Category: Evidence based practice

Introduction

Evidence based practice is application of behavioral and mental health intervention to solve particular problem for which systemic empirical research has shown prove of possible effectiveness as a therapy (Dale,2005). Recently, use of evidence based practice has been supported by various professional associations. For instance American nurses association. It advocates the use evidence based practice amongst its member in formulating their interventions (Mitchell, 1999).

Nosocomial infections are acquired from health care units during treatment. For infection to be considered nosocomial, it has to appear after 48 hours or more hours after admission or within 30 days after discharge. These infections become rampant when the health care personnel become contented and fail to observe health hygiene practices (Black, 1996).

A theoretical framework which is a collection of interrelated concepts like a theory but not necessarily so well worked-out guided me in determining what things I will measure, and what statistical relationships I will look for. I came up with theoretical framework related to developing infection control and management program for licensed nurses in long term care facility.

This infection control program included Objectives, Content outline resources, Power point presentation, Handouts, Case Scenarios. Often I went through collected information and gave out my views to curb the infections. Over the entire program is a system to monitor and investigate causes of infection and manner of spreading.

Describe the development of the project

To begin my project, I completed Literature review on Evidence based practice (EBP) so as to become familiar with resources that are available to synthesize the information. I met with mentor and other Key staff members to discuss findings of literature review. I did theoretical review framework related to infection control to measure, and determine what statistical relationships I was to look for. I initiated house wide audit for last three months on nosocomial infections and the origin of the infection for all residents at Burien long term care facility.

I continued with data collection process and administered needs assessment as to licensed nurses at facility nurses meeting. I reviewed federal and Washington State Regulations on nosocomial infections.

I then met with infection control program coordinator to determine key issues to address in infection management program. I developed infection management program which included objectives, content outline resources, power point presentation, handouts, case Scenarios. Over the entire program was a system to monitor and investigate causes of infection and manner of spreading. I reviewed surveillance data routinely and made recommendations for the prevention and control of additional cases. The written infection control program is to be reviewed periodically by the facility.

I reviewed infection management program and the power point presentation with mentor and infection control coordinator.

I identified a conceptual basis for educational program and scheduled meeting with licensed nurses educational specialist to review the infection management program in-services and presentation. I the developed a pretest/posttest to measure the knowledge of Licensed nurses.

I set up date and time to implement infection management program for licensed nurses.I delivered an in-service infection management program using a power point presentation with content, objectives, outline, resources, handouts, and case scenarios.

The mentor completed written feedback report and developed evaluation tool on success of the infection management program.

The mentor completed written feedback report and developed evaluation tool on success of the infection management program.

I administered evaluation tool to licensed nurses and analyzed the percentage of infection one month after implementation of infection management. I met with mentor and infection control coordinator to review all evaluation results

Analysis of learning experiences

I identified that there is a needs for developing infection control and management program for health care facilities since the current infection control system may not be effective.

There is need for health care unit to develop proper communication tool to staff or families /visitors in efforts to control nosocomial infections.

Evidence based practice application is appropriate in carrying out systemic empirical research in order to achieve accurate intervention. This fact was evidenced by staff realizing that some of the resident current infection was avoidable after report was presented to them. In addition, the health care personnel agreed that this new program was friendly and easy to follow. Also Staff verbalized it was an excellent system and so far no confusion had been noted.

Nosocomial infections preferences are high in most health care units due to failure by staff to follow health hygiene practice. This is backed up by the fact that after the new infection management program was implemented on November 01, 2010; the Facility infection rate dropped down by 42 percent. Infection rate for January 2011 was 2.9%. This results indicate tremendous percentage reduction in nosocomial infection hence the infection management program was effective.

One of the barriers to Evidence based practice that nurses often cite is the time it takes to search and find research evidence. Often nurses are either not familiar with how to search the literature or they are overwhelmed by the amount and variety of evidence that is available.

Describe the implementation of the Practicum Learning Agreement

Literature search on needs for developing infection control and management program for licensed nurses in long term care facility: A literature review of 15 peer reviewed journal article on EBP was completed. By completing the literature review, I was able to have an important part of EBP is to become familiar with resources that are available to synthesize the information met with mentor and other Key staff members to discuss findings of literature review. I learnt that the facility usually doesnt use that much EBP. The usual practice for the facility was random controlled trail. After much discussion, we concluded that the literature review summary was appropriate for utilization with the patient population in the facility clinical setting.

Review theoretical framework; I was able to understand a theoretical framework is a collection of interrelated concepts, like a theory but not necessarily so well worked-out. A theoretical framework guided me in determining what things I was to measure, and what statistical relationships I was to look for. I submitted this summary of the theoretical framework related to developing infection control and management program for licensed nurses in long term care facility.

Initiation of house wide audit for last three months on nosocomial infections and the origin of the infection for all residents at Burien long term care facility; currently the facility has 102 residents in long term setting. I started every single active chart to audit for the last three months nosocomial infections and the origin of the infection and then compared the collected data to standard written definitions or criteria of infections. At the end of chart review I was able to determine that the facility did not have specific system on regular basis to identify new cases during defined time periods.

Review of the audit finding and conclusion with the facility infection control coordinator/ mentor; I discussed with Mentor and infection control coordinator findings of charts audit and the last three months nosocomial infections in the facility. I had broken down my report by units and types of infection. After much discussion, we all agreed that the facility did not have specific system to enhance infection preventions and minimize the potential for transmission of infections.

Administration of needs assessment as developed to licensed nurses at facility nurses meeting; I planed very carefully and cautiously, before I implemented a solution, to improve current performance. I made four items questionnaires with six matching quizzes. This was delivered to licensed nurses at different shifts at the facility.

Review of federal and Washington state Regulations nosocomial infections: I reviewed and summarized current federal and Washington state regulations F441. The facility must establish and maintain an infection control program designed to provide a safe, sanitary and comfortable environment.

I met with infection control program coordinator at Burien long term care facility to determine key issues to address in infection management program. I discussed with infection control program coordinator key issues such as recognizing infection control practices while providing care, hand hygiene, handling and processing of linens, use of standard precautions, and appropriate use of transmission based precautions and isolating or separating residents.

Development of infection management program; I developed infection control program which include Objectives, Content outline resources, Power point presentation, Handouts, Case Scenarios. Over the entire program is a system to monitor and investigate causes of infection and manner of spread. Surveillance data was routinely reviewed and recommendations made for the prevention and control of additional cases. The written infection control program is to be reviewed periodically by the facility.

power point presentation for licensed nurses at the facility for preventing the spread of infection; I developed power point presentation for licensed nurses to illuminate the importance of implementing effective and consistent infection control measures in the facility which included processes that could contribute to better outcomes for the residents in the facility to maintain health and well-being of residents and staff. The lesson covered the guideline developed by the U.S. centers for disease control (CDC).

