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NURS 6052 Week 3 Essentials of Evidence-Based Practice

Identifying a Researchable Problem

The aim of this paper is to outline an area of interest, identify a problem, and explore its impact on the nursing practice community. It will generate five research questions and describe the feasibility analysis. Additionally, the paper will present and discuss a PICOT question along with ten keywords for conducting a literature review related to the PICOT question and its rationale.

Summary of Interest

Peripheral vascular access is a common procedure, with approximately 80% of new admissions requiring at least two peripheral intravenous catheters (PIV) per patient (New, Rickard, Osborne, & Webster, 2015). Many healthcare organizations adhere to outdated recommendations of rotating PIVs every 72 to 96 hours (New, Rickard, Osborne, & Webster, 2015). However, recent studies have suggested that PIVs can be safely changed only when clinically necessary without negative outcomes (Keogh, 2013). By examining existing policies and standards, it is possible to improve patient care, outcomes, and healthcare costs. It is essential for nursing practice to prioritize patient safety and provide evidence-based care. Unnecessary invasive procedures may be seen as doing harm, and cost-effective care is also a responsibility of the nursing community.

The Five Questions

How can nursing and supply costs be effectively contained while ensuring patient safety? This question aims to explore cost containment strategies, such as reducing the number of home visits for PIV rotation and minimizing supply usage, to achieve both cost savings and patient satisfaction through safe practices.

Why do organizations continue to adhere to outdated policies regarding PIV rotation based on a timed schedule rather than clinical assessment? This question seeks to understand the reasons behind the persistence of outdated policies and the potential barriers to implementing evidence-based practices. Relevant data from the organization’s national footprint and system can be analyzed to shed light on this issue.

What is the national infection rate for PIV catheters? This question highlights the importance of accessing data from the Centers for Disease Control, collaborating with other healthcare organizations, and utilizing information from various professional associations to determine the current infection rate and inform evidence-based interventions.

NURS 6052 Week 3 Essentials of Evidence-Based Practice

Would it be more beneficial to change peripheral intravenous catheters as clinically necessary rather than on a predetermined schedule? This preliminary PICOT question examines whether it is preferable to extend the duration of PIV dwell time beyond 72 hours and only change the catheters when there is a clinical indication. The question compares patient satisfaction and safety outcomes to determine the optimal approach.

What tools and interventions are being utilized to enhance patient safety and reduce infection rates in patients with PIVs? This question aims to explore existing strategies and practices implemented in healthcare settings to improve patient safety and decrease PIV-related infections. Additionally, it seeks to identify the factors contributing to PIV infections.

The chosen research questions are more focused to ensure the relevance of findings in the decision-making process. They are feasible and can be completed within a six-month timeframe, considering the wealth of available resources (Tatano Beck & Polit, 2017). The study directly relates to infusion nursing and cost-effective care. 

NURS 6052 Week 3 Essentials of Evidence-Based Practice

The participation of field nurses in data collection is invaluable, and the study includes nationwide participants, representing 27 states with both full-time nursing staff and agency nurses, allowing for potential variations in care. Collaboration between the management team and nursing department ensures a focus on best practices and policy within the organization. Ethical considerations should not pose a significant issue as the data will be collected during patient care utilizing a peripheral IV for infusion. Financial concerns may arise due to the time and expertise required for data analysis and discussion to support policy and procedure changes (Tatano Beck & Polit, 2017).

Keywords

A search for current peripheral vascular access was conducted in the Walden University library database. MEDLINE and CINAHL databases were searched for recommendations and guidelines published between January 2006 and December 2016, using keywords such as “peripheral intravenous access,” “catheterization, peripheral,” “IV,” “infusion nurse guidelines,” “venous catheters,” “nursing care,” “vascular devices,” “vascular access devices,” “infection rates,” “sepsis,” “piv,” “complications,” “contamination,” “catheter care,” “vascular,” “catheter-related infections,” “nursing assessment,” “practice guidelines,” “clinical practice guidelines,” “evidence-based guidelines,” and “best practice guidelines.” The search generated numerous articles, which are being reviewed to select relevant literature based on inclusion criteria related to the PICOT question being researched. Keywords play a crucial role in retrieving pertinent scientific papers from a vast collection of related publications (Meiratta & Sharma, 2002). NURS 6052 Week 3 Essentials of Evidence-Based Practice

Summary

The rotation of peripheral intravenous catheters is an area of interest. Despite current recommendations to change PIVs based on clinical necessity, many healthcare organizations continue to adhere to outdated policies of timed rotation every 72 to 96 hours (New, Rickard, Osborne, & Webster, 2015). This research aims to bridge the gap between practice and standards by examining the feasibility of implementing evidence-based policies.

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