NR 451 WEEK 2 DISCUSSION, THE CLINICAL QUESTION

Week 2: The Clinical Question Your capstone change project begins this week when you identify a practice issue that you believe needs to change. The practice issue must pertain to a systematic review that you must choose from a List of Approved Systematic Reviews for the capstone project, whose link may be found in the guidelines for the Week 3 Capstone Project: Milestone 1 assignment page. • Choose a systematic review from the list of approved reviews based on your interests or your practice situation. • Formulate a significant clinical question related to the topic of the systematic review that will be the basis for your capstone change project. • Relate how you developed the question. • Describe the importance of this question to your clinical practice previously, currently, or in the future. • Describe what a research-practice gap is. I understand what you mean that my clinical question is a medial not nursing one. I suppose I was thinking nursing intervention would be to remind the doctors that the SCIP protocol was not being followed. There have been a few doctors that said that it should have been caught by nursing that the antibiotics were not ordered. I was under the impression that I had to relate my clinical question to the systematic review I chose from the list. Would either of the following be appropriate? Clinical question: Use of antimicrobial dressings and topical antibiotics vs the traditional sterile gauze dressings on surgical sites cause decrease SSI’s. s P- (Patient, population, or problem): Adult patients who undergo surgery I- (Intervention): Use of topical antibiotics including antibiotic dressings C- (Comparison with other treatment/current practice): Compared to traditional sterile gauze dressings O- (Desired outcome): reduction of surgical site infections T- (Time Frame): 30 days post operatively Or may I deviate from the chosen systematic review from the list and choose a different topic. I encounter patients whom along with their families culture, believe that rest is important after surgery to promote healing. Ambulation is somewhat of a challenge and hinders recovery. Clinical question: In patients with bowel surgery, how does early frequent ambulation and nourishment compare to conventual recovery methods of rest and bowel rest, affect the return of bowel function and length of hospitialization in the first 72 hours postoperatively? P- (Patient, population, or problem): Adult patients who undergo colorectal surgery I- (Intervention): Early and frequent ambulation with early nutrition C- (Comparison with other treatment/current practice): Compared to less ambulation and bowel rest O- (Desired outcome): affect return of bowel function and length of hospital stay T- (Time Frame): 72 hours post operatively