Category: EBP 1 Posts

Ethical Considerations for EBP

August 6, 2021 / ecarrell

Before EBP, my perception of the nurse’s role in ethical practice was veery narrow, and only consisted of concepts like HIPAA, and patient advocacy. However, I now understand that they have a much more involved position. Nurses spend a significant amount of time with all of their patients, which means they know them on the most intimate level. In that respect, they can identify and screen potential patients for research candidacy. Therefore, they also need to make sure that patients and their families have all of the information necessary to be able to make an informed decision about participation. Much of the informed consent process is done by nurses. In terms of the research itself, nurses make sure that data and evidence is well-constructed, has relevance, significance and is valuable. They also assess the quality of the research and work to improve the methods that aren’t efficacious based on their past experiences.

Knowing the process of the research ethics is helpful, as being able to plan and execute a clinical investigation is a very valuable skill in the field of nursing. Clinical research is the reason that modern science is as advanced as it is. Nurses see firsthand what is and what is not therapeutic, and this can become a trial-and-error sort of process in itself. So, it is very important for nurses to be a part of clinical research, as they are the primary data gatherers in the patient care setting. They are familiar with patterns of symptoms and outcomes and have great intuition about their patients.

The Evidence Based Practice course allowed me to get a better sense of what clinical research looks like, as well as what the initiation process entails. I learned that nurses have far more responsibility than I originally thought, but it makes complete sense that we do, as we know the patient care process better than anyone. I feel that my confidence has grown as far as my ability to gather and evaluate journal articles. Being able to identify the strengths and weaknesses of a study is a very good skill to have moving forward!

EBP Final Paper Team 8

August 5, 2021 / ecarrell

The paper attached examines the relationship between music therapy and stress levels in mechanically ventilated patients in the ICU. By forming an accurate and applicable PICOT question, we were able to streamline our research and gather pertinent data points to formulate our paper. The knowledge gleaned from our Evidence Based Practice course also guided our efforts in piecing together an efficacious research process.

Team-8-EBP-FINAL-Paper Download

EBP Final Reflection

August 1, 2021 / ecarrell

Evan Carrell

EBP Final Reflection

August 1, 2021

This project was valuable in many ways. Working in a team is always a challenge, as combining multiple writing styles and preferences into one paper requires adjustments. In my future nursing practice, I will inevitably encounter situations where I will need to collaborate with colleagues who I disagree or clash with. Additionally, this foundational experience allowed me to practice finding appropriate research articles that fit well with the group’s PICOT question. The ability to find evidence to back up a research question will certainly be something I’m faced with in the clinical setting. In order to successfully write this paper, I had to pull outcomes from multiple different clinical trials and evaluate them based on their relevance, variables and reproducibility. Being able to pick out the strengths and weaknesses of a clinical trial is a very valuable skill to have, as doing so is vital in the process of eliminating redundancy, while increasing search efficiency.

In the instance of the research into our topic specifically, I learned a lot about the benefits of music therapy. None of the studies we found cited any observable disadvantages or adverse effects associated with this intervention. The results from these studies showed me the benefits of implementing music therapy hospital wide. I can say for certain that in my future practice, I will utilize music therapy in the treatment of my patients.

As far as my individual team contribution, I learned that I work best with structure, and laying out a clear outline of what my work will look like helps me organize my thoughts. Luckily, my teammates operate similarly, and our work came together fairly smoothly

EBP Appraisal and Synthesis

July 25, 2021 / ecarrell

July 25, 2021

After researching our chosen topic (the use of music therapy in mechanically ventilated patients) it became clear to us that this technique, while maybe not widely implemented, is effective and useful in the clinical setting. From the start, just based on a quick overview of our articles, we knew that music therapy was understood to be helpful in creating a healing environment. However, I didn’t realize the extent to which it was useful in shortening hospital stays, preventing agitation, and decreasing the number of days on a ventilator. Additionally, our articles pointed out that music therapy as a treatment is cost-effective, requires minimal resources, and does not require additional training for staff.

