The impact of a clinical practice problem on the patient or patients and the organization it affects.
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.
- 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.
- PICO Components and EBP Question
- Evidence Appraisal
- 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.
- 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.
- 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.
- Data Analysis
- Statistical methods: Identify the statistical tests used to analyze the data.
- Results: Summarize the key findings and their statistical significance.
- 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).
- 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.