Evidence Based Practice Project Proposal Paper

Description

Refer to the PICOT you developed for your evidence-based practice project proposal. If your PICOT required revision, include those revisions in this assignment. You will use your PICOT paper for all subsequent assignments you develop as part of your evidence-based practice project proposal in this course and in NUR-590, during which you will synthesize all of the sections into a final written paper detailing your evidence-based practice project proposal Evidence Based Practice Project Proposal Paper

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Write a 750-1,000-word paper that describes your PICOT.

  1. Describe the population’s demographics and health concerns.
  2. Describe the proposed evidence-based intervention and explain how your proposed intervention incorporates health policies and goals that support health care equity for the population of focus.
  3. Compare your intervention to previous practice or research.
  4. Explain what the expected outcome is for the intervention.
  5. Describe the time for implementing the intervention and evaluating the outcome.
  6. Explain how nursing science, social determinants of health, and epidemiologic, genomic, and genetic data are applied or synthesized to support population health management for the selected population.
  7. Create an Appendix for your paper and attach the PICOT. Be sure to review feedback from your previous submission and revise your PICOT accordingly.
  8. Complete the “APA Writing Checklist” to ensure that your paper adheres to APA style and formatting criteria and general guidelines for academic writing. Include the completed checklist as the final appendix at the end of your paper Evidence Based Practice Project Proposal Paper.

Refer to the “Evidence-Based Practice Project Proposal – Assignment Overview” document for an overview of the evidence-based practice project proposal assignments.

You are required to cite at least four to six peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

PICOT Draft Name: Jonathan Garcia Part II: In the table below, describe the population and the intervention. (You will continue drafting the PICOT, completing the shaded areas in Topic 3.) PICOT Question P Population I Intervention C Comparison Intubated patients in the ICU. Semi-fowlers positioning while intubated on a ventilator. Positioning the patient in semi-fowlers result in a lower incidence of nosocomial pneumonia when compared to the supine position Semi-fowler positioning is more effective in reducing the O Outcome incidences of nosocomial pneumonia T PICOT Timeframe 6 months In mechanically ventilated ICU patients (P), does positioning the patient in semi-fowlers (I) result in a lower incidence of nosocomial pneumonia (O) when compared to the supine position (C) In a 6 month research(T). Problem There has been an increased prevalence of ventilated-associated pneumonia or nosocomial Statement pneumonia which are among the ventilated infections that affects patients receiving mechanical intubation in ICUs. These infections affects patients and prolongs their hospital stays and could portray risks of increased mortalities and high healthcare costs. With the © 2021. Grand Canyon University. All Rights Reserved. advanced healthcare system, policies and interventions are required to regulate the high rates of nosocomial pneumonia and ventilated-associated infections (Zhu et al., 2020). The primary focus is to evaluate the prevalence of VAP in the healthcare system and implement possible interventions to eradicate the occurrence of the problem. Also, the use of semi-fowler or semi-recumbent position for patients in ICU receiving mechanical ventilation or ventilation intubation can prevent the occurrence of VAP infections (Zhu et al., 2020)Evidence Based Practice Project Proposal Paper.

Semi-fowler or semi-recumbent positioning of patients are compared to supine position which have been deemed ineffective based on their cause of ventilated infections. Randomized trials have been implemented to help ascertain the relevance of semi-folwer’s position in comparison with supine positioning for patients in ICU receiving mechanical ventilation. Ventilated-Associated Pneumonia is a common disease that has increased due to inappropriate positioning of mechanically ventilated patients in ICU (Mezidi & Guerin, 2019). The problem can be prevented by implementing effective positioning which increases safety and quality of care to ICU patients and recommendations aimed to compare semi-fowler or semi-recumbent positioning against supine positioning. Mechanical ventilation and the use of supine patient positioning is the leading cause of ventilator infections which can increase the risks of suspected VAP infections, ICU mortality incidences, lengthy of ventilation process, prolonged hospice stay, antibiotic use, and other adverse events that affects the patients in ICU (Zhu et al., 2020)Evidence Based Practice Project Proposal Paper.

