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In this assignment students must discuss the importance of research in nursing and outline how evidence-based practice has impacted the profession of nursing.  Within this essay, students must identify a patient in their clinical environment (past or present) whose management was based on practices and policies implemented as a result of research. Students should evaluate the management strategies used for their chosen patient in relation to current evidence for best practice.  You must provide a rationale for selecting your chosen patient within the context of evidence-based practice and support this with relevant literature.  Throughout the essay, students are to draw on current evidence to critically evaluate whether this corresponded with current best practice.

 

CASE STUDY

Tony Black (de-identified) is a 86-year-old man who presented to the orthopaedic ward after having an elective right total hip replacement. He has nil known drug allergies however, he is sensitive to endone as it caused him hallucinations with previous surgeries. He was operated under general anesthesia and spinal morphine and received 2 grams of intravenous cefazolin intraoperatively. On transferred to the ward Tony’s vital signs were between the flags, he was haemodynamically stable and had intravenous cannula on left forearm and indwelling catheter insitu. Furthermore, his wound at right hip was covered with PICO dressing, had 1 belovac drain next to surgical site.   Tony’s spinal site was noted dry and intact and had tegaderm dressing in place. 

Tony has a medical history of hypertension, diabetes, hypercholesterolemia, Obesity, and a high body mass index that is 35.1 (height: 181cm, weight: 115kg). Besides, Tony also has Positive (MSSA): Methicillin-Susceptible Staphylococcus aureus), asthma and osteoarthritis. Tony’s surgical history reveals that he had left total hip arthroplasty 2 years ago that was complicated by cellulitis requiring intravenous antibiotics for 5 days. Moreover, he also had prostatectomy and radiation therapy for prostate carcinoma 5 years ago. 

 

EVIDENCE BASED MANAGEMENT : PREVENTION OF SURGICAL SITE INFECTION FOLLOWING RIGHT TOTAL HIP REPLACEMENT 

Policy/protocol after elective right total knee replacement at the Mater Hospital: 

  • Administration of prophylactic antibiotics postoperatively for 24 hours. 

Effective against common pathogens associated with SSI

Preferably a first generation cephalosporins such as cefazolin 

 

 

 

  • Regular wound assessment and wound care 

 

Monitoring Surgical site for signs of infections 

Keeping surgical site clean and dry 

Use of sterile dressing (PICO) for high risk patients and 

aseptic non-touch technique while dressing change 

 

  • Patient education 

Proper hand hygiene after personal care 

Leave dressing dry and intact, 

if water gets in -> to notify Doctors/Nurses straight away

Avoid unnecessary touch at surgical site 

Monitor wound for signs of infections : increased redness, swelling , warmth, ooze and fever

 

 

 

 

 

Rubric 

  1. Discusses importance of research in nursing and outlines how evidence based practice is used and impacts the profession and clinical practice of nursing. (35%) 800-1000 words maximum

 

  • Extremely concise discussion of the importance of research in nursing and how this guides clinical practice in nursing. Links this well to relevant literature

 

 

  1. Clear identification of a patient whose management was based pathways, policies or practices implemented as a result of research. (35%) 1000-1500 words

 

  • Clear identification and discussion of a patient whose management was based on evidence with sophisticated evaluation of the nursing management associated with a pathway, policy or procedure. Includes detailed description of the patient, the pathway or policy and critical analysis of evidence-based literature to support the pathway or policy.

 

 

  1. Evidence of focused reading and use of relevant literature. Assignment should have a clear & logical approach to presentation, writing and referencing (30%)

 

  • Comprehensive reference list demonstrating extensive reading of relevant literature which is well linked to the essay content. Outstanding academic writing style with a logical and easy to follow flow. Maintains patient confidentiality.

 

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