Scholarly research is one of the most important elements of the work of a DNP. According to the official source, nursing practitioners are responsible for promoting evidence-based practice through deliberate research activities aimed at improving the nursing profession (“American Association of Colleges of Nursing: DNP Essentials,” n. d.). Moreover, the implementation of evidence-based practice is essential for the integration of research and practice in the nursing field. This paper explores the phenomenon of evidence-based practice in nursing, its key models and frameworks applicable to the topic under investigation, and the role of developing PICO questions for DNP projects.
Evidence-based practice is an approach to clinical nursing practice that emphasizes objectivity, critical thinking, and research-based expertise when making care-related decisions. According to White et al. (2019), “evidence-based medicine de-emphasizes intuition, unsystematic clinical experience, and pathophysiologic rationale as sufficient grounds for clinical decision making and stresses the examination of evidence from clinical research” (p. 3). Moreover, when nurses use evidence-based practice under the conditions of supporting organizational culture, “the highest quality of care is delivered and the best patient, provider, and system outcomes are achieved (Melnyk et al., 2009, p. 51). In such a manner, the implementation of evidence-based practice in nursing establishes strict quality assurance standards validating the patient-centered approaches to care.
Several key steps in implementing a DNP project related to evidence-based practice exist. Such research projects revolve around the formulation of PICO questions, which is the abbreviation for such components of scholarly inquiry as problem/patient, intervention, comparison, and outcome (Jensen, n. d.). Jensen (n. d.) identifies seven steps necessary to conduct a reliable, evidence-based research project. First, the formulation of a PICO question should initiate the project. At this stage, the researcher is expected to identify the problem or the patient population, the intervention and its comparison, as well as the expected outcome (Jensen, n. d.). Second, the keywords for the PICO question should be identified within the four elements of the question to inform the following steps of the literature search.
Third, a nurse should plan the search strategy by identifying databases, synonyms for keywords, and core elements of the researched question. Fourth, the search should be executed using a combination of search strategies (Jensen, n. d.). Fifth, the results should be refined with an emphasis on the recent literature proving findings related to evidence-based practice. Sixth, the literature should be reviewed once the most relevant results are refined. Finally, the level of evidence should be determined based on its quality measured against the hierarchy of evidence (Jensen, n. d.). Thus, having completed these seven steps, a DNP is capable of conducting a reliable and comprehensive research project that would contribute to nursing evidence-based practice.
The phenomenon under investigation is the streamlining of care in surgical units by means of advanced automated technologies. PICO question is as follows: In patients admitted to open surgery (P), what is the effect of augmented reality use (I) in comparison to the use of non-technological operative methods (C) on patient recovery effectiveness (O)? This PICO research might be approached from the perspectives of such frameworks as the Johns Hopkins Nursing EBP Model and the Iowa Model of Research-Based Practice to Promote Quality Care (White et al., 2019). The first model implies developing an inquiry, then integrating practice and learning through practice questions, evidence, and translation, and the identification of best practices for further care improvement (White et al., 2019). The second model is based on the algorithm for validating evidence-based practice research findings, implemented through the responses to a list of specific questions.
The search of the literature and scholarly data contributing to the outlined PICO question allows for identifying several features. In particular, the number of studies covering this topic is insufficient, which validates the necessity of conducting such a research project. Moreover, the studies on augmented reality are commonly based on the overall benefits of simulation-based care, with an emphasis on the differences between its variants (Viglialoro et al., 2021). On the other hand, research discloses the challenges imposed on augmented reality in the context of open surgery (Fida et al., 2018). In summation, the discussed characteristics of evidence-based practice demonstrate its essential role in delivering high-quality patient-centered care. The developed PICO question is centered around the issues of using augmented reality in open surgery. The outlined steps and applicable frameworks of evidence-based research will allow for contributing reliable findings to the case for improved patient care.
American Association of Colleges of Nursing: DNP essentials. (n. d.). Web.
Fida, B., Cutolo, F., di Franco, G., Ferrari, M., & Ferrari, V. (2018). Augmented reality in open surgery. Updates in Surgery, 70(3), 389-400.
Jensen, K. A. (n. d.). 7 Steps of the perfect PICO research. EBSCO CINAHL.
Melnyk, B. M., Fineout-Overholt, E., Stillwell, S. B., & Williamson, K. M. (2009). Evidence-based practice: Step by step: Igniting a spirit of inquiry. The American Journal of Nursing, 109(11), 49-52.
Viglialoro, R. M., Condino, S., Turini, G., Carbone, M., Ferrari, V., & Gesi, M. (2021). Augmented reality, mixed reality, and hybrid approach in healthcare simulation: A systematic review. Applied Sciences, 11(5), 1-20.
White, K. M., Dudley-Brown, S. P., & Terhaar, M. F. (Eds.). (2019). Translation of evidence into nursing and healthcare. Springer Publishing.