Review of Infection management program and the power point presentation with mentor and infection control coordinator. I discussed with infection management program and the power point presentation with mentor and infection control coordinator. After much discussion and some additional lesson plan, we all agreed the material is ready to be presented for licensed nursing staff.

Identification of a conceptual basis for educational program; my goal of building the system and teaching staff was to prepare nurses and empower them. I realized that empowerment is a concept that adds present and future quality of life. An empowered mind enables a nurse to utilize knowledge at higher levels and apply it to real-life situations. An empowered mind permits a nurse to successfully maneuver the path to self-actualization.

Development of Pretest/Posttest to measure the knowledge of Licensed nurses; I prepared Pretest/Posttest to administer during in-services for licensed nurses at Burien long term care facility to measure the knowledge of Licensed nurses of the current status and after the in-service /presentation of infection control and management program. I understand that it is important to be able to determine the extent to which each and every nurse met the objectives. Clearly, I wanted to know if nurses learned what I taught them. In order to assess learning, I had baseline or pre-assessment of what nurses know prior to in-service as well as an indication of what they know after in-service.

Set up date and time and implemented infection management program for licensed nurses. Set up in-service date by the staff development coordinator for Nov 10^th 2010 in different shifts, and also set up the new infection management program implementation for November 15^th, 2011. Staff development coordinator to post sign at employee lounge and common areas the in-service poster.

Delivery of an in-service infection management program using a power point presentation with content objectives, outline, resources, handouts, and case scenarios; I started at 6am for night shift nurses, then 10 AM for day shift nurses, and 3 pm for evening shift nurses. I was prepared well for the presentation. I was ready with ideas for in-services/ meetings that would make it fun and interesting. I know from my own experience that to sit in a room listening to someone talk and talk and talk or put on a video gets very boring after the first 10 minutes. We had fun with it, I was able to get interaction with the class and the learning objectives were met. I did start with a mystery and conclude with a fact. In each session at the middle, I had a proper hand washing techniques exercise.

Completion of written feedback report by the mentor; I requested the mentor to complete written feedback report on the implementation of the infection management program. I received both verbal and written report. My mentor was extremely happy about the overall program and presentation. I also received good compliment from the nurses.

Evaluation tool on success of the infection management program; I developed a one page survey tool to collects feedback from nurses on how they feel about the program. This one-page survey inquired about nurses satisfaction with the program and the impact of the program on minimizing infections. It also implied to me if the program is happening the way they are supposed to, how to improve the program as we go along and if the program helped the nurses. The results of this survey were shared with mentor and infection control coordinator.

Administration of evaluation tool to licensed nurses; I administered the survey tool to licensed nurses. I made myself thoroughly familiar with the survey scale before attempting to interview the nurses. The survey was administered in a private and quiet environment. And also the nurses were prepared for the survey.

Analysis of percentage infection; It has been about a month since the new infection control program established. I did talk to many staff members regarding the program in addition I calculated the nosocomial infection rate. It came up 6.4 % for one month since the program established. There was a 20% improvement from the last month.

Review of all evaluation results with mentor and infection control coordinator. I was able to evaluate the program with mentor and infection control coordinator to review all evaluation results. The infection rate for the month of the month of January so far was 4.64%, which is 42% down from the usual monthly rate. Everyone was happy to see an improvement in minimizing nosocomial infections. Thus it made me to believe that the new infection control program is effective.

Evaluation of the value practicum had on my learning carrier path

I realized the importance of evidence based practice in solving problem; calculated the nosocomial infection rate. It came up 6.4 % for one month since the program established. There was a 20% improvement from the last month. The infection rate for the month of the month of January so far was 4.64%, which is 42% down from the usual monthly rate.

Realized the importance of team working in coming with proper intervention; this research program was made successful by the adequate support portrayed by the staff, the coordinator, mentor and the patients.

Application of infection management program is effective in controlling nosocomial infections. This was evident after the program yielded results and proved effective in nasocomial infection control.

Made me appreciate simple measure are required to control nososomial infection in health units. In addition, it created a plat form for knowledge discovery, trough developing the infection control program which was efficient in controlling nasocomial infection.

Highlight professional relationships developed during the project and the value of those relationships

In the course of the project, I was keen on our professional relationships with colleagues as we collaboratively focused on a Commitment to Excellence and our partnership. This relationship was guided by values, structures, and processes that support registered nurse control of the delivery of nursing care and the environment in which care is delivered.

Professional relationships focus on giving the quality services and related care in health facilities.

Professional relationship focused on appreciating personnel contribution toward attaining anticipated objectives.

Open communication is key for considering every individual during the program development.

Conclusion

Evidence based practice application is appropriate in carrying out systemic empirical research in order to achieve accurate intervention.

Nosocomial infections preferences are high in most health care units due to failure by staff to follow health hygiene practice.

One of the barriers to Evidence based practice that nurses often cite is the time it takes to search and find research evidence.

References

Black, J.G. (1996). Microbiology principles and applications. NJ: Prentice Hall.

Dale, A. (2005). Evidence-based practice: compatibility with nursing. Nursing Standard Journal, 12 (40) 48-53.

Mitchell, G. (1999). Evidence-based practice: critique and alternative view. Nursing Science Quarterly journal, 12 (1) 30-35.

Introduction

Nurses are always expected to use evidence-based practices in their work as patients see them as the basis for quality healthcare delivery and reliability. Evidence-based practices might be excellent strategies for the treatment of complex diseases. However, many nurses face a problem of lack of knowledge and inability to follow all new scientific achievements. The desire of nurses to improve their knowledge is great, and new strategies for applying evidence-based practices are used by healthcare workers.

Barriers

One of the individual problems of failure in using evidence-based practices is the lack of time, knowledge, and skills. Moreover, nurses might be affected by their workplace and workflow concerns and low self-esteem while using evidence-based practice. However, some external factors, such as changes in organizational structure, politics, and new regulations in the healthcare industry, might slow down the implementation of evidence-based practice (Renolen et al, 2018). Even though nurses have positive reflections on the practice, scientific facts are still in high demand.

Strategies to remove barriers

Nurses are on the way to development and they are ready to include evidence-based practice in their routines. To overcome the barriers, task juggling should be implemented. At the beginning of the working day, nurses should plan their day and not decide what to do on track (Renolen et al, 2018). Furthermore, the division of tasks should not be underestimated as, during the working day, new tasks received from the leader or physician might confuse, and productivity will go down. Also, more freedom could be given to nurses in the use of evidence-based practice without discussions with physicians, only relying on their experiences.

