Evidence-based practice is taught early in the nursing career and has great importance and impact towards nursing practice
Evidence-based practice is taught early in the nursing career and has great importance and impact towards nursing practice
Responses to Discussion Questions
NURS 500 Response #1 Monica B
Week 4 Discussion 1
We can demonstrate nursing processes and responses to treatment by implementing evidence-based practice care. Evidence-based practice determines what works best for patients. It’s a more comprehensive control study or a trial. Some evidence-based practice we use is cost-effectiveness or infection control. We use the evidence in the hospital setting that we acquire through research and clinical data.
An example would be using the waffle mattress in the ER to prevent pressure ulcers for patients. The effectiveness of preventing hospital-acquired pressure ulcers decreases further expenses on wound care treatments. Another evidence-based practice process we use in the emergency department is foley insertion. We limit the use of foley insertion to prevent urinary tract infections. They use evidence-based research and statistics to determine changes that can affect patients and create safe and more cost-effective care.
References
McEwen, M., & Wills, E. M. (2019). Theoretical basis for nursing. Wolters Kluwer.
NURS 500 Response #2 Emily T
Week 4 Discussion 1
Evidence-based practice is taught early in the nursing career and has great importance and impact towards nursing practice. Evidence-based practice is utilizing current research and best data and research evidence to improve patient quality care and prevent unsafe nursing practices (Cardoso et al., 2021). It also integrates the patient’s values, preferences and condition that guides in improving clinical patient outcomes. EBP is also referred to as the problem-solve approach, as it allows for nurses and healthcare providers to translate the research findings to real world application (Cardoso et al., 2021).
As an OR circulator, one of our main goals in the operating room is to prevent surgical site infections. Surgical site infections are the most common infection from health care-associated infections (Siedelman & Anderson, 2021). They are also known to lead to adverse patient outcomes and potentially death. In my current nursing practice, EBP strongly comes into play as utilizing EBP into my nursing practice it can lower the rate of surgical site infections. This results in less chances of patients having an adverse outcome and reduces prolonged hospitalizations and death. I could apply EBP in my current nursing practice by ensuring patients are receiving their prophylactic antibiotics, provide chlorhexidine-based skin antisepsis, properly cleaning the site of surgery, maintain a regulated body temperature, good hand hygiene before and during surgery, wear sterile protective equipment, proper hair removal, and control blood sugar for diabetic patients (Fuglestad et al., 2021). These are ways that that I apply EBP in my current nursing practice, of course, there are more ways such as educating patients on tobacco cessation prior to surgery, wear a mask, keep the OR doors closed, cover your hair, and maintain short nails.
Reference
Cardoso, D., Couto, F., Cardoso, A. F., Bobrowicz-Campos, E., Santos, L., Rodrigues, R., Coutinho, V., Pinto, D., Ramis, M. A., Rodrigues, M. A., & Apóstolo, J. (2021). The Effectiveness of an Evidence-Based Practice (EBP) Educational Program on Undergraduate Nursing Students’ EBP Knowledge and Skills: A Cluster Randomized Control Trial. International journal of environmental research and public health, 18(1), 293. https://doi.org/10.3390/ijerph18010293
Fuglestad, M. A., Tracey, E. L., & Leinicke, J. A. (2021). Evidence-based Prevention of Surgical Site Infection. The Surgical clinics of North America, 101(6), 951–966. https://doi.org/10.1016/j.suc.2021.05.027
Seidelman, J., & Anderson, D. J. (2021). Surgical Site Infections. Infectious disease clinics of North America, 35(4), 901–929. https://doi.org/10.1016/j.idc.2021.07.006
NURS 521 Response #1 Marlene G
Week 4 Discussion 1
Apply the differences between negligence and malpractice to the practice of nursing. Provide examples to illustrate your points.
Malpractice is an improper performance of skill by a professional held by professional standards of care. Negligence is the failure to perform an action unintentionally that is deemed to be reckless or harmful to a patient that has a disregard for the safety of another.
The difference between the two is that negligence does not require a breach of the standard of care. Secondly, only injuries caused by negligence will be able to claim damages. Negligence can be caused by omissions or unintentional mistakes.
A nursing malpractice example would be purposely making an error during routine care, such as when drawing blood or taking a patient’s blood pressure.
A nursing negligence example would be improper medication administration; this also includes wrong doses.
Reference
https://www.freshrn.com/malpractice-vs-negligence-nursing/Links to an external site.
Pozgar, G. D. (2014). Legal and Ethical Issues for Health Professionals (4th ed.). Jones & Bartlett Learning. https://online.vitalsource.com/books/9781284089530Links to an external site.
NURS 521 Response #2 Wing L
Week 4 Discussion 1
According to Butts (2015), “negligence is failure of the nurse to give care as a reasonably prudent and careful person would give under similar circumstances. Malpractice is improper or unethical conduct or unreasonable lack of skill by a nurse or other professional that results in damages”. To put it simply ,negligence is nurse’s unintentional mistake causes unintended harm on patient. Malpractice on the other hand is when the nurse knows, but unwilling to follow proper standard of care and causes harm on patient.
Example of negligence: A nurse failed to document the reason of withholding a medication. The patient’s heart rate is below 60 beats per minute. After assessing the patient’s apical pulse, the nurse decided to withhold the Digoxin for the patient according to the heart rate parameters (hold if HR<60 bpm). However, the nurse forgot to document the reason why she did not administer to the patient.
