Now that you have located available research on your PICOT question, you will examine what the research indicates about nursing practices. Connecting research evidence and findings to actual decisions and tasks that nurses complete in their daily practice is essentially what evidence-based practice is all about. This final component of the Course Project asks you to translate the evidence and data from your literature review into authentic practices that can be adopted to improve health care outcomes. In addition, you will also consider possible methods and strategies for disseminating evidence-based practices to your colleagues and to the broader health care field.
- Consider Parts 1 and 2 of your Course Project. How does the research address your PICOT question?
- With your PICOT question in mind, identify at least one nursing practice that is supported by the evidence in two or more of the articles from your literature review. Consider what the evidence indicates about how this practice contributes to better outcomes.
- Explore possible consequences of failing to adopt the evidence-based practice that you identified.
- Consider how you would disseminate information about this evidence-based practice throughout your organization or practice setting. How would you communicate the importance of the practice?
In a 3- to 4-page paper:
- Restate your PICOT question and its significance to nursing practice.
- Summarize the findings from the articles that you selected for your literature review. Describe at least one nursing practice that is supported by the evidence in the articles. Justify your response with specific references to at least 2 of the articles.
- Explain how the evidence-based practice that you identified contributes to better outcomes. In addition, identify potential negative outcomes that could result from failing to use the evidence-based practice.
- Outline the strategy for disseminating the evidence-based practice that you identified throughout your practice setting. Explain how you would communicate the importance of the practice to your colleagues. Describe how you would move from disseminating the information to implementing the evidence-based practice within your organization. How would you address concerns and opposition to the change in practice?
Part 3 of the Course Project is due by Day 7 of Week 10. It should be combined with the other two components of the Course Project and turned in as your Portfolio Assignment for this course. Note: In addition, include a 1-page summary of your project.
For this final iteration you will need to:
- Submit your paper to Grammarly and Turnitin through the Walden Writing Center. Based on the Grammarly and Turnitin reports, revise your paper as necessary.
- Reminder: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The School of Nursing Sample Paper provided at the Walden Writing Center provides an example of those required elements (available from the Walden University website found in this week’s Learning Resources). All papers submitted must use this formatting.
Note: The Course Project will be your Portfolio Assignment for this course.
Translating Evidence into Practice
PICOT Question: In hospitalized patients above 65 years (P), how does diet and fluid intake (I) compare to drugs therapy (C) in reducing the hospitalization duration and economic burden while promoting the quality of the individual’s wellbeing (O) over 1-month (T)?
Significance to Nursing Practice
Constipation is a major challenge among geriatrics. As espoused by Martinez-Martinez, Calabuig-Tolsa, and Cauli (2017), the condition is common among the hospitalized individuals and the diagnosis is centred on a number of symptoms including incomplete evacuation, bowel movements, and long evacuation duration. The manifestation of these challenges is represented by hard and lumpy stools and anorectal obstruction sensation. In addition, the majority of these patients use manual manoeuvres to defecate. According to Munch, Tvistholm, Trosborg, and Konradsen (2016), the condition is also related to other issues such as diarrhoea as a result of fecaloma, bacteria in the urine, and vomiting. Besides, the condition affects one’s mental health and may result in depression. Managing the condition entail different approaches including pharmacological and non-pharmacological. Although holistic management of constipation is effective in alleviating the symptoms, asserting on the best approach between drug therapy and fluid and water intake is a challenge which is the foundation of the PICOT question.
The significance of the PICOT is to examine the most effective approach in managing constipation between drug therapy and taking fibre and diet. While the pharmacotherapy approach is effective in addressing the condition, long-term strategies are imperative to avert other challenges such as polypharmacy. For instance, Gandell, Straus, Bundookwala, Tsui, and Alibhai (2013) argue that the use of osmotic agencies promotes water secretion in the lumen which maintains isotonicity. However, these osmotic agents are characterized by side effects such as abdominal pain, bloating, and diarrhoea. Increasing fibre and fluid intake manage the symptoms are considered as lifestyle modifications. These strategies are described by taking more than 3-5 glasses of water per day. Increasing fibre intake involves consuming more vegetables and fruits to improve metabolism. De Giorgio et al. (2015) argue that these approaches besides alleviating the constipation symptoms improve the overall health of the patient. This PICOT question will, therefore, provide a better understanding of the best constipation management nursing practices.
Summary of the Articles and Nursing Practice
Chronic constipation among the elderly has increased significantly. According to Gandell et al. (2013), with the prevalence approaching 50%, constipation is presently considered a public health concern with some of the aspects associated with the increase being gender, race, and economic status. Notably, the condition is prevalent among those from low economic status, the non-white, and women. In addition, the condition is related to other issues such as anxiety and depression. One of the primary challenges in managing the condition is the lack of effective diagnosis strategies. This is affirmed by De Giorgio et al. (2015) who found that profound diagnoses approaches are imperative which aid in developing the condition management strategies in line with the individual’s factors. There are different management approaches such as using laxatives and lifestyle modification. While investigating constipation prevalence among geriatrics, Lamas et al. (2017) found that poor nutrition and using different, and many medications are the foundation of the condition high prevalence.
