1. Identify a common activity or nursing intervention in your own practice setting that you feel may not be supported by evidence. Locate 1 peer-reviewed research article in a peer-reviewed journal that supports this change of practice. Summarize the article being sure to include the clinical question and/or problem statement. outcome and recommendations for practice.
2. Discuss why you would or wouldn’t consider implementing the recommendations from this article into practice. If you would consider implementing the recommendation, what would be the next steps in applying the information into your practice setting and within your organization?

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Solution

Question 1

As a healthcare professional, there are several practices we are taught to adhere to and they have remained to be a culture in the area of practice. Some of these practices that most nurses tend to believe in I am certain that some of them are not evidence-based practices but they just originate from mare beliefs. One such nursing intervention that is widely practiced is the Trendelenburg position where the patient is laid with the head slightly declined bellow the feet in a supine position. The position is believed to alleviate effects of hypovolemic shock among other medical purposes. One peer reviewed article that I will use is one authored by Rahmawati and Dilaruri (2021) and published by the Journal of Nursing Practice. The article is titled “The Role of Passive legs Raising Position in Hypovolemic Shock”.

The study was to assess Trendelenburg position which is described as a state of elevating the legs slightly above the position of the head and how it is used to mitigate the effects of hypovolemic shock. The study employed a case study of a 75-year-old male presenting signs of hypovolemic shock to establish evidence for the practice. The authors concluded that the Trendelenburg position helped increase in the Mean Arterial Pressure after 5 minutes of the intervention.

The clinical question was to establish whether Trendelenburg position was effective in alleviating the effects of hypovolemic shock among patients presenting shock. Even through the outcome of the study supported the practice; the data used was scarce and hence cannot be adopted as a best practice. The authors recommended that the practice be used as it is beneficial among patients with hypovolemic shock due to its effect in increasing venous blood to return to the heart.

Question 2

I am impressed by the recommendations of the study but will however not consider its implementation in our organization. Even though the study has helped unearth the myths associated with the use of the Trendelenburg position in clinical practice, I will not consider the recommendations of the study because they are not valid or reliable given that they are based on a single case study. Given the weakness of the research presented, it cannot outlaw a belief which has been in existence for such a long time. I would have only recommended the study if the information could have been reliable enough.

Reference

Rahmawati, I., & Dilaruri, A. (2021). The Role of Passive legs Raising Position in Hypovolemic Shock: A Case Report and Review of the Literature. Journal Of Nursing Practice, 4(2), 177-184.