NUR 550 Nursing Practice Problem Assignment

NUR 550 Evidence-Based Practice Project Proposal Identification of Nursing Practice Problem Assignment

NUR 550 Evidence-Based Practice Project Proposal Identification of Nursing Practice Problem Assignment

PICOT Draft

Name_____________________________________
Part 1: Propose a relevant nursing practice problem for an evidence-based practice project. Explain why you selected this topic and how it is relevant to advance nursing practice. Include one research article that demonstrates support for the nursing practice problem.

To provide optimal health care, nurses should work without being overwhelmed and always ready to serve all populations. However, the number of patients visiting health care facilities because of obesity and related complications has surged in the last decade. Some of the most at-risk population segments are school-age children and adolescents. My nursing practice problem for an evidence-based practice project is obesity among school-age children. Robinson et al. (2017) found that vulnerability to obesity has increased among children due to unhealthy lifestyles associated with sedentary living, such as watching television and gaming for a long time. I selected this topic since obesity is among the health care issues increasing mortality and morbidity rates in children as its prevalence increases. Being at risk of obesity implies that school-age children will be more exposed to chronic illnesses, such as heart disease and diabetes, and reduced quality of life (Che et al., 2018; De Lorenzo et al., 2019).

Such adverse health outcomes increase illness burden in health care organizations, families, and society and increase nurses’ workload. In response, nurses should explore health care issues affecting population health and directly impacting their work and provide evidence-based interventions. I found the article by Stiglic and Viner (2019) to be relevant to the issue and directly supporting the nursing practice problem. Stiglic and Viner (2019) confirmed that obesity hampers children’s well-being, and interventions such as reducing screen time effectively reduce obesity rates. To improve health outcomes, nurses can also help patients and families to understand the risks of obesity and educate them on the recommended amount of screen time for children while encouraging parents to regulate the time that children spend on the screens.

Part II: In the table below, describe the population and the intervention. (You will continue drafting the PICOT, completing the shaded areas in Topic 3.)

PICOT Question
P Population School-age children with obesity
Obesity among school-age children has reached epidemic levels in the United States. De Lorenzo et al. (2019) described obesity as significant public health concern since it affects the physical, psychological, and cardiovascular health of the affected populations. Data from 2015-2016 shows that 1 in 5 children in the United States aged 6 to 19 years has obesity, and the rate has tripled since the 1970s (Centers for Disease Control and Prevention, 2018). Risk factors include poor eating habits, lack of physical activity, genetics, and negative childhood events. Therefore, immediate, evidence-based, and population-driven interventions are necessary to reduce the surging rates.

I Intervention Reducing screen time
Increased screen time is among the unhealthy lifestyles reducing the level of physical activity among school-age children. According to Robinson et al. (2017), screen media exposure increases obesity levels by encouraging more eating while viewing, reducing sleep duration, and increasing the possibility of taking sugary and low-nutrient foods. In addition, more screen time also exposes children to marketing that influences their eating habits and preferences. As a result, reducing screen time is a perfect intervention to keep children from these dangers to reduce obesity incidence.

NUR 550 Evidence-Based Practice Project Proposal Identification of Nursing Practice Problem Assignment

Learners will select a valid nursing practice problem for an evidence-based practice project proposal. The project will be completed in sections, beginning in NUR-550 and culminating in a final written paper detailing the evidence-based practice proposal in NUR-590.

The purpose of this assignment is to select a relevant nursing practice problem for your evidence-based practice project proposal. To identify a relevant problem, consider problems generally faced in nursing practice (coordination of health care, assessment, education, patient support, trauma prevention, recovery, health screenings, etc.).  Use the “PICOT Draft” template to complete this assignment.

Use a national, state or local population health care database to research indicators of disparity. Choose a mortality/morbidity indicator to identify a clinical problem or issue that you want to explore pertaining to a population of focus. Use this indicator to begin to formulate a PICOT statement.

Refer to the “Evidence-Based Practice Project Proposal – Assignment Overview” document for an overview of the evidence-based practice project proposal assignments.