Conclusion

Access to evidence-based practices is becoming more open to nurses of different backgrounds and with different experiences. Barriers to the use of practices are more surmountable, and with this trend, nurses will no longer worry about their workflow.

Reference

Renolen, A., Hoye, S., Hjalmhult, E., Danbolt, L. J., Kirkevold M. (2018). Keeping on track  Hospital nurses struggles with maintaining workflow while seeking to integrate evidence-based practice into their daily work: A grounded theory study. International Journal of Nursing Studies, 77, 179-188.

Treating PTSD: A Review of Evidence-Based Psychotherapy Interventions

Watkins, L. E., Sprang, K. R., & Rothbaum, B. O. (2018). Treating PTSD: a review of evidence-based psychotherapy interventions. Frontiers in Behavioral Neuroscience, 12, 258. Web.

Summary: The article reviews recent guidelines for PTSD treatment and discussed each methodology through evidence-based analysis. After conducting experimental research, the study suggests PE, CPT and trauma-focused CBT should remain the primary treatment for PTSD. Despite considering side effects and dropout rates, the recommended treatment methodic have proved their efficiency. However, the study recommends further examination of those treatments that were «recommended» other than «strongly recommended».

Critical analysis of the current treatment guidelines for complex PTSD in adults

De Jongh, A., Resick, P.A., Zoellner, L.A., Van Minnen, A., Lee, C.W., Monson, C.M., Foa, E.B., Wheeler, K., Broeke, E.t., Feeny, N., Rauch, S.A., Chard, K.M., Mueser, K.T., Sloan, D.M., Van der Gaag, M., Rothbaum, B.O., Neuner, F., de Roos, C., Hehenkamp, L.M., & and Bicanic, I.A. (2016). Critical analysis of the current treatment guidelines for complex PTSD in adults. Depression and Anxiety, 33(5), 359-369. Web.

Summary: The article focuses on the importance and necessity of phase-based approach in PTSD treatment. Findings reveal that there is no evidence supporting the impact of phase-based approach in positive treatment and there is significantly more profit from trauma-focused treatment preceded with stabilisation phase. Based on the reseach, the conslusion was made that current treatment guidelines might be too conservative and require evidence-based revision.

Post-traumatic stress disorder: overview of evidence-based assessment and treatment

Lancaster, C., Teeters, J., Gros, D., & Back, S. (2016). Post-traumatic stress disorder: overview of evidence-based assessment and treatment. Journal of Clinical Medicine, 5(11), 105. Web.

Summary: The article reviews common characteristics and risk factors of PTSD and describe the measures used for monitoring and treating of this disorder. The study concludes that pharmacological treatments have shown to be relatively effective, but there appear to be concerns about relapse. Psychosocial interventions decrease the risk of relapse, but have significant rates of dropout or non-responsive behaviour from patients. Evidently, there is a need to investigate new strategies for PTSD treatment.

Introduction

Compared to other professions, nursing practitioners spend a significant portion of their time caring for patients through administration of treatment, catering for patients needs and making major decisions concerning the care process. Most nursing practitioners are also involved in the formulation and design of policies to enhance the wellbeing of patients, carrying out research and enlightening patients and their communities. To stay relevant, nursing practice must evolve into a profession that is more focused on continuous research and knowledge, hence the significance of evidence based practice (Youngblut and Brooten 467).

Evidence based nursing refers to the practical use of best research in the clinical care of patients. Best evidence entails best nursing research, knowledge, management, policy, and practice. Evidence based nursing advocates for utilization of the best, up-to-date available evidence to address patient needs. Traditionally, nursing practice was based on the opinions and experiences of the practitioners, and less often incorporated input from non-practitioners. The emergence of evidence based nursing practices shifted treatment approaches to become evidence oriented, resulting into establishment of treatment standards that are more rational and consistent (Youngblut and Brooten 470).

Evidence based practice focuses more on the needs of the patient, thus it encompasses processes of lifelong learning through regular assessment of issues that have direct practical implications to the patients, then critically and efficiently evaluating the existing best evidence for the particular issue in order to implement it. The process of evidence based practice, therefore, involves the identification of a practice issue, formulation of the possible hypotheses to the question, followed by search for best evidence from credible resources.

The evidence obtained is then critically evaluated and the clinical relevance assessed in order to generate recommendations. The approved evidence is then utilized in clinical practice and evaluated to determine its effectiveness and outcomes. Evidence based practice is, thus, a life-long, self-directed, issue-based learning that involves assessment of the relationship between clinical reasoning and research evidence.

Importance of Evidence Based Nursing

Evidence based nursing is particularly important because it offers practical clinical standards of practice that have been shown to contribute to positive patient outcomes. Evidence based practice is established on practical guidelines, known as best practice, that have been well acknowledged by practitioners and health care organizations for they have been proved to be integral in the achievement of the health sectors stringent practice standards.

In nursing, evidence based practice is well accepted for its role in enhancing individualization of nursing care to the needs of the patients, for its effectiveness, and the opportunity it offers to nurses to utilize the value of clinical judgment. Evidence based nursing ensures that patients receive care that is relevant to their problem, promotes sound decision making process that is more explicit, reduces risks to the patient, thus, ensuring maximization of benefits, and provides the practitioners with the knowledge that empowers them to evaluate healthcare research and practice. This makes nurses to keep pace with advances in nursing practice (Youngblut and Brooten 472).

Evidence Based Practice in Addressing Gaps in Nursing Knowledge

The nursing practice is a profession of continuous learning and development. Evidence based practice empowers nurses to be adept in obtaining relevant nursing knowledge rapidly, thus facilitating making of critical decisions based on an informed process. Evidence based nursing has been shown to equip the practitioner with the ability to evaluate data before applying the data in the care of patients, thus positively influencing health outcomes.

Evidence based practice also encourages nurses to stay informed on current and innovative care standards in order to remain relevant in the profession. Evidence based practice represents a rational development in the persistent effort to narrow the gap between research and practice, and facilitates the use of research knowledge in real life clinical care settings (Youngblut and Brooten 474).

Patients depend on nurses to perform the best in order to sustain their health. This subsequently compels the nurses to be actively involved in a continuous learning mechanism to evaluate the best approach for care delivery. Evidence based nursing practice, therefore, empowers nurses to fully actualize their professional role and avoid confining themselves to technical knowledge (Mulhall 4).

A number of studies have shown that evidence based practice positively influences nursing practice and is significant to safe nursing practice (Youngblut and Brooten 473; Kania-Lachance et al. 48). It has positively influenced the attitudes of nurses towards the profession, while its effective use is associated with quality care, improved patient outcomes, professional development, satisfaction, and success in professional practice. The provision of high quality care is directly linked to progressive professional advancement and acquisition of relevant nursing knowledge and skills in relation to developments in nursing practice.

