Clinical Nursing Practice Problem Assignment Paper

Select and identify ONLY one quality or safety clinical priority area from the assignment guidelines practice scenario. Summarize why you believe the nursing practice problem/issue is the most important.  Summarize your rationale (why) for choosing the problem.  Clinical Nursing Practice Problem Assignment Paper

PICOT Question

Using the NR439 Guide for Writing PICOT Questions and Examples located in the assignment guidelines, write out your PICOT question. Include the PICOT letters in your question. Use the instructor feedback from the Week 2 Check-In to develop your question.

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Define each of the PICOT elements from your question above.

Use the instructor feedback from the Week 2 Check-In.

I– (Intervention):

C– (Comparison):

O– (Measurable outcome):

T– (Time frame in months): Clinical Nursing Practice Problem Assignment Paper

Using only the Chamberlain University Library:

(1) Locate evidence that is relevant to your chosen nursing practice problem.  Explain how you believe the evidence is relevant to your chosen nursing practice problem.

(2) Explain why you chose the evidence

(3) Provides a complete APA reference to the evidence (must include authors, year, title of the evidence, title of the resource)

(4) Evidence must be published within the last 10 years

(5) Provides the permalink

APA Reference and permalink:

Summarize what you learned from the evidence. Summarize why you believe the nursing evidence-based practice committee should focus their next research project on the nursing practice problem. Clinical Nursing Practice Problem Assignment Paper

Identify 4 (or more) relevant searchable terms you used for your search for evidence.

Strategies

Select 4 (or more) relevant search strategies you used to narrow/limit your search for

evidence.

____   Full text

____   Boolean Operators/Phrase

____   Selected publication dates within last 10 years

____   Subject, title, or author search box

____   Truncation (used an asterisk * at the beginning or end of a word)

____   Academic or scholarly (Peer Reviewed) journals

____   Quotation marks for key words

____   Selected key terms from PICOT question

____   Others: (list below): ____________________________________________

Problem/PICOT/Evidence Search (PPE) Worksheet (Based on Wk. 2 Check-In PICOT)
Criteria The quality priority area identified is discharge instruction or teaching (educational intervention) for newly diagnosed middle-aged adults with hypertension.
This issue is most important because it determines medication compliance as well as compliance with lifestyle measures such as exercise and diet (Kaplan, 2016; MacDonald & Pescatello, 2018).
The rationale for choosing this problem is that hypertension in the middle-aged is an epidemic that is responsible for adverse health outcomes such as heart cardiovascular disease.
Clinical Nursing Practice Problem

Select and identify ONLY one quality or safety clinical priority area from the assignment guidelines practice scenario. Summarize why you believe the nursing practice problem/issue is the most important. Summarize your rationale (why) for choosing the problem. Clinical Nursing Practice Problem Assignment Paper

Clinical Nursing
PICOT Question

Using the NR439 Guide for Writing PICOT Questions and Examples located in the assignment guidelines, write out your PICOT question. Include the PICOT letters in your question. Use the instructor feedback from the Week 2 Check-In to develop your question. In middle aged adults with a new diagnosis of hypertension (P), does thorough discharge teaching (I) compared to common practice (C) decrease the rate of readmission (O) within 30 days (T)?

Define PICOT Elements

Define each of the PICOT elements from your question above.
Use the instructor feedback from the Week 2 Check-In. P- (Patient population/patients of interest): Middle-aged adults newly diagnosed with hypertension.

I- (Intervention): Thorough discharge teaching (educational intervention).

C- (Comparison): Common or usual practice of discharging patients with hasty instructions.

O- (Measurable outcome): Rate of readmission.