You are required to cite one peer-reviewed source to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are not required to submit this assignment to LopesWrite. t

PICOT Draft

Name_____________________________________

Part 1: Propose a relevant nursing practice problem for an evidence-based practice project. Explain why you selected this topic and how it is relevant to advance nursing practice. Include one research article that demonstrates support for the nursing practice problem.

Part II: In the table below, describe the population and the intervention. (You will continue drafting the PICOT, completing the shaded areas in Topic 3.)
PICOT Question
P Population
I Intervention
C Comparison
O Outcome
T Timeframe
PICOT

Problem Statement

Course Code Class Code Assignment Title Total Points
NUR-550 NUR-550-O503 Evidence-Based Practice Project Proposal: Identification of Nursing Practice Problem 10.0

Optional: ThinkingStorm

Description:

For additional information, the following is recommended:

ThinkingStorm is an online tutoring resource that provides flexible support to supplement traditional educational environments. The tutoring center is remotely accessible to GCU learners with a computer and an Internet connection and offers convenient hours for learners with busy schedules. ThinkingStorm tutoring includes a writing center that offers 24/7 submission-based writing support, as well as live writing support across the curriculum.

If you are interested in utilizing ThinkingStorm’s writing support, submit your documents chapter by chapter, rather than as a full manuscript.

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To access ThinkingStorm, click on the link provided and select the yellow “Go to ThinkingStorm” button.

Optional: Grammarly

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For additional information, the following is recommended:

Grammarly is an online writing assistance application that reviews written submissions and suggests context-specific corrections for grammar, spelling, word usage, wordiness, style, punctuation, and plagiarism. The reasoning for each suggested correction is provided, allowing users to make informed decisions about how to correct writing issues.

Grammarly can be installed as free browser extension, though Grammarly Premium requires an annual subscription. This subscription is not a GCU-required purchase.

NUR-550 Course Objectives

Description:

In this course, the student will:

1. Explore research articles, nursing and related theories, applying levels of evidence, and theoretical frameworks to identify quality research studies.
2. Demonstrate understanding of scientific inquiry, knowledge generation, utilization, and dissemination in advanced nursing practice.
3. Evaluate the evidence for potential solutions/innovations that can potentially solve a health care issue and improve patient outcomes.
4. Identify gaps in nursing knowledge and evidence-based practice that can potentially be resolved by planning and implementing a practice change project.
5. Formulate a clinically researchable question amenable to an innovative evidence-based practice change proposal.
6. Write a scholarly literature review that supports a clinically researchable question amenable to an innovative evidence-based practice change proposal.
7. Evaluate health policy and advocacy issues for the purpose of improving health care outcomes.
8. Engage in scientific inquiry into the state of health care delivery, patient-centered care, and ethical principles related to health beliefs, health promotion, and risk reduction of diverse populations.
9. Propose quality improvement initiatives that advance the delivery of safe, high-quality health care.
10. Use principles from epidemiology, biostatistics, genetics, genomics, and cultural competence to guide comparisons of various patient populations.

Re: Topic 1 DQ 1

Evidence-based practice (EBP) is the process of combining evidence from studies, clinical expertise and patient values and preferences to come to a conclusion to promote the best patient-centered care (Nurse.com, 2021). However, it has been noted that much evidence-based practice takes time to be implemented into practice, and often does not progress past being published in a professional journal (Weiss et al., 2018). According to Titler (2018), there is a gap between EBP recommendations and the actual implementation of said recommendations to help improve patient care. Given this, translational research is utilized. Translational research is the process by which evidence-based interventions are incorporated into real-life, clinical settings (Melnyk & Fineout-Overholt, 2019). The process of translational research falls under the umbrella of translational science, in which EBP interventions are utilized and put into place to help improve patient care and outcomes, as well as the health of the overall population (Titler, 2018).

Although both EBP and translational research are related, they are not to be used interchangeably (Titler, 2018). According to Titler (2018), EBP is the application of evidence while translational research is the implementation of the evidence into practice. This includes executing knowledge, research designs and methods into real-life in practice, communities and public health settings. Translational research focuses on applying these EBP interventions to help improve patient outcomes, and to determine what strategies work for whom, why they work, and in what environment they work in (Titler, 2018).

