Discussion: Summary Of Evidence-Based Practice Project

Discussion: Summary of Evidence-Based Practice Project

Discussion part I:

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.

Discussion part II:

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.

Discussion Part 1

Summary of Evidence-based Project

My intervention embraces the use of chlorohexidine in bathing the central line to reduce the rate of central line-associated bloodstream infection (CLABSI). Chlorohexidine has bactericidal properties has been used in various healthcare centers to prevent CLABSI. Patients in the ICU are prone to infections including CLABSI, ventilation-associated pneumonia, and Catheter-associated urinary tract infections. Notably, the most common cause of infection in ICU is a Methylene-resistant staphylococcus aureus (T. Bell & O’Grady, (2017 Discussion: Summary of Evidence-Based Practice Project). The rise of infection is contributed by reduced immunity, invasive life-saving procedures, and comorbidities. CLABSI can negatively impact ICU patients by increasing hospital stay, morbidity, increased cost of care, and mortality.

Treatment of CLABSI is quite expensive in terms of resources and time, yet preventive measures will lead to better patient outcomes and reduce the rate of complications. As a nurse working in the ICU, I have experienced many patients suffering from CLABSI that have complicated their outcomes due to inadequate preventive measures. I propose the use of chlorohexidine to bathe central lines in ICU patients to prevent CLABSI, as evidenced by several pieces of research, including that by T. Bell & O’Grady, (2017 Discussion: Summary of Evidence-Based Practice Project). Furthermore, most healthcare facilities that have leveraged the use of chlorhexidine have reported improved outcomes with reduced infection rates.

In addition, daily correct aseptic procedure with little contamination is efficient in reducing CLABSI. As a nurse, I have no obligation to refute the application of evidence-based practice to improve the quality of care to my patients. In line with the requirement of coming up with evidenced-based research, I came up with a PICOT question as follows: In patients admitted in ICU with a central line catheter (P), how does the use of chlorhexidine (I) compared with flushing central line using normal saline (C) lead to the reduced central line-associated bloodstream infection (O) over six months (T)?

References

Bell, T., & O’Grady, N. P. (2017). Prevention of central line-associated bloodstream infections. Infectious Disease Clinics of North America, 31(3), 551–559. https://doi.org/10.1016/j.idc.2017.05.007

Lin, W.-P., Chang, Y.-C., Wu, U.-I., Hung, M.-C., Chuang, P.-Y., Wang, J.-T., Sheng, W.-H., Chen, Y.-C., & Chang, S.-C. (2017). Multimodal interventions for bundle implementation to decrease central line-associated bloodstream infections in adult intensive care units in a teaching hospital in Taiwan, 2009-2013. Wei Mian Yu Gan Ran za Zhi [Journal of Microbiology, Immunology, and Infection], 51(5), 644–651. https://doi.org/10.1016/j.jmii.2017.08.008

Discussion Part 2

The Spirit of inquiry is a sense of curiosity within an individual necessary for practice and learning. A nurse who has a spirit of inquiry will repeatedly ask why certain practices are performed in a certain way (S. G. Bell, 2021). Through inquiry, one can challenge and question some practices while developing creative ways to solve problems. Furthermore, the spirit of inquiry enables possibilities for discoveries. The spirit of inquiry within an organization can be encouraged through encouraging continuous questioning of existing practices to improve quality of care, use of evidence-based practices (EBP) to enhance decision-making, enhancing communication skills used in inquiring clarity, and encouraging innovative thinking through participation in EBP (S. G. Bell, 2021 Discussion: Summary of Evidence-Based Practice Project).

EBP entails using proven clinical practices to offer competent care aided by proper decision-making. Nurses acquire EBP knowledge through reading researched papers and involving in research practices. Through EBP, patient care is individualized, leading to improved quality of care, reduced cost care, improved patient experience, and enhanced clinical expertise (Li et al., 2019). Furthermore, nurses use EBP knowledge to order specific tests and offer treatments to improve patient care and outcomes. Nonetheless, implementation of EBP requires various steps, including cultivating the spirit of inquiry, development of a PICOT question, searching of best evidence from literature, conducting a critical appraisal of the evidence, application of findings to make decisions in the clinical setting, and evaluating the effectiveness of the EBP respectively (Li et al., 2019 Discussion: Summary of Evidence-Based Practice Project). Up on approval of an EBP based on its effectiveness, the practice is published in medical journals and scholarly sites to be used as reference points in the future. However, the implementation strategies of EBP may vary depending on the policies and nursing specialties. For example, in my specialty, an EBP is implemented based on available literature that supports its effectiveness for patient care.