Question

I need help with collaborating the 2.

How does a nurse know what (if any) knowledge in a research study is usable for clinical practice? What would a critical thinker look for in the evidence before deciding to change? What influence do credibility and clinical significance have on your decisions to integrate research-based evidence into your practice?

The discussion below is my initial post.

Fall risk is a major risk at any hospital facility. Any time you have a patient that has physical limitations they are at risk for fall. Therefore, we have to take measures to protect them. In my facility, the patient who are at high risk for falls (e.g. elderly, heavily medicated, visual impairment, cognitive decline, h/o falls etc.) are placed in a yellow gown, yellow socks, yellow arm band, the strobe light above the entrance to the door is lit yellow, bed in low position with the safety rails up, check mark placed on the fall risk symbol outside the door, and the bed alarm is set to alert the staff if the patient chooses to get out the bed. Also, everything should be placed at arm's reach. The goal of patient safety is to prevent additional harm while the patient is hospitalized. It is necessary that the patient do not get out the bed without assistance from the staff. As a secretary, I connect our call light to each nurse CNA that is assigned to that patient room. There was an incident where a cognitive impaired patient, bed alarm went off because he wanted to use the bedside commode which was across the room. The nurse turned off the bed alarm, so it would stop alarming. She safely placed the patient back into the bed after assisting him with the commode but left without turning the bed alarm back on. The patient got up again and we heard a loud boom. We searched the rooms to see where the noise came from and that same patient was on the floor with a bruise to his face from the fall. The staff assisted the patient back to the bed. The patient said he was trying to reach for his glasses. The physician, family, house supervisor, and manager were notified. Labs and X-rays were ordered by the physician. It is necessary to make sure every precaution is placed before leaving the room. The nurse had to fill out an incident report and stay after work so she could be re-educated on her careless behavior. In this incident, the nurse should have made sure the bed alarm was in place, checked to see the patient had everything in arm’s length and was educated on how to use the hand hell nurse call light. Also checked to see if the patient needed anything else before leaving the room.

Answer 1

Nurses are expected to access, appraise and incorporate the research evidence into clinical practice. Nurse has to form an appropriate clinical question and search for the vidence and gather further information about the question. According to the information gathered ,  Appraise the relevance of the evidence, incorporate the evidence into a strategy for action and then evaluate the decisions made. Selection of Decision also involves combination of knowledge and one's own clinical expertise, patient preference and evidences in the context of available resources .

The critical thinker has to check for the strength of the evidence before selection of the decision. Also a thorough literature search is necessary.

In order to incorporate evidence into practice the research has to expect a positive outcome and benefits should be always more than the risk.  

Patient preference need to be considered while incorporating evidence in practice.