Sample NURBN1015 Introduction to Evidence Based Practice and Research Assignment

NURBN1015 Introduction to Evidence-based Practice and Research Assignment Sample

Assignment Brief

This assessment task requires you to build on the evidence you summarised and evaluated in Assessment task 2a in order to respond to the clinical question in the form of an essay. The clinical question you chose for task 2a must be used for assessment task 2b. You will need to use at least SIX (6) peer-reviewed primary research articles in total. THREE (3) of these articles will be the three you used in the annotated bibliography, and you need to source at least THREE MORE articles yourself.

CLINICAL SCENARIO CHOICE – USE THE SAME CHOICE AS TASK 2A

Choose the same topic you used to complete Assessment tasks 2a.

Clinical scenario choice 1: Pressure injury prevention

Dario is a student nurse working in an aged care facility and is looking after Mr George Florentine an 82-year old man who suffered a stroke four months ago. He is not able to mobilise without assistance. It was handed over that Mr Florentine needs re-positioning every 2 hours. However, Dario’s buddy nurse says that is not necessary as he has a pressure relieving mattress.

Clinical scenario choice 2: Nutrition in wound healing

Amelia is a student nurse working in a residential facility caring for Iris Johnson a 92-year-old female with a ulcerative wound to her left lateral malleolus. The ulcer is 2cm in diameter and sloughy in appearance with minimal hemoserous exudate. Iris has been prescribed vitamin D and folic acid supplements to help with the healing process; however Amelia’s buddy nurse says that this is silly because nutrition has nothing to do with wound healing.

WORD LIMIT

The word limit is 1500 words (+/- 10%). The reference list is not included in the word count. In-text citations are included in the word count.

ESSAY STRUCTURE

The ‘applying evidence to practice’ essay is to be written using an essay structure with an introduction, a body, and a conclusion. The essay format provides you the opportunity to concisely present the findings from the research articles that directly respond to the clinical question/s, compare and contrast the findings, and then apply what is known to your own clinical nursing practice.

The essay should be structured as follows - do not include headings/subheadings in your submission:

Write the clinical question you have developed from the chosen scenario at the top of your essay – this is your essay title.

Introduction: Word limit allocation (approximately) 150 words

What to include
Introduce the topic (the clinical question you are answering), outline the scope of the paper (what you will cover) e.g., evidence-based strategies, how they are applied and evaluated (follow the paragraph topics below)

Paragraph 1: Word limit allocation (approximately) 300 words

What to include

What new knowledge from the research studies can be applied to improve nursing care or patient outcomes?
Compare and contrast findings – paragraph 1.

Paragraph 2: Word limit allocation (approximately) 300 words

What to include

Compare and contrast findings – paragraph 2.

Paragraph 3: Word limit allocation (approximately) 300 words

What to include

Apply this new knowledge from paragraphs 1 and 2 to nursing practice: What strategies will you use to implement new knowledge into patient care?

Paragraph 4: Word limit allocation (approximately) 300 words

What to include

State the methods you can use to demonstrate that nursing practice or patient care is improved.

Conclusion: Word limit allocation (approximately) 150 words

What to include

Summary of the main points
Reference list: (Not included in word count)
Include all references used in text in APA 7th style
Total word count = 1500 (+/-10%)

ESSAY PREENTATION GUIDELINES

Solution

Brief introduction

Immobility, such as that brought on by protracted bed rest at a medical facility, can lead to pressure injuries also termed as bedsores. Most pressure injuries are preventable, and they contribute significantly to patient treatment needs in the healthcare industry. Pressure damage is included on the national list of hospital acquired problems (HACs). The national list of 16 HACs is the product of a detailed methodology that involves literature reviews, clinical interaction, and concept testing with both public and private institutions (Hajhosseini et al., 2020). The hips, heels, tailbone, elbows, head, and ankles are among the skeletal parts of the body that are commonly the locations of these injuries. Pressure injuries can be treated in a number of ways, depending on the stage. Once the wound's stage and severity have been determined, it must be cleaned, frequently with a saline solution (Dalvand et al., 2018). After being cleaned, the wound has to be kept clean, moist, and properly wrapped. To cover the wound, the doctor may select from a range of bandages. This assignment would help to understand the preventive measures that must be taken to prevent the chances of pressure injury.

Body paragraph 1

Topic sentence: Keeping the skin clean and clear of bodily fluids can prevent pressure injury

Evidence: The first stage in skin care is routine assessment of the skin itself. In high-friction areas, patients and/or caregivers should pay careful attention to the skin and keep it dry, clean, and protected from pressure injuries by keeping an eye out for early warning signs (especially at high-pressure spots). Sensors can alert patients or caregivers to any changes in the environment that can make pressure injuries more likely to occur (Jiang et al., 2020). These sophisticated monitoring techniques include pressure mapping and real-time patient monitoring. This is an opportunity for early management and the reduction of pressure injuries for assignment help.

The following best practices for skin care in this patient population are recommended are every day, examining the skin, moisturizing at least twice daily to keep the lipid barriers functioning optimally, using additional skin barriers if the patient experiences incontinence, cleansing, rinsing, and drying the skin after incontinence or when there is too much moisture present, to cushion and protect sensitive areas, using the appropriate therapies, and whenever necessary, or every two hours, changing into breathable clothes (Cox et al., 2018). Dressings are one pressure ulcer therapy strategy. There are many different types of dressings, and they can range widely in price (Sala et al., 2021). Hydrogel dressing is one type of available dressing. The high-water content of hydrogel dressings keeps ulcers moist, preventing them from drying out. According to popular belief, wet wounds heal more quickly than dry ones. Numerous research has examined the possibility that hydrogel dressings for pressure ulcers have a faster rate of healing than other kinds of dressings or topical treatments (Alderden et al., 2018).

