Assessment 2: Understanding EBP Concepts and Music Therapy in Nursing

This assignment explores evidence-based practice (EBP) in nursing, covering its role according to the Registered Nurse Standards for Practice, and how it enhances clinical decision-making. It examines the importance of patient values, barriers, and enablers to EBP implementation, and the significance of randomized controlled trials. The second part of the assignment focuses on a case study involving individual music therapy for depression. The analysis includes an appraisal of the study's strengths and weaknesses, an evaluation of music therapy's effectiveness, and a recommendation for its use, considering benefits, harms, and costs. The assignment demonstrates an understanding of research concepts and their application in clinical settings, providing a comprehensive overview of EBP and its implications in nursing practice.

EVIDENCE FOR NURSING Assessment Item 2: Understanding research concepts
Due date: 5 pm, Weight: 35% Submission via Turnitin
Intent
This assessment allows you to demonstrate your understanding of evidence based practice concepts and processes
and apply your knowledge to case studies.
Instructions
Read the questions carefully and answer all parts of the questions.
 If required, provide references.
 Follow the word limits. (387+850)
PART One: Evidence based practice concepts (17.5 marks)
1. According to the Registered Nurse Standards for Practice (2016), what is the role of evidence based
practice in the nursing profession? (100 words±10% , 4 marks). Needs referencing.
Answer: The registered nurse standard for practice defines the evidence-based practice as a practice that
attempts to determine the best practice in nursing by accessing and judging the available evidence found from the
most valid, recent and available findings from the scholarly researches. The registered nurse standard for practice
recognizes the evidence based practice framework to be effective in ensuring the quality of care and safety in the
nursing practice. According to the standard 1, the nursing staff must apply their critical thinking and analyzing ability
for accessing and analyzing the best evidence from the reliable research finding and also apply them in practice
(Nursing and Midwifery Board of Australia 2016).
2. How can the Evidence Based Practice Model enhance nurses’ clinical decision-makings? (100 words±10%,
4 marks). Needs referencing.
Answer. The evidence based practices draw evidence from various scholarly resources, which describe a certain
practice that the nurses are attempting to put in practice. A thorough analysis of the literature and the evidence
described by it provides the nursing staff with an idea about the efficacy of the practice along with the expected
outcome from the practice, which enables them to predict the possible outcomes in the patient upon application of
the practice. Thus the evidence based practice approach ensures the clinical safety of the patients, which is an
important aspect to consider during a clinical decision making (Ellis 2019).
3. One of the components of Evidence Based Practice is consideration of the patient’s values and
preferences. What does this mean? Using an example, explain the importance of this component (100
words±10%, 4 marks). Needs referencing.
Answer: The main focus of an evidence based practice is to ensure patient safety; however, the practice is also
aimed at ensuring a standard quality of care, which is patient-centred. Thus the patients are provided with choices or
options so they can decide on a treatment procedure for themselves, considering their own values and preferences.
Every patient has different values and preferences in their life, which they follow strictly as that is important for their
mental well-being (Portney 2020). As for example, if evidence from the literature suggests that a particular disease
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condition can be controlled by the application of pharmacological intervention and a non-pharmacological
intervention, the nurse might ask the preference of the patient before developing a care plan for the patient.
4. Reflecting on your last clinical placement or clinical work experience, explain four barriers and four
enablers to the implementation of evidence-based practice in the clinical settings? (100 words±10%, 4
marks).
Answer: As a nursing student, I first faced with the challenge of identifying the appropriate evidence from the
scholarly resources. The barriers were my lack of knowledge about the appropriate search strategies, lack of skills for
critically appraising the literature and the lack of access to a wide range of resources. I also found time to be another
major barrier. According to my experience, the enablers for implementation of the evidence based practice were the
encouraging attitude of my supervisors, an improved therapeutic relationship with the patients, organizational
appraisal and personal development with all the knowledge.
5. Why are randomized controlled trials considered to be ‘higher level evidence’? (50 words±10%, 1.5
marks). Needs referencing
Answer: Randomized control trial is a study design that aims for minimizing the bias in a research study. The
study design selects the samples in a random manner and without any specification. Thus the results of the study
can be considered as unbiased and also there is a lesser tendency for systemic error (Kaefer et al. 2019).
PART TWO: The case study (17.5 marks)
No need to use references in your answers to the questions below.
Read the article by Erkkila at al. (2011), titled ‘Individual music therapy for depression: randomized controlled trial’.
