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Purpose

Reading, understanding, and appreciating original nursing research literature is essential for evidence-based practice (AACN, 2008; QSEN, 2018). This assignment provides a learning activity for students to read an original research study and complete a worksheet to demonstrate understanding of the study purpose, design, sample, data collection, analysis, limitations, conclusions, and the importance of reading research literature.


Course Outcomes

This assignment enables the student to meet the following Course Outcomes.

CO1: Examine the sources of evidence that contribute to professional nursing practice. (PO 7)

CO2: Apply research principles to the interpretation of the content of published research studies. (POs 4 & 8)

CO4: Evaluate published nursing research for credibility and significance related to evidence-based practice. (POs 4, 8)

CO5: Recognize the role of research findings in evidence-based practice. (POs 7 & 8)


Assignment Directions

  1. Read over each of the following directions, the required Reading Research Literature worksheet, and grading rubric.
  2. Review the following link which contains a tutorial for your Week 6 Assignment. Tutorial may look slightly different session to session. Grading criteria and rubric will be the same.

    Click here for transcript.(Links to an external site.)


    https://lms.courselearn.net/lms/video/player.html?video=0_jhxsfia6
  3. Download and complete

    the required



    Reading Research Literature (RRL) worksheet(Links to an external site.)



    . This must be used.
  4. Download or access

    the required article below. This must be used.

    Diacon, A. & Bell, J. (2014). Investigating the recording and accuracy of fluid balance monitoring in critically ill patients. Southern African Journal of Critical Care, 30(2), 55-57.

    https://chamberlainuniversity.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=edsdoj&AN=edsdoj.2db92a9d728747eaa508e67b298f67bd&site=eds-live&scope=site(Links to an external site.)
  5. This assignment contains:


    • Purpose of the Study:

      Using information from the required article and your own words, summarize the purpose of the study. Describe what the study is about.

    • Research & Design:

      Using information from the required article and your own words, summarize the description of the type of research and the design of the study. Include how it supports the purpose (aim or intent) of the study.

    • Sample:

      Using information from the required article and your own words, summarize the population (sample) for the study; include key characteristics, sample size, sampling technique.

    • Data Collection:

      Using information from the required article and your own words, summarizeone data that was collected and how the data was collected from the study.

    • Data Analysis:

      Using information from the required article and your own words, summarizeone of the data analysis/ tests performed or one method of data analysis from the study; include what you know/learned about the descriptive or statistical test or data analysis method.

    • Limitations:

      Using information from the required article and your own words, summarize onelimitation reported in the study.

    • Findings/Discussion:

      Using information from the required article and your own words, summarize one of the authors’ findings/discussion reported in the study. Include one interesting detail you learned from reading the study.

    • Reading Research Literature

      : Summarize why it is important for you to read and understand research literature. Summarize what you learned from completing the reading research literature activity worksheet.
  6. You are required to complete the worksheet using the productivity tools required by Chamberlain University, which is Microsoft Office Word 2013 (or later version), or Windows and Office 2011 (or later version) for MAC. You must save the file in the “.docx” format. Do NOT save as Word Pad. A later version of the productivity tool includes Office 365, which is available to Chamberlain students for

    FREE

    by downloading from the student portal at

    http://my.chamberlain.edu(Links to an external site.)

    . Click on the envelope at the top of the page.
  7. Submit the completed Reading Research Literature Worksheet to the Week 6 Assignment.


Best Practices

  • For questions about this assignment, please contact your instructor.
  • Spell check for spelling and grammar errors prior to final submission.
  • Please see the grading criteria and rubrics on this page.
  • Please use your browser’s File setting to save or print this page.


Scholarly Sources and Citations

  • Use APA format in citations and references.


**Academic Integrity**

Chamberlain College of Nursing values honesty and integrity. All students should be aware of the Academic Integrity policy and follow it in all discussions and assignments.

By submitting this assignment, I pledge on my honor that all content contained is my own original work except as quoted and cited appropriately. I have not received any unauthorized assistance on this assignment. Please see the grading criteria and rubrics on this page.


