BASED ON YHE PICOT YOU DEVELOPED FOR NUR-550, SUMMARIZE THE INTERVENTION YOU ARE PROPOSING NUR 590
Based on the PICOT you developed for NUR-550, summarize the intervention you are proposing. How does this support the population of focus, your setting, and role? Justify how the problem you selected to investigate is amenable to a research-based intervention using the PICOT format. Include your PICOT statement with your response.
Science teaches us to explore and question. In medicine, it the same. There is always something to explore in medicine, whether its to improve upon interventions or to learn complex diseases. Throughout my career as a nurse and nursing student, it was always expressed to me that in order for me to become a successful nurse I would need to engage in continuing education for the life of my career. In life, we should always strive for continuing education for personal development and growth. The future of nursing will require nurses to question, explore and take initiative making decisions on patient care, interventions, in leadership and public health. “Explain the importance of a spirit of inquiry in an evidence-based culture and what you can do as an advanced registered nurse to encourage this within your practice or organization. In response to your peers, compare the role and implementation of EBP in your specialty area with another advanced registered nurse specialty” (National League of Nursing, 2014, para. 1). The COVID-19 pandemic was a wake up call in that we as a nation need to focus on improving our nursing practice. Nurses will need to be encourage and pushed into leadership roles, executive positions and in the areas a research and development. Many nurses took the lead in saving their patients and hospitals as the pandemic ravaged hospitals throughout the country. There was also a spike in people researching how to get into the field of medicine (particularly in nursing and nursing research). There became a fascination into epidemiology, public health and medical research as people and nurses became curious about vaccine development and how outbreaks of disease and virus happen. As a advanced registered I would encourage evidence based culture by being an example of someone who uses EBP and work in collaboration with other staffers to implement EBP research into the real world. During the heigh of the pandemic, EBP research was used to help patients as other interventions and methods failed.
In the field of advanced nursing practice, there are various ways advanced nurses implement EBPs. Nurse practitioners implement and EBP “when she/he prescribes a treatment for a patient that is substantiated by scientific research; Often, nurse practitioners look for an experimental study that compares the efficacy of a treatment with an untreated control group” (Nurse Practitioner Schools, 2021).
For nursing midwives, EBP is are used to enhance the lives of the mother, child and community. Mothers are the backbone of communities and the health and safety of woman determines the health and safety of their respective communities. Areas of challenges are identified and EBP are used to improve the lives of women in order to safely carry, deliver and raise children.
National League of Nursing. (2014). Practical/Vocational Nursing Program Outcome: Spirit of Inquiry. https://www.nln.org/docs/default-source/default-document-library/spirit-of-inquiry-final.pdf?sfvrsn=0
Nurse Practitioner Schools. (2021). Guide to Evidence-Based Nursing Practice for NPs. Retrieved from https://www.nursepractitionerschools.com/resources/guide-to-evidence-based-nursing-practice/
A spirit of inquiry could be rephrased as curiosity and desire for increased knowledge by on current best practices as defined by research. Currently it can take many years for new information to be put into practice to achieve the quadruple aim of EBP: improvement of healthcare quality, improved patient outcomes, reduced costs, and empowered clinicians (Melnyk & Fineout-Overholt, 2019). Some ways to evaluate EPB includes quality improvement projects as well as outcome management (Melnyk & Fineout-Overholt, 2019).
Nursing informatics is the study and integration of nursing with information technology, like EHRs and statistics, to support all care team members in decision making. Advanced practice nurses can encourage EBP and inquiry by identifying and solving problems. Therefore, nursing informatics (NI) can use help improve processes and the floor nurses’ experiences with EHR. One way my organization is doing this currently is re-educating nurses on the EHR system, Meditech. Nurses have been showing each other “one thing I learned.” Therefore, while in class the nurse may heave learned one thing, by sharing that learning, nurses have reinforced their learning while picking up other time saving tips.
Melnyk, B.M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing and healthcare: A guide to best practice (4th ed.). Wolters Kluwer. ISBN-13:9781496384539
An evidence-based culture in a healthcare organization is an easy thing to aspire to, yet a challenging and rigorous process to truly pursue and achieve. It is essential that a “spirit of inquiry” be fostered in order to truly achieve the ultimate goal of evidence-based practice that comes from a culture that supports clinical care that is validated by substantial research and data.
According to Wyant (2018), it is critical that a culture of evidence-based practice begin with asking the right questions, and pursuing the correct information to support practice change in order to achieve better patient care results and outcomes. But even before the right questions can be asked, a spirit of inquiry must exist in order to stimulate the curiosity and wonder of what could be, and how things could be better. Known as “step 0” of the evidence-base practice process, a spirit of inquiry, or wonder, is often triggered when a registered nurse reads an article with an interesting approach to a patient care issue, an individual comes up with an idea as to better improve a care practice, or the question is simply asked, “what else is out there, and is there a proven way to do this best?”. All of these initial questions support a spirit of inquiry, which triggers the beginning of an amazing journey known as evidence-based practice, translational research, literature review and practice implementation and observation/improvement (Wyant, 2018).
As a registered nurse, and specifically as a nurse leader, it is one’s duty to promote, celebrate and praise those who ask the hard questions of why and how patient care could be improved. It is essential that these individuals with a deep wonder of the “what if’s” be supported and encouraged to speak up, in order to create a culture of evidence-base practice that begins with the genuine spirit of inquiry and curiosity (Wyant, 2018). As a current nurse leader, and one who coaches others in leadership practices and improvement projects, this is a great reminder to me to speak truth into these individuals that when an engaged caregivers asks how we could do better, it is not necessarily a critique on the current – but instead, a genuine curiosity, and wonder of what could be.
Wyant, T. (2018). A Spirit of Inquiry Leads to Evidence-Based Answers to Practice Questions.
A spirit of inquiry by nurses that goes through a systematic process for raising clinical questions is a core factor in EBP journey (Wyant, 2020). This occurs when a nurse thinks of a question in relation to an existing clinical practice and seeks ways to improve that particular practice. One way to encourage this within the organization as an advanced practice nurse is to lead by example. For example, while working in the unit we see multiple elderly patients having difficulty sleeping in the hospital, our thinking minds as clinicians will ask ourselves how we can improve their sleep patterns. This process is called the spirit of inquiry, where the “questioning” begins to exist. Motivating staff to share their experiences and thoughts should be encouraged. Their curiosity could potentially lead to improving patient’s health.
The role of EBP in my specialty area of practice with emphasis in healthcare quality and patient safety is significant in improving clinical practice and addressing patient safety concerns. Because EBP involves a problem-solving approach that integrates research evidence, it can improve health outcomes and quality of service (Songur et al., 2018). In comparison to other specialty practice, such as nurse anesthetists, EBP can help them determine which interventions can assist in guiding their practice. For example, if there are high rates of atelectasis, they can come up with EBPs that focus on the role of breathing exercises to be used pre and post procedures to determine if such interventions can help in decreasing incidence rates of atelectasis in patients.
Sonğur, C., Özer, Ö., Gün, Ç. (2018). Patient safety culture, evidence-based practice and performance in nursing. Syst Pract Action Res, 31, 359–374. ttps://doi.org/10.1007/s11213-017-9430-y