Evidence-based translation for advanced nursing practice

From personal experiences, I have learned that evidence-based practice is very important as it enables the health care provider to use well-designed studies from randomized control trials, meta-analysis, qualitative study, clinical cohort study, practice guidelines, among other sources of evidence (Lui, 1).  I have learned that evidence-based practice guide clinicians in clinical practice. I have utilized evidence-based health care and it has helped me by providing a useful insight especially in patient care. For example, I have applied evidence-based practice in dealing with patients with stroke. In most cases, stroke affects the elderly individuals, and lower incidents in young individuals. Stroke affects the quality of life by causing negative effects on physical and cognitive abilities (Lui, 1).In finding the preventative measures, we implemented the evidence-based practice of rehabilitation.  According to several studies, patients with stroke become disabled after discharge. For example, a community-based cohort study found that 58% of patients with stroke (from 85 years) died after post-stroke (Lui, 1). Another multicenter cohort study found that elderly patients who are taken to nursing facilities do not suffer from multi-morbidity. To prevent patients with stroke from developing cognitive impairment and other post-stroke condition, we referred them to rehabilitation where they could receive natural mechanisms of recovery.  Note that stroke causes brain damage and neurogenesis or self-repair occurs through the higher intensity of therapy. In rehabilitations, patients discharged from acute care received skill learning which promoted plasticity and improved stroke recovery (Lui, 1). They also received motor retraining which promoted motor recovery. Therefore, using the evidence-based practice of stroke, rehabilitation improved the quality of care in that there was an improvement in functional outcomes, reduction in hospital stay, and other benefits.

 An evidence-based practice model that I might use in my doctorate project is the Iowa Model for Evidence-Based Practice to Promote Quality Care. The project that I have identified is Depression screening after stroke in patients under 64 years old.  The rationale for choosing this model is that the model is patients-centered, and the purpose of the project is to promote quality care, or in other words to promote excellence (Brown, 152). From multiple research, I have learned that patients with stroke suffer from post-stroke depression.  Therefore, my project will focus on the need for assessment and treatment of post-stroke depression. Note that screening is useful as it will detect depression and clinicians will be able to improve depressive symptoms through treatment in acute care settings.  In the project, the aim is to evaluate whether early screening of depression will reduce mortality, and improve quality of life (Brown, 152). The lowa model is associated with strengths in that it will focus on the problem (depression),  it will identify the team that will be involved in the practice (depression screening),  it will evaluate whether the practice has achieved the desired practice change, and the model will address the PICOT questions, that is;  population, intervention, control, outcome, and time. In general, the lowa model will help come up with research findings, and implement the findings into clinical practice. Note that the purpose of the project is to come up with evidence-based practice and in this, the practice is screening for depression in patients with stroke to improve the quality of care (Brown, 152). However, the lowa model is associated with weaknesses as it only focuses on a team of clinicians and this means that there are barriers to implementation. There must a team to develop, implement, and evaluate the practice. Nevertheless, I will use the model in my current and future projects since it will help come up with a clinical question, address the problem with the interest stakeholders, and ensure a successful implementation.

 

Work cited

 

 

Brown, Carlton G. "The Iowa Model of Evidence-Based Practice to Promote Quality Care: An

Illustrated Example in Oncology Nursing." Clinical Journal of Oncology Nursing 18.2

(2014).

 

Lui, Siew Kwaon, and Minh Ha Nguyen. "Elderly stroke rehabilitation: overcoming the

complications and its associated challenges." Current gerontology and geriatrics

research 2018 (2018).