T- (Time frame in months): Thirty (30) days.
Evidence Retrieval Process and Summary

Using only the Chamberlain University Library:
(1) Locate evidence that is relevant to your chosen nursing practice problem. Explain how you believe the evidence is relevant to your chosen nursing practice problem.
(2) Explain why you chose the evidence
(3) Provides a complete APA reference to the evidence (must include authors, year, title of the evidence, title of the resource)
(4) Evidence must be published within the last 10 years
(5) Provides the permalink Clinical Nursing Practice Problem Assignment Paper
The evidence below has been chosen because it is relevant to the PICOT question. It has been chosen because it addresses the PICOT elements.
APA Reference and permalink:
Farahmand, F., Khorasani, P., & Shahriari, M. (2019). Effectiveness of a self-care education program on hypertension management in older adults discharged from cardiac-internal wards. ARYA Athrosclerosis, 15(2), 44-52. https://doi.org/10.22122/arya.v15i2.1787
Leppin, A.L., Gionfriddo, M.R., Kessler, M., Brito, J.P., Mair, F.S., Gallacher, K., … Montori, V.M. (2014). Preventing 30-day hospital readmissions: A systematic review and meta-analysis of randomized trials. JAMA Internal Medicine, 174(7), 1095-1107. https://doi.org/10.1001/jamainternmed.2014.1608
Still, K.L., Davis, A.K., Chilipko, A.A., Jenkosol, A., & Norwood, D.K. (2013). Evaluation of a pharmacy-driven inpatient discharge counseling service: Impact on 30-day readmission rates. The Consultant Pharmacist, 28(12), 775–785. https://doi.org/10.4140/TCP.n.2013.775
Implications of the Evidence
Summarize what you learned from the evidence. Summarize why you believe the nursing evidence-based practice committee should focus their next research project on the nursing practice problem. The evidence from literature indicates that comprehensive patient teaching with clear discharge instructions and the importance of medications and other interventions to newly diagnosed hypertension patients is effective. It is effective in reducing readmission rates due to exacerbation of the hypertension. Reasons for this exacerbation include noncompliance to medications, diet, and exercise prescriptions.
The EBP committee should focus on this practice problem because the initiative will improve the quality of care.
Evidence Search Terms
Identify 4 (or more) relevant searchable terms you used for your search for evidence.
“Middle-aged,” “newly diagnosed,” “hypertension,” and “discharge education.”

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Evidence Search
Strategies

Select 4 (or more) relevant search strategies you used to narrow/limit your search for
evidence.
 ____ Full text
 ____ Boolean Operators/Phrase
 ____ Selected publication dates within last 10 years
____ Subject, title, or author search box
____ Truncation (used an asterisk * at the beginning or end of a word)
 ____ Academic or scholarly (Peer Reviewed) journals
____ Quotation marks for key words
 ____ Selected key terms from PICOT question
____ Others: (list below): Clinical Nursing Practice Problem Assignment Paper ____________________________________________
References
Farahmand, F., Khorasani, P., & Shahriari, M. (2019). Effectiveness of a self-care education program on hypertension management in older adults discharged from cardiac-internal wards. ARYA Athrosclerosis, 15(2), 44-52. https://doi.org/10.22122/arya.v15i2.1787
Kaplan, N.M. (2016). Hypertension highlights: The many benefits of exercise. Journal of the American Society of Hypertension, 10(4), 280-281. https://doi.org/10.1016/j.jash.2016.01.016
Leppin, A.L., Gionfriddo, M.R., Kessler, M., Brito, J.P., Mair, F.S., Gallacher, K., … Montori, V.M. (2014). Preventing 30-day hospital readmissions: A systematic review and meta-analysis of randomized trials. JAMA Internal Medicine, 174(7), 1095-1107. https://doi.org/10.1001/jamainternmed.2014.1608
MacDonald, H.V. & Pescatello, L.S. (2018). Exercise prescription for hypertension: New advances for optimizing blood pressure benefits. Lifestyle in Heart Health and Disease, 115-136. https://doi.org/10.1016/B978-0-12-811279-3.00009-4
Still, K.L., Davis, A.K., Chilipko, A.A., Jenkosol, A., & Norwood, D.K. (2013). Evaluation of a pharmacy-driven inpatient discharge counseling service: Impact on 30-day readmission rates. The Consultant Pharmacist, 28(12), 775–785. https://doi.org/10.4140/TCP.n.2013.775 Clinical Nursing Practice Problem Assignment Paper