Evidence Based Practice in Enhancement of Quality of Patient Care

There is a persistent call for the delivery of nursing care that combines best evidence, critical thinking and new technology in order to improve the quality of care. Studies have demonstrated that nursing practitioners offer health care based on the knowledge they learned in nursing schools, and less often do they base their practice on knowledge from journal articles and reports that are considered up to date.

Considering that the average nurse may be above 40 years in age, this shows that most nursing practitioners may be applying knowledge that is outdated, meaning that quality patient care and desirable health outcomes cannot be achieved (Kania-Lachance et al. 53). The use of evidence based practice enables nurses to deliver high quality patient care established on research and knowledge instead of the old ways, which are based on traditions, myths and outdated literature. Evidence based practice, thus, becomes a significant mechanism through which care that is current and that is based on the latest research evidence is applied (Mulhall 5).

Evidence Based Practice and Improvement of Patient Outcomes

The major role of nurse practitioners is to help their patients achieve improved health outcomes. In contrast to the early practice that was geared towards reduction of morbidity and mortality, current nursing practice extends to other issues such as health care costs, clinical symptoms, functional ability, and quality of life of the patient. The current care, based on evidence based practice critically evaluates nursing practices and outcomes to generate knowledge that is essential in enhancing the quality of care (Kania-Lachance et al. 48).

Studies have shown that patients who are provided with evidence based nursing care experience better health outcomes and increased levels of satisfaction as compared to those who receive care based on traditional practice. Evidence based nursing practice ensures that patients and their families are provided with the best and up-to-date care possible since nurses are empowered to tackle healthcare issues using an evaluative and qualitative approach from the patients perspective.

Evidence based nursing practice depends on researched information, patient reports and nursing practitioner experiences in the collection of information that is employed in the provision of care. This helps in the identification of the kind of treatments that are effective on an individual patient and those that are not; hence it ensures that patients receive care that is individualized and most appropriate. Most studies have indicated that the use of best available research knowledge is associated with a lot of benefits than when nurses employ care practices whose mode of action and outcomes has not been established or are poorly understood (Emanuel et al. 22).

A majority of patients entrust nurses with their lives, with the belief that the nursing practitioners will make decisions that would positively impact their health. Evidence based nursing, therefore, provides a mechanism through which nurses regularly base their decisions on the care they deliver to their patients. These decisions have the potential to influence the health outcomes of the patients positively or negatively. It has been shown that patients would experience improved outcomes if the care provided to them is engrained on researched and proven practices (Kitson 460).

Evidence Based Practice and Efficiency of Nursing Practice

Evidence based nursing has also been shown to enhance the efficiency of nursing practice. Nursing care decisions made based on information supported by research makes it convenient for the practitioners to choose the most appropriate care for the patient, instead of adopting untested practices which often carry higher health risks (Emanuel et al. 22).

Evidence based practices, therefore, help in saving time, which is subsequently utilized in caring for other patients in critical conditions. Evidence based practice also ensures that the practitioners apply the available evidence in order to achieve desirable outcome in a cost effective way and minimal time (Kitson 461).

How Evidence Based Practices Enhance Decision Making Processes

Evidence based practice has been shown to be important in supporting and informing decision making at various levels such as clinical, administrative and educational. Through the integration of research, experience, clinical expertise, expert input and client choices, evidence based nursing ensures that clinical decisions reflect the best existing knowledge.

As evidence based practice usually considers risks, costs and benefits of a health care intervention against the preferences of the clients, the nursing practitioners get encouraged to evaluate their practice and decide on the interventions that deliver desirable outcomes. The use of evidence based practice in nursing, in turn, enhances the practitioners confidence since all the decisions are made based on proven standards (Kitson 459).

Most people place great value on accountability in the health care sector since it forms the basis for consistent quality care. This challenges the health care providers to regularly evaluate their practice in order to merge research and practice. Evidence based practice, therefore, offers a systematic framework in decision making that reflects best practices and accountability. It provides the nursing practitioners with the opportunity to evaluate the available evidence, thus eliminating the possibility of adopting poor practices that are inefficient and harmful to their clients (Youngblut and Brooten 473).

Conclusion

New clinical evidences arise regularly through completion of research, technological innovations, and from clients who present with unique issues and individual experiences. Basing nursing practice on the knowledge obtained in nursing schools compromises the quality of care due to the redundancy nature of this knowledge.

Evidence based practice is essential in enhancing the safety of the patients since the care they receive reflects the best evidence available. Evidence based practice, therefore, remains an integral component of current nursing practice, hence the need for nursing practitioners to employ it in the enhancement of patient safety and improvement of health care outcomes.

Evidence based practice has emerged as the most efficient, effective and economical method of delivering health care.Additionally, evidence based nursing helps in identifying the gaps in knowledge and conflicts in evidence, thus yielding the potential to narrow the research-practice gap and offering a mechanism for addressing problematic clinical practice issues.

As evidence based practice in nursing is well recognized by many health care stakeholders such as accrediting bodies, professional organizations and third party payers, it is integral in the enhancement of quality and reduction of health care variations. Evidence based practices presents a paradigm that is central to the realization of best possible outcomes at possibly lower costs.

To practice evidence-based nursing, nurses are required to have the extra education that enhances their ability to assist others, in addition to making them more knowledgeable and value their profession. This requires the nursing practitioners to be engaged in continuous learning process so that they can have knowledge relevant to the issues that need to be addressed, and have the competency to appraise the robustness of the evidence.

Works Cited

Emanuel, Vernel, Day Karen, Diegnan Lorraine and Pryce-Miller Maxine. Developing Evidence-Based Practice among Students. Nursing Times, 107.49/50 (2011): 21-23. Print.

Kania-Lachance, Donna M., Best Patricia J. M., McDonah Margaret.R., and Ghosh Amit K. Evidence-Based Practice and the Nurse Practitioner.The Nurse Practitioner, 31.10 (2006): 46-54. Print.

Kitson, Alison. Towards Evidence-Based Quality Improvement: Perspectives from Nursing Practice. International Journal for Quality in Health Care, 12.6 (2000): 459-464. Print.

Mulhall, Anne. Nursing, Research, and the Evidence. Evidence Based Nursing, 1(1998): 4-6. Print.

Youngblut, JoAnne M. and Brooten Dorothy. Evidence-Based Nursing Practice: Why is it Important? AACN Clin Issues, 12.4 (2001): 468-76. Print.

