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Evidence-base in nursing - Essay Example

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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 ...Show more
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Summary

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…
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