References

American Association of Colleges of Nurses. (2008). Executive summary: The essentials of baccalaureate education for professional nursing practice. http://www.aacnnursing.org/Education-Resources/AACN-Essentials

Quality and Safety Education for Nurses. (2018). Quality and safety education for nurses competencies. http://qsen.org/competencies/pre-licensure-ksas/#evidence-based_practice


NR439 Reading Research Literature Worksheet Rubric

NR439 Reading Research Literature Worksheet Rubric

CriteriaRatingsPts

This criterion is linked to a Learning OutcomePurpose of the StudyUsing information from the required article and mostly your words, thoroughly summarize the purpose of the study. Describe what the study is about. Provide details.


30.0


ptsThoroughly summarizes the criteria in the first column. Excellent details are provided.


26.0


ptsMostly summarizes the criteria in the first column or one criteria lacks details.


24.0


ptsMinimally summarizes the criteria in the first column or one criteria is missing. Fair details provided.


11.0


ptsPoorly summarizes the criteria in the first column. Vague details provided.


0.0


ptsAll criteria from the first column are missing.

30.0 pts

This criterion is linked to a Learning OutcomeType of Research & the DesignUsing information from the required article and your own words, summarize the description of the type of research and the design of the study. Include how it supports the purpose (aim or intent) of the study. Provide details.


20.0


ptsThoroughly summarizes the criteria in the first column. Excellent details are provided.


18.0


ptsMostly summarizes the criteria in the first column or one criteria lacks details.


16.0


ptsMinimally summarizes the criteria in the first column one criteria is missing. Fair details provided.


8.0


ptsPoorly summarizes the criteria in the first column. Vague details are provided.


0.0


ptsAll criteria from the first column are missing.

20.0 pts

This criterion is linked to a Learning OutcomeSampleUsing information from the required article and your own words, summarize the population (sample) for the study; include key characteristics, sample size, sampling technique. Provide details.


20.0


ptsThoroughly summarizes the criteria in the first column. Excellent details are provided.


18.0


ptsMostly summarizes the criteria in the first column or one criteria lacks details.


16.0


ptsMinimally summarizes the criteria in the first column or one criteria is missing. Fair details provided.


8.0


ptsPoorly summarizes the criteria in the first column. Vague details are provided.


0.0


ptsAll criteria from the first column are missing.

20.0 pts

This criterion is linked to a Learning OutcomeData CollectionUsing information from the required article and your own words, summarize one data that was collected and how the data was collected from the study. Provide details.


20.0


ptsThoroughly summarizes the criteria in the first column. Excellent details are provided.


18.0


ptsMostly summarizes the criteria in the first column or one criteria lacks details


16.0


ptsMinimally summarizes the criteria in the first column or one criteria is missing. Fair details are provided.


8.0


ptsPoorly summarizes the criteria in the first column. Vague details are provided.


0.0


ptsAll criteria from the first column are missing.

20.0 pts

This criterion is linked to a Learning OutcomeData AnalysisUsing information from the required article and your own words, summarize one of the data analysis/ tests performed or one method of data analysis from the study; include what you know/learned about the descriptive or statistical test or data analysis method. Provide details.


20.0


ptsThoroughly summarizes the criteria in the first column. Excellent details are provided.


18.0


ptsMostly summarizes the criteria in the first column or one criteria lacks details.


16.0


ptsMinimally summarizes the criteria in the first column or one criteria is missing. Fair details are provided.


8.0


ptsPoorly summarizes the criteria in the first column. Vague details are provided.


0.0


ptsAll criteria from the first column are missing.

20.0 pts

This criterion is linked to a Learning OutcomeLimitationsUsing information from the required article and your own words, summarize one limitation reported in the study. Provide details.


20.0


ptsThoroughly summarizes the criteria in the first column. Excellent details are provided.


18.0


ptsMostly summarizes the criteria in the first column or one criteria lacks details.


16.0


ptsMinimally summarizes the criteria in the first column or one criteria is missing. Fair details are provided.


8.0


ptsPoorly summarizes the criteria in the first the column. Vague details are provided.


0.0


ptsAll criteria from the first column are missing.

20.0 pts

This criterion is linked to a Learning OutcomeFindings/DiscussionUsing information from the required article and your own words, summarize one of the authors’ findings/discussion reported in the study. Include one interesting detail you learned from reading the study. Provide details.


20.0


ptsThoroughly summarizes the criteria in the first column. Excellent details are provided.


