NUR5924 :Exploring Evidence for Practice 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-life care 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 for your colleagues and your profession. In your ICU career so far, you’ve probably noticed an issue or area of practice that’s made you wonder why things are being done that way. Sometimes there’s a logical explanation for the practice, intervention, environmental set-up, documentation or communication styles used – but other times the answer is ‘because it’s always been done that way’. The Australian

College of Critical Care Nurses (ACCCN) Practice Standards (2015), on which your clinical performance appraisal (Assessment task 5) is based, include a requirement for demonstrating evidence-based practice (specifically, standard 12: Engages and contributes to evidence-based critical care nursing practice). In order to achieve this outcome, you will need to develop skills to critique the evidence available. This will enable 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 the many professional issues impacting staff, patients or families in the ICU. This assignment builds on the unit content by requiring analysis and synthesis of evidence and/or other professional guidelines on a contemporary professional issue for Intensive care nursing.

You are required to review the evidence addressing an issue or area of practice that you’d like to explore further. You are encouraged to identify and choose your own topic, based on your interests, experiences and career plans. Please review some potential topics for inspiration at the end of this document.

Explore the evidence in the literature

You should then explore the research literature surrounding your chosen topic, to identify:

• 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 - rather the task is to identify primary pieces of research and, when reviewing these literature, you are encouraged to appraise the research papers you cite and critically appraise 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 paper read this resource (available via NUR5924 reading list): Evidence-Based Practice for

Advanced Practice Emergency Nurses, Part II: Critically Appraising the Literature (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 communicating that understanding. Note also that your question might change as you start to engage with the literature. This is normal, and perfectly ok!

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

Assignment Brief

The assignment brief, in addition to the marking rubric, will assist you in structuring your 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
• Conciseindication of the main sections that will 

Tip: Evidence cited for this section should come from credible sources including peer-reviewed publications.

 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: Evidence cited here should include credible sources including peer-reviewed publication

Key Factors/ Variables (~750 – 1000 words)

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

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

Tip: The evidence cited here should only include peer-reviewed studies and can include literature reviews e.g. systematic reviews, scoping reviews.

Tip: There are some general rules to help you critically appraise a paper for use in your academic writing. This source provides an example of a checklist to critically appraise a paper (available via NUR5924 reading list): Dissecting the literature: the importance 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 and  Discuss the strengths and weaknesses of each approach and any limitations of each approach described.

Tip: The evidence cited here for analysis should only include primary peer

reviewed research (i.e. original research). You will be comparing different primary papers to inform possible approaches or strategies, so critical analysis of the studies here will help rationalise and inform your recommendations below.

 Recommendations (~ 250 words)

5. Based on evaluation of the data (described in point 4 above), prioritiseapproaches you consider most relevant and/or likely to be effective in your clinical setting/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 you do not introduce new content here.

Potential Topics for Inspiration

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 well do we partner with consumers?

• 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

o Professional development and career planning