NUR5924:Exploring EvidenceforPractice Assignment

Alignment with Unit Learning Outcomes:

6. Critically evaluate the continued development of intensive care therapies,analysing contemporary nursing issues, while identifying areas for future research,development,quality improvement and

7. Explore socio-cultural, legal and ethical issues associated with the provisionof intensive care to patients and their families such as the provision of end-of-lifecare and organ donation in the ICU.

8. Critically assess teamwork, leadership and the professional attributes that areessential in the intensive care setting.

Context:

As an ICU nurse, you are responsible for advocating for your patients, but also foryour colleagues and your profession.In your ICU career so far, youve probablynoticed an issue or area of practice thats made you wonder why things are beingdonethatway.Sometimestheresalogicalexplanationforthepractice,intervention,environmental set-up, documentation or communication styles used but othertimesthe answer is becauseits always been done thatway.TheAustralian

College of Critical Care Nurses (ACCCN) Practice Standards (2015), on which yourclinical performance appraisal (Assessment task 5) is based, include a requirementfor demonstrating evidence-based practice(specifically, standard 12: Engages andcontributes to evidence-based critical care nursing practice).In order to achieve thisoutcome, you will need to develop skills to critique the evidence available. This willenable you to maintain an informed position on practice in the intensive care setting.

The purpose of this assignment is to focus on analysing the evidence of one of themany professional issues impacting staff, patients or families in the ICU. Thisassignment builds on the unit content by requiring analysis and synthesis ofevidence and/or other professional guidelines on a contemporary professional issuefor Intensive care nursing.

Youarerequiredtoreviewtheevidenceaddressinganissueorareaofpracticethatyoud like to explore further.You are encouraged to identify and choose your owntopic, based on your interests, experiences and career plans. Please review somepotential topics for inspiration at the end of this document.

Explore the evidence in the literature

Youshouldthenexploretheresearchliteraturesurroundingyourchosentopic,toidentify:

• causes/ influencing factors behind the issue

• the impact of the issue on stakeholders i.e. patients/ families/ nurses/ hospitals/communities (as relevant to your topic)

• other challenges caused by this issue

• approaches, strategies and solutions for addressing the issue

• limitations of the approaches/ strategies/ solutions

It is beyond the scope of this assessment task to conduct a literature review - ratherthe task is to identify primary pieces of research and, when reviewing theseliterature, you are encouraged to appraise the research papers you cite and criticallyappraise them for inclusion (see tip below and tips in the assignment brief below).

Tip: To assist you in deciding what papers are appropriate to include in your paperreadthisresource(availableviaNUR5924readinglist):Evidence-BasedPracticefor

AdvancedPracticeEmergencyNurses,PartII:CriticallyAppraisingtheLiterature(Shapiro & Donaldson, 2008)

Note: exploring the evidence literature is not the same as writing your response!Exploring is about developing your understanding; writing is about communicatingthat understanding.Note also that your question might change as you start toengage with the literature.This is normal, and perfectly ok!

Evidence cited in this paper should be published within 8 years (excluding seminalpapers).

Assignment Brief

The assignment brief, in addition to the marking rubric, will assist you in structuringyour exploration of evidence for practice.

Introduction (~ 250 words)

1. Identify a contemporary issue in intensive care nursing. Review the currentevidence to provide an introduction that clearly and succinctly describes:

• Focus questions
• Key definitions
• Context
• Scope of your exploration
• Conciseindicationofthemainsectionsthatwill

Tip:Evidencecitedforthissectionshouldcomefromcrediblesourcesincludingpeer-reviewedpublications.

Background (~250 - 500 words)

2. Describe the background of the issue :

• Describe the relevant issue
• Explain the extent and the importance of the issue
• Identify the key stakeholders impacted by the issue (eg. patients/ families/nurses/ hospitals/ communities- as relevant to your topic)

Tip:Evidencecitedhereshouldincludecrediblesourcesincludingpeer-reviewedpublication

KeyFactors/Variables(~7501000words)

3. Critically analyse the evidence to identify and describe the main factors

influencing the issue and their impacts (eg. education, resource availability- this willbe dependent on your chosen topic)

Tip:Theevidencecitedhereshouldonlyincludepeer-reviewedstudiesandcaninclude literature reviews e.g. systematic reviews, scoping reviews.

Tip: There are some general rules to help you critically appraise a paper for use inyour academic writing.This source provides an example of a checklist to criticallyappraise a paper (available via NUR5924 reading list): Dissecting the literature: theimportance of critical appraisal: Kirsty Morrison (2017)

Possible approaches/ strategies/ solutions (~750 words)

4. Evaluate/synthesise the evidence utilising primary research papers (within 8years, excluding seminal papers) to identify and describe possible approaches andDiscuss the strengths and weaknessesof each approach and anylimitations of each approach described.

Tip:The evidence cited herefor analysis should onlyinclude primary peer

reviewedresearch (i.e. original research).You will be comparing different primarypapers to inform possible approaches or strategies, so critical analysis of the studiesherewill helprationalise and informyour recommendationsbelow.

Recommendations (~ 250 words)

5. Based on evaluation of the data (described in point 4 above), prioritiseapproachesyouconsidermostrelevantand/orlikelytobeeffectiveinyourclinicalsetting/workplace, and provide a rationale. Justify and outline the limitations.

Highlight how this will benefit the key stakeholders identified.

Conclusion (~200 words)

6. Provide a summary of the focus question introduced, your informed answer andwhy it matters.

Tip:ensure that youdo not introducenew content here.

PotentialTopicsforInspiration

Nursing strategies

• Care of paediatric patients in a general ICU

• Significance of morbidity and mortality related to ICU delirium can ourpractice improve these outcomes?

Specific roles

• The deteriorating patient: the role of the ICU Liaison nurse

• Difficultconversations,how welldo wepartner withconsumers?

• Improving Organ donation after cardiac death

• Withdrawal of treatment within a critical care environmentPerson-centred teams
• Deteriorating patients family presence during resuscitation

• ICU follow up clinicsClinical therapies in ICU
• Rescue strategies in severe acute hypoxia: Current consensus andcontroversies

• Clinical therapies in the ICU such as the role of Swan Ganz Catheters forcardiac patients

Professional issues:

• Addressing culture in intensive care

• Managing accidents, incidents and errors in the intensive care

• Readiness for practice in the intensive care

oProfessional development and career planning