Introducing Evidence Based Practice for Nursing Adult Nursing

This article discusses the recommended management of an adult with Covid in a care home using evidence-based practice for nursing adult nursing. It covers the PICO framework, search terms, databases, Boolean operators, and inclusion and exclusion criteria. The article also includes a discussion of the implications for practice and references.

INTRODUCING EVIDENCE BASED
PRACTICE FOR NURSING ADULT
NURSING
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TABLE OF CONTENTS
INTRODUCTION......................................................................................................................3
SEARCH....................................................................................................................................4
PICO framework....................................................................................................................4
Search term.............................................................................................................................4
Databases................................................................................................................................5
Boolean operators...................................................................................................................6
Inclusion and exclusion criteria.............................................................................................6
DISCUSSION............................................................................................................................7
IMPLICATION FOR THE PRACTICE....................................................................................7
REFERENCES...........................................................................................................................8
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INTRODUCTION
Covid-19 is the uncertain pandemic situation that has adversely impacted on health
and well being of number of individuals that are living within the society. It has resulted in
making more and more adult people ill and even causing death of them, so both government
and healthcare organisation take steps to protect them from impact of Covid-19. Management
of adult with covid-19 in care home is important in order to provide appropriate care and
support to them so that they can easily overcome from the health issue.
Evidence based practice is the process bringing together the best available research,
input and professional expertise to identified necessary information. It helps in ensuring that
clinical practices are based on sound evidence as a results the patient can get maximum
benefits. Furthermore, it also results in more consistent clinical recommendation and
practices that could be used across health services. In short, it can be stated that the evidence
based practice contribute in effectively defining the best practices rather than finding
alternative method that could be used to support existing practices (Ellis, 2019). The patient
are been consulted in the process of EBP when it generate question related to the effect of
particular treatment or care, outcome of diseases and choice of diagnostic test. Likewise,
question such as whether the treatment was effective “is being asked to the patient in order to
get reliable, relevant and more accurate evidence related to the stud for better decision
making in future circumstances. In addition to this, clinical evidence practices are best that
consist of study related to least possible biases. Also make use of expertise clinical skills,
knowledge and experience in order to find out accurate diagnosis, appropriate choice of
treatment and best care to the patient (Boltz and et.al., 2020. ). It should also consider the
expectation and value of patient while deciding intervention that could be used to treat the
individuals.
The aim of conducting research related to management of adult care in care home
with respect to covid-19 because it helps in identifying method that are being used by the
healthcare profession to delivered services to adult patient in effective manner. The way it
can be more improved so that their life can be saved. The report will highlight crucial
information related to the way adult are being managed at care home in context of
Coronovirus. Through making use of structure i.,e introduction, search strategy, discussion,
conclusion, implication of practice to represent information in better way (Kim, Mallory and
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Valerio, 2020). For analysing the topic- five articles will be used to understand the outcome
that has been gained related to the study.
SEARCH
In order to complete the study related to “recommended management of an adult with
Covid in a care home”, there are different search strategy that has been used by the researcher
to gathered sufficient information. Such as, planned to make use of five recent articles to
extract necessary information related to the way health care services can be rendered to adult
people for their health and well being. Therefore, use of different article has contributed in
checking that whther the facts, figure present in the study are accurate, reliable and valid or
not and finding out best suggested related to management of adult in care home with context
of covid-19.
PICO framework
PICO framework is acronym for framework that is mainly defined in order to help in
building of focused based medicine clinical question. As without well focused question, it is
difficult and time consuming process to identified that actual resources and search for
relevant evidence. For evidence based practice, mainly PICO framework is being used in
order to formulate question, facilitate literature search and make study useful (Grove and
Cipher, 2019). Such as:
1. P- Patient or problem- Adult with Covid.
2. I- Intervention – services provided by Care Home
3. C- Comparison- Nil
4. O- Outcome– Effective care of Adult in care Home in situation of Covid-19
PICO question: What are the recommended management of an adult with Covid in a care
home?
