Despite its several advantages, the procedure is fraught with several disadvantages and complications. One of the complications of such an intervention is development of pressure sores over the nasal bridge (Callghan and Trapp, 1998). Pressure sores are a common cause of concern in those treated with NIPPV because of the consequences of the sores and associated morbidity and mortality. Several strategies have been defined and developed to prevent or minimize the development of pressure sores. However, which strategy is most suitable for the patient can be ascertained only through suitable literature review done through research. According to Polit and Hunger (1999; cited in Melnyk et al, 2000), "research utilization is the use of some portion of research in practice that is similar to the manner in which it was used in the original study. Making clinical decisions based on appropriate evidence is known as evidence-based practice. According to McKibbon (1998), "Evidence-based practice (EBP) is an approach to health care wherein health professionals use the best evidence possible, i.e. the most appropriate information available, to make clinical decisions for individual patients. EBP values, enhances and builds on clinical expertise, knowledge of disease mechanisms, and pathophysiology. It involves complex and conscientious decision-making based not only on the available evidence but also on patient characteristics, situations, and preferences." Literature review is the most critical exercise for EBP. Literature search for EBP can be done effectively by creating appropriate question in PICO format. In this essay, strategies to prevent facial nasal bridge pressure sore related to NIPPV will be discussed through suitable literature review for evidence based practice. Aims and objectives To ascertain various strategies to prevent facial nasal bridge sores due to noninvasive ventilation and to provide solutions for questions related to prevention of facial nasal bridge sores in those ventilated using NIPPV for evidence based practice in a clinical setting. Search strategy The commencement of search in electronic databases was based on the inclusion/exclusion criteria and knowledge of the hierarchies of evidence. Hierarchy provides a confidence measure to the end-user (Evans, 2003). According to Evans (2003), randomized control trials can be considered of good standard and they are in fact labeled as the gold standard of research for providing optimal research designs to answer pertinent questions. However, systemic reviews and meta-analysis have topped the hierarchy list. Google Scholar and PubMed were the databases used for search. The search words used were “pressure sores”, “non invasive ventilation” or “face masks” and “prevention”. Though the searches yielded several articles, most of them were irrelevant and hence only a few which were relevant were reviewed. It was noted that both search engines placed the results in a hierarchical order with the most relevant articles coming first or accorded higher star ratings. This search yielded valuable papers. Background and rationale NIPPV causes improvement in the gaseous exchange. It also reduces the risk for development of respiratory tract infection and also excessive production of secretions. However, long term application of NIPPV can lead to discomfort and other complications like gastric
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Facial Nasal Bridge Pressure Sore Prevention Related to NIPPV: Evidence-Based Practice Introduction Nasal intermittent positive pressure ventilation (NIPPV) is a useful strategy to prevent control of symptoms and cause improvement in the quality of life of those patients with not only acute respiratory failure but also chronic respiratory failure…
Practice innovation is based on the idea of evidence based nursing practice. Evidence based practice in nursing, EBPN, is used to gauge the quality of services offered by an individual nurse, during practice. It is done by obtaining research findings that are concrete and executing them in the nursing practice.
Throughout the years, innumerable changes have been implemented. Nursing had come a long way from then simple task of assisting physicians, to the current role of advance practitioner and advocate of patients' health. One key concept that is taking the limelight for the past decades is the importance of evidence-based practice.
Evidence based practice (EBP) was formulated with the intention of addressing targets in the health sector especially integration of clinical expertise and adherence to the Best Medicine Practices (BMP). The approach equally improves the quality of nursing services and guarantees that patients acquire valuable clinical assistance.
Furthermore, some interventions which reliable researches showed to have significant benefits have been largely ignored. By bringing together the results of research in a systematic way, appraising its quality in the light of question being asked synthesizing the results in an explicit way and making the knowledge base more accessible, it is hoped to foster a greater sensitivity to the evidence by researchers, policy makers, health practitioners and the public.
However, the use of the term "evidence based" had confused many practitioners. Several researches were done to clarify the term. Aside from misconceptions and misinterpretations, evidence based nursing practice is also plagued with debates and issues that need to be resolved.
Currently, nurse scholars are attempting to move beyond the safe confines of the randomized control trial as the gold standard of science. Unfortunately, the teaching and research of these forerunners are often discounted by their peers who feel compelled
In addition, the evidence based care theory has enabled the practitioners evaluate the set programs from a scientific point of view. ONeall & Brownson (2005) indicate that this involves applying the scientific way of
One of the major strategies applied in my organization is the principle of evidence-based practice. To provide quality services to the patients, we need to foster a spirit of research, coordination and
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