That being said, I can confidently say that I will implement music therapy into my future nursing practice. At no point in any of our articles were any adverse effects listed, which is a promising finding. Considering that it does no additional harm, and actually reduces anxiety for patients at no additional cost, I would use it for as many patients as possible.

I think the only point of disagreement my groupmates and I had about the findings was how we might tweak our PICOT question. Some of the research articles we found talked about ICU patients specifically, others talked about conscious versus unconscious patients, and we went back and forth for a bit about how specific our patient population should be.

During the writing process, the only challenge we faced as a group was blending our writing styles in our paper, which worked out nicely once we revised the paper as a group.

From Inquiry Through Discovery

June 13, 2021 / ecarrell

After coming up with our original PICOT question, and finding reliable resources, my group was able to narrow down our topic a bit more. Originally, our question was “What is the relationship between music and patient outcomes in the ICU?”, which was a good start, but it was still a bit vague. Researching the original question helped us to more narrowly define “patient outcomes” and we decided to focus on anxiety levels in ventilated patients. Our revised question is “What is the relationship between music and anxiety levels in critically ill ventilated patients in the ICU?” This was a difficult process, as our searches came up with multiple potential outcome topics. However, it seemed like the majority of the primary resources we found discussed playing music for ventilated ICU patients and monitoring more self-reported measures like pain and anxiety. We were quickly able to agree on this change, given the number of pertinent journal articles we found. I think what was helpful for our process as a group was our collective ability to connect to this subject, and share personal stories relating to our question. We are all very devoted to and excited about our chosen topic!

Planning the Journey

May 28, 2021 / ecarrell

I anticipate this group project going smoothly. I have worked with my teammates during group work before, and I know that we all trust each other’s ability to do good work. Our communication plan so far is to talk over text, email and zoom to work out details and assign tasks. We will set deadlines for ourselves and hold each other accountable for the work we agree to do. In the case of a conflict, we will have honest conversations and reorganize, reassigning tasks and making edits as needed. Respectful, timely communication is key to successful group projects. I don’t foresee many barriers to completing this project, however, everyone tends to do work and write papers a little bit differently, so that is good to keep in mind preemptively. We each have different levels of clinical experience as well, and that is an important factor as we prepare to write a paper involving hospital policies and different interventions in the care process. This same idea will be useful in future nursing practice, as every individual brings a completely different set of experiences to the table, which can be an advantage as well as a disadvantage at times.

Thinking About the Journey

May 19, 2021 / ecarrell

After the first semester of nursing school, I can tentatively say that I am interested in critical/intensive care nursing. My previous experiences as both a phlebotomist at Maine Med and a nursing student at Mercy have lead me to consider units like NICU, SCU, CTICU, and CICU. I am someone who likes a more intense, involved, high acuity environment. I am also attracted to the unpredictable nature of intensive care, as well as the more intimate patient-to-nurse ratio. Additionally, I have a solid background in pharmacy, which would most likely come in handy, as intensive care patients are often on a lot of life-sustaining medications. I would like to learn more about the specific responsibilities nurses have in the clinical care setting, and how those differ from what I’ve seen in my clinical rotations on the medical/surgical floors.

At this point, my assumptions about EBP are that it is a system that works toward implementing the best methods of patient care based on observed outcomes. Last semester, we learned about the importance of paying close attention to outcomes, or how patients respond to treatments and interventions. I think this class will help inform us about the best methods for identifying a need for improvement, as well as the best ways to communicate that need to our coworkers. I’m sure that as we learn more about different nursing interventions and therapies in other classes, we will be able to apply what we learn in EBP. In the clinical setting, we can more directly see how evidence-based improvements are implemented in the field, and we will have the ability to ask our instructors more about how research is done at a specific site. While this knowledge be useful in communication with fellow nurses, it is also vital that we use EBP interprofessionally, as healthcare is a co-dependent system that relies on all levels of staff keeping each other in check. I would guess that it helps to get an outsider’s perspective, as an unbiased eye may see room for improvement where others can’t. Additionally, research done by one department may identify a need for adjustment in another department.