Research Support

In the PICOT question for this project, the constituent parts are as follows:

• P  patients aged 50 years and older;
• I  the adherence to antihypertension drugs;
• C  inconsistency or nonadherence to antihypertension drugs;
• O  decrease in hypertension;
• T  when done over six months.

The specified population is important for this project because older adults are more subject to hypertension and its complications. The adherence to antihypertension drugs has been proved to increase patient outcomes; therefore, it has been chosen as an intervention. A significant part of hypertensive patients do not or poorly adhere to their medications (Abegaz et al., 2017). Therefore, it has been chosen as a comparison since it is important to identify the magnitude of the effect of adherence compared to nonadherence. Hypertensive patients suffer from high blood pressure, so the desired health outcome for them is a decrease in hypertension. Finally, the project should be long enough to identify the difference in health outcomes resulting from the chosen intervention; therefore, a period of six months has been chosen.

The need for research guided by the identified PICOT question is supported by the existing literature. For example, Peacock and Krousel-Wood (2017) admit that the link between high adherence to antihypertensive drugs and decreased blood pressure is strong Yet, they call for further research in this field to find out the relation between adherence to medications and a broad spectrum of patient health outcomes (Peacock & Krousel-Wood, 2017). Various studies show that hypertension is a common disease, especially among older adults, and high adherence is a feasible solution for patients suffering from this illness.

Search Method

To identify studies related to the formulated PICOT question, the search through two databases, Google Scholar and PubMed, was performed. The criterion for exclusion was the date of publication earlier than 2016; therefore, the search was limited to the articles published between 2016 and 2020. The keywords used included antihypertensive drugs, adherence, and older adults. The operator AND was used to find results related to all three keywords. In PubMed, the search filters were also applied, namely, meta-analysis, randomized control trial, and systematic reviews. PubMed found 14 articles matching the specified publication date, filters, and keywords, two of which appeared to be relevant to the topic. In Google Scholar, the search showed 19,400 results, which were sorted by relevance; therefore, only the first several pages were explored, and five more relevant articles were found.

Out of the total of seven articles that appeared in the initial reference list, three were excluded. The criterion for exclusion was an irrelevance to the PICOT question since these articles did not investigate the association between adherence to hypertension and patient health outcomes. Instead, they were focused on reasons why patients did not adhere to medications and possible interventions to improve adherence. The final selection of articles included three studies: one systematic review, one cohort study, and one case-control study.

Summary of Studies Used

The first study was a systematic review of studies exploring hypertensive patients nonadherence to their medications. It was conducted by Abegaz et al. (2017), and the findings indicated that 45.2% of hypertensive patients and 83.7% of patients with uncontrolled blood pressure did not adhere to their antihypertensive drugs. They also found evidence that nonadherence to medications leads to high risks of cardiovascular events and stroke. The strength of their study is that they used 28 high-quality articles from 15 countries, which included a total sample of 13,688 subjects (Abegaz et al., 2017). The study is of value to healthcare professionals since it identified characteristics of patients who were more likely to show poor adherence to medications. Yet, it has limitations, which is the high level of heterogeneity of studies. See Appendix for the review of literature evaluation table, which includes data about this and further articles.

The second study aimed at proving the hypothesis that high adherence to medications in adults aged 85 years and older led to a reduced risk of cardiovascular events. It was performed by Corrao et al. (2017), who used a cohort of older patients with hypertension who were not previously treated with antihypertensive drugs. Their results confirmed their hypothesis since older patients who adhered to their medications showed a decreased risk of cardiovascular events than their low-adherent counterparts. The strength of the study was the exploration of a large unselected sample, and the limitation was the use of information about drug prescriptions to determine levels of adherence.

Kim et al. (2018) aimed at exploring the long-term effects of adherence to medications in patients who survived an acute hemorrhagic stroke. Their retrospective cohort study showed that patients who adhered to antihypertensive drugs after the acute hemorrhagic stroke had a reduced risk of such adverse events as recurrent stroke or myocardial infarction compared to non-adherent patients. The strength of the study is that it explores the effects of adherence in a specific group of patients. Yet, the limitation is that the study was retrospective, which means that the causal relationship between adherence and adverse events after acute hemorrhagic stroke could not be established.

Selection of Research

All the studies selected for the research support were evaluated using Rapid Critical Appraisal Checklists fit for particular types of studies and appeared to have valid results, which corresponded to the expected outcomes. The chosen three articles are relevant to the PICOT question since they prove the benefit of high adherence to antihypertensive drugs for a decrease in hypertension and demonstrate that nonadherence leads to increased health risks. The selected studies have levels of evidence IV and V; therefore, the evidence provided in them is reliable.

References

Abegaz, T. M., Shehab, A., Gebreyohannes, E. A., Bhagavathula, A. S., & Elnour, A. A. (2017). Nonadherence to antihypertensive drugs. Medicine, 96(4), 1-9.

Corrao, G., Rea, F., Monzio Compagnoni, M., Merlino, L., & Mancia, G. (2017). Protective effects of antihypertensive treatment in patients aged 85 years or older. Journal of Hypertension, 35(7), 1432-1441.

Kim, J., Bushnell, C. D., Lee, H. S., & Han, S. W. (2018). Effect of adherence to antihypertensive medication on the long-term outcome after hemorrhagic stroke in Korea. Hypertension, 72(2), 391-398.

Peacock, E., & Krousel-Wood, M. (2017). Adherence to antihypertensive therapy. Medical Clinics of North America, 101(1), 229-245.

Appendix

Review of Literature Evaluation Table

The Quadruple Aim is a framework based on the Triple Aim approach, which was, in turn, developed by the Institute for Healthcare Improvement to create a more efficient system of health care delivery. The Quadruple Aim framework includes four major domains: reducing costs, improving population health and patient experience, and healthcare team well-being (Arnetz et al., 2020, p. 362). Evidence-based practice (EBP) is closely linked to the Quadruple Aim, as it is commonly used as a strategy that assists healthcare professionals and providers in achieving the goals of the Aim.

The first goal of the Quadruple Aim is highly impacted by EBP, since the latter acts as a basis for all important aspects of efficient and productive patient care. These aspects include validated research evidence, profound clinical expertise, and the integration of patients preferences. The application of EBP also helps nurses stay informed about the recent research and medical protocols (Kim et al., 2019). In addition, it allows involving patients in their care plans, which ultimately increases the quality of patient care and improves the patient experience.

Evidence-based practice is also an essential element of the second goal of the Quadruple Aim: improving population health. Procedures, practices, and policies that are considered as parts of the evidence-based approach make a broader concept of evidence-based public health (EBPH) (Allen et al., 2018). Therefore, there is a direct connection between EBP and population health.