18.0


ptsMostly summarizes the criteria in the first column or one criteria lacks details.


16.0


ptsMinimally summarizes the criteria in the first column or one criteria is missing. Fair details are provided.


8.0


ptsPoorly summarizes the criteria in the first the column. Vague details are provided.


0.0


ptsAll criteria from the first column are missing.

20.0 pts

This criterion is linked to a Learning OutcomeReading Research LiteratureSummarize why it is important for you to read and understand research literature. Summarize what you learned from completing the reading research literature activity worksheet. Provide details.


30.0


ptsThoroughly summarizes the criteria in the first column. Excellent details are provided.


26.0


ptsMostly summarizes the criteria in the first column or one criteria lacks details.


24.0


ptsMinimally summarizes the criteria in the first column or one criteria is missing. Fair details are provided.


11.0


ptsPoorly summarizes the criteria in the first the column. Vague details are provided.


0.0


ptsAll criteria from the first column are missing.

30.0 pts

This criterion is linked to a Learning OutcomeScholarly Writing, Mechanics, Organization, Spelling, Sentence Structure, Grammar


10.0


ptsExcellent writing, mechanics, organization, spelling, sentence structure, grammar. No errors or 1-2 errors noted.


6.0


ptsGood writing, mechanics, organization, spelling, sentence structure, grammar. A few errors noted.


4.0


ptsFair writing, mechanics, organization, spelling, sentence structure, grammar. Some errors noted.


3.0


ptsPoor writing, mechanics, organization, spelling, sentence structure, grammar. Many errors noted.


0.0


ptsVery poor writing, mechanics, and organization. Errors throughout are noted. Writing is difficult to understand or follow.

10.0 pts

This criterion is linked to a Learning OutcomeAPA In-Text Formatting for Cited Sentences


10.0


ptsExcellent APA in-text formatting with no errors. Uses mostly your own words with no more than two direct quotes.


5.0


ptsGood APA formatting. Uses APA in-text citation formatting with 1-2 errors noted.


4.0


ptsFair APA formatting. Uses APA in-text citation formatting with some errors noted or does not use in-text citation formatting.


3.0


ptsPoor APA formatting with many errors noted.


0.0


ptsVery poor APA with errors noted throughout.

10.0 pts

This criterion is linked to a Learning OutcomeRequired RRL Worksheet and Required Article Use


0.0


pts0 points deducted Required RRL Worksheet used for this assignment and Required Article used for this assignment. 0 points deducted


0.0


pts20 points (10%) deducted Required RRL Worksheet NOT used and/or Required Article NOT used for this assignment results in a deduction of 20 points (10%). 20 points deducted

0.0 pts

This criterion is linked to a Learning OutcomeLate Deduction


0.0


pts0 point deduction


Submitted on time


0.0


ptsNot submitted on time – Points deducted


1 day late = 10 deduction; 2 days late = 20 deduction; 3 days late = 30 deduction; 4 days late = 40 deduction; 5 days late = 50 deduction; 6 days late = 60 deduction; 7 days late = 70 deduction; Score of 0 if more than 7 days late

