The Clinical Question Essay

NR 451 Week 2: The Clinical Question Essay

NR 451 Week 2: The Clinical Question – Your capstone change project begins this week when you identify a practice issue that you believe needs to change. The practice issue must pertain to a systematic review that you must choose from a List of Approved Systematic Reviews (Links to an external site.)Links to an external site. for the capstone project.

  • Choose a systematic review from the list of approved reviews based on your interests or your practice situation.
  • Formulate a significant clinical question related to the topic of the systematic review that will be the basis for your capstone change project.
  • Relate how you developed the question. The Clinical Question Essay
  • Describe the importance of this question to your clinical practice previously, currently, or in the future.
  • Describe what a research-practice gap is.


NR 451 Week 2: The Clinical Question Instructor Opinion


I think all of us at one time or another has certainly asked our selves…There has to be a better way of doing this.  In this discussion you need to choose a systematic review from the topics provided in the class resources that is pertinent to your current or past practice.  Remember you will not really be expected to implement the practice, just how you would start the process.  For instance, CAUTI or catheter associated urinary tract infections are a major problem in the hospital. The Clinical Question Essay In surgical patients especially.  When I worked on the surgical floor years ago, I was made aware of the non sterile catheter insertion procedure done in pre-op. The staff would just pour a little water over the peri area and insert.  We had some raging post op UTIs needless to say even when the Foley was removed on day one.

Follow the steps above in your discussion question and tell us some of your stories of research-practice gaps.  Your capstone project one is fill out the Practice Issue and Evidence Summary Worksheet on your chosen systematic review.  Please review your posting requirements You should have one initial post and 2 posts to 2 different class mates.

I encourage all of you to use one of the systematic reviews provided in the class resources section, this is a starting point and not the only reference you should use, it is just a start your research.  If there is another topic you would like to use, you must have a systematic review that covers that topic.  The systematic review must be used as one of your references but other references will certainly be necessary.

Also, please come to the questions and answer web-ex I’m having next week.  It is posted in the announcements. The Clinical Question Essay.
Happy posting!

The systematic review that I chose was obstetrics with a focus on skin to skin care.  I currently work on a pediatric unit where NAS babies are transferred after they are stable following birth.  I have seen many children sit on this unit for a month too two months going through withdrawal.  These children have myoclonic tremors, increased muscle tone, inconsolable irritability, and an overall rough start in life.  Most of these children don’t have a high parental involvement; but I was wondering what the affects would be on their weaning process if they had daily skin to skin. I want to know if their negative symptoms would dissipate faster, would they come off the drugs faster, and would their overall health improve quicker allowing them to either go home or be placed in foster care.  I believe it is important to my current practice because we have a large population of mothers that go through the methadone clinic in town.  If we found a way to improve family centered care while simultaneously shortening the weaning process for the infant and minimizing withdrawal symptoms it could mean the difference between these babies staying with us for a few weeks compared to a few months. “:Newborns with moderate to severe NAS are typically treated with oral opioids, and then weaned over days to weeks.  Pharmacologically treated NAS is prolonged and costly, with lengths of stay of 2 to 12 weeks and estimated charges of $90 000 per admission (Holmes et al).” The Clinical Question Essay Research practice gap is when there is evidence based research supporting a specific practice but it hasn’t been implemented into actual patient care.

NR 451 Week 2: The Clinical Question

Holmes, A. V., Atwood, E. C., Whalen, B., Beliveau, J., Jarvis, J. D., Matulis, J. C., & Ralston, S. L. (2016). Rooming-In to Treat Neonatal Abstinence Syndrome: Improved Family-Centered Care at Lower Cost. Pediatrics,137(6). doi:10.1542/peds.2015-2929 The Clinical Question Essay