It can be argued that EBP improves population health, as the EBPH framework involves making decisions based on well-researched methods and credible data collection tools. Since health professionals have access to more and higher-quality information on the most efficient medical practice, they are able to provide improved services to the population, which is a major benefit (Brownson et al., 2018). The quality of prevention programs and policies is also increased with the application of EBP, and the use of public health resources is optimized.

In addition to improving patient experience and population health, EBP takes account of the issue of costs in healthcare, which is the third goal of the Quadruple Aim. To analyze and evaluate all the costs required to implement EBP, it is important to calculate its Return on Investment (ROI) (Cullen & Hanrahan, 2018). This evaluation consists of three steps: determining the cost avoided, determining the cost of implementing, and evaluating the ROI, which is followed by linking the outcomes to organizational values and mission.

While implementing EBP may cause certain expenses, it can be argued that maintaining evidence-based care eventually costs less. First, this approach helps to optimize the use of drugs, as the personnel will be trained to utilize less expensive medication without compromising patient outcomes or increasing the toxicity (Walewska-Zielecka et al., 2021). In turn, less toxic regimens will result in fewer cases of severe adverse reactions. This will also lead to cost reduction as a result of fewer hospital visits.

The fourth aspect of the Quadruple Aim, is the work and life of healthcare providers can also benefit from evidence-based practice. One of the issues EBP focuses on is empowering nurses and doctors, which is essential to prevent a number of negative outcomes. Studies have shown that health professionals experience of stress, burnout, and depression leads to reduced job satisfaction and poorer performance (Chen et al., 2021). Therefore, it is crucial to empower doctors and nurses and engage them in the decision-making process regarding the ways to facilitate organizational processes and reduce the workload.

To improve health professionals working experience, the evidence-based practice includes developing a flexible schedule. In addition, doctors and nurses are encouraged to participate in personal health, wellness, and stress management programs to decrease burnout (Armstrong, 2019). As a result, hospital employees feel empowered, experience significantly less stress, have higher job satisfaction levels, are more motivated to engage with patients, and are more considerate about patient outcomes.

References

Allen, P., Jacob, R. R., Lakshman, M., Best, L. A., Bass, K., & Brownson, R. C. (2018). Lessons learned in promoting evidence-based public health: Perspectives from managers in state public health departments. Journal of Community Health, 43(5), 856-863. Web.

Armstrong, G. (2019). Quality and Safety Education for Nurses teamwork and collaboration competency: Empowering nurses. The Journal of Continuing Education in Nursing, 50(6), 252-255. Web.

Arnetz, B. B., Goetz, C. M., Arnetz, J. E., Sudan, S., VanSchagen, J., Piersma, K., & Reyelts, F. (2020). Enhancing healthcare efficiency to achieve the quadruple aim: An exploratory study. BMC Research Notes, 13(1), 362. Web.

Brownson, R. C., Fielding, J. E., & Green, L. W. (2018). Building capacity for evidence-based public health: Reconciling the pulls of practice and the push of research. Annual Review of Public Health, 39(1), 27-53. Web.

Chen, M., Ran, B., Gao, X., Yu, G., Wang, J., & Jagannathan, J. (2021). Evaluation of occupational stress management for improving performance and productivity at workplaces by monitoring the health, well-being of workers. Aggression and Violent Behavior, 12(2), 101713. Web.

Cullen, L., & Hanrahan, K. (2018). Evidence-based practice and the bottom line: An issue of cost. Healthcare Financial Management Association. Web.

Kim, J. S., Gu, M. O., & Chang, H. (2019). Effects of an evidence-based practice education program using multifaceted interventions: A quasi-experimental study with undergraduate nursing students. BMC Medical Education, 19(1), 71. Web.

Walewska-Zielecka, B., Religioni, U., SoszyDski, P., & Wojtkowski, K. (2021). Evidence-based care reduces unnecessary medical procedures and healthcare costs in the outpatient setting. Value in Health Regional Issues, 25(2), 23-28. Web.

The health assessment procedure performed in one of the Chicago schools helped to reveal an important issue. Thus, the school lacks recommendations and strategies connected to evidence-based practice. Several factors evidence the importance of the given topic. First of all, nurses should have clear, transparent, and adequate guidelines to demonstrate a high level of effectiveness and help learners in various situations. It means that the lack of evidence-based recommendations and strategies might affect their functioning and precondition the deterioration of outcomes. For this reason, it becomes critical to address the problem and guarantee that all nursing guidelines are supported by evidence-based recommendations linked to recent research and practice.

In such a way, regarding the problem described above, the following PICOT question can be formulated:

Do nurses (P) who have nursing guidelines supported by evidence-based recommendations (I) demonstrate higher performance levels (O) compared to nurses who use outdated guidelines (C) during their work (T)?

In such a way, the following PICOT question helps to address the outlined problem. It is formulated regarding the current demands to evidence based practice and nursing research (Selekman et al., 2019). It requires comparing different groups of nurses regarding using relevant recommendations during their work. Answering the question formulated above, it is necessary to employ credible and relevant sources. For this reason, the following articles were selected.

Esteban-Sepúlveda, S., Sesé-Abad, A., Lacueva-Pérez, L., Domingo-Pozo, M., Alonso-Fernandez, S., Aquilue-Ballarin, M., Barcelo-Martinez, A. I., Cristobal-Dominguez, E., Bujalance-Hoyos, J., Dossantos-Sanchez, C., Pascual-Pascual, M. A., Garcia-Arteaga, E., Galisteo-Gimenez, M., Mas-Dalmau, G., Heredia-Reina, M. P., Roca-Marti, S., Riart, M. P., Albornos-Muñoz, L., Gonzalez-Maria, E., & Fernández-Domínguez, J. C. (2021). Impact of the implementation of best practice guidelines on nurses evidence-based practice and on nurses work environment: Research protocol. Journal of Advanced Nursing, 77(1), 448460. Web.

Database: National Center for Biotechnology Information.

The article was selected because of several reasons. First of all, it speaks about the idea of evidence-based practice and its importance for the modern nursing field. The authors assume that the introduction of the given concept contributed to the positive shift in the nursing practice (Esteban-Sepúlveda et al., 2021). At the same time, it resulted in reconsidering the nursing environment and the work of a specialist. Furthermore, the article revolves around the importance of guidelines supported by the recent findings and resting on the central assumptions of evidence-based practice. The findings prove that nurses perception of their work depends on the work environment, which is formed by numerous factors, including the existing guidelines (Esteban-Sepúlveda et al., 2021). For this reason, it becomes critical to provide them with transparent and relevant recommendations.

Shannon, R. A. (2018). School nursing EBP clinical guidelines: What they are and are not, and why they matter. NASN School Nurse, 33(2), 104105. Web.