0.0 pts

This assignment will be uploaded automatically to Turnitin upon submission to verify this is your original work and no parts were copied from another student.Turnitin is now more closely integrated wi
ARTICLE Investigating the recording and accuracy of fluid balance m onitoring in critically ill patients A Diacon, MCur; J Bell,’ 3 MCur, BCur, PGDN 1 D ivisio n o f Nursing, F aculty o f M ed icin e a n d H e alth Sciences, Stellenbosch University, Cape Town, South A fric a 3 TASK A p p lie d Science, Karl Bremer Hospital, Bellville, Cape Town, South Africa 3 D e p a rtm e n t o f N ursing Science, School o f C linical Care Sciences, F aculty o f H e alth Sciences, Nelson M a n d e la M e tro p o lita n University, P o rt Elizabeth, S outh Africa Corresponding author: A Diacon ([email protected]) Background. The accurate assessment o f flu id bala nce data c o lle c te d d u rin g physical assessment as w e ll as d u rin g m o n ito r in g and re c o rd -k e e p in g fo rm s an essential p a rt o f t h e ba seline p a tie n t in fo rm a tio n th a t g u id e s m edic al and n u rs in g in te rv e n tio n s a im e d at a c h ie vin g p h ysio lo g ica l s ta b ility in pa tie n ts. An in fo rm a l a u d it o f 2 4 -h o u r flu id bala nce records in a local in te n sive care u n it (ICU) showed t h a t seven o u t o f te n flu id balance calcula tion s w ere in correct. O b je c tiv e . To id e n tify and describ e c u rre n t c lin ica l nu rsin g pra ctice in flu id bala nce m o n ito r in g and m ea sure m ent accuracy in ICUs, c o n d u c te d as p a rt o f a bro a d e r s tu d y in p a rtia l fu lfilm e n t o f a M aster o f N ursing degree. M e th o d s . A q u a n tita tiv e a p p ro a c h u tilis in g a d e s c rip tiv e , e x p lo r a to r y s tu d y d e sig n was a p p lie d . An a u d it o f 103 ICU reco rds was c o n d u c te d t o e sta b lis h th e c u r r e n t p ra ctice s and accu racy in re c o rd in g o f f lu i d b a la nce m o n ito r in g . Data w e re c o lle c te d u sing a p u rp o s e -d e s ig n e d to o l based on releva nt lite ra tu re and pra ctice experience. Results. O f th e o rig in a l recorded flu id balance calcula tion s, 79% de via te d by m ore th a n 50 mL fro m th e a u d ite d calcula tion s. F u rth e r­ more, a s ig n ific a n t re la tio n s h ip was s ho w n be tw e e n in accu rate flu id balance c a lc u la tio n and a d m in is tra tio n o f d iu re tic s (p=0.01). Conclusion. The m a jo rity o f flu id balance records w ere in c o rre c tly calcula ted. S AfrJC rit Care 2014;30(2):55-57. DOI:10.7196/SAJCC.193 M a in t a in in g a b a la n c e b e tw e e n f l u i d in ta k e and o u t p u t plays an im p o r ta n t role in th e m a n a g e m e n t o f a c r it ic a lly ill p a tie n t. The a c c u ra te assessm ent o f t h e f lu i d bala nce da ta c o lle c te d d u r in g physical assessment as w e ll as d u r in g m o n ito r in g a c tiv itie s and re co rd -ke e p in g fo rm s an essential p a rt o f th e baseline p a tie n t in f o r m a t io n t h a t g u id e s m e d ic a l an d n u r s in g in te r v e n tio n s t o achieve ph ysio log ica l s ta b ility in a p a tie n t. Changes in a c ritic a lly ill p a tien t’s flu id balance can c o m p lic a te th e p a tien t’s clinica l c o n d itio n . It is, th e re fo re , necessary th a t f lu i d ba la nce pa ra m e te rs are accu­ ra te ly m o n ito re d and recorded fo r all p a tie n ts in in te nsive care units (ICUs).111 A daily ob serva tion sheet is used to record all vital signs, nursing interventions, medical procedures and th e flu id balance fo r each 24-h pe rio d o f a day. The flu id balance record comprises records o f th e intake and o u tp u t o f fluids by a p a tie n t over a 24-h period. The difference betw een th e volumes is calculated to pro vid e th e 24-h flu id balance.121 The m o n ito rin g o f a patient’s f lu id balance is o f great im p o rta n ce in u n de rsta nd ing and m anaging a patient’s clinical status and, as such, accurate m o n ito rin g and recordin g o f flu id balance data plays an essential role in p a tie n t care m an agem ent.131 Several stu d ie s have c o n s id e re d th e re la tio n s h ip b e tw e e n flu id im balances and p a tie n t outcom es in c ritica l care. The Sepsis Occurrence in A cu te ly III Patients (SOAP) stu d y by V in cen t et al.,m c o n d u c te d across 198 ICUs in Europe in 2002, d e te rm in e d th a t a p o sitive f lu id balance is a strong p ro g n o s tic f a c to r f o r death in c r iti­ cally ill patients. Sim ilarly, research by Alsous et a/.,151 Boyd et al.m and Payen et o/.I7] c o n clu d e d th a t a m ore p o sitive flu id balanceis associated w ith an increased risk o f m o r ta lity in p a tie n ts w ith se p tic shock or acute renal failure. Furtherm ore, Rosenberg et a/ . 