The Evidence-Based Practice Change Paper
The Evidence-Based Practice Change
Health care challenges vary across health care organizations depending on patients’ vulnerabilities, demographics, and geographical locations, among other factors. The impacts of such challenges on patients’ health and safety are profound. Accordingly, health care organizations must adopt evidence-based interventions by combining scientific evidence, patients’ preferences and values, and clinical expertise. Scientific evidence is sourced from current, peer-reviewed literature and should address a clinical problem in detail. The purpose of this paper is to provide a solution to a clinical problem using the evidence-based approach.
Identification of the Problem and Impact on Nursing Practice
The problem necessitating evidence-based interventions is the incidence of hospital-acquired pneumonia in patients admitted in the hospital within two to three days. Whether it is ventilator-associated (VAP) or non-ventilator-associated (nvHAP), the incidence of hospital-acquired pneumonia should be reduced significantly. Damas et al. (2022) found that VAP is the leading hospital-acquired infection (HAI) in the United States. The impacts of such infections are far-reaching given that they extend hospital stays and increase medical expenses due to health complications, readmissions, and increasing vulnerabilities to other diseases. They cause deaths too. Health statistics indicate that the mortality rate related to hospital-acquired pneumonia ranges between 33% and 50% in intensive care units (Rosario et al., 2021). Unless addressed effectively, the problem will continue risking patient safety, increasing health care costs, and causing preventable deaths.
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The evidence-based practice relies on current, relevant, and peer-reviewed evidence. The search for relevant literature was conducted on leading nursing databases focusing on strategies to reduce the incidence of hospital-acquired pneumonia. Regarding what went well, evidence on hospital-acquired pneumonia incidence reduction is available in nursing literature. As a result, it is not very challenging to get qualitative and quantitative research on practical solutions. Barriers included a lack of sufficient literature to compare the efficacy of hospital-acquired pneumonia prevention bundles and other strategies. A more detailed analysis of the interventions is crucial to determine the most effective.
Research Findings and Validity of Evidence
Several strategies can reduce the incidence of hospital-acquired pneumonia, as scientific evidence proposes. Rosario et al. (2021) found a multi-component intervention effective in reducing hospital-acquired pneumonia. A key component of this intervention is the pneumonia prevention bundle. Damas et al. (2022) found that noble-metal alloy (NMA) coating of endotracheal tubes during hospitalization effectively reduces the incidence of hospital-acquired pneumonia. The validity of the evidence in each case cannot be questioned. In quantitative research, validity entails the extent to which the methods measure a concept accurately. Damas et al. (2022) assessed the effectiveness of the interventions in all patients. In the follow-up, Rosario et al. (2021) only lost six out of 123 participants but still managed to get data from electronic health records. Given this, the evidence is highly valid and reliable.
Suggestions for Implementation
Health care organizations cannot achieve the desired outcomes without implementing evidence-based practice recommendations. Successful implementation of the proposed recommendations to reduce the incidence of hospital-acquired pneumonia requires a phased approach. The first step is to identify the intervention that best suits the organization. Secondly, an implementation team should be composed. The third step would be organizing the resources. Fourthly, the implementation team would execute the proposals while helping nurses to adopt changes and adjust appropriately. Outcomes should be also be evaluated and corrective actions integrated where necessary.
Hospital-acquired pneumonia has far-reaching consequences on a patient’s health. Reducing its incidence through evidence-based strategies is critical to its effective management and control. A multi-component intervention and the use of NMA-coated endotracheal tubes during hospitalization have been found effective in reducing the incidence. The same approaches can be used in health care settings to reduce the incidence of patients hospitalized within two to three days.
Damas, P., Legrain, C., Lambermont, B., Dardenne, N., Guntz, J., Kisoka, G., … & Misset, B. (2022). Prevention of ventilator-associated pneumonia by noble metal coating of endotracheal tubes: A multi-center, randomized, double-blind study. Annals of Intensive Care, 12(1), 1-10. https://doi.org/10.1186/s13613-021-00961-y
Rosario, B. H., Shafi, H., Yii, A. C., Tee, L. Y., Ang, A. S., Png, G. K., … & Taha, A. A. (2021). Evaluation of multi-component interventions for prevention of nosocomial pneumonia in older adults: A randomized, controlled trial. European Geriatric Medicine, 1-11. https://doi.org/10.1007/s41999-021-00506-3
The purpose of this assignment is to provide a solution to a clinical problem using the Evidence Based Practice process.
1. Identification of problem and impact on nursing practice.
2. Clearly describe the research process, including what went well, barriers encountered, and what is still needed.
3. Correlates research findings to identified clinical issue.
4. Summarizes validity of qualitative and quantitative evidence.
5. Findings are clearly identified.
6. Recommends practice change with measurable outcomes and addresses feasibility issues.
7. Suggestions for implementation.
8. Conclusion of content findings. References
Damas, P., Legrain, C., Lambermont, B., Dardenne, N., Guntz, J., Kisoka, G., …&Misset, B. (2022). Prevention of ventilator-associated pneumonia by noble metal coating of endotracheal tubes: A multi-center, randomized, double-blind study. Annals of Intensive Care, 12(1), 1-10. https://doi.org/10.1186/s13613-021-00961-y
Rosario, B. H., Shafi, H., Yii, A. C., Tee, L. Y., Ang, A. S., Png, G. K., … &Taha, A. A. (2021). Evaluation of multi-component interventions for prevention of nosocomial pneumonia in older adults: A randomized, controlled trial. European Geriatric Medicine, 1-11. https://doi.org/10.1007/s41999-021-00506-3