Database: SAGE Journals.

The article is also an important source that can be used to speak about the critical importance of clear guidelines supported by the recent research findings. The primary strength of the given work is that it outlines the significant features of quality EBP clinical guidelines and discusses the advantages associated with their use in everyday practice (Shannon, 2018). It contributes to the improved understanding of the critical importance of recommendations helping nurses to perform their work at a high level. At the same time, the information provided in the article can be used to improve the existing guidelines and ensure the drawbacks presented in them are found and corrected (Shannon, 2018). For this reason, the article is an important source, and it is necessary to employ it to speak about the selected problem.

Altogether, the health assessment helped to reveal the problem of the lack of clear, transparent, and relevant guidelines supported by the EBP and recent research. For this reason, a specific PICOT question can be formulated to address the concern. Speaking about the identified issue, it is possible to use the articles by Esteban-Sepúlveda et al. (2021) and Shannon (2018) as they offer essential and valuable information on the topic. The works prove the critical importance of guidelines in nursing practice and offer the models and methods that can help to improve existing recommendations and attain success.

References

Esteban-Sepúlveda, S., Sesé-Abad, A., Lacueva-Pérez, L., Domingo-Pozo, M., Alonso-Fernandez, S., Aquilue-Ballarin, M., Barcelo-Martinez, A. I., Cristobal-Dominguez, E., Bujalance-Hoyos, J., Dossantos-Sanchez, C., Pascual-Pascual, M. A., Garcia-Arteaga, E., Galisteo-Gimenez, M., Mas-Dalmau, G., Heredia-Reina, M. P., Roca-Marti, S., Riart, M. P., Albornos-Muñoz, L., Gonzalez-Maria, E., & Fernández-Domínguez, J. C. (2021). Impact of the implementation of best practice guidelines on nurses evidence-based practice and on nurses work environment: Research protocol. Journal of Advanced Nursing, 77(1), 448460. Web.

Shannon, R. A. (2018). School nursing EBP clinical guidelines: What they are and are not, and why they matter. NASN School Nurse, 33(2), 104105. Web.

Selekman, J., Shannon, R. A., & Yonkaitis, C. F. (2019). School nursing: A comprehensive text (3^rd ed.). F.A. Davis Company. Web.

Quality Improvement Plan

The current quality improvement plan aims to reduce the rate of falls among patients within the Med-Surg/COVID/Cardiovascular unit. The plan involves three crucial steps to be carried out in the effort to help both patients and healthcare providers in the designated department alleviate the burden of falls, which significantly reduces the quality of care and increases the likelihood of complications and co-morbidities. The initial step in the plan is to increase nurse staffing levels at the Med-Surg/COVID/Cardiovascular unit to ensure that there is an adequate number of providers available to care for patients. As suggested by Kim et al. (2019), the lack of staffing on hospital floors is among the factors influencing the occurrence of falls. Even though mandating to hire more personnel to the hospital can be challenging, the step is essential for establishing a solid framework for quality improvement.

The second step is concerned with the timely monitoring and assessment of high-risk patients and the introduction of bed alarms to prevent unassisted falls that cause serious injuries. As patients are being admitted to the Med-Surg/COVID/Cardiovascular unit, they will be assessed for their risks of falling at the facility. For high and moderate-risk patients, the bed alarms will be introduced to allow them to call for the assistance of nurses or other hospital personnel when they need to get up and walk somewhere. The bed alarms are important because they will reduce the necessity for personnel to visit each hospital bed and ask patients whether they need help (Mileski et al., 2019). Therefore, there will be more time for healthcare providers to address important tasks and offer immediate assistance as soon as their patients need them. In addition to bed alarms, the facility can also test chain sensors, caution signs, and protective equipment effectiveness.

The final step in the quality improvement plan is concerned with personnel training in accordance with the guidelines provided by the Safety Quality Committee to improve nursing self-efficacy and boost the management and prevention of falls. While the training can be costly, it is necessary to educate personnel on how to use the supportive equipment for fall prevention as well as assessing the likelihood of patients fallings during their stays at hospitals. In combination with increasing staffing levels, training and education have the potential for creating an overall favorable environment to address the risks of falls.

Resources Needed

To implement the quality improvement plan, financial, human resources, and educational resources are needed. First, it may be necessary for the Med-Surg/COVID/Cardiovascular unit to seek financial support from investors, both in private and public sectors. The management of the facility can compose a proposal for the quality improvement with a designated budget for it to send to the National Institutes of Health or the Howard Hughes Medical Institute. Both organizations are known for providing funding to facilities and researchers. Second, human resources are needed as a means to increase staffing levels at the unit. Drawing from financial resources, it is possible to incentivize the applications to the facility and attract skilled nursing professionals. Financial resources will also be needed to facilitate the purchasing and dissemination of fall prevention and management technologies and resources.

Third, educational resources are crucial to plan implementation because they are necessary for engaging personnel into ongoing training and professional improvement essential for quality improvement. Today, most training can occur through digital means such as online conferences and coaching, which is possible to carry out whenever personnel has time to engage in training. Financial and human resources are necessary to facilitate personnel training to fund the time of trainers and coaches as well as cover any expenses that go toward nurses overtime and software or hardware needs. Even though the quality improvement plan may be costly, financial support from governmental and non-governmental organizations is needed to facilitate its smooth implementation and the reaching of objectives. It is important to note that the abundance of resources need to carry out the quality improvement plan will require some time to be acquired, which can slow down the progress. However, without the resources, it is unlikely that the plan can succeed to the expected level.

Summary

To summarize, the proposed quality improvement plan is tasked with the challenge of preventing and reducing the occurrence of falls within the Med-Surg/COVID/Cardiovascular unit. The plan is three-fold and entails the improvement of care quality through increasing staff numbers, educating and training personnel additionally, as well as introducing preventive and assistive measures to aid at-risk patients. In order to implement the initiative, it is necessary to establish a solid framework of information exchange and collaboration among healthcare providers while also seeking financial, human, and educational resources. It is expected that the plan will not be easy to implement because it entails several steps that require different resources for success. However, the quality initiative is crucial to implement because it will allow to address the challenge head-on and with the help of a comprehensive and multi-dimensional approach.

References

Kim, J., Kim., S., Park, J., & Lee, E. (2019). Multilevel factors influencing falls of patients in hospital: The impact of nurse staffing. Journal of Nursing Management, 27(5), 1011-1019.

Mileski, M., Brooks, M., Topinka, J. B., Hamilton, G., Land, C., Mitchell, T., Mosley, B., & McClay, R. (2019). Alarming and/or alerting device effectiveness in reducing falls in long-term care (LTC) facilities? A Systematic Review. Healthcare (Basel, Switzerland), 7(1), 51. 

