CNA341 Identifying Issues and Searching for Evidence Assignment Sample

Improving Health and Nursing Practice through Translational Research

Introduction to the Issue

The identified issue from the nursing practice that requires an evidence-informed approach is the “hourly patient rounding”. As a nurse I feel this is an important issue because patient safety is the core duty of the nursing staff. And, to increase patient safety hourly patient rounding is considered as a nursing intervention that helps in doing so. This helps by enabling the nurses in identifying and addressing the patient’s needs proactively and by helping to reduce the rate of patient’s falls (Hicks, 2015). Not only in increasing the patient safety and reducing the patient’s falls but, hourly patient rounding also plays an important role in nursing practice by helping in reducing the call lights for the augmented nurse competence as well as satisfaction and most importantly it also improve the patient’s perceptions regarding their care (Mitchell et al. 2014). According to Schlegl, Ducournou and Ruof, (2017) evidence based practice (EBP) indicates a methodical, yet holistic approach to the patient-centered care in health care. The three elements of EBP triad entail the best external evidence; individual practitioner’s clinical expertise, and the patients' preference. So, EBP is the integration of these 3 elements that is applied to the decision making process in order to achieve the goal of patient-centered care. The essence of these three elements is incorporating the best available evidences with the practitioners’ expertise by considering the patient’s preferences. The practitioners’ expertise refers to the practitioners’ overall experience, learning, and clinical skills.

By linking these three elements with the identified issue, it could be seen that the first element of the EBP triad is the best evidences and by linking it with the issue it has been seen that the evidences for hourly patient rounding says visiting patient every hour can potentially reduce the rate of patient’s falls along with identifying and addressing the patient’s needs spontaneously can help in increasing the patient safety (Hicks, 2015). The second element of the EBP triad is practitioners’ expertise, so with the practitioners’ learning, skills, and experiences it has been seen that how to actually implement the hourly rounding without making it daunting and irritable for the patient. While, the third element i.e., patient’s preferences and without breaching their values and beliefs, the visits could be modified and oriented towards the patient. Incorporating all the three elements into this issue will help the nursing practice to attain the patient-centered care and patient safety.

The Question and The Question Framework

However, there are various benefits of hourly patient rounding but, still not all facilities have implemented this protocol to their settings just because of the challenges faced during its implementation. So, the developed research question from the issue would be what are the challenges that prevent the implementation of hourly patient rounding in the healthcare setting? It has been seen that in the evidence based practice, structuring the research question is considered to be one of the most important and decisive part of the research uprightness. A successful research project depends on the value of a focused research question. Formulation of the research question is the preliminary step for conducting a valuable and reliable research. PICO i.e., Population, Intervention, Comparison, and Outcome is a framework that has been used by the researchers in order to prepare a valuable research question and for the facilitation of the literature review. With the help of this framework it becomes easy to connect with the various aspects of the research question together towards a significant and suitable research design (Eldawlatly et al. 2018). As per the study presented by Eriksen and Frandsen, (2018) it has been stated that the study that follows the PICO format is able in determining the indulgent of the whole happening very well as it encompasses the experiences of a definite population group regarding a definite situation. So, according to the PICO format the population in the structured research question will be hospital settings; Intervention in the structured research question will be hourly patient rounding; comparator would be the challenges; and the Outcome for this will be based on the incorporation of three elements of the EBP triad.

The Search

A good research strategy can be defined as a step-by-step action plan that directs the opinion and efforts of the researcher. This helps in enabling a systematic conduct of the research in order to produce the quality results along with the detailed reporting. This helps in enabling an individual to focus on enhancing the quality along with saving the time and the resources (Malliari and Togia, 2017). For the formulated research question, qualitative approach will be used. The qualitative research is the research that entails collecting as well as analyzing the data which is non-numerical. This helps in developing a strong understanding regarding the concepts, experiences, or opinions (Sutton, Jane and Austin, 2020). This type of research gathers the in-depth insights regarding the selected research question.

The research strategy used will include relevant search key terms, database choice, and Boolean key terms.