There are five phases of translational research, which are known as “bedside to community” (Titler, 2018). The first phase, T0, refers to basic science research which includes preclinical and animal studies. After this, a phase 1 clinical trial must be done, to test the safety in a small group of humans, which is known as the T1 phase. The next phase of translational research, T3, includes both phase 2 and 3 clinical trials which tests the safety in a larger group of people and allows for comparison of common treatments. Phase four, or T4, includes phase 4 clinical trials and outcomes research which can be applied into practice. Lastly, phase five (T5) consists of a translation to the community, in which the larger population outcomes research is obtained (Titler, 2018). Translational research can be seen with the implementation of vaccinations. After evidence and research is conducted in regard to the particular disease and vaccine components, the application of the scientific evidence can be applied in trials to see how the product of the research can be used effectively in practice (Centers for Disease Control and Prevention, 2020).

References

Centers for Disease Control and Prevention. (2020, December 17). Topic area 5: Translational

          research. https://www.cdc.gov/niosh/programs/review/ecb/topic5.html

Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing &

          healthcare: A guide to best practice. Wolters Kluwer.

Nurse.com. (2021). Evidence-based practice. https://www.nurse.com/evidence-based-practice

Titler, M. G. (2018). Translation Research in Practice: An Introduction. Online Journal of Issues

in Nursing, 23(2), 1. https://doi-org.lopes.idm.oclc.org/10.3912/OJIN.Vol23No02Man01

Weiss, M. E., Bobay, K. L., Johantgen, M., & Shirey, M. R. (2018). Aligning Evidence-Based

Practice With Translational Research: Opportunities for Clinical Practice Research.

JONA: The Journal of Nursing Administration, 48(9), 425–431.

https://doi-org.lopes.idm.oclc.org/10.1097/NNA.0000000000000644

The type of translational research conducted in this study was T1. T1 translational research involves the development of treatments and interventions (Vukotich, 2016). In this study, a multidisciplinary approach was employed to improve nutrition in preterm neonates. Although approved nutritional guidelines were in place, routine chart audits revealed noncompliance (Page et al., 2017). Therefore, an evidence–practice gap existed. The researchers’ goal was to identify barriers to the timely delivery of the appropriate nutrition in a tertiary‐level Neonatal Critical Care Unit through the development of an implementation project to ensure best practices (Page et al., 2017). Information was obtained via individual interviews with medical and nursing staff and digitally recorded with informed consent of the participants (Page et al., 2017). After analysis of the interview questions, the data highlighted inconsistent practice and a lack of adherence to guidelines regarding nutritional support as a barrier to achieving optimal early nutrition (Page et al., 2017). As a result of this study, appropriate and specific interventions were developed, implemented, and evaluated (Page et al., 2017).

T1 translational research was conducted because interventions were needed to increase compliance with following nutritional guidelines in the treatment of preterm neonates. New knowledge was gained to enhance patient care and improve patient outcomes. Furthermore, the interventions developed were intended to change behaviors and bridge the evidence–practice gap.

References

Page, D., Gilroy, M., Hurrion, E., Clark, L., & Wilkinson, S. (2017). Optimising early neonatal nutrition using translational research methodology. Nutrition & Dietetics, 74(5), 460–470. https://doi-org.lopes.idm.oclc.org/10.1111/1747-0080.12333

Vukotich, C. J., Jr. (2016). Challenges of T3 and T4 translational research. Journal of Research Practice, 12(2). Retrieved from http://jrp.icaap.org/index.php/jrp/article/view/552/454

Topic 1 DQ 2

Using the GCU Library (notably the GCU Library: Nursing and Health Sciences Research Guide), find a database, journal, or other collection of resources that focuses on translational research. Select a population health problem or issue of interest from the available studies. What type of translational research is used for the study? Provide rationale as to why this is the best.

