NR439 Week 2 Discussion, Search for Literature and Levels of Evidence

NR439 Week 2 Discussion, Search for Literature and Levels of Evidence 1. Reflect on your practice, and identify a significant nursing clinical issue or change project that you would like to search for evidence in online sources. Formulate searchable, clinical questions in the PICO(T) format for your nursing clinical issue. 2. Next, review the guidelines for the PICO(T) Assignment due week 3. Use your PICO(T) elements to search for one report of a single, original study that has been published within the last 5 years from the CCN Library that is relevant to your nursing clinical issue. 3. Briefly describe how it is relevant to your nursing clinical issue. Remember to give complete reference to the study. With working on a telemetry step down unit, I’ve noticed that there are multiple types of alarms that go off during a normal work day. Sounds of vents bucking or disconnecting, call lights, bed alarms, our new avasys video monitors that watch patient who are at high risk of climbing out of bed, IV pumps and our cardiac monitoring system just to name a few. With all of these alarms constantly going off, there is a higher risk for nurses to not immediately react to certain alarms sounding since they appear all to frequently. This can become an issue and be detrimental to our patients. My facility has taught members of the team to sit and specifically be our monitor technicians to continuously monitor the cardiac rhythms of our patients. According to Houser, “Of primary importance to the selection of an approach is the nature of the research question” (Houser, pg. 37). Based on developing the PICO(T) formatted question, my question is: – By working on a telemetry unit with continuous tele monitoring, how can we reduce nonaction required alarms from sounding and prevent inessential actions for cardiac monitoring? In the article that I read, by Mary Jahrsdoerfer called Case Study Reducing Interruption Fatigue through Improved Alarm Support, she mentioned that the floors they conducted the study on modified their telemonitoring systems to be customized for specific patients based on clinical circumstantial need. The article also included a system of changing cardiac leads daily with proper skin prep to prevent artifact from occurring and setting unnecessary alarms off. In the article, they of course set alarms for the life threatening rhythms such as “asystole, ventricular tachycardia, ventricular fibrillation, extreme tachycardia, extreme bradycardia, apnea, and oxygen desaturation” (pg. 111). Ultimately, from the results I read, they were able to reduce the alarms up to 25% by altering the settings per patient. This article utilized a quasiexperi- mental study by analyzing an ICU unit, a progressive unit and two telemetry units for a total of 52 beds. References: Houser, J. (2018). Nursing research: Reading, using, and creating evidence (4th ed.). Sudbury, MA: Jones and Bartlett. Jahrsdoerfer, M. (2016). Reducing Interruption Fatigue through Improved Alarm Support. Biomedical Instrumentation & Technology, 50(2), 109-113.

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