Phase 1: Asking Questions

Evidence based practice begins with asking questions. Have you ever wondered why a certain procedure or process is done a certain way? Have you ever wondered why a certain procedure or process is done instead of a different one? Have you ever wondered if something could be done more efficiently or safer? Have you ever wondered if something more could have been done for your patient before they were discharged? These are all good questions and great places to begin. Phase 1 will be a brainstorming session, you will explore and look at some questions you may have had in the past or some you may have now. Next you will explore your question to see if there is enough evidence to support your question. If you cannot find enough evidence to support your question, you may have just thought of a good research question, however, it might not be the best question for the evidence-based practice project. Remember, EBP is looking at existing evidence and research along with clinical expertise and patient preferences to support our practice, whereas research is a systematic scientific process that leads to new knowledge.

Instructions

Within your group discuss your interest as a nurse. Discuss questions you had or have as a student nurse, write down these questions and ideas. Consider the significance your question has to nursing and the potential impact your project could make.  Research your questions and thoughts. Determine if your question could be a good question for this project. Determine if the issue has been addressed either through research or through EBP projects. You may need to revise your question or develop new questions. Finalize your question and be prepared to explain the rationale behind your question and why it would be a good question for the project.

Resources:

Nursing Research (LoBiondo-Wood & Haber), Chapter 1, pg. 49-50, pg. 389

The Agency for Healthcare Research and Quality, AHRQ: www.ahrq.gov (Links to an external site.)

The National Guideline Clearinghouse, NGC: www.guideline.gov (Links to an external site.)

(Links to an external site.)The Joanna Briggs Institute: www.joannabriggs.org (Links to an external site.)

Sigma Theta Tau International, STTI: www.nursingsociety.org (Links to an external site.)

(Links to an external site.)Patty Hanks Shelton School of Nursing, PHSSN: library resources

Once you have found a good clinical question you will put that question in the PICO Question format. The PICO(T) model is the most commonly used model to frame EBP clinical questions. The PICO model helps to focus your question and research to enable you to find relevant research and evidence that can be applied to nursing practice. Please take some time to review the PICO(T) model and some examples.

P: Patient Population/Patient condition
I: Intervention
C: Comparison
O: Outcome
T: Time

Click on the link below for a resource for developing PICOT questions and examples:

PICO Guide (Links to an external site.)

please find me three questions and explain as instruction above. ” my class is nursing resarch and theory

 

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can you please write an observation paper on pre operation room. and please follow the rubric also i attach sample of my friend work please try to do as her 

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My clinical rotation for this week is preoperation room. I saw many patients the floor was so busy in the morning. One of the case that I saw 64 years female, she came for Esophagogastroduoddenoscopy. She has history of HTN, hypothyroidism. Consent in, she took her medication for hypothoidism today and she is NPO midnight, and she stop asprin 14/09/2019. Her vital signs is TEM 97.2, pulse 79, BP 162/89, respiratory 20. O2 98%. The nurse ask pt about her name date of birth. And she ask about allergy, procedure and who is the doctor, also, when NPO, what medication she took and when the last time. Then she ask the pt to change dress. Then inserte the IV with the fluid. Bed in lower position and call light with pt.  Also take three consent from pt one for procedure one of anthesea and one for blood. Also ask pt to remove the jowlary and glass and dentior. And check the lab result if any abnormality and inform thr surgon and anethesea. Then give hand off report to OR nurse . note in the perioperation no time out only for some surgery. 

My nursing diagnosis is 

Fear and anxiety related to procedure as evidence by pt verbalize she is restless and not sleep two night and her Bp 162/89. 

My goal is 

Patien will able to report decrease anxiety and fear and blood decrease to normal level by 1122on 09/18/2019. 

Intervention:

Explain the procedure to the pt, answer her questions, put her in comfortable position. 

Goal met patent relax and she said feel better and anxiety decrease and I check her BP 128/80) this what i see and you can add more intervention and please follow each suction in rubric 

 

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 Answer the following questions 

1.  What is an issue that you see in field site of place of practice

2. How is it impacting nursing and patient outcomes

3. what are your  thoughts on something you can do to make a change with a positive impact ( this could be new process, surveys, education, starting a nursing council, etc) You will need to show that it is a real issue ( for burnout if you consider you can send a survey to staff with questions pre and post your change to evaluate if staff is feeling different. 

 

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 Read the summery and power point presintation and write the comment for each one. 

In order to provide quality and precise care to children with thyroid dysfunction,  clinicians can’t just treat children as small adults. Children have different normal ranges and  organ development than adults therefor their treatment must accommodate those differences.  Despite these difference however, there is limited research and information documented about  these ranges, leaving hospitals and clinics to average their own range references. This in itself is  a challenge due to the lack of sufficient blood samples and volume restraints. To help alleviate  these challenges however, a study was performed to help establish ranges in children and  adolescents by collecting samples from 8 different collection sites and analyzing the data that  was gathered. This research helps establish testing ranges which aids in the diagnosis and  treatment of disorders such as Hashimoto’s thyroiditis and Grave’s disease (Rogers 2017).

Sources Rogers,  L. C. (2017). Pediatric thyroid testing plays an essential role in  disease management. MLO: Medical Laboratory Observer, 49(5), 18–19.  Retrieved from http://search.ebscohost.com.ezproxy.hsutx.edu.

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Summary of “Echocardiography basics for the nurse in cardiovascular care” An Echocardiogram is used to assess the structure and function of the heart. There are  two ways to perform an echocardiogram, transthoracic or transesophageal. Transthoracic is less  invasive but transesophageal can give a clearer image of the smaller structures of the heart. The  echocardiogram can measure continuous wave, pulse wave, color mapping, and tissue to get a  better picture of the heart function. A patient could expect to see a summary, report, and numbers  portion of their echocardiogram results. Echocardiogram is indicated in multiple heart  abnormalities such a heart murmur, suspected cardia masses, and prosthetic valve assessment to  name a few. Echocardiogram is a versatile and widely used imaging technique for the heart. 

 

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 I need only to answer these questions based on the articles.

1- What is main lesson regarding CBC interpretation based on the article interpretation a Blood Count? Why do a CBC? Your response must include something from the article (interpretation a Blood Count).

2- What is the main lesson regarding blood glucose monitoring based on the article Blood Glucose Monitoring in Diabetes??? Your response must include from the article.

3- How is the question “when to rely on what the monitor tells you vs the patient “resolved in the article The Balance between Assessment and Monitoring”?? What conclusion is reached?

4- What is the main lesson regarding lab testing Based on the article Detecting  Hypo-Magnesemia? What did you take away from it? 

5- What do you learn from the patient teaching section of the article BUN/Creatinine that you can apply to your general nursing practice? In short if you made a template for patient teaching labs based on section what would it include and Why?

 

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