1. Search items: These are the words that have to be entered whenever searching for the journal articles into the database search boxes. These key terms signifies the key concepts of the research topic. Appropriate key terms are necessary to be identified and search to find the relevant articles to the research topic because without the appropriate key terms, it is very difficult to find the relevant articles (Cooper et al., 2018).

2. Database choice: Selecting the appropriate journal databases is considered as an important research tool in order to navigate proceeding to complete a regimented research publication. Once the right database is selected and the appropriate key terms has been identified it becomes easy to investigate the relevant literature. Thus, selecting an appropriate journal database is as crucial as the right journal article collection for the literature (Vassar et al. 2017).

The selected database for this research would be CINAHL and Pubmed. According to a study presented by Wright, Golder and Lewis-Light, (2015) CINAHL databases have been considered as one of the most widely-used as well as respected tools for the researches related to nursing by the students as well as the health professionals worldwide. CINAHL databases have been seen to provide the most authentic, credible, and unique studies for the literature reviews. While, PubMed is the stipulation of two resources that are MEDLINE and the National Library of Medicine. This database has been considered as a widely accessible biomedical resources across the globe. Most of the journals that are present in the database of Medline/PubMed are peer reviewed (Williamson and Minter, 2019).

3. The search strategy: There are three Boolean operators that are AND, OR and NOT that have been used as conjunctions for combining or excluding the keywords in a particular search. This results in more extensive and focused results. Combining two key terms by using ‘AND’ will help in retrieving the articles that contains both the key terms. Using ‘OR’ expands the search and help in retrieving more articles that are specify either subject. While, using ‘NOT’ narrows the research and results in retrieving the articles that contains the first word but not the second one (Grewal, Kataria and Dhawan, 2016).

Inclusion and exclusion criteria: The inclusion criteria are those features that have been included in the study. While, the exclusion criteria are those features that have been disqualified and excluded from the study. All the article from year 2015 till now were included and the article published before 2015 were excluded.

Search history for CINAHL

Search history for Pubmed:

The articles:

The four selected research article are:

1. Nurses' Experiences and Perceptions of Hourly Rounding: A Private Australian Catholic Hospital Single Case Study (Francis et al. 2019).

This article is useful for the research question as this research article is reporting on the experiences and perceptions of the nurses on the hourly rounding that is undertaken at the private hospital in Australia. The evidence from the article suggests that hourly nursing rounds are directly linked with the positive outcomes. Though, there are certain barriers regarding the effective hourly rounding that have been reported and discussed in the paper which will help us to conduct our research on the formulated question well.

1. Hourly Rounding: A Fall Prevention Strategy in Long-Term Care (Mitchell, 2017)

This article is useful for the research question as this article is successfully discussing about the process improvement enterprise of a long-term care unit that has been experienced an augmented rate in the number of falls over the past 3 months. So, this article will be helpful in evaluating whether the staff education along with the implementation of the evidence-based hourly patient rounding would be helpful and effective in reducing the rate of patient falls.

1. A systematic review: barriers to hourly rounding (Toole, Meluskey, and Hall, 2016).

This article is useful for the research question as this is a systematic review over the barriers that are faced in hourly rounding which will give plenty amount of information regarding our formulated question. The barriers that have been identified in the study shows direct linkage with the front line staff that are performing hourly patient rounding. So, incorporating such information that ate evidence based would be helpful in conducting the research.

1. Effect of Hourly Rounds Implementation on Women's Perceptions of Nursing Care (Lobatch, 2019)

This article is useful for the research question as this study shows the other side of the research question that is how the hourly rounds can affect the perceptions of the women regarding the nursing care.