Therefore, there is the need to reevaluate the patient positioning which would be effective to prevent the occurrence of ventilated-associated pneumonia and other ventilated infections. © 2021. Grand Canyon University. All Rights Reserved. References Mezidi, M., & Guérin, C. (2019). Effect of body position and inclination in supine and prone position on respiratory mechanics in acute respiratory distress syndrome. Intensive care medicine, 45(2), 292-294. Zhu, Q., Huang, Z., Ma, Q., Wu, Z., Kang, Y., Zhang, M., … & Huang, F. (2020). Supine versus semi-Fowler’s positions for tracheal extubation in abdominal surgery-a randomized clinical trial. BMC anesthesiology, 20(1), 1-9. © 2021. Grand Canyon University. All Rights Reserved. Translational Research Graphic Organizer PICOT Question – In mechanically ventilated ICU patients, does positioning the patient in semi-fowlers result in a lower incidence of nosocomial pneumonia when compared to the supine position? Nursing Practice Problem: Ventilated-Associated Pneumonia is a common disease that has increased due to inappropriate positioning of mechanically ventilated patients in ICU. The problem can be prevented by implementing effective positioning which increases safety and quality of care to ICU patients and recommendations aimed to compare semi-fowler or semi-recumbent positioning against supine positioning. Comparison 1: Translational Research vs. Qualitative Research Criteria Effects of 60° Semi-recumbent Semi‐recumbent position versus supine Observations Position on position for the prevention of ventilator‐ (Similarities/Differences) Preventing Ventilator-associated associated pneumonia in adults requiring Pneumonia: mechanical ventilation © 2021. Grand Canyon University. All Rights Reserved. A Single-blind Prospective https://www.ncbi.nlm.nih.gov/pmc/articl Randomized es/PMC7016937/ Clinical Trial Translational Research Type: http://dspace.tbzmed.ac.ir:8080/xmlui/ Translational research handle/123456789/45001 Traditional Research Type: Qualitative research Methodology Randomized clinical trial of using 25 Search for evidence from online libraries Head-of-bed-elevation patients recruited in surgical ICU units and randomized controlled trials (Wang (HOBE) was effective to for ventilation mechanical surgery et al., 2016). The evidence obtained from lower pulmonary infiltration (Hassankhani et al., 2017)Evidence Based Practice Project Proposal Paper.

The online libraries such as CENTRAL, of chests for patients. patients were designated to be MEDLINE, EMBASE, CINAHL, and Both methods were effective positioned differently over a year of CBM comparing the impacts of semi- to prevent VAP. intensive care with the aim of recumbent positioning and supine © 2021. Grand Canyon University. All Rights Reserved. providing insights about the risks positioning to prevent ventilated- Semi-recumbent position associated with positioning and VAP. associated pneumonia (VAP). helped reduce the risks of VAP. Both used randomized clinical trials over a period of time. Both methods did not provide information about the change of positioning by slight change of degrees of elevation. Goals To help assess and present insights of To evaluate the safety of patients Both have similar goals and the benefits and effectiveness of Head- receiving intensive care during objectives as they dictate the of-bed-elevation (HOBE) on 60 mechanical intubation. impacts of semi-recumbent degrees in the prevention of VAP. To assess the effectiveness of semi- positioning and head-of-bed- Compare HOBE of 60 degrees against recumbent position in reducing the risks elevation in preventing cases 45 degrees for patients in ICU and the of VAP (Wang et al., 2016). © 2021. Grand Canyon University. All Rights Reserved. prevention of VAP (Hassankhani et To help patients in ICU avoid of VAP infections (Bassi et al., 2017). complications that would interfere with al., 2017). To measure how HOBE 60 degrees their recovery process. Both methods are effective helps improve gas circulation and air and are prevents the issues circulation associated with VAP to patients receiving mechanical ventilation intubation. Data Data was obtained from a single-blind Quality of evidence was utilized as it Data collection was different Collection prospective randomized clinical trial involved the evaluation of data from as one involved perusal of which involved 25 patients. Each peer-reviewed articles (Wang et al., evidence from peer-reviewed group (HOBE 60^0 and HOBE ^45) 2016). Authors screened titles, abstracts, clinical articles and the other were recruited and results obtained for and full-texts containing information one used clinical trials. a year (Hassankhani et al., 2017)Evidence Based Practice Project Proposal Paper.

