NURS-FPX6218 Assessment 1 Proposing Evidence Based Change
Evidence-based practice involves the use of scientific research, patient preferences, and clinical knowledge to provide high quality care to patients. It is a critical approach to solving healthcare delivery problems by adopting the best intervention related to scientific research evidence. Changes guided by evidence from well-designed research increase patient comfort, safety, and outcomes.
To answer the question of which tracheal suctioning method has reduced incidences of pain related to suctioning and pneumonia associated with dependence on a mechanical ventilator, research is paramount. Scientific research provides findings that help in implementation of an intervention which is scientifically approved and supported by evidences. Practice aided by research evidence is more likely to be effective in reducing adverse effects while improving patients’ health outcomes (Curtis et al., 2017). This signifies the importance of advocating for and adopting a research based practice in care delivery.
Articles related to the PICOT question are evaluated to determine distress; ventilator related infections (pneumonia) and pain incidences when using open and closed suctioning methods on ventilator supported patients. The study by Khayer et al. (2020) is relevant to answering the PICOT question as it compares pain levels on using open tracheal suctioning and closed suctioning on patients on ventilators. The study uses mechanically ventilated patients to collect data. The results show that all the methods cause pain, but open suctioning causes a 50% increase in pain during and after suctioning, while closed suctioning causes a 40% increase in pain (Khayer et al., 2020). This shows that the closed suctioning method is associated with less pain than the open suctioning method.
The study concludes that the pain level of mechanically ventilated patients is determined by the suctioning system used. It is more when using an open suction system. Therefore, the authors recommend the adoption and use of a closed suction system as it is associated with less pain. The study suggests that nurses should be trained and educated on the use of closed suction systems to promote their use. This evidence from this research advocates for the adoption of a practice that is evidence-based.
The article by Ebrahimian et al. (2020) evaluates the severity of pain associated with using open and closed suction systems and among patients who have traumatic brain injuries. The study also assesses the variations of physiological indicators such as heart rate, blood pressure levels, and oxygen saturation in the blood. The results show a four-times increase in pain level after using an open suction system, while that of using a close suction system is almost the same as the baseline levels. There is evidence of higher decreased oxygen saturation levels in the blood after using open suction systems compared to using closed suctioning methods.
The study recommends the use of closed suction systems in patients on mechanical ventilators as it is associated with higher pain reduction in patients with traumatic brain injuries. Closed suction systems cause improvements in physiological indicators compared to open suction systems. This study proposes the use of evidence-based practice, which is the use of a closed suction system to promote patients’ comfort and recovery. It is evident that evidence-based practices are best adopted when findings from scientific research are used as they guide changes in clinical practices (Mathieson et al., 2019).
As broached in the paper, evidenced based practices can only be adopted if adequate scientific research is conducted and evidences provided. Answering the PICOT question using research is a clear indication of the uses of scientific researches to adopt the best nursing intervention, in this case use of closed suction method, to solve a nursing problem and improve the patient satisfaction and health outcomes.
References
Curtis, K., Fry, M., Shaban, R. Z., & Considine, J. (2017). Translating research findings to clinical nursing practice. Journal Of Clinical Nursing, 26(5-6), 862-872. https://doi.org/10.1111/jocn.13586
Ebrahimian, A., Tourdeh, M., Paknazar, F., & Davari, H. (2020). The Effect of the Open and Closed System Suctions on Pain Severity and Physiological Indicators in Mechanically Ventilated Patients with Traumatic Brain Injury: A Randomised Controlled Trial. Turkish Journal Of Anaesthesiology And Reanimation, 48(3), 202–207. https://doi.org/10.5152/TJAR.2019.03342
Khayer, F., Ghafari, S., Saghaei, M., Yazdannik, A., & Atashi, V. (2020). Effects of Open and Closed Tracheal Suctioning on Pain in Mechanically Ventilated Patients. Iranian Journal Of Nursing And Midwifery Research, 25(5), 426–430. https://doi.org/10.4103/ijnmr.IJNMR_135_18
Mathieson, A., Grande, G., & Luker, K. (2019). Strategies, facilitators and barriers to implementation of evidence-based practice in community nursing: A systematic mixed-studies review and qualitative synthesis. Primary Health Care Research & Development, 20, E6. doi:10.1017/S1463423618000488
