Essay Sample on EBP among Nurses: Preventing VAP with Oral Chlorhexidine

Introduction

The prevention of infections such as pneumonia is crucial among nurses. The utilization of current evidence-based practice (EBP) among nurses is needed to prevent and control VAP. In EBP, the formulation of a research question requires a patient, intervention, comparison, outcome, and timeframe (PICOT) format. For this paper, the PICOT question is as follows: Among adult patients who are mechanically ventilated (P) the use of oral chlorhexidine (I) compared to no oral chlorhexidine (C) helps to prevent VAP (O) within 4 weeks (T)? The purpose of the paper is to describe the problem in the PICOT question as it relates to evidence-based solutions, nursing intervention, patient care, health care agencies, and nursing care.

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Evidence-Based Solution

Applying EBP to prevent and control VAP will improve the quality of life of patients. Saunders et al. (2016) affirmed that nurses should be ready for EBP adoption. Regarding the PICOT question, the application of EBP is significant because it will help nurses find the best practice to reduce infections such as VAP in patients who are mechanically ventilated. Evidence-based decision-making requires asking the right clinical questions and searching through credible databases to answer those questions (Bowen & Forrest, 2017). A sample of an evidence-based resource is by Li et al. (2015) who investigated the role of routine oral care to prevent infections such as VAP in mechanically ventilated patients. In their research, the authors found that the application of chlorhexidine, an oral care antiseptic, prevented the occurrence of VAP. From such research, nurses can apply the results in their clinical practice to prevent the occurrences of VAP.

Nursing intervention

Interventions are crucial practices that nurses should master. Aslam and Emmanuel (2010) described the term intervention as a plan to treat the patient such as a procedure, therapy, diagnostic test, and prognostic factor. Regarding the PICOT question, the nursing intervention applicable to the prevention and control of VAP is the use of chlorhexidine. In their study, Li et al. (2015) found that chlorhexidine reduced the prevalence of VAP significantly. Theoretical frameworks can help to improve clinical practice and direct the use of evidence-based nursing interventions. Mitchell (2013) emphasized that change is vital to progress. Also, Farrugia et al. (2010) stated that knowing the right intervention is crucial in determining the outcome of a clinical problem. When nurses decide to change their practices in settings, that use mechanical ventilation, the number of infections such as VAP will reduce.

Patient care

With the application of chlorhexidine, nurses can manage to prevent VAP in adult patients within 4 weeks. The PICOT question applies to patient care because, during the timeframe, nurses will need to put in the effort to improve adult patients’ health outcomes. Gillam et al. (2016) discussed the use of medication education to improve patients’ experience. Also, Gardner et al. (2016) stated that the application of EBP or research will help to improve patient care. Nurses could learn more about chlorhexidine medication and its importance in reducing VAP.

Health care agency

Healthcare agencies provide educational resources to nurses. The Center for Evidence-based Medicine (2014), for example, emphasized the use of evidence-based research to improve the quality of care and health outcomes. Additionally, the Institute for Healthcare Improvement (n.d) recommended the Plan-Do-Study-Act (PDSA) Cycles, which are useful in ensuring successful change. The PICOT question relates to health care agencies because nurses can retrieve crucial information from the websites to improve information about the significance of evidence-based practice to reduce VAP in mechanically ventilated patients.

Nursing care

Johnston et al. (2016) discussed reflective practice in improving the needs of patients in palliative care. According to the authors, nurses should consider their attitudes, actions, and behaviors. Nursing care relates to the PICOT question in a way that during the 4 weeks, nurses need to exercise reflective practice to improve the care they give to patients.

Conclusion

Overall, evidence-based research is significant in nursing practice to improve patients’ health outcomes. Through EVP, nurses can formulate a PICOT question that would help them find solutions to clinical problems. Relating to the PICOT question discussed in the paper, nurses can manage to improve the quality of lives of mechanically ventilated patients.

References

Aslam, S., & Emmanuel, P. (2010). Formulating a researchable question: A critical step for facilitating good clinical research. Indian journal of sexually transmitted diseases and AIDS, 31(1), 47–50. doi: 10.4103/0253-7184.69003

Bowen, D. M., & Forrest, L. J. (2017). Translating research for evidence-based practice. Retrieved from https://pubs.royle.com/publication/?i=369630&article_id=2666624&view=articleBrowser&ver=html5

Center for Evidence-Based Medicine. (2014). Asking focused questions. Retrieved from https://www.cebm.net/2014/06/asking-focused-questions/

Farrugia, P., Petrisor, B. A., Farrokhyar, F., & Bhandari, M. (2010). Practical tips for surgical research: Research questions, hypotheses and objectives. Canadian journal of surgery. Journal canadien de chirurgie, 53(4), 278–281. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2912019/

Gardner, K., Jr, Kanaskie, M. L., Knehans, A. C., Salisbury, S., Doheny, K. K., & Schirm, V. (2016). Implementing and sustaining evidence-based practice through a nursing journal club. Applied nursing research: ANR, 31, 139–145. doi: 10.1016/j.apnr.2016.02.001

Gillam, S. W., Gillam, A. R., Casler, T. L., & Curcio, K. (2016). Education for medications and side effects: a two part mechanism for improving the patient experience. Applied nursing research: ANR, 31, 72–78. doi: 10.1016/j.apnr.2015.11.017

Institute for Healthcare Improvement (n.d). Science of improvement: Testing changes. Retrieved from http://www.ihi.org/resources/Pages/HowtoImprove/ScienceofImprovementTestingChanges.aspx

Johnston, B., Pringle, J., & Buchanan, D. (2016). Operationalizing reflexivity to improve the rigor of palliative care research. Applied nursing research: ANR, 31(e1–e5). doi:10.1016/j.apnr.2015.10.010

Li, L., Ai, Z., Li, L., Zheng, X., & Jie, L. (2015). Can routine oral care with antiseptics prevent ventilator-associated pneumonia in patients receiving mechanical ventilation? An updated meta-analysis from 17 randomized controlled trials. International journal of clinical and experimental medicine, 8(2), 1645–1657. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4402740/

Mitchell G. (2013). Selecting the best theory to implement planned change. Nursing management (Harrow, London, England 1994), 20(1), 32–37. doi:10.7748/nm2013.04.20.1.32e1013

Saunders, H., Vehviläinen-Julkunen, K., & Stevens, K. R. (2016). Effectiveness of an education intervention to strengthen nurses' readiness for evidence-based practice: A single-blind randomized controlled study. Applied ursing research: ANR, 31, 175–185. doi: 10.1016/j.apnr.2016.03.004