Search term
Search terms are keywords that are being utilised by the scholar in order to extract
useful information pertaining to the “recommended management of an adult with Covid in a
care home”. In another words, these are the key terms that has been add in the NICE database
to have suitable article for the study (Wu, 2020). So words that are being used to search
article are being explained in detailed as follow:
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Terms Synonyms
Covid- 19 Covid-19 and Coronavirus,
Management Administration, supervision, organisation
Recommendation Suggestion, propose, idea
Care home Care home and nursing home or residential home
Treatment Cure, therapy
Outcomes Results
Databases
Database can be collection, store of data, facts and information in well organised and
structured manner that can be easily accessible through electric form. NICE that is national
institute for health and care excellence database has been used in the present research related
to “”the recommended management of an adult with Covid in a care home”. The database has
been generally designed in order to record all the aspects of NICR from publication to trust
compliance level. Therefore, the several databases that have been used in context of the study
can be explained through table such as:
Database Description
NICE In this database that record and evidence trust level of
compliance to NICE guidance this maintained record
of all aspect of compliance such as response, evidence
and request (White and et.al., 2019).
Boolean operators
Boolean operators are simple words that are been used as conjunction with an
motivate to either exclude or combine keywords in the particular search to accumulate
necessary information. It formulate basis of mathematic and database logic by connecting the
search words. Such as, basically three Boolean operators i.,e And, or and not are mainly used
in any type of research in order to get the right article for accumulation of information.
While in context of the present study, the scholar has planned to make use of And, or
Boolean operator. Likewise, and has contributed in narrowing the research as “ management
of adult and care home” is being used that helps in finding all those articles that have both the
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keywords (Lowe and et.al., 2021). Thus, it has set boundaries that articles rather than the
above mentioned need not to be find out. On the other hand, the “or’ operator is being used
to make study wide or get more articles- “suggestion related to management of adult in care
home in covid-19 or the way care home services care be improved in delivering services to
adult in situation of covid”. Thereby through making use of “or” it has widened the scope by
searching all relevant articles related to the terms.
Inclusion and exclusion criteria
To select the article as per the study, inclusion and exclusion criteria has been used
that has helped in including only those articles or thing that make research useful for all. At
the same time, identify the key criteria that could be used to exclude from the study for better
outcome. Therefore, the inclusion and exclusion criteria pertaining to “”the recommended
management of an adult with Covid in a care home” is explained in detailed in the below
table:
Inclusion Criteria Exclusion Criteria
Articles that are being included in the studies
that has been published in English language
Only.
In case any other language than English has
been used in the study that it has been
excluded.
Articles selected for study are those
published in 2020-2021. So, only recent
study are being included in the research.
Before 2020 published studies are not been
included in the research.
The article that make use of key terms such
as Covid-19, care home, management and
adults are being included in the study (Patino,
and Ferreira, 2018).
On the other hand, study that are not related
to Covid- 19 pandemic, not related to adult
and health care are been excluded
DISCUSSION
The recommended management of adults suffering from covid in care home has been
found to be highly specific, where advanced working medical research has been evolving to
bring on competent working strategies. Covid 19 has been found to one of the most serious
pandemic where research in latest medical science and cases have shown significant working
rise, based on extended new working aspects. Below are some of the most authentic research
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articles on adult suffering from covid-19in care home, which has been found to be one of the
most essential aspect evolving in medical and nursing fields.
Mark James Rawle,Deborah Lee Bertfield and Simon Edward Brill, (2020) conducted
a study which is based on typical presentation of Covid-19 patients who face difficulties in
early isolation within care homes. Aim behind research was to analyse symptoms and
associated mortality of Covid-19 in older adults focusing on care home residents admitted to
secondary care. It is cohort study of 134 consecutive impatient of over 80 years old
hospitalized with PCR confirmed Covid-19 in UK were symptoms and frailty were analysed
using group comparisons and logistic regression. The study was conducted using quantitative
research, where statistical analysis has been done based on demographical and clinical
characteristics. The differences between community dwelling and care home residents, and
associations with mortality were assessed using between group comparisons and logistic
regression methods. The chosen study has been informative, in depth practically worked on
towards quantitative method application for analysing specific findings.
Results in the study signified that care home residents were less likely to experience
cough, (46.9% vs 72.9%, P = .002) but more likely to present with delirium (51.6% vs
31.4%, P = .018), particularly hypoactive delirium (40.6% vs 24.3%, P = .043). It has been
found that there were no differences in mortality or length of stay based on residential status,
where various respiratory symptoms such as cough, sore threat and chest pain were found in
older age patients. Study has been done in accurate authentic manner, where results Covid-19
in older adults often present with atypical symptoms. Individuals presenting atypical
symptoms especially with anorexia, have high mortality rate which increases health risk
factors. The recommendation of study is that vigilance in diagnosis is recommended in care
homes settings where hypoactive delirium and anorexia are concerned.
