoor activities. I try to work out when I’m able to in my free time.
I look forward to all the acknowledge and experience shared and learned in this Class. With my future career goal in mind, I understand that writing and researching new articles and keeping up with new medical content will be required; therefore, I believe this Class will help me understand the need for and importance of doing research. I also see myself applying the knowledge learned from this course to interact with my peer’s professionality. This Class will help me gain the in-depth knowledge needed to improve patient-centered care.
One best practice related to a Family nurse practitioner is the focus of care on the patient and the family’s involvement. This best practice recommendation allows the FNP to use the nursing process, current evidence, and the national standard of care to provide a holistic approach to patient-centered care to foster professional practice (American Association of Nurse Practitioners, 2019). This process emphasizes the use of the nursing process, assessment, diagnosis, planning, and evaluation of the patient and family care. The best practice also recommends that FNPs, provide health and wellness education to patients and or the family through the utilization of community resources and facilitating patient and family participation in health decision and goal planning.
As a future FNP, I envision myself using this best practice to care for my patients and their families. Providing holistic care includes looking at and treating the patient as a whole. This means caring for all aspects of their health as much as possible while also encouraging their participation. FNP deals with various diseases that include patient treatment and family and patient education (Lynch,2019). The safe healthcare practice allows them to maintain their certifications. Certification allows the nurse or provider to demonstrate professional care and provide evidence-based practice care to the patient. The application of these best practices helps providers understand their role, allowing them to stay certified and demonstrate competency. Certified nurses and providers are responsible for all care provided to their patients (American Nurses Association,2015). They are also held accountable for their actions and the outcome of the care supplied as they practice under a particular scope of care.
· #2 My name is Jacey Hebert and I am currently employed at the University of Florida Proton Center in Jacksonville. Here I am a radiation oncology nursing case manager for adults. I see patients going through radiation treatment once a week and work with a doctor to address symptoms and concerns from the patient.
· I see myself applying knowledge from this course by always changing my practice because evidence based practice is always changing. I hope this course helps me reach my most current skills and how to stay up to date with my skills.
· The article I chose for evidence-based practice has given me more insight to something that had happened to me at work today. Today the doctor I work with had ordered a PEG tube placement on a patient I had felt was not quite in need of a PEG tube placement at this visit today. This article I had read was about PEG tube placement in head and neck cancer patients (my primary site at work) and discussed the results of placing a feeding tube at treatment initiation against patients who do not. The article conclusion states, ” Patients who have a percutaneous endoscopic gastrostomy (PEG) tube placed at treatment initiation experience less overall weight loss and fewer hospitalizations and toxicity-related treatment interruptions” (Cady 2007).
· This will influence my treatment as a necessary reminder that anticipating patient needs is more effective than reacting in many cases. As a PMHNP I will not do oncology, but I will keep this in mind.
· Best practices facilitate certification success by making sure that test takers understand that evidence based practice is the correct practice. It is important that we stay on top of the changes in practice in our work and keep adapting.
Cady, Jormain, ARNP,M.S., A.O.C.N. (2007). Nutritional support during radiotherapy for head and neck cancer: The role of prophylactic feeding tube placement. Clinical Journal of Oncology Nursing, 11(6), 875-80. Retrieved from https://prx-herzing.lirn.net/login?url=https://www.proquest.com/scholarly-journals/nutritional-support-during-radiotherapy-head-neck/docview/222744146/se-2?accountid=167104