Example of malpractice: A nurse failed to report critical lab values to doctor. The lab called the nurse about a patient’s hemoglobin level is 6.2. The nurse was busy assisting another patient to the bathroom, so she did not report the hemoglobin level to the doctor right away. The nurse thought she didn’t have time to do blood transfusion anyway, so she decided to report to the doctor later when she had more free time. Failure to report low hemoglobin level to doctor in a timely manner can be dangerous to the patient and could lead to heart failure or death.
References:
Butts, J. B. (2015). Nursing Ethics (4th ed.). Jones & Bartlett Learning.
NURS 521 Response #1 Dasha B
Week 4 Discussion 2
As a nurse, I understand the importance of providing safe and effective care to patients while maintaining patient safety. I understand how essential it is to prioritize patient safety and provide safe and effective care. The case of Alyssa is a poignant example of the potential harm that can result from medical errors and a lack of transparency in healthcare (Hemmelgarn, 2023). This case can be used to illustrate the importance of patient-centered care, communication, and collaboration among healthcare providers.
One of the possible barriers that nurses may face when acting on what they believe to be the morally correct action is the pressure to conform to institutional or peer expectations. In Alyssa’s case, her initial diagnosis of ALL was based on a label attached to her by a second-year resident, which later proved to be incorrect. Nurses may encounter similar situations where they feel that the initial diagnosis or treatment plan is not in the best interest of the patient. However, they may hesitate to challenge the provider’s decision due to fear of retribution or perceived lack of power in the healthcare hierarchy (Greenberg & Wills, 2019).
Another barrier that nurses may face is a lack of institutional support for transparency and disclosure (Liukka et al., 2020). Alyssa’s parents were not informed of the medical errors that led to her death until three years, seven months, and twenty-eight days later. Nurses may feel uncomfortable disclosing medical errors or adverse events to patients or families due to the fear of litigation or negative consequences for themselves or their colleagues (O’Connell et al., 2021).
To overcome these barriers, nurses should prioritize patient safety and advocate for open communication, collaboration, and transparency in healthcare. They can do this by engaging in interprofessional teamwork, promoting patient-centered care, and using ethical decision-making frameworks to guide their actions (Greenberg & Wills, 2019). Additionally, nurses can work with institutional leaders to develop policies and protocols that support transparency and disclosure, educate patients and families on their rights to information and informed consent, and provide emotional support to those who have experienced medical harm.
In conclusion, the case of Alyssa serves as a reminder of the importance of maintaining patient safety and providing safe, effective care. Nurses play a critical role in advocating for transparency, collaboration, and patient-centered care, and must navigate potential barriers such as institutional pressures and lack of support for disclosure. By prioritizing patient safety and working collaboratively with other healthcare providers, nurses can help prevent medical errors and promote a culture of transparency and accountability in healthcare.
References:
Hemmelgarn, C. (2023). Alyssa Hemmelgarn. Patient Safety Movement Foundation. https://psmf.org/patient-safety/patient-stories/al…
Liukka M, Steven A, Moreno MFV, Sara-Aho AM, Khakurel J, Pearson P, Turunen H, Tella S. Action after Adverse Events in Healthcare: An Integrative Literature Review. Int J Environ Res Public Health. 2020 Jun 30;17(13):4717. doi: 10.3390/ijerph17134717. PMID: 32630041; PMCID: PMC7369881.
Greenberg, R. N., & Wills, J. (2019). Ethical Challenges and Opportunities for Nurses in the Digital and Social Media Age. Online Journal of Issues in Nursing, 22(3). https://doi.org/10.3912/OJIN.Vol22No03EthCol01Links to an external site.
O’Connell, P. J., McCaughan, D., & McKenna, H. P. (2021). Patient safety and disclosure of adverse events: an integrative review. Journal of Nursing Management, 29(5)
NURS 521 Response #2 Vanessa D
Week 4 Discussion 2
Safe and effective care translates into positive patient outcomes. On the other hand, compromised care increases the risk of adverse outcomes, death, and increased cost to both the patient and the health care entity. Alyssa’s cases provide a suitable illustration of ways to improve patient safety and the effectiveness of care. Notably, in Alyssa’s case, nurses can learn three important lessons related: to communication, family-centered care, and a culture of safety (Daley, 2015). In terms of communication, the case highlights how the breakdown in communication between the patient family and the care provider creates a risk to the patient. In essence, poor communication played a role in the subsequent diagnosis of anxiety. Also, the case illustrates the value of family-centered care, where patient families are key in the delivery of care. As for the culture of safety, a “just culture” would be appropriate in helping identify gaps in the healthcare systems, at the same time, address the gaps without the fear of retribution.
Besides, the illustration also highlights the importance of alternative dispute resolution. In this regard, the errors that resulted in Alyssa’s death did not trigger legal litigation, but rather, the hospital resorted to offering an apology and implementing a system to prevent future errors (Daley, 2015). Thus, based on the illustration, safe, efficacious care requires an intersection of a patient, culture, and optimal communication. However, in Alyssa’s case, nurses will encounter two sets of barriers related to the limitation in autonomy and organizational restraint. Nurses are required to use clinical judgment as the basis for decision-making. But the input from the parent with limited clinical knowledge has the potential to affect decision-making. Also, the hospital structure did not allow a nurse to perform different models, hindering their ability to provide quality care.
Reference
Daley, J. (2015, February 17). For Colorado mom, story of daughter’s hospital death is key to others’ safety. Colorado Public Radio. https://www.cpr.org/2015/02/17/for-colorado-mom-st…
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