NR 505 Week 1 Area of Interest in NP
The identified area of NP interest is surgical site infections (SSIs). According to Walker (2023), SSIs are frequently reported healthcare-acquired infections (HAIs) that account for 14% − 25% of the total HAIs. An SSI is an infection that occurs at a surgical incision site within 30 days of a surgical procedure. SSIs often have a negative effect on patient outcomes and quality of life. They are linked with extended periods of hospitalization, high medical costs, poor patient satisfaction, and increased patient morbidity and mortality. Thus, a rigorous approach is needed to identify and manage the risk of infection across the preoperative, intra-operative, and post-operative phases of care. Seidelman et al. (2023) identify several strategies linked with reduced SSI rates. One of the measures is using chlorhexidine gluconate and alcohol-based skin preparation. Jalalzadeh et al. (2022) found that in adult patients undergoing a surgical procedure, skin preparation using 2·0–2·5% chlorhexidine in alcohol or 1·5% olanexidine is effective in preventing SSIs. Thus, I would propose skin preparation with chlorhexidine in alcohol to reduce SSI rates in the clinical setting for patients undergoing surgical procedures.
References
Jalalzadeh, H., Groenen, H., Buis, D. R., Dreissen, Y. E., Goosen, J. H., IJpma, F., Van der Laan, M. J., Schaad, R. R., Segers, P., Van der Zwet, W. C., Griekspoor, M., Harmsen, W., Wolfhagen, N., & Boermeester, M. A. (2022). Efficacy of different preoperative skin antiseptics on the incidence of surgical site Infections: A systematic review, GRADE assessment and network meta-analysis. SSRN Electronic Journal. https://doi.org/10.2139/ssrn.4047135
Seidelman, J. L., Mantyh, C. R., & Anderson, D. J. (2023). Surgical Site Infection Prevention: A Review. JAMA, 329(3), 244–252. https://doi.org/10.1001/jama.2022.24075
Walker, J. (2023). Reducing the risk of surgical site infections. Nursing standard (Royal College of Nursing (Great Britain): 1987), 38(10), 77–81. https://doi.org/10.7748/ns.2023.e12185
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Purpose
Over the course of the next eight weeks, we will be examining concepts related to nursing research and the translation of evidence to practice. To help you better understand the process, you will be identifying a practice issue for nurse practitioners. You will develop a PICOT question associated with the issue, find evidence to support a change in practice, and present your recommendations for change to your peers. This week, we will work on helping you refine your area of interest so that you will be able to develop a concise question for next week’s assignment. You are encouraged to use the area of interest you chose for the project in NR500NP and/or NR501NP; however, you may choose a different area if you wish.
Select an issue in nurse practitioner (NP) practice that is of interest to you and in which you would like to see a practice change occur. Conduct a review of literature to see what is currently known about the topic. In 1-2 paragraphs, describe the scope and relevance of the issue and your recommended change. Provide reference support from at least two outside scholarly sources to support your ideas. Please pick something you can do as a NP in your practice that is patient focused. Your intervention needs to relate to a measurable patient health outcome. Please avoid anything that would require a policy or law change, such as full-practice authority. Burnout and satisfaction surveys also are not appropriate topics as they are not patient centered.
Review this 4-minute video to gain a better understanding of the requirements of a PICOT question. The PICOT question is not a research question, but a quality improvement issue that requires a practice change.
