Nursing and Reasoning
Introduction (100 words)
The intricacy of clinical problems makes it imperative for health care providers to use novel interventions to address them fully. Nurses –especially baccalaureate-prepared nurses – have the responsibility to identify and provide optimal solutions to clinical problems within their working environment. Nurses have numerous options at their disposal for addressing clinical problems in their health care settings. However, evidence-based practice (EBP) provides nurses with an optimal tool for developing clinical interventions that are effective and responsive to the health care needs of the patients. EBP is a novel method for collecting and translating scientific evidence into clinical practice. The tool allows nurses to integrate their clinical expertise with global best practices in health care to enhance patients’ outcomes – low morbidity and mortality – and health-related quality of life. Although clinical problems are diverse and unique to patients, baccalaureate-prepared nurses should be able to identify and provide optimal solutions to them.
Clinical problems vary from one health care setting to another. However, some health care challenges are phenomenal in all health care settings. For example, medical errors such as inaccurate diagnosis, incomplete diagnosis, and missed care occur often in all health care settings. Clinical problems have a significant impact on patients’ outcomes – high morbidity and mortality -, the cost of care, and the recovery process. At my work station – a large private hospital -, numerous strategies and tools are employed to eliminate preventable clinical errors and problems. Nonetheless, complex clinical challenges are hard to overcome with simple techniques or review of nursing procedures. For example, clinical records show that 15% of in-patients contract hospital-acquired pneumonia (HAP) during their stay at the facility at any given time. The disease predisposes patients to length hospitalization and risk of death. Therefore, getting a scientific-based solution to address the clinical problem may go a long way in reducing its deleterious effects and the related health care costs.
HAP – both ventilator and non-ventilator pneumonia – is one of the most prevalent hospital-acquired infections in the United States. Ventilator acquired pneumonia (VAP) affects critically-ill or ventilated ICU patients 48 hours after being placed in mechanical ventilation. On the other hand, Non-ventilator HAP affects patients 48 hours after being admitted to the hospital. HAP, like all other types of pneumonia, is caused by various bacteria such as Streptococcus pneumonia and pseudomonas aeruginosa among others. Pneumonia causing bacteria colonizes the upper respiratory tract and eventually spread to the lungs if left untreated or undetected within a few hours or days. The disease has a mortality rate of approximately 20 % and is a major cause of prolonged hospitalization among critically ill ICU patients. Additionally, HAP contributes to the overuse of resources – hospital beds, ventilation, and funds – which jeopardizes the smooth running of health care facilities and the wellbeing of other patients.
The occurrence of ventilator acquired pneumonia (VAP) in the hospital is managed using a variety of approved nursing interventions including minimal ventilator exposure, regular oral hygiene, coordinated subglottic suctioning, proper staffing, and regular exercises. The combined use of the nursing remediation identified above reduces the incident rate of VAP significantly. They serve two main objectives: First, they insulate the patients from contracting VAP. Second, they inhibit the pneumonia bacteria from colonizing the mouth and the respiratory tract of the patients thereby reducing their disease-causing effects. Non-ventilated pneumonia – accounts for 90% of the HAP cases in the hospital – is managed using proper management of dysphagia, oral care, and physical exercises. However, the interventions have a minimal effect due to the limited understanding of the disease.
Conclusion
Clinical problems have a substantial effect on the quality of nursing care and patients’ outcomes. Baccalaureate trained nurses should be able to identify and formulate responsive nursing solutions to clinical problems in their work environment to enhance the quality care and patients’ experience. EBP provides nurses with an optimal tool for using scientific data to mitigate the effects of clinical problems with far-reaching health consequences.