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5 pages/≈1375 words
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APA
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Health, Medicine, Nursing
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Research Paper
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English (U.S.)
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Topic:

Impact of Restrain Use in Nursing Practice to the Patient and Community

Research Paper Instructions:

This is the first assignment for NURS4000. The assignment is due by Day 7 of Week 1. For this Application Assignment, write a four to five page paper, excluding title and reference pages, on a practice-related problem as described below. You may select a problem from the National Guideline Clearinghouse as long as it is under nursing control. For instance, reducing the risk of infection is under nursing control, while the type of surgery performed for a patient problem is not under the control of nursing. For example, reducing the risk of infection is under nursing control, while the type of surgery performed for a patient problem is not. Below is a list of topics. However, you may select another problem that is of interest to you.
- Pain management (SD)
o Acute
o Chronic
- Pressure ulcers
- Wrong side surgery
- Fall risk assessment
- Restraint use
- Urinary Tract Infections (UTIs)
- Methicillin Resistant Staph Aureus Infections (MRSA)
- Blood incompatibility
- Air embolism
Use the following guidelines and evaluation criteria to guide your paper. Use the headings below for each section. Use a minimum of five references, 5 years of age or less with the exception of a classic source, from the professional nursing literature in the assigned course readings and other references in the Walden Library. If they are relevant, you may use one or two professional Web sites in addition to the literature reference.
Begin this paper with a brief paragraph that provides an overview of the assignment and its purpose. There is no separate heading for this paragraph; the heading for this paragraph is the same as the title of the paper. This paragraph will be about 2–3 sentences. The last sentence in this paragraph is a sentence that begins "The purpose of this paper is to………..”. This paragraph is worth 10 points.
Practice Setting Problem—20 points
Select and describe one of the practice-related problems from those listed in the online classroom, from your own work setting, or from the National Guideline Clearinghouse. The practice problem you select needs to be one that is under nursing control. This section is 1 paragraph.
Importance of the Clinical Problem and its Significance to Nursing Practice— 40 points
Discuss the importance of the practice-related problem you selected. Explain why this problem is significant to nursing practice. (20 points)
Describe what the added expectations for BSN-prepared nurses are in addition to those of RNs with an associate degree or diploma nurse in connection to the identified practice-related problem? Consider the liberal arts core education of the BSN and the added courses of the BS nursing curricula. (20 points)
Impact on Patients and/or a Community — 20 points
Describe the specific impact of the practice-related problem on the patient and/or community affected by the identified problem. Include factors such as where the problem is most prevalent, the typical age of patients, and a description of the community impacted by this problem. State the costs of care associated with this practice problem. This section is 2 paragraphs.
Differences in Care Based on Evidence - 40 points
Identify at least two aspects of patient care related to this problem that would change or have changed in the practice setting when that care is based on evidence. “Evidence” means that research, reported in a peer reviewed journal, supports the change in practice. Be sure to provide the outcomes of specific research by providing an in text citation. Providing a citation for the National Clearinghouse Guidelines does not provide study outcomes. The National Clearinghouse Guidelines are based on research. Review the reference list of the guideline to identify studies that report specific research outcomes.
Summary— 20 points
Provide a one-paragraph summary of the main points of the paper. According to APA format, each paragraph must be, at minimum, three sentences in length.
Format/style
Proofread the paper and correct any typos, grammar, spelling, punctuation, syntax, or APA format errors before submitting your paper to Turnitin. Use at least the required minimum number of references from the professional nursing literature for this assignment. Up to 40 points can be deducted from the grade for this assignment for these types of errors.
Total possible points for assignment = 150 points.
When completed, save the assignment as APP1+last name+your first initial.doc. For example, Sally Ride's Week 1 Application Assignment would be named "APP1_RideS.doc". Submit this assignment via Turnitin.  
References
Use APA format for the citation of sources. Remember that each source on this list must be cited in text.
Use a minimum of five references, 5 years of age or less with the exception of a classic source, from the professional nursing literature in the assigned course readings and other references in the Walden Library. If they are relevant, you may use one or two professional Web sites in addition to the literature reference
PLEASE SELECT FROM THE LIST OF REFERENCES BELOW
Readings
-Course Text: Schmidt, N. A., & Brown, J. M. (Eds.). (2012). Evidence-based practice for nurses: Appraisal and application of research. (Laureate Education, Inc., custom ed.). Sudbury, MA: Jones and Bartlett.