Body paragraph 2

Topic sentence: Pressure Redistribution resulting in pressure relief might help to prevent pressure injury

Evidence: Pressure injuries can be avoided by controlling friction and shear. There are mainly two approaches to doing this. The first step entails choosing the optimum materials for the patient's surroundings and support surfaces like beds, mattresses, and cushions. Equal weight redistribution is another goal of these support surfaces. The choice of fabric can also significantly affect how much mechanical stress the patient receives; for instance, it has been demonstrated that textiles made of silk have far lower friction forces than fabrics made of cotton (Padula et al., 2019). On pressure redistribution surfaces, skin contact is increased, resulting in a continuous, even IP. The best material for foam and low-air-loss mattresses is this one. Polyurethane foams that are lightweight are made to contour to the patient's body and account for pressure points in certain areas. With pressure redistribution incorporated directly into their characteristic shapes, cut-foam mattresses and laminated surfaces are only two examples of the increasingly sophisticated material architectures that have resulted from this. Low pressure treatment mattresses also offer pressure redistribution since they continually circulate low air pressure throughout the mattress to spread the user's weight. It is comparable to low air loss therapy, with the exception that the air is kept in the mattress to prevent full deflation when the pump is switched off (Cox et al., 2020). Pressure relief effectively prevents pressure accumulations by focusing on high pressure areas of the body. These surfaces typically contain air-filled cells that might expand and contract based on the surrounding conditions (Fulbrook et al., 2019). For instance, it may be useful to regularly reduce pressure in the lowest third of the mattress if the patient's heels and lower legs are more prone to pressure sores when lying on a mattress. In this case, alternate-air technology can be useful. This cyclical mechanism uniformly distributes pressure over the mattress in response to the patient's needs, reducing the chance of pressure buildups for a lengthy period of time (which also gives the mattress an undulating IP measurement).

Body paragraph 3

Topic sentence: Repositioning of the patient would help to reduce pressure injury

Evidence: Another element of effectively managing mechanical stress is repositioning the patient as needed, ideally every two hours (Sharp et al., 2019). To alert the patient or the staff when repositioning is necessary, auditory aids like alarms or sensors may be used. Repositioning may also be assisted by tools, pillows, or slings that make it easier to move the patient. The application of pressure mapping technologies can also help with patient positioning. This device enhances the visual assessment of a patient's skin by examining the cellular-level processes and biomarkers connected to the early formation of pressure ulcers (De Meyer et al., 2019). Patient positioning includes maintaining neutral body alignment in compliance with the requirements of the treatment. It is accomplished by preventing hyperextension and excessive lateral rotation. Because it lowers the possibility of harm and the negative effects of immobility, proper patient placement is an essential aspect of nursing. Correct patient positioning optimizes exposure to the treatment region while minimizing exposure. Furthermore, there is no evidence that gradually shifting one's position or weight would affect how much pressure is applied at the contact between the sacrum and buttocks (Yap et al., 2022). However, there is evidence that even little adjustments to weight or posture can have an impact on the gravitational equilibrium. Further research must be done to determine how well modest modifications to weight or posture might minimize pressure injuries in patients receiving critical care.

Body paragraph 4

Topic sentence: Usage of medical devices and physical barriers can prevent pressure injury

Evidence: Any object that comes into contact with the patient's skin might result in a pressure injury. This is compounded worse in the pediatric inpatient environment where device-related pressure injuries account for the majority of all pediatric pressure injuries due to the underdeveloped skin barrier and decreased tissue tolerance (Lin et al., 2020). As medical care becomes more complex and includes more devices, nurses must effectively assess patients' requirements and protect patients' skin from getting device-related pressure injuries. creating a physical barrier that shields moisture and irritants from the skin's health and regeneration. By producing a transparent barrier, the wipes lessen diaper rash and skin irritation caused by incontinence without altering the absorbency of incontinence products (Padula et al., 2021). Barrier wipes have been shown to minimize redness and discomfort when used in diaper cares by avoiding breakdown and may be applied similarly to traditional barrier lotions. Barrier wipes do not need to be removed and permit ongoing integumentary examinations.

In addition to the aforementioned fundamental measures, patients and caregivers should pay particular attention to food and water. People who are undernourished are far more susceptible to get pressure injuries. A healthy diet that is balanced, enough hydration, and the use of supplements as needed can all significantly reduce the incidence of pressure injuries in patients (Munoz et al., 2020).

Brief conclusion

From the above discussion it can be concluded that pressure injuries occur when pressure causes a localized damage to the underlying skin and soft tissue. Hospitals and long-term care facilities continue to have a lot of concerns about these skin and soft tissue injuries. They are costly for patients and in the healthcare system, and they have a detrimental effect on patients' quality of life. If the considerable morbidity and death rates linked to these pressure injuries are to be avoided, they must be immediately identified and treated. When different kinds of tension are applied to the skin's surface, a pressure injury happens. When dealing with a pressure injury, infection prevention is essential. If the wound becomes infected, the rest of the body might be in risk. Pressure injuries should be avoided whenever practical since they could have a negative effect on patient outcomes. The first measures in preventing pressure injuries are a comprehensive skin assessment and suitable skin care. Making a management decision for pressure injuries will be aided by the assessment of patients upon arrival. Care plans may also include other things like moisturizing the skin, protecting bony prominences, shielding it from dampness, redistributing pressure, and more.

References