181 d e te rm in e d th a t a cu m u la tiv e ne g a tive flu id balance in pa tien ts w ith acute lu ng in ju r y is associated w ith lo w e r m o rta lity . The conclu sions o ffere d by these studies req uire th a t m o n ito rin g and reco rd in g o f flu id balance data m u st be c o m p le te and accurate, w ith assessment o f a p a tien t’s flu id balance b e in g recognised as an im p o r ta n t c o m p o n e n t o f n u rsin g any c ritic a lly ill pa tie n t. In South Africa (SA), th e practice o f a registered nurse is regulated by th e Scope o f Practice draw n up b y th e SA Nursing Council.191 Chapter 2, section 2(i) o f these regulations identifies th a t flu id balance m o n ito rin g is pa rt o f th e scope o f practice o f a registered nurse. Therefore, a registered nurse w o rking in a critical care en viro nm en t is responsible and a cco un ta ble fo r th e accurate reco rd in g and calcula tion o f flu id balance w h en caring f o r and m anaging a critica lly ill patient. Managing a patient’s flu id balance is as equally im p o rta n t as carrying o u t any o th e r p a tie n t care a c tiv ity fo r th e critica lly ill, such as a d m in isterin g a m edica tion pre scriptio n or p ro v id in g n u tritio n .121 Fluid balance m an ag em en t in ICU patients is com plex. M o n ito rin g and m easurem ent o f flu id balance requires close a tte n tio n to ensure th a t c urre nt m ethods are ap plied accurately and con sisten tly to provid e th e m ost c om p le te data, up on w h ic h p a tie n t m anagem ent decisions can be based. Based on practice experience and u n d e rpin ne d by an in form al a u d it o f 24-h flu id balance charts in a local ICU, where seven o u t o f ten calculated totals were incorrect, th e research question posed was: W hat are th e curre nt practices o f registered nurses in ICUs w ith regard to flu id balance m on ito rin g ? SAJCC November 2 0 1 4 , Vol. 3 0 , No. 2 55 ARTICLE A q u a n t i t a t iv e a p p ro a c h u t i l is i n g an exploratory, descriptive study design was applied. The study was conducted in ICUs across three purposively selected hospitals o f one private sector hospital group. The ICUs o f these hospitals were similar in terms o f th e ir patient admission profiles, w ith the same nursing docum entation and policies applied at all three hospitals. An a udit to o l was developed from relevant literature and clinical experience to assess particular aspects o f the sampled fluid balance records. Two critical care nurse experts evaluated the content and face validity o f the audit tool; no changes were required. A pretest o f the audit tool was conducted at one additional ICU o f the same hospital group to determine the accuracy and relevance o f the measurements; no changes were required. The pretest data were not included in the study data. A statistician determined the tool to be appropriate and adequate for data collection and analysis purposes. Ethical approval for the study was obtained from the Human Research Ethics Committee at the Faculty o f Medicine and Health Sciences, Stellenbosch University, as well as the relevant committee o f the hospital group. The population for this study was critical care patient records. The study sample was drawn from fluid balance records according to the following inclusion criteria: • Nursing records o f admissions to ICUs for th e firs t 48 h o f th e patient’s stay, from 1 July to 31 December 2011 • Patients over the age o f 18 years as per the definition o f an adult in the Children’s Act No. 38 o f 20051′ 01 • P atients classified as ‘in te n s iv e care’: a ctivity 1 or 2 on the patient classification system o f th is h o s p ita l g ro u p . This cla ssifica tio n was used by th e d o c to rto d e te rm in e fin a n cial charges to th e p a tie n t. No w r it t e n p o lic y re g a rd in g this classification was available from the hospitals. A simple random sampling technique was im plem ented to select patient records for th e a u d it: all th e adm ission num bers o f patients meeting the inclusion criteria were id e n tifie d th r o u g h th e hospital in fo rm a ­ tio n system and admission record book o f th e ICU. The p a tie n t record file th a t was connected w ith every th ird