write a 2–3 paragraph summary of how you have used evidence throughout this course to answer your compelling clinical questions.
Please respond to both the discussions. 250 words each. 2 references each. Less than 5 years.
We have looked at evidence-based practice in-depth and in detail throughout this class. This started with the creation of a PICOT question. My original PICOT question was: In hospitalized 5150 patients, how does cognitive stimulation compared with mental deprivation affect overall feelings of the 5150 experiences during a seventy-two-hour hold? After diving into the research, I found that not many articles addressed this issue. My PICOT question then evolved into patients at high risk or diagnosed with postpartum depression. Do nonpharmacological treatments vs. pharmacological interventions improve outcomes within the first three months of the postpartum period. This generated a ton of evidence to sort through, and many of the randomized clinical trials and systematic reviews that I researched has conflicting data. I decided to be more specific in my most recent PICOT question. I modified it to this: in patients diagnosed with postpartum depression, do estrogen-based treatments vs. treatment without estrogen improve Edinburgh Postnatal Depression Scores within the six weeks of the postpartum period. Through the research done for this paper, I determined that estrogen replacement through transdermal estradiol patches may not be the best treatment for most of my future patients suffering from postpartum depression (Li et al., 2019). However, according to Li et al. (2019), there may be some noted benefits in special patient populations. This means only selecting women at low risks for adverse events of taking transdermal estradiol.
To implement this type of evidence-based change, it is essential to do so systematically and carefully. According to Melnyk and Fineout-Overholt (2018), there is a scale on how to implement evidence-based findings into one’s practice. This scale speaks to eighteen different ways, as a student, I can implement these findings into current and future practice. The first six are what we went through in this class—looking at evidence-based literature, formulating PICOT questions, sharing and discussing this information with peers. The big one for me is number 17, “Made a clinical decision about how to care for a patient based on patient outcome data.” (Melnyk & Fineout-Overholt, 2018, p. 737). I have not done this yet and am not sure how many postpartum depression patients I will see in my emergency department practice. Still, If I do, I will encourage physical activity, diet, and exercise as non-pharmacological treatments, based on the research provided by my second PICOT question.
Li, H. J., Martinez, P. E., Li, X., Schenkel, L. A., Nieman, L. K., Rubinow, D. R., & Schmidt, P. J. (2019). Transdermal estradiol for postpartum depression: Results from a pilot randomized, double-blind, placebo-controlled study. Archives of Women’s Mental Health, 23(3), 401–412. https://doi.org/10.1007/s00737-019-00991-3
Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Wolters Kluwer Health.
Throughout this term Evidence-Based Practice (EBP) has been studied, dissected, and put into use. The EBP implementation scale is a tool that consists of 18 statements that allow the user to determine how many times they use each of the description. This is important because it gives an indication of EBP usage in clinical practice. Research has shown that nurses that have more belief in EBP tend to use it more often than nurses that do not (Abu-Baker, AbuAlrub, Obeidat, & Assamairan, 2021).
Since learning how to properly understand, vet, and apply evidence, I have been able to better screen the information that I am using for my clinical question. Things from the EBP implementation scale like shared information with colleagues and informally discussed EBP ranked highest on the list because EBP is rarely used in my department. However, for the use of my clinical question, the use and discussion of databases, reading and critically apprising studies, sharing outcome data and promoting the use of EBP ranks very high. Having this scale will make the future of my EBP usage much more thorough by giving me rock solid guidelines to pay very close attention to.
For my clinical question, I used various levels of evidence, vetting of the evidence, supporting and contradictory evidence, as well as a breakdown of some of the evidence. I was able to find significant support for the implementation of my intervention based on the evidence and hope that the findings will be supported when I introduce them at work. Nevertheless, I will be proud of what I present regardless of what leadership chooses to do.
Abu-Baker, N., AbuAlrub, S., Obeidat, R.& Assamairan, K. (2021). Evidence-based practice beliefs and implementations: a cross-sectional study among undergraduate nursing students. BMC Nurs 20(13). https://doi.org/10.1186/s12912-020-00522-x
Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Wolters Kluwer Health.
Comments from Customer
This was the discussion is the responses are answering.
Compelling Clinical Question application
An evidence-based implementation scale is available in your text. Review this scale and write a 2–3 paragraph summary of how you have used evidence throughout this course to answer your compelling clinical questions.