NR 393 Nursing History Week 5 Discussion Evidence-Based Practice Changes
NR 393 Nursing History Week 5 Discussion Evidence-Based Practice Changes
Evidence-Based Practice Changes
Purpose:
The purpose of this discussion is for learners to examine one area in the 20th century where evidence has changed practice.
Course Outcomes:
This discussion enables the student to meet the following course outcome:
CO3: Identify persons and events in nursing history impacting evidence-based practice from the 20th century and 21st century. (PO8)
Directions:
Discussions are designed to promote dialogue between faculty and students, and students and their peers. In discussions students:
Demonstrate understanding of concepts for the week
Integrate scholarly resources
Engage in meaningful dialogue with classmates
Express opinions clearly and logically, in a professional manner
Use the rubric on this page as you compose your answers.
Discussion
The evidence to guide nursing practice has changed greatly during the 20th century. Select one area where evidence in nursing care changed during the 20th century and tell us about it.
As in our chapter readings, nursing research and education is discussed throughout the years. “An almost endless effort . . . has changed nursing practice and provided the body of knowledge to support evidence-based practice. . .” (Judd & Sitzman, 2014). Nursing research and education will always continue, so that nurses can improve patient care.
In the 20th century, and in the very beginning years of the 21st century, nurses were trained according to evidence-based practice, to aspirate intramuscular injections. Not long into the beginning years of the 21st century, evidence-based practice states that this procedure is no longer necessary.
Nurses were originally trained to aspirate intramuscular injections, to verify that the injection was in the muscle and not in a vein. If blood aspirated into the syringe, this meant that the injection was placed in a vein, and then the syringe with the blood and medicine would need to be discarded, and the medicine drawn up again. The act of aspirating was to be done over a five to ten second period.
“More recently, evidence-based guidelines do not advocate aspiration. . .” (Do you need to aspirate, 2016). Aspirating intramuscular injections today is no longer necessary. The rationales for this new procedure are that the sites that intramuscular injections are given in do not contain major blood vessels, there is no evidence that aspiration without or with blood eliminates the chance of being in a blood vessel, not aspirating reduces the time of the injection, there is less waste of medications, less pain, and most nurses do not wait and aspirate over the recommended five to ten second period. (Evidence-based Injection Practice, n.d.).
However, if using the dorsal gluteal area, aspiration is needed, because you must be careful of the sciatic nerve and blood vessels. Therefore, it is not recommended to use this area. (Evidence-based Injection Practice, n.d.).
Nursing gives many drugs intramuscularly, so it is necessary to keep up on medication education. For example, one intramuscular medication that I have given many times is Haldol, to calm down patients. As stated above, some advantages to no longer having to aspirate intramuscular injections is less pain and reducing the time of the injection. If having to give Haldol, usually it is needed to be given quickly, and less pain is beneficial for the patient. So far, the changes to this evidence-based practice has proved to be successful in my practice.
References
Do you need to aspirate when giving intramuscular (IM) injections? (December 11, 2016). Retrieved from https://ed-areyouprepared.com/wp-content/uploads/2018/12/Do-you-need-to-aspirate-when-giving-intramuscular.pdfLinks to an external site.
Evidence-based Injection Practice: To Aspirate or Not. (n.d.). Retrieved from www.nnpnetwork.org/Uploads/EBPLinks to an external site. aspiration poster 9 25 12 for iowa.pdf
Judd, D., & Sitzman, K. (2014). A history of American nursing: Trends and eras. (2nd ed.). Jones & Bartlett
ALSO READ:
NR 393 Nursing History Week 6 Assignment
NR 393 Week 6 Discussion Reflection on 19th and 20th Century Nursing
NR 393 Nursing History Week 6 Assignment Course Project Phase 3: Reflection Paper
NR 393 Nursing History Week 6 Discussion Reflection on 19th and 20th Century Nursing
NR 393 Nursing History Week 7 Discussion Impact in the 21st Century
NR 393 Nursing History Week 8 Discussion From the Past to the Future
The nursing profession evolved greatly in the 20th century. Two catapults that greatly changed the nursing profession were both world wars. Evidenced-based practice and the rapid increase in technology contributed to many changes in the way nursing was performed. One area that I found interesting and is a great contrast to how our practice works today was the concept of Public Health Nursing. The ideas that kept changing in the early 20th century, such as clean water, sanitation, and the use of vaccines began to start during this time period. “Advancing knowledge about germ theories from the mid-1800s to the mid-1900s focused medical evolution on “hygiene and sanitation . . . the forefront of the struggle against illness and disease,” and work done in these two areas “resulted in unprecedented longevity, concomitant with markedly improved quality of life in the last century and a half” (Judd 2014). These ideas go back to Nightingale’s original theories of cleanliness, fresh air, and sanitation, but now in the 20th century have been scientifically identified and the advances in knowledge lead to the eventual understanding of germ theories and epidemiology. ” During the 1920s, vaccines for diphtheria, pertussis, tuberculosis, and tetanus were introduced. The result was an increase in life expectancy from 59.7 years to 74.9 years over the next 30 years.” (Judd, 2014) Increasing life expectancy like this was revolutionary and nurses advocated for public health measures. Sanitation and vaccines were new and public education was a task that nursing took on in order to continue this cause.
I thought reading about this history right now while answering questions on vaccines and during a pandemic were very timely as we as nurses are once again educating the public on health measures and sanitation guidelines. Nursing has always been about education for the patient, and in the 20th century, the nursing profession began to greatly increase its role as public health advocates and educators.
References:
Judd, D., & Sitzman, K. (2014). A history of American nursing: Trends and eras. (2nd ed.). Jones & Bartlett
https://www.nursing.upenn.edu/nhhc/american-nursing-an-introduction-to-the-past/
ADDITIONAL INSTRUCTIONS FOR THE CLASS
Discussion Questions (DQ)
Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.
Also Read: NR 393 Nursing History Week 4 Discussion Impact of 19th Century Nurses
Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.
One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.
I encourage you to incorporate the readings from the week (as applicable) into your responses.
Weekly Participation
Your initial responses to the mandatory DQ do not count toward participation and are graded separately.
In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).
Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.
APA Format and Writing Quality
Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).
Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
I highly recommend using the APA Publication Manual, 6th edition.
Use of Direct Quotes
I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.
As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.
It is best to paraphrase content and cite your source.
LopesWrite Policy
For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.
Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.
Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?
Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.
Late Policy
The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.
If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.
I do not accept assignments that are two or more weeks late unless we have worked out an extension.
As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.
Communication
Communication is so very important. There are multiple ways to communicate with me:
Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.