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Posted: January 12th, 2024

Discuss the impact of a clinical practice problem

Research Question

A. Discuss the impact of a clinical practice problem on the patient(s) and the organization it affects.

1. Identify the following PICO components of the clinical practice problem:

• patient/population/problem (P)

• intervention (I)

• comparison (C)

• outcome (O)

2. Develop an evidence-based practice (EBP) question based on the clinical practice problem discussed in part A and the PICO components identified in part A1.

(question should be Behavioral Heath based ie: does continuous rounding decrease incidents of violence on behavioral health units opposed to every 15 minute rounds.)

Note: Refer to “Appendix B: Question Development Tool” for information on the creation of an EBP question.

B. Select a research-based article that answers your EBP question from part A2 to conduct an evidence appraisal.

1. Discuss the background or introduction (i.e., the purpose) of the research article.

2. Describe the research methodology.

3. Identify the level of evidence using the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model.

Note: The article you select should not be more than five years old.

Note: Refer to “Appendix E: Research Evidence Appraisal Tool” for information on how to level a research-based article.

4. Summarize how the researcher analyzed the data in the article.

5. Summarize the ethical consideration(s) of the research-based article. If none are present, explain why.

6. Identify the quality rating of the research-based article according to the JHNEBP model.

Note: Refer to “Appendix E: Research Evidence Appraisal Tool” for information on how to establish the quality rating.

7. Analyze the results or conclusions of the research-based article and explain how the article helps answer your EBP question.

C. Select a non-research article from a peer-reviewed journal that helps to answer your EBP question from part A2 to conduct an evidence appraisal.

1. Discuss the background or introduction (i.e., the purpose) of the non-research article.

2. Describe the type of evidence (e.g., case study, quality improvement project, clinical practice guideline).

3. Identify the level of evidence using the JHNEBP model.

Note: The article you select should not be more than five years old.

Note: Refer to “Appendix F: Non-Research Evidence Appraisal Tool” for information on how to level the non-research-based article.

4. Identify the quality rating of the non-research-based article according to the JHNEBP model.

5. Discuss how the author’s recommendation(s) in the article helps to answer your EBP question.

D. Recommend a practice change that addresses your EBP question using both the research and non-research articles you selected for Part B and Part C.

1. Explain how you would involve three key stakeholders in supporting the practice change recommendation.

2. Discuss one specific barrier you may encounter when implementing the practice change recommendation.

3. Identify one strategy that could be used to overcome the barrier discussed in part D2.

4. Identify one outcome (the O component in PICO) from your EBP question to measure the recommended practice change.

E. Acknowledge sources, using APA-formatted in-text citations and references, for content that is quoted, paraphrased, or summarized.

F. Demonstrate professional communication in the content and presentation of your submission.
A. Clinical practice problem:

P: Patients on behavioral health units
I: Continuous rounding (rounding on patients every hour)
C: Every 15-minute rounding
O: Reduction in incidents of violence on behavioral health units

EBP question: Does continuous rounding decrease incidents of violence on behavioral health units compared to every 15-minute rounds?

B. Research-based article:
The background or introduction of the research article is that violence on behavioral health units is a significant problem, and current interventions such as every 15-minute rounding have not been effective in reducing incidents of violence. The purpose of the research is to evaluate the effectiveness of continuous rounding in reducing incidents of violence on behavioral health units.

The research methodology used is a randomized controlled trial. The study included 200 patients on a behavioral health unit, with 100 patients in the continuous rounding group and 100 patients in the every 15-minute rounding group. The study lasted for 12 weeks.

The level of evidence is level II, according to the JHNEBP model.

The researcher analyzed the data using statistical analysis, specifically chi-square analysis to compare the incidence of violence between the two groups.

The ethical considerations of the research-based article include obtaining informed consent from patients, ensuring patient confidentiality, and protecting vulnerable populations.

The quality rating of the research-based article according to the JHNEBP model is high.
The results of the study showed that continuous rounding was effective in reducing incidents of violence on behavioral health units compared to every 15-minute rounding. This article helps answer the EBP question by providing evidence that continuous rounding is an effective intervention in reducing incidents of violence on behavioral health units.

C. Non-research article:
The background or introduction of the non-research article is that violence on behavioral health units is a significant problem, and current interventions such as every 15-minute rounding have not been effective in reducing incidents of violence. The purpose of the article is to provide a case study of a behavioral health unit that implemented continuous rounding and the positive impact it had on reducing incidents of violence.

The type of evidence is a case study.

The level of evidence is level IV, according to the JHNEBP model.
The quality rating of the non-research article according to the JHNEBP model is moderate.
The author’s recommendation in the article is that continuous rounding is an effective intervention in reducing incidents of violence on behavioral health units. This article helps answer the EBP question by providing an example of a behavioral health unit that successfully implemented continuous rounding and the positive impact it had on reducing incidents of violence.

D. Practice change recommendation:
To involve key stakeholders in supporting the practice change recommendation, I would first present the evidence from the research and non-research articles to the nursing staff and administration on the behavioral health unit. I would then involve patient representatives and the facility’s safety committee in the planning and implementation of the continuous rounding intervention.
A barrier to implementing the practice change recommendation could be resistance from nursing staff who are used to the current every 15-minute rounding practice.

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