M2 Lesson 4 Discussion Create An Original Posting With A Min

M2 Lesson 4 Discussioncreate An Original Posting With A Minimum Of

Create an original posting with a minimum of words. Back up your arguments with reliable evidence. Asking the Relevant Clinical Questions Evidence-based nursing is a process founded on the collection, interpretation, appraisal, and integration of valid, clinically significant, and applicable research. It is not about developing new knowledge or validating existing knowledge, but rather translating existing evidence so that it can be applied to clinical decision making. This process starts with formulating a sound PICO question.

PICO is a format for developing a good clinical research question prior to starting a review or research. It is a mnemonic used to describe the four elements of a sound clinical foreground question. Scenarios: #1 A nurse in the PACU is interested in ways to decrease the use of pain medication in post-op patients. She’s wondering if classical music or guided imagery might be efficacious. #2 A 17-year-old African American woman, just diagnosed with hepatitis B, has been taking acetaminophen for headaches. Her mother has heard that acetaminophen can cause liver problems, and she asks you if her daughter should continue taking the drug for her headaches, considering her hep-b diagnosis. #3 You are on a hospital committee exploring best practices in inpatient oncology nursing. The first question to come before the committee is, “how can we improve patients’ sleep quality and quantity without resorting to sleep medication?†The committee decides to explore relaxation techniques (e.g., massage; music), noise reduction, bed/pillow comfort, and ambient temperature changes. Your assignment is to find the best practices to reduce noise levels on the unit. #4 A 53-year-old woman with rheumatoid arthritis wants to possibly change her medication to short-term low-dose corticosteroids instead of NSAIDS, which are upsetting her stomach. Will the corticosteroids be as effective? #5 Jeff, a smoker of more than 30 years, has tried to quit unsuccessfully in the past. A friend of his recently quit with acupuncture. He wonders if he should try it. Instructions: Choose one (1) clinical scenario above, and answer the following questions: What is evidence-based nursing practice and why is it important? What is the PICO process? Formulate a well defined clinical question that will yield the most relevant and best evidence. Describe the background of the question Present the question using PICOT format Indicate what will be the best study to answer the clinical question.

Paper For Above instruction

Evidence-based nursing (EBN) is an approach to care that emphasizes the use of the most current and valid research findings to inform clinical decision-making. It combines clinical expertise with the best available external evidence and patient preferences to ensure the highest quality of care. EBN is crucial because it improves patient outcomes, enhances the quality of care, reduces unnecessary interventions, and promotes professional accountability. By integrating research into practice, nurses can address complex clinical questions effectively and improve health care delivery (Melnyk & Fineout-Overholt, 2019).

The PICO process is a systematic method used to formulate clear, focused clinical questions that guide evidence searching and appraisal. It stands for Population, Intervention, Comparison, Outcome, and sometimes Time (PICOT). This framework ensures that the questions are specific and answerable, facilitating the identification of relevant evidence. Developing a well-structured PICOT question helps clinicians target literature searches and appraise evidence efficiently, leading to more informed and effective nursing practices (Schmidt & Brown, 2019).

Choosing scenario #4 involving a 53-year-old woman with rheumatoid arthritis contemplating corticosteroid therapy is particularly relevant. Her concern about efficacy and safety of corticosteroids compared to NSAIDs is common among patients seeking to optimize treatment while minimizing side effects. Formulating a PICOT question in this context allows for targeted research to inform clinical decisions, balancing efficacy and safety in medication management for rheumatoid arthritis.

The background of this question revolves around the need for effective symptom control in RA patients who experience adverse effects with standard treatments. NSAIDs, while effective, can cause gastrointestinal discomfort, prompting consideration of alternative therapies such as corticosteroids. However, corticosteroids carry their own risks, including immunosuppression, osteoporosis, and metabolic disturbances. Therefore, clinicians need evidence on whether short-term low-dose corticosteroids can provide comparable efficacy to NSAIDs without unacceptable adverse effects (Ref 1).

The formulated PICOT question is: “In adult patients with rheumatoid arthritis (P), does short-term low-dose corticosteroid therapy (I), compared to NSAIDs (C), result in similar efficacy for symptom control and fewer gastrointestinal side effects (O), over a period of 4 weeks (T)?”

To answer this clinical question, the best study design would be a randomized controlled trial (RCT). RCTs are considered the gold standard for comparing treatment efficacies because they minimize bias and confounding variables, providing high-quality evidence. An RCT comparing short-term low-dose corticosteroids versus NSAIDs in RA patients would provide definitive data on effectiveness and safety, guiding clinicians in making evidence-based treatment decisions (Higgins & Green, 2011).

References

• Higgins, J. P., & Green, S. (Eds.). (2011). Cochrane handbook for systematic reviews of interventions. The Cochrane Collaboration.
• Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare: A guide to best practice. Wolters Kluwer.
• Schmidt, N. A., & Brown, J. M. (2019). Evidence-based practice for nurses: Appraisal and application of research. Jones & Bartlett Learning.
• Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing practice. Wolters Kluwer.
• Smeltzer, S. C., Bare, B. G., Hinkle, J. L., & Cheever, K. H. (2010). Brunner & Suddarth's textbook of medical-surgical nursing. Wolters Kluwer.
• Gerrish, K., & Lacey, A. (2019). The research process in nurses' and midwives' practice. Wiley Blackwell.
• Burns, N., & Grove, S. K. (2017). Understanding nursing research. Elsevier.
• Sackett, D. L., Rosenberg, W. M. C., Gray, J. A. M., Haynes, R. B., & Richardson, W. S. (1996). Evidence-based medicine: What it is and what it isn't. BMJ, 312(7023), 71-72.
• Levett-Jones, T., & Sutton, K. (2018). Enhancing evidence-based practice in nursing. Elsevier.
• Stevens, K. R. (2013). The impact of evidence-based practice in nursing and the empowerment of nurses. MEDSURG Nursing, 22(5), 306–312.