◦Chapter 1, "What Is Evidence-Based Practice?"
This chapter defines evidence-based practice (EBP) as the integration of clinician expertise, patient preferences, and practice that is grounded in both theory and research evidence. The authors describe multiple ethical paths that a nurse can take to obtain evidence and improve patient care. In addition, this chapter covers barriers that might prevent the adoption of an EBP such as time or lack of resources.
◦Chapter 2, "Using Evidence Through Collaboration to Promote Excellence in Nursing Practice"
Chapter 2 identifies five levels of collaboration that are essential to the promotion of EBP: individual, organizational, regional, national, and international. The chapter also discusses ethical principles, codes, and laws that aim to protect the rights of human subjects.
◦Chapter 3, "Identifying Research Questions"
Nurses in practice can help determine those research questions that can lead to improved patient care and changes in practice. The process of identifying research problems and the development of EBP questions are discussed in this chapter. The authors provide guidelines for identifying research problems, narrowing the scope of a research question, and formulating a problem statement.
◦Chapter 14, "Weighing In on the Evidence"
◾"Clinical Practice Guidelines: Moving Ratings and Recommendations Into Practice" (pp. 376–378) This section of Chapter 14 introduces clinical practice guidelines, which provide nurses with direction on how to incorporate research findings into their daily routines. This selection explains the evolution and use of clinical practice guidelines, which consolidate research findings and seek to resolve a specific clinical problem.
Web Sites
-National Guideline Clearinghouse
http://www(dot)guideline(dot)gov
The National Guideline Clearinghouse' is a database of EBP guidelines geared toward health professionals. A part of the U.S. Department of Health and Human Services, the database provides the health industry with objective, full-text guidelines, comparison tools, and Web forums, among other interactive research features.
-Agency for Healthcare and Research Quality. (2009). NGC guidelines syntheses. Retrieved from http://www(dot)guideline(dot)gov/syntheses/.
This section of the National Guideline Clearinghouse' Web site provides a synthesis of EBP guidelines. A large number of these guidelines are provided for a variety of conditions ranging from Alzheimer's disease to urinary tract infections.
-Sigma Theta Tau International: Honor Society of Nursing
http://www(dot)nursingsociety(dot)org/Pages/default.aspx
Sigma Theta Tau International strives to support and disseminate research findings to improve nursing practice.
Optional Resources
Readings
Fitzsimons, E. & Cooper, J. (2012). Embedding a culture of evidence based practice. Nursing Management,19(7), 14-19. Retrieved from www(dot)nursingmanagement(dot)co(dot)uk
Kernan, W.N., Ovbiagele, B., Black, H.R., Bravata, D.M., Chimowitz, M.I., Ezekowitz, M.D….Wilson, J.A. (2014). AHA/ASA guideline: Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack. A guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, doi: 10.1161/STR.0000000000000024 Retrieved from http://stroke(dot)ahajournals(dot)org/content/early/2014/04/30/STR.0000000000000024.full.pdf+html
NURS 4000 Required Course Readings
**NOTE: Week 3 articles are listed on the Week 3 Tab of this guide **
Ashton S. (2014) Researcher or nurse? Difficulties of undertaking semi-structured interviews on sensitive topics. Nurse Researcher. 22(1), 27-31. doi: 10.7748/nr.22.1.27.e1255
Cornell, P., Gervis, M.T., Yates, L. & Vardaman, J.M. (2014). Impact of SBAR on nurse shift reports and staff rounding. MedSurg Nursing, 23(5), 334-342.
Hurlbut, J.M., Robbins, L.K. & Hoke, M.M. (2011). Correlations between spirituality and health-promoting behaviors among sheltered homeless women. Journal of Community Health Nursing, 28(2), 81-91. DOI:10.1080/07370016.2011.564064
Kerfoot, K.M. & Douglas, K.S. (2013a). The impact of research on staffing: An interview with Linda Aiken-Part I. Nursing Economic$, 31(5), 216-219, 253.
Kerfoot, K.M. & Douglas, K.S. (2013b). The impact of research on staffing: An interview with Linda Aiken-Part II. Nursing Economic$, 31(6), 273-276,306.