Hello, my name is Dr. Lynch. Hey, I’m an assistant professor a Chamberlain University College of Nursing. Today we’re gonna talk about pico questions and best practices in formulating these questions. There are five parts to a pico question. Patient intervention, comparison, outcome in time. The slides subsequently we will discuss each part of this question. The first ingredient for cooking up a pico question is population. Pick a broad topic, drill down, focus down so that then your population is very specific. Type two diabetic female patients age 30 to 40 who consume over 400 g of carbohydrates per day. A bunch more specific population then patients with diabetes intervention. What intervention do you think will make a difference? Is that supported by the scholarly literature? What is being done in clinical practice today? Are there better alternatives? You must use an intervention based on scholarly literature? Remember the definition of scholarly literature is a US based peer reviewed journal article geared for clinicians published in the past five years, or the latest clinical practice guideline. Comparison. So what is the standard of care currently? Patients without the intervention, patients without a condition, patients without risk factor. This part defines another population who will be used as a comparison against the group receiving the intervention. What is your desired outcome? The outcome should relate directly to the intervention and outcomes should be measurable. Time. This is a specific timeframe to demonstrate the outcome. In quality improvement efforts, the timeframe has to be realistic and manageable. Not over years, may not be even over months, but it could be. But it is usually a short timeframe to make an improvement effort. Many students ask what the differences between pico research and quality improvement questions. This chart will help you understand the difference. The pico question used here is in postoperative kidney transplant adults aged 65 to 75, how does a health coach compared with no health coaching affect hospital readmission rates within 90 days of discharge? This is a perfect pico question compared to the research question or QI question that also could be asked about this matter. Here’s an example. In real life, you’re a nurse practitioner working in a skilled nursing facility, the rate of false as unacceptable. And your care team has come together to discuss what should be done about this. Your pico question is, in elderly patients between age 65.75 residing in a sniff, how do fall prevention programs with risk assessment compared to fall prevention programs without risk assessment effect fall rates within 90 days after the intervention. So you can see how this question will guide how you view the literature on this topic. You will be looking for fall prevention with risk assessment in the scholarly literature to see what has worked in other places. What are the crucial ingredients in an outpatient fall prevention program? The literature holds the key, holds the answer to these questions. If you need further assistance, please contact your instructor directly. You can also contact the librarians at the Chamberlain library who can be accessed through many means, email, chat on real time. This material comes from Malbec and find out overhauled book evidence-based practice in nursing and health care, a guide to best practice, which is a great addition to your library.
A zero is the lowest score that a student can be assigned.
Faculty may submit any collaborative discussion posting to Turnitin in order to verify originality.
Total Points Possible: 50
Preparing the Assignment
Discussion Criteria
Application of Course Knowledge: The student’s initial post contributes unique perspectives or insights gleaned from personal experience or examples from the healthcare field. The student must accurately and fully discuss the topic for the week in addition to providing personal or professional examples. The student must completely answer the entire initial question. Initial post must be posted by Wednesday at 11:59pm MT. Two resources must be used in your initial post. One from the weekly reading or lesson and one outside source.
Engagement in Meaningful Dialogue: The student responds to a student peer and course faculty to further dialogue.
Peer Response: The student responds substantively to at least one topic-related post by a student peer. A substantive post adds content or insights or asks a question that will add to the learning experience and/or generate discussion.
A post of “I agree” with a repeat of the other student’s post does not count as a substantive post. A collection of shallow posts does not equal a substantive post.
The peer response must occur on a separate day from the initial posting.
The peer response must occur before Sunday, 11:59 p.m. MT.
The peer response does not require a scholarly citation and reference unless the information is paraphrased and/or direct quotes are used, in which APA style standards then apply.
Faculty Response: The student responds substantively to at least one question by course faculty. The faculty question may be directed to the student, to another student, or to the entire class.
A post of “I agree” with a repeat of the faculty’s post does not count as a substantive post. A collection of shallow posts does not equal a substantive post.
The faculty response must occur on a separate day from the initial posting.
Responses to the faculty member must occur by Sunday, 11:59 p.m. MT.
This response does not require a scholarly citation and reference unless the information is paraphrased and/or direct quotes are used, in which APA style standards then apply.
Integration of Evidence: The student post provides support from a minimum of one scholarly in-text citation with a matching reference AND assigned readings OR online lessons, per discussion topic per week. Two resources total and to count must be an in-text citation in your initial post.