References for Identifying Issues and Searching for Evidence

Cooper, C., Booth, A., Varley-Campbell, J. Britten, N. and Garside, R. 2018. ‘Defining the process to literature searching in systematic reviews: A literature review of guidance and supporting studies’, BMC Medical Research Methodology, vol. 18, no. 85. https://doi.org/10.1186/s12874-018-0545-3

Eldawlatly A, Alshehri H, Alqahtani A, Ahmad A, Al-Dammas F, and Marzouk A. 2018. ‘Appearance of Population, Intervention, Comparison, and Outcome as research question in the title of articles of three different anesthesia journals: A pilot study’, Saudi Journal of Anaesthesia, vol. 12, no. 2, pp. 283-286. doi:10.4103/sja.SJA_767_17

Eriksen, M B and Frandsen, T F. 2018. ‘The impact of patient, intervention, comparison, outcome (PICO) as a search strategy tool on literature search quality: A systematic review’, Journal of the Medical Library Association, vol. 106, no. 4, pp. 420–431. https://doi.org/10.5195/jmla.2018.345

Grewal A, Kataria H, Dhawan I. 2016. ‘Literature search for research planning and identification of research problem’, Indian Journal of Anesthesia, vol. 60, no. 9, pp. 635-639. doi:10.4103/0019-5049.190618

Hicks D. (2015). Can Rounding Reduce Patient Falls in Acute Care? An Integrative Literature Review. Medsurg Nursing : Official Journal of the Academy of Medical-Surgical Nurses, 24(1), 51–55.

Lobatch, E. and Wise, S. (2019) ‘Effect of Hourly Rounds Implementation on Women’s Perceptions of Nursing Care’, Nursing for Women’s Health, vol. 23, no. 2, pp. 114–123. doi: 10.1016/j.nwh.2019.01.009.

Malliari, A and Togia, A. 2017. ‘An analysis of research strategies of articles published in Library Science journals: the example of Library and Information Science Research’, Qualitative and Quantitative Methods in Libraries, vol. 5, no. 4, pp. 805-818. ISSN 2241-1925.

Mitchell, M D, Lavenberg, J G, Trotta, R L, and Umscheid, C 2014, ‘Hourly rounding to improve nursing responsiveness: a systematic review’, The Journal of Nursing Administration, vol. 44, no. 9, pp. 462–472. https://doi.org/10.1097/NNA.0000000000000101

Mitchell, RA 2017, ‘Hourly Rounding: A Fall Prevention Strategy in Long-Term Care’, Hourly Rounding: A Fall Prevention Strategy in Long-Term Care, p. 1, viewed 15 September 2020, .

Francis K, Kurtsev A, Walter D, Steele C, and Staines C. 2019. Nurses' Experiences and Perceptions of Hourly Rounding: A Private Australian Catholic Hospital Single Case Study. International Archeives of Nursing Health Care vol. 5, pp. 125. doi.org/10.23937/2469-5823/1510125

Schlegl E, Ducournau P and Ruof J. 2017. ‘Different weights of the evidence-based medicine triad in regulatory, health technology assessment, and clinical decision making’, Pharmaceutical Medicine, vol. 31, no. 4, pp. 213-216. doi:10.1007/s40290-017-0197-3

Sutton, Jane, and Zubin Austin. 2015.’Qualitative Research: Data Collection, Analysis, and Management’, The Canadian journal of hospital pharmacy, vol. 68, no. 3, pp. 226-31. doi:10.4212/cjhp.v68i3.1456

Toole, N., Meluskey, T. and Hall, N. (2016) ‘A systematic review: barriers to hourly rounding’, Journal of Nursing Management (John Wiley & Sons, Inc.), vol. 24 no. 3, pp. 283–290. doi: 10.1111/jonm.12332.

Vassar, M., Yerokhin, V., Sinnett, P M., Weiher, M., Muckelrath, H., Carr, B., Varney, L., andCook, G. (2017). Database selection in systematic reviews: an insight through clinical neurology. Health Information and Libraries Journal, vol. 34, no. 2, pp. 156–164. https://doi.org/10.1111/hir.12176

Williamson, P O. and Minter, C. 2019. ‘Exploring PubMed as a reliable resource for scholarly communications services’, Journal of the Medical Library Association : JMLA vol. 107, no. 1, pp. 16-29. doi:10.5195/jmla.2019.433

Wright, K., Golder, S. and Lewis-Light, K. 2015.What value is the CINAHL database when searching for systematic reviews of qualitative studies? Systematic Reviews, vol. 4, no. 104. https://doi.org/10.1186/s13643-015-0069-4

Remember, at the center of any academic work, lies clarity and evidence. Should you need further assistance, do look up to our Nursing Assignment Help

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