Integrating Evidence-Based Practice in Nursing Care - Essay Sample

Introduction

The nursing care is guided by the Evidence-Based Practice (EBP), which in turn provides the foundation for the evidence based research. The production of new data from research means that it must be communicated clearly within the healthcare environment. Ideally, the nursing and the related personnel must, therefore, work in collaboration efficiently to support the EBP as well as supporting its integration in their everyday practice (Straus, Glasziou, Richardson, & Haynes, 2018). This assignment aims at reflecting how nursing knowledge is disseminated for both professional and personal use. In this paper, the PICOT question utilized explored whether the use of preoperative versed (midazolam) in pediatric patients offers adequate post-operative pain control compared to not using versed (midazolam).

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PICOT Question Design

Working in the Surgery, Prep, and the Recovery Unit within the local hospital offered me more significant insights regarding the clinical topic under investigation. I came across pediatric patients who were being subjected to various surgical procedures. Ideally, those under ten years had their IV started within the operating room through the use of anesthesia, whereas those over ten years had their IV started in the preoperative area. The administration of the oral midazolam preoperatively could play a critical role in both the categories of pediatric patients. However, the limited accessibility to the IV implies that the IV midazolam is not administered except the oral version of it. Significant inconsistencies of the children being treated with midazolam before the surgery procedure was one of the things I noticed. Similarly, it emerged that those treated with midazolam preoperatively demonstrated a better post-operative pain control. The PICOT questions under the investigation in this paper are, "Does medicating with oral versed midazolam in a preoperative manner r reduce post-operative pain compared to patients who do not receive versed (midazolam) within the pediatric patients? As such, the P offers a representation of the pediatric patients, the administration of oral versed represents me, C represents comparing not medicating preoperatively, and O represents post-operative pain management while T signifies during the post-operative period.

Literature Review

The first article that I used was the "Pre-anesthetic medication with intranasal dexmedetomidine and oral midazolam as an anxiolytic. Fundamentally, this clinical trial was a prospective, randomized, double-blind, controlled trial that was conducted on children 2-12 years of age (Linares et al., 2014). Broadly, a total of 108 pediatric patients were involved in the trial, and their anxiety was assessed using a modified Yale scale. The anxiety is closely related to pain and pain perception with children, and this constituted the use of this method.

The second article, "dexmedetomidine superior to midazolam as a premedication in children? A metaanalysis of randomized controlled trials". This study was aimed at identifying the randomized controlled trials that compare the dexmedetomidine premedication with midazolam or ketamine premedication or placebo in children (Sun, Lu, Huang, & Jiang, 2014). The major parameters investigated included the satisfactory separation from parents, adequate mask induction, emergence agitation, and post-operative nausea and vomiting, and the post-operative rescue analgesia.

Act Process/Methodology

As part of the process of researching my Picot question, I used two databases that are relevant to the field of nursing as well as the medical. These included the Pub-Med and the Cinahl. The use of advanced search when possible and included vital words or phrases. Notably, the initial use of the word "versed" did not generate many articles. However, the words midazolam revealed many articles and research papers on the topic. For effective results, my search entailed (versed or oral midazolam), (pediatric or children) as well as the (post-operative pain or preoperative pain). My selection process was further narrowed down after going through the abstracts of the various article. For reliability and validity, I tried to include the articles that were current and recently published five years ago to present.

Implication to Nursing

The EBP can support the evidence during nursing research. In this way, the nursing practice could transform to improve the safety and efficacy of care. The Interproffessional collaboration will increase the strength of the research and will raise the likelihood that the quality of delivery will increase. The current nursing practice requires nurses to demonstrate various capabilities that address a broader array of health issues (Melnyk & Fineout-Overholt, 2011). Nurses must operate within their Scope of Practice as stipulated by the American Nurses Association and The Code of Ethics for Nurses and the Standards of Nursing Practice.

Conclusion

In conclusion, the PICOT question provided insights regarding children being medicated before painful procedures or surgery. Fundamentally, reduction of anxiety and pain preoperatively and postoperatively is critical for the healing process and patient satisfaction. This implies that the medication Midazolam may or may not be appropriate for reducing the pain and anxiety. Nurses must engage in further research to establish a formal care practice about medicating pediatric patients preoperatively.

References

Linares, S. B., Garcia, C. M., Ramirez, C. I., Guerrero, R. J., Botello, B., Monroy, T. R., & Ramirez, G. X. (2014, January). Pre-anesthetic medication with intranasal dexmedetomide and oral midazolam as an anxiolytic. A clinical trial. An Pediatr (Barc). http://dx.doi.org/10.1016/j.anpedi.2013.12.006

Melnyk, B. M., & Fineout-Overholt, E. (2011). Evidence-based practice in nursing and healthcare: A guide to best practice. Philadelphia: Lippincott, Williams & Wilkins.

Straus, S. E., Glasziou, P., Richardson, W. S., & Haynes, R. B. (2018). Evidence-Based Medicine E-Book: How to Practice and Teach EBM. Elsevier Health Sciences.

Sun, Y., Lu, Y., Huang, Y., & Jiang, H. (2014). Is dexmedetomidine superior to midazolam as a premedication in children? A metaanalysis of randomized controlled trials. Pediatric Anesthesia, 24(8), 863-874.