A copy of this article is in the Assessment 2 folder.
6. Can you trust the results of this study? What are the strengths and weaknesses of this paper? (Hint: refer
to the CASP for randomized controlled trials to guide you in the critical appraisal of this study) (200
words±10%, 9 marks).
Answer: The study was a randomized control trial, which is known to be providing a high level of evidence, thus
the study can be considered as trustworthy.
The focus area of the study was a clinical intervention of music therapy. There was a randomized selection of the
patients for the treatment in this study. There was an appropriate accounting of all the patients in their respective
groups for concluding the study. Thus the results of the trial can be considered as valid. The healthcare workers and
the researchers were not “blind” to the treatment. However, the patients’ “blindness” cannot be determined from
the article. The patient groups that were selected at the start of the trial were from a similar age group. Both
experimental groups and the control group were provided with standard depression management treatment
therapy. Thus it can be considered that both of the groups were treated equally apart from the experimental
intervention. Thus the study worth continuing. The study also found music therapy to be sufficiently effective in the
selected population as there was a significant improvement in the anxiety and depression scores along with the
general functioning scores in the patients. There was a high level of confidence (95%) found for the results from the
confidence tests. The results are completely applicable to a local population, and the practice does not present with
any kind of harm to the patients. Thus the results of the study can be considered as sufficiently helpful.
However, there were also some limitations to the study, which were identified by the authors themselves.
According to them, the study did not explore the long term effect of the selected intervention, and also the music
therapy was applied with the standard care alone. They did not consider the cost-effectiveness of the intervention
either.
However, these limitations do not lower the trustworthiness of the study.
7. Was music therapy effective in treating the depression of the patients? (Hint: present and interpret the
results for depression outcome- see Table 2 for the summary of the results- you need to consider the
results for intervention and control groups, whether the difference between these groups is statistically
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significant, and if the estimation of the results for the wider population is precise (100 words±10%, 5
marks)
Answer: The study found music therapy to be sufficiently effective in lowering the depression in the selected
patients compared to the control group of patients. The difference was evident from the statistical scores between
the two groups of patients. For the three months follow up report, there was a mean difference of 4.65 considering
the depression scores in the test group and control group; the same for the anxiety score was 1.82 and for
functioning it was -2.11. The study had a 95% confidence interval, and thus, the researchers were 95% confident
about the reliability of the findings of this study. Thus its applicability to a broader population can be confirmed.
8. Would you recommend music therapy for patients with depression? (Justify your answer taking into
consideration the benefits, harms, and the cost of the intervention) (100 words, ±10% 3.5 marks)
Answer: The randomized control trial established that music therapy to be sufficiently effective for treating patients
with depression. There was a significant improvement in the depression scores and the anxiety scores for the
patients who received this therapy. Thus the beneficiary effect of this therapy on the patients with depression is
evident from this study. This intervention is completely harmless for the patient. However, the researchers did not
analyze the cost-effectiveness of this intervention. Thus I will recommend this therapy if there are no financial
restrictions from both the patient’s side and the organizational side.
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References:
Casp-uk.net, 2018. CASP Checklist: 11 Questions To Help You Make Sense Of A Randomised Controlled Trial. [online]
Casp-uk.net. Available at: <https://casp-uk.net/wp-content/uploads/2018/01/CASP-Randomised-Controlled-Trial-
Checklist-2018.pdf.> [Accessed 13 April 2020].
Ellis, P., 2019. Evidence-based practice in nursing. Learning Matters.
Erkkilä, J., Punkanen, M., Fachner, J., Ala-Ruona, E., Pöntiö, I., Tervaniemi, M., Vanhala, M. and Gold, C., 2011.
Individual music therapy for depression: randomized controlled trial. The British journal of psychiatry, 199(2), pp.132-
139.
Kaefer, M., Castagnetti, M., Herbst, K., Bagli, D., Beckers, G., Harper, L., Kalfa, N. and Fossum, M., 2019. Evidence
Based Medicine III; Level of evidence. Journal of pediatric urology.
Nursing and Midwifery Board of Australia, 2016. Nursing And Midwifery Board Of Australia - Registered Nurse
Standards For Practice. [online] Nursingmidwiferyboard.gov.au. Available at:
<https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards/registered-
nurse-standards-for-practice.aspx> [Accessed 13 April 2020].
Portney, L.G., 2020. Foundations of Clinical Research: Applications to Evidence-Based Practice. FA Davis.
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