What is a scholarly resource? A scholarly resource is one that comes from a professional, peer-reviewed publication (e.g., journals and government reports such as those from the FDA or CDC).
Contains references for sources cited
Written by a professional or scholar in the field and indicates credentials of the author(s)
Is no more than 5 years old for clinical or research article
What is not considered a scholarly resource?
Newspaper articles and layperson literature (e.g., Readers Digest, Healthy Life Magazine, Food, and Fitness)
Information from Wikipedia or any wiki
Textbooks
Website homepages
The weekly lesson
Articles in healthcare and nursing-oriented trade magazines, such as Nursing Made Incredibly Easy and RNMagazine (Source: What is a scholarly article.docx; Created 06/09 CK/CL Revised: 02/17/11, 09/02/11 nlh/clm)
Can the lesson for the week be used as a scholarly source?
Information from the weekly lesson can be cited in a posting; however, it is not to be the sole source used in the post.
Are resources provided from CU acceptable sources (e.g., the readings for the week)?
Not as a sole source within the post. The textbook and/or assigned (required) articles for the week can be used, but another outside source must be cited for full credit. Textbooks are not considered scholarly sources for the purpose of discussions.
Are websites acceptable as scholarly resources for discussions?
Yes, if they are documents or data cited from credible websites. Credible websites usually end in .gov or .edu; however, some .org sites that belong to professional associations (e.g., American Heart Association, National League for Nursing, American Diabetes Association) are also considered credible websites. Websites ending with .com are not to be used as scholarly resources
Professionalism in Communication: The post presents information in logical, meaningful, and understandable sequence, and is clearly relevant to the discussion topic. Grammar, spelling, and/or punctuation are accurate.
Wednesday Participation Requirement: The student provides a substantive response to the graded discussion question(s) or topic(s), posted by the course faculty (not a response to a peer), by Wednesday, 11:59 p.m. MT of each week.
Total Participation Requirement: The student provides at least three substantive posts (one to the initial question or topic, one to a student peer, and one to a faculty question) on two different days during the week.
Discussion Rubric
Category Points Description
Application of Course Knowledge 15 Answers the initial discussion question(s)/topic(s), demonstrating knowledge and understanding of the concepts for the week by Wednesday at 11:59pm MT.
Engagement in Meaningful Dialogue With Peers and Faculty 10 Responds to a student peer AND course faculty furthering the dialogue by providing more information and clarification, adding depth to the conversation
Integration of Evidence 15 Assigned readings OR online lesson AND at least one outside scholarly source are included. The scholarly source is:
1) evidence-based, 2) scholarly in nature, 3) published within the last 5 years
Total content points = 40 points
Grammar and Communication 5 Presents information using clear and concise language in an organized manner
Reference Citation 5 References have complete information as required by APA
In-text citations included for all references AND references included for all in-text citation
Total format points = 10 points
Discussion total points = 50 points
**To view the grading criteria/rubric, please click on the 3 dots in the box at the end of the solid gray bar above the discussion board title and then Show Rubric.
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NR505NP Scholarly Discussion Rubric
NR505NP Scholarly Discussion Rubric
Criteria Ratings Pts
This criterion is linked to a Learning Outcome Application of Course Knowledge
Answers the initial discussion question(s)/topic(s), demonstrating knowledge and understanding of the concepts for the week.
15 pts
Excellent
Addresses all aspects of the initial discussion question(s) applying experiences, knowledge, and understanding.
14 pts
Very Good
Addresses most aspects of the initial discussion question(s) applying experiences, knowledge, and understanding
12 pts
Satisfactory
Addresses some aspects of the initial discussion question(s) applying experiences, knowledge, and understanding.
8 pts
Needs Improvement
Addresses some aspects of the initial discussion question with little depth and lack of application of experiences, knowledge, or understanding.
0 pts
Unsatisfactory
Does not address the initial question(s).
