The impact of a clinical practice problem on the patient or patients and the organization it affects.

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Discuss the impact of a clinical practice problem on the patient or patients and the organization it affects.

1. Identify each of the following PICO components of the clinical practice problem:

• P: patient, population, or problem

• I: intervention

• C: comparison

• O: outcome

2. Develop an evidence-based practice (EBP) question based on the clinical practice problem discussed in part B and the PICO components identified in part B1.

Note: Refer to the “Appendix B: Question Development Tool” web link for information on the creation of an EBP question.

C. Select a research-based article that answers your EBP question from part B2 to conduct an evidence appraisal.

Note: The article you select should not be more than five years old.

1. Discuss the background or introduction (i.e., the purpose) of the research-based article.

2. Describe the research methodology used in the research-based article.

3. Identify the level of evidence for the research-based article using the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model.

Note: Refer to the “Appendix E: Research Evidence Appraisal Tool” web link for information on how to level a research-based article.

4. Summarize how the researcher analyzed the data in the research-based article.

5. Summarize the ethical considerations of the research-based article. If none are present, explain why.

6. Identify the quality rating of the research-based article according to the JHNEBP model.

Sample Solution

Clinical Practice Problem: High rates of medication errors in the administration of insulin to patients with diabetes in a community hospital.

Impact on Patients:

  • Increased risk of adverse drug events (ADEs): Medication errors can lead to hypoglycemia, hyperglycemia, or other serious complications, potentially resulting in hospitalization, disability, or even death.
  • Decreased quality of life: Patients who experience medication errors may suffer from anxiety, fear, and decreased trust in healthcare providers.
  • Increased healthcare costs: Medication errors can result in prolonged hospital stays, additional treatments, and increased healthcare expenses.

Impact on Organization:

  • Legal and financial liabilities: Medication errors can lead to lawsuits, settlements, and increased insurance premiums.
  • Damage to reputation: A reputation for frequent medication errors can negatively impact the organization’s image and patient satisfaction.
  • Decreased efficiency: Medication errors can disrupt workflow, increase workload for healthcare providers, and lead to decreased efficiency.
  1. PICO Components and EBP Question

P: Patients with diabetes in a community hospital I: Implementation of a barcode medication administration (BCMA) system C: Current medication administration practices O: Reduction in medication errors related to insulin administration

EBP Question: Does the implementation of a barcode medication administration (BCMA) system reduce medication errors related to insulin administration in patients with diabetes in a community hospital?

  1. Evidence Appraisal

Note: To provide a comprehensive and accurate evidence appraisal, I would need to access a specific research-based article that addresses the EBP question. However, I can outline the general steps and considerations involved in such an appraisal.

  1. Background and Introduction
  • Purpose: Identify the research question or objective of the study.
  • Rationale: Understand the reasons for conducting the study, including the significance of the clinical practice problem and the potential benefits of the intervention.
  1. Research Methodology
  • Study design: Determine the type of study design used (e.g., randomized controlled trial, observational study, case-control study).
  • Sampling: Evaluate the adequacy and representativeness of the sample.
  • Data collection: Assess the methods used to collect data, including the reliability and validity of measurement instruments.
  • Intervention: Describe the details of the intervention, including its implementation and fidelity.
  1. Level of Evidence
  • JHNEBP Model: Use the Johns Hopkins Nursing Evidence-Based Practice model to categorize the level of evidence based on the study design and methodological rigor.
  1. Data Analysis
  • Statistical methods: Identify the statistical tests used to analyze the data.
  • Results: Summarize the key findings and their statistical significance.
  1. Ethical Considerations
  • Informed consent: Assess whether informed consent was obtained from participants.
  • Confidentiality: Evaluate the measures taken to protect participant privacy and confidentiality.
  • Ethical approval: Determine if the study was approved by an institutional review board (IRB).
  1. Quality Rating
  • JHNEBP Model: Use the JHNEBP model to assign a quality rating to the study based on its methodological rigor and the strength of its findings.

By carefully evaluating these aspects of the research-based article, you can assess its credibility, relevance, and applicability to your clinical practice problem.

 

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