Adam L Gordon and et.al, (2020) conducted a study provides commentary on
dilemmas faced by clinicians and care home staff involves in planning and delivering best
care during covid-19 pandemic. There has been major implications of Covid19 is managed
within care homes for longer term health improvement, where focus has been maintained
predominantly on UK highlighting complementary experiences from Netherlands and Ireland
with view of exploring principles. Study specifies discussion about quarantine of residents
and potential harms, experiences within living in isolation during phase of their treatment. It
has been also found that personal protective equipment supply for care homes during
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pandemic, has been suboptimal. Measures for implementing augmented care in car homes ,
including treatments with oxygen and augmented care and subcutaneous fluids has been
discussed in chosen study. Healthcare, social car and government agencies within care home
residents and staff are to be physically and psychologically worked on for better support
management, during time of crisis for care homes. It is a qualitative research, where
advanced care planning has been found to modify clinical trajectories and improve outcomes
for care home residents to be developed on. The augmented medical support in care homes,
have been analysed where proportion of people with covid-19 have mild symptoms and
survive regardless of interventions. It specifies that provision of subcananeous fluids and
oxygen in care home setting avoids need for hospital admission for patients, which is
essential factor. Study also shed light on fact that dilemmas of health and social care workers
have been found to be challenging, where losses and difficulties faced by care home sector
have significantly raised systematic issues. Recommendations from the study are based on
aspects, where delimmas faced must be met by healthcare, social care and government
agencies. if care home residents are to be physically and psychologically support are highly
significant.
M Gosch and et.al, (2021) has conducted research on recommendations for
management of Covid- 19 pandemic in long term care facilities. The covid pandemic has
affected long term care facilities and vulnerable residents specifically within recent time. It
has been analysed that recommendations for LTCF for prevention and medical care of
residents are based on expertise of authors who are specialists in geriatric medicine.
Recommendations within study are based on addressing LTCF management, their operators
and physicians working in LTCFs for providing necessary framework conditions. Also
research presents significant study where guidance for LTCfs as well as physicians has been
done, for improvising outcomes and care of residents within long term facilities during
pandemic. Chosen study is qualitative based and has identified in depth critical research
based on specific parameters, for improvising long term facilities for vulnerable residents
affected by covid-19 pandemic. Formulating key messages on essential measures needs to be
further adhered for staff members to minimise infection spread, also overcrowding has to be
minimized. Nursing home crowding index is the mean number of residents recuperating from
Covid-19 related symptoms, where this enables to develop timely measures to be adopted in
productive manner. Article within chosen study also further recommends adherence to LTCF
further improvises outcomes and care of residents in long term facilities during recent
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pandemic time. The checking for indications within hospital admission has to be further
improvised, where patients oxygen saturation should not be more than 94 %, and
immediately should be taken to nearest hospital. Article in recent findings within study has
been found to be authentic, where treatment plans, medical reports and medications based on
specific scores like CFS and CCI are based. It has been also identified that best specific
methods integration enhances functional vision, extended improvement on productive
parameters within healthcare services.
COVID-19 rapid guideline: Managing COVID-19, (NICE)
Study is Covid-19 managing rapid guideline specifies research based on various age groups
and their specific medical recovery from covid-19. Typical symptoms are cough, fever and
loss of sense within smell and taste along with breathlessness which causes anxiety issues
variedly. Research done in study has significantly shed lightAdults experiencing fatigue,
muscle pain need to contact to near hospital immediately should be done variedly based on
further practical health recovery. The additional information in chosen study, specifies that
children and young people under 18 years with covid-19 where symptoms include nasal care,
poor appetiate including gastrointestinal symptoms such as skin rashes. The analysis within
study, is more informative regarding possible risks, benefits and possible likely outcomes
within treatments options for patients within pandemic. It can be also analysed that people
with pre existing advanced commodities must have care plans and advance decisions to
refuse treatments including attempts for cardiopulmonary decisions. The chosen study also
specifies that major adherence has to be improved, where checking regularly has to be
optimised considering immediate improvement. Also, research has been found to be
primitively essential for improvising further extended recovery from covid-19. Community
settings and hospital settings have to be improved, further for more competent engagement
towards best treatments where equity, acceptability and feasibility shall be improved. It can
be analyzed that study has been working towards integrated optimum efficiency, within
qualitative research method for analysing specific functional vision. Study has also identified
critical aspects about recommendations for providing best medical treatments, and
channelizing effective recovery aspects within timely manner for patients having covid-19.