15 pts
This criterion is linked to a Learning Outcome Engagement in Meaningful Dialogue With Peers and Faculty
The student responds to a student peer and course faculty to further dialogue.
10 pts
Excellent
Responds to a student peer AND course faculty furthering the dialogue by providing more information and clarification, thereby adding much depth to the discussion.
9 pts
Very Good
Responds to a student peer AND course faculty furthering the dialogue by adding some depth to the discussion.
8 pts
Satisfactory
Responds to a student peer and course faculty, adding minimal depth to the discussion.
5 pts
Needs Improvement
Responds to a student peer or course faculty, adding minimal depth to the discussion.
0 pts
Unsatisfactory
No response post to another student or course faculty.
10 pts
This criterion is linked to a Learning Outcome Integration of Evidence
Assigned readings OR online lesson AND at least one outside scholarly source are included. The scholarly source is:
1) evidence-based, 2) scholarly in nature, 3) published within the last 5 years.
15 pts
Excellent
Integrates evidence from: • assigned readings OR online lessons AND • at least one outside scholarly source. Sources are credited.*
14 pts
Very Good
Integrates evidence from: • no assigned readings OR online lesson is included • at least one outside scholarly source is included. Sources are credited.*
12 pts
Satisfactory
Integrates evidence from: • assigned readings OR online lesson • no outside scholarly source is included. Sources are credited.*
8 pts
Needs Improvement
Integrates evidence from: • assigned readings OR online lesson • no outside scholarly source is included. Sources are not credited.*
0 pts
Unsatisfactory
Does not integrate any evidence.
15 pts
This criterion is linked to a Learning Outcome Grammar and Communication
5 pts
Excellent
Presents information using clear and concise language in an organized manner (0–1 error in English grammar, spelling, syntax, and punctuation).
4 pts
Very Good
Presents information using clear and concise language in an organized manner (2–3 errors in English grammar, spelling, syntax, and punctuation).
3 pts
Satisfactory
Presents information using understandable language; information is not organized (4 errors in English grammar, spelling, syntax, and punctuation).
2 pts
Unsatisfactory
Presents information using understandable language; information is not organized (5-6 errors in English grammar, spelling, syntax, and punctuation).
0 pts
Unsatisfactory
Presents information that is not clear, logical, professional, or organized to the point that the reader has difficulty understanding the post (7 or more errors in English grammar, spelling, syntax, and/or punctuation).
5 pts
This criterion is linked to a Learning Outcome Reference Citation
5 pts
Excellent
References have complete information as required by APA (0-1 errors). In-text citations included for all references, AND references are included for all in-text citations (0 errors).
4 pts
Very Good
References have most information as required by APA (2 errors). In-text citations included for all references, AND references are included for all in-text citations (0 errors).
3 pts
Satisfactory
References have some information as required by APA (3 errors). In-text citations included for all references, AND references are included for all in-text citations (0 errors).
2 pts
Unsatisfactory
References have some information as required by APA (4 errors). In-text citations included for all references AND references are included for all in-text citations (0 errors).
0 pts
Unsatisfactory
References missing 5 or more elements AND/OR In-text citations missing OR final references not included for in-text citations.
5 pts
This criterion is linked to a Learning Outcome Late Penalty Deductions
0 pts
0 Points Deducted
A 5% late penalty will be imposed for discussions posted after the deadline on Wednesday, regardless of the number of days late. NOTHING will be accepted after 11:59pm MT on Sunday (i.e. student will receive an automatic 0)
0 pts
2.5 Points Deducted
0 pts
This criterion is linked to a Learning Outcome Total Participation Responses
0 pts
0 Points Deducted
A 5% penalty will be imposed for not entering at least THREE posts on the minimum of TWO separate days. NOTHING will be accepted after 11:59pm MT on Sunday (i.e. student will receive an automatic 0)
0 pts
2.5 Points Deducted
0 pts
Total Points: 50