Two nursing practices common in the literature are patient education and promoting lifestyle modification. In patient education, it involves enlightening the individual regarding the condition and the different management strategies. According to Yilmaz and Asiret (2017), creating patient awareness regarding the condition and the different management strategies including the drugs enhances their decision-making process on various aspects such as treatment. In addition, such patients are highly involved in implementing management strategies. In the second nursing practice, it entails developing a life-modification plan with the patient while considering individual factors such as other conditions. This describes the person-centred care where the management plan is developed in line with the person’s factors. According to De Giorgio et al. (2015), the majority of constipation patients respond positively to lifestyle modification approaches including taking plenty of fluid, vegetables, and fruits. Despite establishing the best management drugs, Munch et al. (2016) note that nurses should work together with the patient to develop a life-modification plan that involves healthy meals, defecation plan, daily water intake targets, and exercises. This approach is also essential in promoting the individual’s overall health.
Importance of the Evidence-Based Practice
As mentioned above, two evidence-based practices in managing constipation are patient education and the developing a life-modification plan. Considering the patient education EBP, Nebhinani and Suthar (2017) note that promoting patient awareness regarding a condition is the foundation of enhancing the implementation plan and achieving the set outcomes. In patient-centred care, awareness programs are described as individual empowerment which enhances the decision-making process. In lifestyle modification, it is aimed at avoiding taking different medications which contribute to the patient’s poor health. According to Yilmaz and Asiret (2017), a majority of patients besides using laxatives take high quantities of fruits and vegetables. In addition, taking plenty of fluids is essential in alleviating constipation symptoms. The merits of lifestyle modification are that they promote the patient’s overall health. This is as asserted by Lamas et al. (2017) who argue that the lack of proper nutrition is a major contributor to constipation. This factor as well as limiting the high intake of drugs should be included in the life modification plan.
Disseminating the Evidence-Based Practice
Drawing from the above discussion and summary of the articles, the combination of patient awareness and lifestyle modification as evidence-based practices is essential in promoting the patient’s health. To disseminate this finding, the publication of the research project and using presentations in seminars and conferences will suffice. Sharing with colleagues the evidence-based practice will involve interacting with them and making the research accessible to every individual. In addition, applying the findings in the actual practice will be important in enlightening other professionals on advanced practices. One of the main challenges in implementing change is resistance from the stakeholders. To address such opposition, involving these individuals in the implementation process is vital as well as including them in the decision-making process. This aids in establishing their thoughts on the evidence-based practice and incorporating their suggestions in the implementation process.
In summary, constipation is a major challenge among geriatrics. The condition which is described by several symptoms such as blockage sensation during defecation and lengthy evacuation is related to other issues such as depression and anxiety. In constipation management, there are different approaches which may be applied to alleviate the symptoms. In pharmacotherapy, it entails the use of laxatives while in non-pharmacological management, it mainly involves lifestyle modification. In this regard, the evidence-based practices related to managing the condition include patient education and developing a life-modification plan. This not only addresses the constipation symptoms but also improves the individual’s overall health. Disseminating these findings would involve sharing my findings through presentation and publishing the research.
De Giorgio, R., Ruggeri, E., Stanghellini, V., Eusebi, L. H., Bazzoli, F., & Chiarioni, G. (2015). Chronic constipation in the elderly: a primer for the gastroenterologist. BMC gastroenterology, 15(1), 130.
Gandell, D., Straus, S. E., Bundookwala, M., Tsui, V., & Alibhai, S. M. (2013). Treatment of constipation in older people. Cmaj, 185(8), 663-670.
Lämås, K., Karlsson, S., Nolén, A., Lövheim, H., & Sandman, P. O. (2017). Prevalence of constipation among persons living in institutional geriatric‐care settings–a cross‐sectional study. Scandinavian journal of caring sciences, 31(1), 157-163.
Martínez-Martínez, M. I., Calabuig-Tolsa, R., & Cauli, O. (2017). The effect of probiotics as a treatment for constipation in elderly people: A systematic review. Archives of gerontology and geriatrics, 71, 142-149. doi: 10.1016/j.archger.2017.04.004
Munch, L., Tvistholm, N., Trosborg, I., & Konradsen, H. (2016). Living with constipation—older people’s experiences and strategies with constipation before and during hospitalization. International journal of qualitative studies on health and well-being, 11(1), 30732.
Nebhinani, N., & Suthar, N. (2017). Constipation in elderly patients with psychiatric disorders. Journal of Geriatric Mental Health, 4(1), 11.
Yilmaz, C. K., & Asiret, G. D. (2017). Identifying the Constipation Levels of Older People and their Interventions for Recovery. International Journal of Caring Sciences, 10(3), 1605-1614.