Data about the comparison of semi-recumbent The exclusion criterion was on progress was recorded in each positioning versus supine position for used by qualitative data morning and evening by nurses which patients in ICU and the prevention of collection while the included age, weight, underlying VAP. 10 Trials were involved but only translational data collection © 2021. Grand Canyon University. All Rights Reserved. disorders, etiology of hospitalization, eight were successful due to loss of track involved the evaluation of history of medication, and drug of records. evidence obtained from sensitivity. various peer-reviewed literatures. Comparison 2: Translational Research vs. Quantitative Research Criteria Supine versus semi-Fowler’s positions for Semi‐recumbent position versus supine Observations tracheal extubation in abdominal surgery-a position for the prevention of ventilator‐ (Similarities/Differences) randomized clinical trial associated pneumonia in adults https://bmcanesthesiol.biomedcentral.com/ar requiring mechanical ventilation ticles/10.1186/s12871-020-01108-5 https://www.ncbi.nlm.nih.gov/pmc/artic Translational Research Type: Quantitative les/PMC7016937/ Translational Research Type: Translational research © 2021. Grand Canyon University. All Rights Reserved. Methodology Randomized clinical trials were used with Search for evidence from online Both utilized the 141 participants where two groups of supine libraries and randomized controlled randomized clinical trials and semi-fowlers positioning were utilized. trials. The evidence obtained from The traditional method The participants were grouped depending on online libraries such as CENTRAL, used online peer-review the supine and semi-fowlers positioning MEDLINE, EMBASE, CINAHL, and methods while the whereby, 70 patients after surgery were CBM comparing the impacts of semi- quantitative method used positioned in supine while the other 71 were recumbent positioning and supine participants to obtain data positioned in semi-fowlers position (Zhu et positioning to prevent ventilated- at the end of the trial al., 2020). associated pneumonia (VAP) (Wang et Evidence was obtained Evidence was obtained from records of al., 2016). from changes of patients’ changes and vital signs such as coughs, healing process for both comfort, pain, and comfort-scores before and medical positions but the after surgery. traditional research utilized evidence from reviewed articles on insights of the discussed positioning © 2021. Grand Canyon University. All Rights Reserved. methods (Bassi et al., 2017). Goals To ascertain that semi-fowlers position is To evaluate the safety of patients Both methods aimed to considered effective and more comfortable receiving intensive care during provide insights on the after mechanical ventilation surgery and mechanical intubation. effective positioning after prevents VAP (Zhu et al., 2020)Evidence Based Practice Project Proposal Paper.

To assess the effectiveness of semi- mechanical intubation To improve the quality of care offered in recumbent position in reducing the risks surgery for patients in ICU ICUs and prevent prolonged hospice stay of VAP (Wang et al., 2016). Both methods ascertained and reduce the risks of infections that might To help patients in ICU avoid that semi-fowler or semi- prolong the recovery process of patients. complications that would interfere with recumbent methods were their recovery process. deemed effective to prevent VAP. Data Demographic data was obtained before Quality of evidence was utilized as it The traditional research Collection surgery involved the evaluation of data from methods collected data After surgery, data obtained included peer-reviewed articles. Authors from peer reviewed articles heartbeat rates, mean arterial pressure, screened titles, abstracts, and full-texts and abstracts concerning © 2021. Grand Canyon University. All Rights Reserved. peripheral capillary oxygen saturation, containing information about the the difference of supine temperature, and respiratory rate (Zhu et al., comparison of semi-recumbent and semi-fowler 2020). positioning versus supine position for positioning in preventing Monitoring of recovery process for both patients in ICU and the prevention of VAP. groups were implemented and changes VAP. 10 Trials were involved but only The quantitative method recorded by nurses. eight were successful due to loss of obtained data from clinical track of records (Wang et al., 2016). operations and real-time patients in a hospital and the evidence offered insights on the benefits of semi-fowler when compared to supine positioning in preventing VAP. © 2021. Grand Canyon University. All Rights Reserved. References Bassi, G. L., Xiol, E. A., Pagliara, F., Hua, Y., & Torres, A. (2017, June). Body position and ventilator-associated pneumonia prevention. In Seminars in respiratory and critical care medicine (Vol. 38, No. 03, pp. 371-380). Thieme Medical Publishers. Hassankhani, H., Akbarzadeh, S., Lakdizaji, S., Najafi, A., & Mamaghani, E. A. (2017). Effects of 60 degrees Semi-recumbent Position on Preventing Ventilator-associated Pneumonia: A Single-blind Prospective Randomised Clinical Trial. JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 11(12), OC36-OC39. Wang, L., Li, X., Yang, Z., Tang, X., Yuan, Q., Deng, L., & Sun, X. (2016). Semi‐recumbent position versus supine position for the prevention of ventilator‐associated pneumonia in adults requiring mechanical ventilation. Cochrane Database of Systematic Reviews, (1). Zhu, Q., Huang, Z., Ma, Q., Wu, Z., Kang, Y., Zhang, M., … & Huang, F. (2020). Supine versus semi-Fowler’s positions for tracheal extubation in abdominal surgery-a randomized clinical trial. BMC anesthesiology, 20(1), 1-9. © 2021. Grand Canyon University. All Rights Reserved Evidence Based Practice Project Proposal Paper