Re: Topic 1 DQ 2

Incidences of stroke in the U.S. have declined in the past few years for the first time in history. However, stroke incidence among older adults has always been higher than younger adults, especially older women (Portz et al., 2018). Older adults of 80 years and above make about 17% of all stroke patients and are at high risk of mortality and prolonged hospital stays (Portz et al., 2018). This journal is in phase T4 type of translational research, where the information obtained in the previous stages is disseminated and implemented. This translational research aimed to investigate the impact of physical fitness and exercises for older adults with chronic stroke. A large body of literature has examined the correlation between self-management intervention such as physical fitness and exercise and chronic stroke. For instance, Schmid et al. (2014) observed that patients with chronic stroke showed physical improvements like body balance after enrolling in a yoga program that involved physical activities such as walking.

Based on the previous literature, Portz et al. (2018) used the information to investigate whether physical fitness and exercise would be used as a clinical intervention for managing chronic stroke. After implementing the information, Portz et al. (2018) found that it is essential for health care professionals to incorporate self-management interventions such as physical fitness and exercise in managing chronic stroke among older adults. This will improve their quality of life, strength, and endurance by incorporating yoga practice. Furthermore, this kind of research will encourage more health care researchers to conduct translational research to reach phase 4 (T4), where yoga practice can be used as an evidence-based intervention for chronic stroke.

References

Portz, J. D., Waddington, E., Atler, K. E., Van Puymbroeck, M., & Schmid, A. A. (2018). Self-management and yoga for older adults with chronic stroke: A mixed-methods study of physical fitness and physical activity. Clinical Gerontologist, 41(4), 374–381. https://doi-org.lopes.idm.oclc.org/10.1080/07317115.2016.1252453

Schmid, A. A., Miller, K. K., Van Puymbroeck, M., & DeBaun-Sprague, E. (2014). Yoga leads to multiple physical improvements after stroke, a pilot study. Complementary Therapies in Medicine, 22(6), 994–1000. https://doiorg.lopes.idm.oclc.org10.1016/j.ctim.2014.09.005

Topic 1 DQ 1

Identify the different levels of translational research. Explain how translational research is different from evidence-based practice and discuss application to population health management.

Discussion Question 2

The selected population health problem for this discussion question is depression. Depression is a mental health disorder characterized by depressed mood, anhedonia, changes in appetite and body weight. The treatment of depression mainly aims at symptom reduction and improvement of the patient’s quality of life (Kraus et al., 2019). The study by Latendresse et al., (2021) is an example of a translational study that focused on depression. The researchers conducted a pilot study to determine the effectiveness of videoconference intervention in reducing perinatal depressive symptoms. The study sample comprised pregnant and postpartum women that participated in an 8-week mindfulness cognitive behavioral intervention that was delivered through videoconferencing platform. The results of the pilot study showed that the delivery of cognitive behavioral interventions via videoconferencing was promising. There were the reductions in the Edinburgh Postnatal Depression Scale scores among the participants by the end of the investigation. The implication was that their risk of developing depression during the postnatal and antenatal periods were significantly reduced.

The study by Latendresse et al., (2021) is a T4 translation research. The pilot study examined the factors and interventions in healthcare that can be used to enhance population health. The study was also a population-level outcome study that offered insight into the effectiveness of technological interventions in managing depression. The intervention was also tested on a large scale using human subjects, which make it T4 translational research.

References

Kraus, C., Kadriu, B., Lanzenberger, R., Zarate Jr., C. A., & Kasper, S. (2019). Prognosis and improved outcomes in major depression: A review. Translational Psychiatry, 9(1), Article 1. https://doi.org/10.1038/s41398-019-0460-3

Latendresse, G., Bailey, E., Iacob, E., Murphy, H., Pentecost, R., Thompson, N., & Hogue, C. (2021). A Group Videoconference Intervention for Reducing Perinatal Depressive Symptoms: A Telehealth Pilot Study. Journal of Midwifery & Women’s Health, 66(1), 70–77. https://doi.org/10.1111/jmwh.13209

Topic 1 DQ 2

Using the GCU Library (notably the GCU Library: Nursing and Health Sciences Research Guide), find a database, journal, or other collection of resources that focuses on translational research. Select a population health problem or issue of interest from the available studies. What type of translational research is used for the study? Provide rationale as to why this is the best.