Role of research
The integration of research into nursing practice has been necessitated by various issues among them the need to transform and redesign care such that it is effective, safe and efficient. The healthcare environment today is characterized by increased patient populations as well as increased complexity of illnesses all which point to an absence of a single procedure or policy that can help manage all the presented issues (Stevens, 2013). In this case, nurses have been tasked with the management of each case as a unique presentation and this has meant that the nurses have to utilize the available research information and data to backup their experience, skill and expertise. Nurses are the foundation on which the healthcare system works and even within this complex environment, the expectation is that they have to seek viable solutions to the healthcare issues that populations present (Houser, 2015).
The emphasis on quality and safe care as the key indicators of patient outcomes has stood out as biggest influence in the integration of research into practice. Nurses today have a role to develop new procedures, policies and processes that assure patients and families of quality and safe care as well as recovery and restoration in a timely manner. Further, the utilization of evidence-based practice has been facilitated and influenced by the availability of technologies that have enabled the collection, analysis and sharing of data in real time which has served as the platform on which nurses can relate the presented clinical issues to the available information as provided by these technologies (Houser, 2015). On the other hand, the nurses have been afforded platforms on which they can expand their education and in this has exponentially increased their appetite for information, innovation and invention. Within these three aspects, evidence-based practice has found a workforce that is suitably aware of the importance of information and more importantly its placation within clinical practice (Stevens, 2013).
Searchable research question
In Mary’s case, there exists various health, social and economic issues that can are supposed to be managed if at all Mary has to be assured of her recovery. Mary has a three-year history of diabetes; she now has COPD and has been at the ER severally. Her hospitalization history in the past few days has risen in frequency and she has been noted to indicate high blood sugar levels and shortness of breath. The drug regimen she has had has not been helpful and she is now very worried. Beyond this, Mary is a caregiver to her husband who has ALS. The family is dependent on a fixed income that has been so since their retirement. Mary’s lifestyle depicts one that is devoid of exercise and physical activity despite her condition and this could be part of the reasons her condition has been progressing from bad to worse. The kind of care that Mary has been afforded on her visits to the hospital has only been limited to her physical health issues. She has not been afforded the holistic care that a patient with such demands would be afforded on a normal clinical process. Most importantly is the recognition that Mary serves as a caregiver, even within her limited health. She is already a primary patient due to her illnesses and further she is a secondary patient as a caregiver. The assessment of her condition has in this case been handled partially which could explain the apparent inability of the drug regimen to manage the condition. Mary’s case this posits the PICOT question “For caregivers within low income households and with a history of chronic illnesses (P), does caregiver health education (I) as compared to socio-economic support (C) reduce the likelihood of progression of the illness as well as hinder their general wellbeing (O)?”
Mary is a sample case of how health issues are influenced by the prevailing social and economic conditions. The integration of holistic and patient-centered care was designed to facilitate the care team to assess the patient holistically across the aspects of physical and history examination, social aspects and particularly lifestyle and even more importantly the economic status of the patient or family. Mary’s assessment was narrowed to the physical examination and health history and the care team ignored the important aspect of Mary’s role as a caregiver to the husband. The care team also disregarded the economic strain that Mary could have been going through in managing her health and that of her husband even within the knowledge that she is at an advanced age within retirement (Stillwell, Fineout-Overholt, Melnyk & Williamson, 2010). The provision of reading materials to Mary by the care team without any concern as to how well she would grasp the content posits how patient education was carried out poorly in this case. Further, it is not even known whether the reading materials provided covered anything on the role of the caregiver in managing their health and that of their patient concurrently.
Given the ignorance of the assessment of pertinent issues in Mary’s, there could be a hidden possibility that the care team afforded a vague examination of the patient and in essence failed to afford them the interventions tailored to her problem. In Mary’s case, two forms of intervention could have been possible if the assessment had been accomplished appropriately. On one hand, it is the integration of caregiver health education for Mary and on the other hand, the alternative intervention would be the provision of social and economic support to Mary and her family. the social and economic support alternative is based on the idea that even with health education, Mary and the husband do not have the income to sustain the demands of the managing the health issues they have within the family (Stillwell, Fineout-Overholt, Melnyk & Williamson, 2010).
References
Houser, J. (2015). Nursing research: Reading, using, and creating evidence (3rd ed.). Sudbury, MA: Jones and Bartlett Publishers.
Stevens, K. (2013). The impact of evidence-based practice in nursing and the next big ideas. The Online Journal of Issues in Nursing, 18(2).
Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., & Williamson, K. M. (2010). Asking the clinical question: A key step in evidence-based practice.American Journal of Nursing, 110(3), 58-61.