Chosen study has been found that covid-19 has also primitively shed light on factors, where
authentic timely research has been done by using best methods about varied age group
patients.
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IMPLICATION FOR THE PRACTICE
Implication for practice as being nurse is that evidence based practice has helped in
understanding that there are different strategies that could be used by the care home to deliver
qualitative services to adult in covid-19. The situation of covid-19 was adverse, as more and
more people are becoming ill and being infected, thus required necessary support and care for
better treatment and health and well being. As nurse will make use of evidence practices to
improve my existing practices that are used to treat the patient so that it can easily recover
from the diseases. Furthermore, information that would like to gain is what all strategy or set
of action could be taken by care home to support people by maintaining social distancing to
avoid spread of diseases from one person to another. It has help in knowing about what all
database can be used to search relevant article and study to understand actual outcome of
taking particular step on individual. The process of search for evidence inform practice, as it
helps in supporting that specific set of action has resulted in particular outcome. Likewise, it
contain detailed about more method of management that is use of digital technology,
understanding the problem face by the patient and many more. No, as such there has been no
gap in the evidence as all the research has been done through making use of particular search
strategy, including recent article and many more.
CONCLUSION
From the above analysed aspects within report, the analysis has concluded in depth
specific focus on recommended management of an adult with Covid in a care home where
research has concluded highly authentic information. The study has also summarised about
recent findings, functional examination and determined focus on strengthened vision used
among critical cases for treating covid 19 cases. It can be also analysed that determined
specific avenues, strengthened vision and also keen domains about competent working
ideologies have been examined. The recent research has also shed in depth light on
strengthened vision, evocative working findings about medical, nursing steps taken by new
fundamental parameters for competitive profound abilities.
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REFERENCES
Books and journals
Atypical presentations of COVID-19 in care home residents presenting to secondary care: A
UK single centre study. 2020. [Online]. Available Through :
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Bassetti, M and et.al, 2021. Clinical Management of Adult Patients with COVID-19 Outside
Intensive Care Units: Guidelines from the Italian Society of Anti-Infective
Therapy (SITA) and the Italian Society of Pulmonology (SIP). Infectious
Diseases and Therapy, pp.1-49.
Boltz, M and et.al., 2020. Evidence-based geriatric nursing protocols for best practice.
Springer Publishing Company.
Commentary: COVID in care homes—challenges and dilemmas in healthcare delivery .
2020. [Online]. Available Through :
https://academic.oup.com/ageing/article/49/5/701/5836695?login=true
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Ellis, P., 2019. Evidence-based practice in nursing. Learning Matters.
Grove, S. K. and Cipher, D. J., 2019. Statistics for nursing research-e-book: A workbook for
evidence-based practice. Elsevier Health Sciences.
Kim, M., Mallory, C. and Valerio, T., 2020. Statistics for evidence-based practice in nursing.
Jones & Bartlett Publishers.
Kolb, M., Dinh-Xuan, A. T. and Brochard, L., 2021. Guideline-directed management of
COVID-19: Do's and Don'ts.
Lowe, S.C and et.al., 2021. Logical Activation Functions: Logit-space equivalents of Boolean
Operators. arXiv preprint arXiv:2110.11940.
Patino, C.M. and Ferreira, J.C., 2018. Inclusion and exclusion criteria in research studies:
definitions and why they matter. Jornal Brasileiro de Pneumologia, 44. pp.84-84.
Recommendations for the management of COVID-19 pandemic in long-term care facilities.
2021. [Online]. Available Through
<https://link.springer.com/article/10.1007/s00391-021-01847-1>
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Vena, J. A., 2021, November. Experiences of Young Adults With Lymphoma During the
COVID-19 Pandemic. In Oncology nursing forum (Vol. 48, No. 6, pp. 648-
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Wu, B., 2020. Social isolation and loneliness among older adults in the context of COVID-
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