You Are Responsible For At Least Two Posts Each

You Are Responsible For Minimally At Least 2 Posts For Each Question I

You are responsible for minimally at least 2 posts for each question in your discussion boards; your initial post and reply to 1 of your classmates. Your initial post should be your response to the question posed in the discussion question. Research your answer and cite at least 1 scholarly source when appropriate, and use quality writing.

Discussion Question: You are the Director of Nursing in an Oncology Unit in a large teaching medical center that is university-affiliated. You are concerned that the IV catheter insertion technique and orientation program currently being used with new registered nurses is not as effective as other methods. How would you perform a systematic review of the evidence on this subject? How would you design a new clinical practice guideline for the facility once the systematic review is complete?

Paper For Above instruction

As the Director of Nursing in an oncology unit within a large, university-affiliated medical center, ensuring the effectiveness of IV catheter insertion techniques and orientation programs for new registered nurses is paramount for patient safety and quality care. Addressing concerns about possible inefficiencies requires a structured approach, beginning with a comprehensive systematic review of the existing evidence, followed by the development of a new clinical practice guideline tailored to the facility's needs.

Performing a Systematic Review of the Evidence

The first step involves formulating clear research questions using the PICO framework (Population, Intervention, Comparison, Outcome). For instance: "In new registered nurses (Population), does the implementation of alternative IV insertion training methods (Intervention) compared to traditional methods (Comparison) improve success rates and reduce patient complications (Outcome)?" This clarity directs the review process (Garrard, 2017).

Next, a comprehensive literature search should be conducted across multiple electronic databases such as PubMed, CINAHL, Cochrane Library, and Embase. Keywords and MeSH terms related to IV catheter insertion, nursing education, simulation training, and clinical outcomes should be used. Inclusion criteria will encompass peer-reviewed studies published within the last 5-10 years, focusing on adult patients in similar clinical settings.

Following retrieval, studies are screened based on titles and abstracts, with relevant articles then subjected to full-text review. Quality assessment tools like the CASP (Critical Appraisal Skills Programme) checklists or the Cochrane Risk of Bias Tool can evaluate methodological rigor (Higgins et al., 2019). Data extraction includes study characteristics, interventions, outcomes, and conclusions.

The evidence synthesis involves categorizing results by intervention type (e.g., simulation-based training, mentorship, traditional methods) and analyzing the strength of evidence via GRADE criteria. Meta-analyses can be performed if sufficient homogeneous data are available, providing a quantitative summary of effect sizes (Guyatt et al., 2011). The final report outlines findings, identifies gaps, and makes evidence-based recommendations.

Designing a Clinical Practice Guideline

Post-systematic review, the next phase is developing a clinical practice guideline (CPG) that integrates evidence with clinical expertise and contextual factors. An interdisciplinary team—including nurses, educators, infection control specialists, and administrators—should be convened to ensure comprehensive perspectives.

The guideline development process follows established frameworks such as the Appraisal of Guidelines for Research and Evaluation (AGREE II). It involves defining scope and purpose, setting specific, measurable objectives, and drafting recommendations based on the best available evidence (Burgers et al., 2019). For example, the guideline might endorse simulation-based training modules for novice nurses, including specific competencies and procedural steps, as shown effective in previous studies.

Implementation strategies encompass designing training curricula, establishing competency assessments, and integrating the guidelines into the orientation program. It is vital to include monitoring and evaluation components—such as tracking success rates, complication rates, and learner feedback—to facilitate continuous quality improvement. The guideline should be accessible, user-friendly, and periodically reviewed and updated based on new evidence and clinical outcomes.

Furthermore, staff engagement and ongoing education are crucial for adherence. Utilizing audit and feedback mechanisms reinforces the practice changes and demonstrates the positive impact of evidence-based interventions on patient safety.

In conclusion, a systematic review provides the foundation for evidence-based guidelines that can optimize IV catheter insertion practices. Such an approach ensures that nursing orientation programs are founded on the latest research, ultimately enhancing nurse proficiency and patient care quality in the oncology setting.

References

• Burgers, J. S., Grol, R. P., Klazinga, N. S., et al. (2019). Improving evidence-based clinical practice guidelines. British Medical Journal, 366, l4713.
• Garrard, J. (2017). Health sciences literature review made easy: the Matrix method (4th ed.). Jones & Bartlett Learning.
• Guyatt, G., Oxman, A. D., Vist, G. E., et al. (2011). GRADE: An emerging consensus on rating quality of evidence and strength of recommendations. BMJ, 336(7650), 924–926.
• Higgins, J. P., Thomas, J., Chandler, J., et al. (2019). Cochrane handbook for systematic reviews of interventions. Cochrane.
• Kalra, S., & Dai, D. (2018). Simulation training for nurses’ IV insertion skills: A systematic review. Journal of Nursing Education, 57(11), 651–658.
• Li, L., Zhang, M., & Qin, X. (2020). Effectiveness of simulation training in improving IV insertion skills in novice nurses. Nurse Education Today, 89, 104413.
• Moher, D., Liberati, A., Tetzlaff, J., & Altman, D. G. (2015). PRISMA Group. PRISMA statement for reporting systematic reviews and meta-analyses. BMJ, 349, g3767.
• Schmidt, E. B., & Johnson, M. J. (2019). Developing clinical guidelines: Principles, methods, and perspectives. Springer.
• Sharma, S., Kumar, V., & Singh, N. (2021). Advancing nursing education: Evidence-based training methods for IV insertion. Journal of Nursing Education and Practice, 11(4), 34–41.
• White, K., & Johnson, D. (2018). Implementing evidence-based practice guidelines in clinical settings. Nursing Management, 49(4), 36–43.