Main Post

It should be noted that the main purpose of research lies in directing and guiding nurses while treating the patients. To enlarge on this, nurses should be open to changes while identifying a particular problem and looking for viable solutions. Being a Director for an Ambulatory Plastic and Reconstructive Surgery Center, I am in charge of controlling surgeons performing facelift operations. So far, they carried out operations without using drains and ice compress because, according to some surgeons, recent research has shown that these methods constrict significantly blood vessels leading to necrotic skills. Nevertheless, due to the latest research, we have found that Jackson Pratt drains and ice compress contribute greatly to healing and faster recovery. In particular, Jackson Pratts drains aimed at draining extra fluid from the traumatized issue (Choucair and Hamra, 2009, p. 250). In the same way, Honrado (2006) has provided evidence that a 24-hour ice compress facilitates the recovery period as well. With regard to these researchers, nurses can now considerably improve practice and provide changes to the sphere of Plastic Surgery.

Main Discussion

The above case proves that through evidence-based practice introduction constitutes a serious challenge to nurses, it still has to take place in healthcare. More importantly, nurses should always be ready to look at issues, consider them through the prism of existing research, and provide reasonable solutions to the identified problems (Tagney, & Haines, 2009). Hence, appropriate structures and frameworks, organizational support, the introduction of evidence-based practice can make it much easier for nurses to face changes and implement them in nursing practice. On whole, evidence-based practice means that nurses should carry out interventions with particular reference to existing researches.

With the introduction of evidence-based practice, our nursing specialty has experienced a bulk of significant improvements. Dramatic changes have been implemented while conducting research on preventive techniques applied in a post-operative period of facial reconstruction. The researches on facelift drains and ice compressions are largely based on empirical research and observation. At the same time, the importance of intuitive knowledge is not of the least importance either because it serves as a ground for building further theoretical concepts and ideas.

The case with ice compression and drain mechanism leads to an assumption that the implementation of existing nursing theories and models is beneficial for the health care system in general (Parker and Smith, 2010). Affiliation to middle-range theories has presented much wider opportunities for coping with facelift complications. Specifically, careful consideration of human anatomy as well as research dedicated to the study of facial surgery has introduced much more favorable methods of post-operational intervention. Hence, the presentation of conventional procedures of facelifting has provided a clearer picture of the main reason for emerging complications as well as a more contrastive view on the benefits of the recently introduced changes. The result of the intervention has been positive because the post-operational period has considerably shortened.

The introduced evidence has turned out to be quite effective because it makes the process of healing less painful and more efficient. In this respect, the selected research has played a pivotal role in transforming theoretical knowledge into practice and in developing new approaches to performing rhitedectomy. What is more important is that it has also provided us with valuable information concerning which interventions will be most cost-efficient as well as what technological devices should be introduced to foster the intervention.

References

Choucair, R. J., and Hamra, S. T. (2009). Nuances of the Composite Face-Lift Technique. Seminar on Plastic Surgery. 23(4), pp. 247-256.

Honrado, C. and Pastorek, N. (2006). Preventing Complications in Facial Plastic Surgery. Current Opinion on Otolaryngology and Head and Neck Surgery. 14(4), pp. 265-269.

Parker, M., & Smith, M. (2010). Nursing theories & nursing practice (3rd ed.). Philadelphia: F.A. Davis.

Tagney, J., & Haines, C. (2009). Using evidence-based practice to address gaps in nursing knowledge. British Journal of Nursing (BJN), 18(8), 484489. Web.

Evidence-based practice involves providing quality care to patients, which is associated with better patient results as well as satisfaction. Evidence-based practice entails continuous research in search of novel practices, policies, and interventions that can better patient outcome.

Irrespective of the fact that valuable knowledge and strong evidence emanate from qualitative and quantitative methods of research, qualitative methods are not used commonly in evidence-based practice (Nieswiadomy, 2012).

A majority of the medical scientists consider qualitative research to be anecdotal and unscientific. On the same note, it is worth pointing out that medicine goes beyond the utilization of scientific rules. Commonly, clinical experience is founded on judgment, reflection, and personal observation.

It is necessary for translating scientific results that allows patient treatment. Personal experience is regarded as un- generalizable and anecdotal. Therefore, it forms a poor foundation for deducing scientific decisions (Eisenhardt, 1989).

Experimental and non- experimental research

Presently, qualitative research studies never involve the review of evidence-based practice studies. Non- experimental and experimental researches form the two kinds of quantitative research studies. Experimental research involves research designs that entail controlling and manipulating the testing involved. This assists in comprehending the causal procedures.

It involves manipulating a few variables and consequently identifying the impact on dependent variables. The changes in the dependent variables are measured and controlled. Experimental research is more convenient where time is of the essence in causal relationships, a cause and effect relationship is consistent, and the correlation magnitude is high.

Non- probability and probability sampling

The major variation between non- probability and probability samples lies in the nature of the studied population. In probability sampling, there is a likelihood that every item will be chosen. On the other hand, in non- probability, there is equal characteristics’ distribution in the entire population.

Therefore, researchers using non- probability sampling believe in the representativeness of the sample, which leads to accurate results. In probability sampling, the selection process is characterized by randomization as opposed to the population’s structure. Probability sampling is often used during surveys while nonprobability sampling is used when selecting respondents for an interview (Eisenhardt, 1989).

Improving clinical practice

HRQOL (Health-Related Quality of Life) is an extremely vital health outcome that is assessed in healthcare services evaluation and research, improvement strategies, and clinical trials. The measures are exceptionally useful in clinical practice situations for informing treatment decisions.

The measures allow treatment of the patient based on his reports. There is a need for increased use of the measures in clinical settings since physicians and nurses have experience in their effectiveness. Moreover, patients often report of the benefits associated with the measures (Nieswiadomy, 2012).

It is recommended that health-related quality of life measures need to be used more in settings involving pediatric healthcare. In such settings, the measures result in facilitation of the communication between physicians and patients, improved satisfaction in parents and patients, unraveling of hidden morbidities, and helping in making clinical decisions.

The measure can be extremely beneficial in pediatric settings in identifying the children whose needs are the greatest. Using the measure is cost-effective, permits targeted and timely interventions for addressing needs in children, and results in more satisfaction in patients (Nieswiadomy, 2012). Therefore, health-related quality of life measurement should be implemented more in healthcare setups.

References

Eisenhardt, K. M. (1989). Building theories from case study research. Academy of management review, 1(3), 532-550.

Nieswiadomy, R. M. (2012). Foundations of Nursing Research (6th ed.). New York: Pearson Prentice Hall.