NR700-60057 Week 6 Analyzing Forms of Nursing Inquiry Presentation Part 3 MP

NR700-60057 Week 6 Analyzing Forms of Nursing Inquiry Presentation Part 3 MP

NR700-60057 Week 6 Analyzing Forms of Nursing Inquiry Presentation Part 3 MP

Differentiate Research, Quality Improvement and Evidence-Based Practice

Purpose
Research
Quality improvement
Evidence-based practice
The purpose of this presentation is to learn what the difference is amongst research, QI and EBP. The importance of breast feeding is discussed in the three articles that were chosen. The articles utilize research, EBP and QI to stress the importance of breast feeding.
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Discuss the importance of breastfeeding
Support and assist with breastfeeding (Hain, 2017)

The articles used state that breastfeeding is beneficial for both mother and baby. One article discusses that there is a lack of breast feeding support by nurses. Breastfeeding decreases mortality in infant, it has ant-infective properties, lowers risk of breast and ovarian cancer as well as a decrease in Diabetes and post partum depression.
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What is research?
The definition of research is a systematic inquiry that uses methods to answer a question. It is used to attain knowledge or confirm existing knowledge based on theory to provide better outcomes for patients. (Hain, 2017)

4

What is quality improvement?
Quality improvement is defined “as systematic, data-guided activities designed to bring about immediate improvement in health care delivery in particular settings”(Polit, 2017).The purpose is to use a systematic approach to collect data in order to identify areas for improvement and bring forth change to help with better patient outcomes.

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What is evidence-based practice?
Evidence Based Practice is defined as “the application of valid, relevant, researched-based information in nurse decision making(Rosenfeld, 2017)”.The purpose of EBP is to use the best evidence attained by research to improve quality of patient care.

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How does DNP apply Research, QI and EBP?
Research – basis of practice
QI – evaluation of existing practices
EBP – implementing care based on research
The DNP applies research to practice by using different theories and methods to collected information on different nursing problems. These results that are found from the studies are then used in practice. Research is the Basis of Nursing Practice.
The DNP applies Quality improvement by evaluating existing practices. This is done by using QI strategies such as regulations, protocols, incentives, education of patients and providers, audits and feedback, provider reminders and organizational changes. (Hughes,2008).
The DNP applies EBP to practice by implementing care based on research in addition to clinical expertise.
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NICU Nurses and Lactation –Based Support and Care
Research article
Cohort design
Nicu nurses – lactation based support
Nurses attitudes on breast feeding (Froh, Dahlmeier and Spatz, 2017)
NICU Nurses and Lactation –Based Support and Care is a research article. The purpose of this study was to address how and when NICU nurses are providing lactation based support. The method used was through a cohort study by having urban hospital nurses answer 21 questions and the Iowa Infant Feeding attitude scale. The results showed that 50.7-72.9% of the nurses provided lactation support to patients. 69.1 % had a positive attitude towards breastfeeding. This study showed that the majority of nurses at this place gave lactation support and supported breast feeding.
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A Quality Improvement Initiative : Improving Exclusive Breastfeeding Rates of Preterm Neonates
Quality Improvement
Team evaluated reasons for inadequate breastfeeding
Increase in newborns getting mothers breastmilk
Expression of breast (Sethi, Joshi, Thukral, Singh Dalal, & Kumar Deorari, 2017)

A Quality Improvement Initiative : Improving Exclusive Breastfeeding Rates of Preterm Neonates is a quality improvement article. A team was put together in a tertiary care NICU to evaluate the reasons for inadequate breast feeding. The data was taken on how much breast milk was expressed from day 1-7. Then the next 15 mothers were counseled (CPNC-comprehensive postnatal breast feeding counseling) on breast feeding in order to promote breast milk expression immediately. The amount of neonates receiving the mothers breast milk by day 7 increased by 80%. There was also a decrease in the need for formula of 50% within the first week. This was accomplished after only 4 weeks of QI.
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Maternity Care Practices That Support Breastfeeding: CDC Efforts to Encourage Quality Improvement
EBP
CDC Survey
Initiatives for improvement on supporting breastfeeding mothers (Grummer-Strawn, Shealy, Perrine, Macgowan, Grossniklaus, Scanlon, & Murphy,2013)

Maternity Care Practices That Support Breastfeeding: CDC Efforts to Encourage Quality Improvement is an evidence based practice article. This EBP article discusses the benefits of breast feeding for mothers health. Lowers the risk of breast , ovarian cancer and type 2 diabetes.This information was collected through meta-analysis study and Analyses of The Nurses Health Study. This article also states that babies who are not breast fed have increased risk for ear and GI infections, SIDS and obesity. Initiatives and surveys are conducted to promote and assist with breast feeding. UNICEF and the WHO have identified 10 steps to successful breast feeding. This initiative gives simple detailed guides for breast feeding support. The CDC has encouraged these steps and provided a survey (mPINC-maternity practices in infant nutrition and care). This survey collects information on maternity practices from maternity units in USA hospitals. The CDC has also supplied funds for QI in order too support breast feeding. The mPINC score has risen from 2009-2011 showing that the initiatives and funds are efforts that are improving breast feeding.
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NR700-60057 Week 6 Analyzing Forms of Nursing Inquiry Presentation Part 3 MP

Outcomes for all Three Studies
50.7%-72.9% provided lactation based support
69.1% had positive attitudes towards breastfeeding
Breast milk expressed increased to 86.6%

The outcomes for all through studies showed positive and supportive attitudes towards breastfeeding. In the research article 50.7%-72.9% of nurses provided lactation based support to NICU mothers and 69.1% of the nurses had positive attitudes towards breast feeding. In the QI article it showed that after initiatives breast milk expressed on day 1 increased to 86.6%.
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Outcomes for all Three Studies

Breast milk expressed increased to 80%
Average score was 63 out of 100
Mean score improved between 2009-2011
The QI also showed that breast milk expressed on day 7 increased to 80%. Th EBP article showed that the mPINC had an average score of 63 out of 100 in 2007 and between 2009-2011 all parts of the mPINC showed improvement. The different parts were L&D, feeding of breast fed infants, breast feeding assistance,mother-infant contact, discharge care, staff training and structural and organizational aspects of care.
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Impact of evidence
All three studies showed improvement
Information gives Nurses evidence for better care

The impact of this evidence showed improvement for breast feeding and support. The idea is to improve and increase breast feeding by using research, EBP, QI, initiatives, support and education.
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Impact of the forms of inquiry on the DNP
Gives evidence
Gives data
Gives resources
Helps improve practice

The impact of the forms of inquiry are that they will ultimately improve practice by providing evidence, data and resources that can be utilized.
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References
Froh, E., Dahlmeier, K.,& Spatz, D. L., (2017.,). NICU nurses and lactation-based support and care. Advances in Neonatal Care ,17(3), 203–208.
Grummer-Strawn, L. M., Shealy, K. R., Perrine, C. G., Macgowan, C., Grossniklaus, D. A., Scanlon, K. S., & Murphy, P. E., (2013). Maternity care practices that support breastfeeding: CDC efforts to encourage quality improvement. Journal of Women’s Health (15409996), 22(2), 107–112.

References


Hain, D. J., (2017). Focusing on the fundamentals: comparing and contrasting nursing research and quality improvement. Nephrology Nursing Journal: Journal Of The American Nephrology Nurses’ Association, 44(6), 541–543.
Sethi, A., Joshi, M., Thukral, A., Singh Dalal, J., & Kumar Deorari, A., (2017). A quality improvement initiative: improving exclusive breastfeeding rates of preterm neonates. Indian Journal Of Pediatrics, 84(4), 322–325.

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