Makaroff, K.S., Storch, J., Pauly, B., & Newton, L. (2014). Searching for ethical leadership in nursing. Nursing Ethics, 21(6), 642-658.
Makic, M.B.F., Martin, S.A., Burns, S., Philbrick, D., & Rauen, C. (2013). Putting evidence into nursing practice: Four traditional practices not supported by the evidence. Critical Care Nurse, 33(2), 28-44. doi: 10.4037/ccn2013787
Montalvo, W & Larson, E. (2014). Participant comprehension of research for which they volunteer: A systematic review. Journal of Nursing Scholarship, 46(6), 423-431. doi: 10.1111/jnu.12097
Schmelzer, M. (2000). Understanding the research methodology: Should we trust the researchers' conclusions? Gastroenterology Nursing, 23(6), 269–274.
Schmelzer, M. (2004). Understanding statistics: What is alpha (á)? Gastroenterology Nursing, 27(6), 292–293.
Schrems, B.M. (2014). Informed consent, vulnerability and the risks of group-specific attribution. Nursing Ethics, 21(7), 829-843. 10.1177/0969733013518448
Tinkham, M.R. (2014). Magnet insights: The value of research councils and journal clubs. AORN Journal, 100(2), 206-209, doi: 10.1016/j.aorn.2014.05.004
Webb, M.S., Passmore, D., Cline, G., & Maguire, D. (2014). Ethical issues related to caring for low birth weight infants. Nursing Ethics, 21(6), 731-741. doi: 10.1177/0969733013513919
Web sites
Agency for Healthcare and Research Quality: National Guideline Clearinghouse. (2013). Putting evidence into practice: Evidence-based interventions to reduce family caregiver strain and burden. Retrieved, November 18, 2014, from http://www(dot)guideline(dot)gov/content.aspx?id=15693

Research Paper Sample Content Preview:
Evidence-based nursing practice: Restraint use
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Evidence-based nursing practice: Restraint use
The nursing practice of using restraints with patients is a common practice-related problem. Using restraints on aged patients brings about several moral issues. Physical restraints disrespect the dignity and autonomy of older people and usually hamper the promotion of self-reliance in elderly patients (Bai et al. 2014). The purpose of this paper is to describe restrain use, the significance of the problem of restrain use in nursing practice, the expectations for BSN-prepared nurses in connection to this problem, the impact of this problem to the patient and community, and to identify two aspects of patient care related to restraint use that would change in practice setting when that care is based on evidence.
Practice setting problem: restraint use
Physical restraints are usually employed with aged patients within non-psychiatric care settings. Researchers have reported that in extended care facilities for the elderly in America, between 25-43% of older people – or at least 1 in 4 – have actually been restrained at least one time (Gerace et al., 2013). Restraints are often employed for various reasons. Restraints might be considered as the only practical way of protecting the safety the patients and decrease the potential for legal liability if they harm other people or themselves whilst being cared for. Particular reasons include controlling agitated or violent behaviour, limiting wondering behaviour and thereby prevent interference or dislodging of the therapeutic devices, and fall prevention (Huizing et al., 2009).
Importance of the Clinical Problem and significance to nursing
The usage of restraints with patients is significant to nursing practice. It is notable that the safety of patients must be the top priority of every nurse. As such, nurses should posses an extensive knowledge base of both the benefits and risks of employing physical restraints. Moreover, their utilization might be seen negatively by the relatives of the patient if the nurse is not able to explain properly how the usage of the restraint is assisting the patient (Huizing et al., 2009). Additionally, the usage of physical restraint could be a source of annoyance for the restrained patient.
The most significant thing nursing staffs could do in order to ensure the best decision with regard to the use of physical restraints is being made is to be thoroughly trained. BSN-prepared nurses and Registered Nurses (RNs) should make sure that the decision to employ restraints is made because other safer alternatives are unavailable. Put simply, physical restraints must be utilized by BSN-prepared nurses as a last resort (Heinze, Dassen & Grittner, 2012). If BSN-prepared nursing staffs are using restraints in order to save time or to try to make their job somewhat simpler, the restraints should not be employed. It is the duty and not an option for a BSN-prepared nurse to preserve patient dignity. Being tied down and restrained is not dignified and this should be considered in addition to safety issues whenever a Registered Nurse is faced with the decision of whether to restrain or not to...
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