NR 505 PICOT/PICo and Practice Questions

NR 505 PICOT/PICo and Practice Questions

NR 505 PICOT/PICo and Practice Questions

Quantitative Approach

Initially, I thought that the qualitative approach would be a better approach for my evidence-based project proposal.  After further review, I now am convinced that the quantitative approach is a better approach for my evidence-based Practice (EBP) project proposal. Evidence-based practice is aimed at hardwiring current knowledge into common care decisions to improve care processes and patient outcomes (Stevens, 2013).   Evidence-based practice also unifies research evidence with clinical expertise and encourages through individualization of care through inclusion of patient preferences (Stevens, 2013).

Why the Quantitative Approach is best for rural populations’ unplanned healthcare (Area of Interest)

Because of my clinical experience with my area of interest in the rural population, this approach will allow a collection of opinions, facts, attitudes, and behaviors to be analyzed.  The quantitative approach will also allow results to be generalized from a larger population such as the rural population.  With the use of the quantitative approach, this population will have the opportunity to reveal their needs and causes of lack of healthcare.  This research approach will be beneficial in order to decrease the incidence of unplanned healthcare, which is one of the biggest healthcare challenges that this population continues to face.  With the use of the quantitative research method, data can be collected from various forms such as: online surveys, paper surveys, telephone interviews, and face to face interviews.  The collection of this data will allow comparison of opinions and further investigation toward a resolution.   As exploration of the chosen population occurs with the combination of clinical experiences, an advancement of the proposed EBP will promote the intended outcome of better healthcare strategies.

PICO Quantitative Question

In the rural population (P) does health education, early diagnosis, and healthcare programs (I) compared to deploying health resources geographically (C) reduce the incidence of unplanned healthcare (O).

Quantitative Practice Question

Is there a link between the lack of healthcare education, early diagnosis, healthcare programs and unplanned healthcare?

 

Reference

Stevens, K.R. (2013).  The Impact of Evidence-based Practice in Nursing and the Next big Ideas.  Online Journal Issues in Nursing, 18(2), 1.  doi: 10.3912/OJIN18No02MAN04

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I believe both quantitative and qualitative approaches could be beneficial for this specific topic, but I plan to focus on the qualitative approach. In qualitative research the focus is on the collection and analysis of data. The researcher has to remain fluid and flexible during the research process. Their direction may need to change slightly in order to get closer to their goal. Qualitative research main purpose is to explore and describe a participant’s experience. The approach starts out with a broad question, but process oriented and context bound (Malagon-Maldonado, 2014). The focus for quantitative research is usually narrow and product related.

My PICo question is: in a hospital setting where nurses conduct bedside shift report opposed to station-based report,

NR 505 PICOT PICo and Practice Questions
NR 505 PICOT PICo and Practice Questions

is patient satisfaction higher?  I picked this question to help guide the nurses to understand the value bedside shift report has for the patients and their families as well as the nurses. We have set this practice as a standard in our hospital and many units do very well. We see staff struggling on the units that have larger number of patients. While using the qualitative approach I will start broad in my question but hope to identify some research specific to the patient satisfaction in the emergency department. As the nursing operations manager of the emergency department, we strive to improve our communication with our patients concerning their plan of care. This research will hopefully identify some of the barriers and how successful organizations supported their staff to overcome those barriers (Taylor, 2015).

 

Malagon-Maldonado, G. (2014). Qualitative Research in Health Design. Health Environments Research & Design Journal (HERD) (Vendome Group LLC)7(4), 120-134. Retrieved from http://www.herdjournal.com.chamberlainuniversity.idm.oclc.org/ME2/Default.asp

Taylor, J. S. (2015). Improving patient safety and satisfaction with standardized bedside handoff and walking rounds. Clinical Journal of Oncology Nursing, 19(4), 414-416. Retrieved from https://cjon.ons.org

When gathering your data are you going to use the nurses in the ER as a point of reference? I work in the ER and we don’t do bedside report but the rest of the hospital does. I do think that giving bedside report would be good so that way if there are any issues with the patient or condition that they are in it can addressed promptly. One really bad scenario is we had a nurse go into to check on her patients after taking report and found that one of her patients was bradycardia and having breathing difficulties. She was not hooked up to the cardiac monitor or the continuous monitoring of oxygen saturation level. Had this been the case someone would have been aware of this patients condition declining instead of the oncoming nurse finding it after receiving report. Bedside report is crucial for oncoming and outgoing
nurses, for it ensures and sustains the continuity of patient care (Sadule-Rios, 2017).

Sadule-Rios, N. (2017). Off to a Good Start: Bedside Report. MEDSURG Nursing26(5), 343-345. Retrieved from https://eds-a-ebscohost-com.chamberlainuniversity.idm.oclc.org/eds/pdfviewer/pdfviewer?vid=2&sid=af15de18-fc5e-4850-97a0-4f51189be927%40sessionmgr4007Links to an external site.

I was recently taking care of a ‘general in patient’ hospice-patient in a local hospital. My job as her hospice nurse is to ensure that the proper comfort measures are ordered by the hospitalist or my hospice administrator and carried out by the facility nursing staff. I arrived at the hospital at 9 o’clock a.m. When I stepped into the patient’s room I realized instantly that she was in distress and her husband was extremely unhappy. The first words he spoke to me were “I don’t think I am getting what I was promised.” After he and I talked further I found that the patient (who should be receiving morphine every hour and haldol every 4 hours) had not received her medications as ordered and he had just arrived around 8:30 a.m. and found her with tachycardia, and tachypnea. To make a long story short. The night nurse had not given bedside report so the distress my patient was in had not been visualized. Her husband was not there to call for her medications and she was not cognitively intact to call out herself. The oncoming day shift nurse had a combative patient within minutes of arriving on the floor so, she was engaged with that patient. If bedside report had occurred a colleague could have helped the day nurse to care for the hospice patient or the combative patient. I feel that bedside report is crucial for any facility nursing care, ED included.

Bedside shift report is not only encouraged in the ER I work, it is expected. Before I worked in the ER, I worked on the telemetry unit where bedside shift report was already being implemented somewhat. It was easier to write down all pertinent information at the nurse server with the chart open than trying to go off of memory and report sheet. So, after an initial report was given, the two nurses would go in to the patient room and introduce the oncoming nurse. When we would receive the surveys back from patients, there were complaints at times that the patients did not feel involved in their plan of care or that no one told them this or that. When I transferred to ER, we did report at the nurse’s station at the computers and then made rounds after report had been given. Recently, within the last couple of years, the Studer group came in to the hospital to help our facility become more in tune with patient satisfaction and bedside report was a main focus to the point that it was included in our nurse skills fair. While some may think that bedside report is an inconvenient nuisance, it has been shown to improve patient satisfaction. ” Safe, effective, and therapeutic communication is a key driver to improvement in the delivery of care and improvement in patient safety” (Radtke, 2013). The patients feel involved in their plan of care and feel like they are an important part of the care team…which they are. At this time, patients can add to the report or ask questions or report new symptoms or if they have pain. Bedside report not only benefits nurses but also is necessary for patient satisfaction.

References:

Radtke, Kimberly. (2013). Improving patient satisfaction with nursing communication using bedside shift report. Clinical Nurse Specialist. CNS. 27. 19-25. 10.1097/NUR.0b013e3182777011.