p a tie n t adm ission n u m b e r was draw n u n til th e required sample was achieved. The sample size was calculated to ensure adequate precision in population estimates, using 95% confidence intervals (CIs). A sample size o f 80 fluid balance records would have resulted in 6% precision in the 95% Cl w idth, assuming a 10% error rate in the calculation o fth e flu id balance. This was well w ith in the accepted precision o f between 5% and 10%. A sample size o f N= 103 was selected and divid e d specifically among the various units under th e guidance o f th e statistician (Table 1). D escriptive statistics were recorded and the Mann-Whitney U-test was used to test associations betw een recorded variables and fluid balance calculation accuracy. Data were recorded on the study audit tool by the researcher and a field worker together in the three hospitals. The fluid balance calculation recorded in eachpatient record for a 24-h period during the first 48 h o f a patient’s stay was noted on the audit tool. A control calculation of each recorded fluid balance total was done by the researcher and verified by the field worker. These audited calculations were recorded in the audit tool. The deviation between the original calculations and the audited calculations was determined and recorded. In a d d itio n to th e flu id balance calculation, baseline vital sign data, modes o f fluid o u tp u t (e.g. diarrhoea), specific data regarding the adm inistration o f blood products, and the number o f continuous intravenous infusions were recorded on th e a udit tool. Results 24-h calculated fluid balance totals The o rig in a l recorded 24-h flu id balance total was compared w ith the audited fluid balance total performed by the researcher and field worker. The difference in calcula­ tio n was referred to as the deviation in fluid balance ca lcu la tio n , and is presented in Table 2 for descriptive reasons. In the a u dit o f 103 flu id balance documents, a total o f 71 (68.9%) recorded calculated fluid balance totals were w ithin a 500 mL deviation from the fluid balance calculated by the researcher. Fourteen recorded calculations (13.5%) were found T a b l e 1.S a m p l i n g f r a m e w o r k H o sp italIn te n s iv e -c a r e beds, nAdmissions: July – D e c e m b e r 2 0 1 1, nRecords s a m p le d , n A 261 02034 B281 02734 C381 02235 D12300Pilot study Table 2. Deviation in fluid balance (A/=103) C a lc u la te d d e v ia tio nO v e ra ll 0 – 3 7 0 60 – 5051 – 5 0 0501 – 1 0 0 01 001 – 2 0 0 0> 2 0 0 1No record n982249 14765 Percentage95.121 4813.56.85.84.9 Median deviation (mL)167 201467541 2493 310 – Mean deviation (mL)493 21184 7541 3713 116 – Range (mL)0 – 3 7060-4661 -463 501 – 9841 008- 1 9282 260 – 3 706 – 5 6 SAJCC November 2 0 14, Vol. 30, No. 2 ARTIC LE DiacRon,iJ i B ReeloR’C RJk nJReeloR’C BIlnk eRIelIR’niJ In a c c u ra te f lu id c a lc u la tio n , m e d ia n (IQR) V a r i a b l e Yes N o p – v a l u e Received blood products 180.5 (60- 1 312) 167 (61 -530) 0.95 CVP measured 202.5 (90 – 764) 119 (41 -320) 0.09 Matched doctor’s prescription 155 (60 – 530) 201 (63 – 708) 0.61 Diuretic administered 279(102-996) 106 (46 – 350) 0.01 Received >2 intravenous drugs 257 (75 -708) 138 (60-435) 0.16 IQR = in t e r q u a r t il e r a n g e ; CVP = c e n tra l v e n o u s p ressure. to deviate between 500 mL and 1 000 mL, w hile seven recorded calculations (6.8%) were found to deviate between 1 000 mL and 2 000 mL. Six recorded calculations (5.8%) were found to have a deviation o f >2 000 mL. There was a significant association between the adm inistration o f diuretics and inaccurate flu id balance calculation (p=0.01), b u t there was no association between other variables and the outcome o f interest (Table 3). Discussion The definition o f a net positive fluid balance as a volume >500 mL used in the study by Alsous e ta /.151 was applied in this study. Of great concern were the 27/103 documents, m ore th a n 25% o f th e sam ple, w it h a deviation o f >500 mL between the recorded ca lc u la tio n and th e c o n tro l ca lcu la tio n . Equally o f concern were th e five p a tie n t records where no fluid balance calculation was available at all. These findings repres­ ent a risk fo r the critically ill patient when one considers th e fin d in g s o f previous studies related to positive fluid balance and p a tie n t m o rta lity .14’81 The fin d in g s o f this study showed that fluid balance calculation is n o t treated as a p rio rity in the nursing m a n a g e m e n t o f a c r itic a lly ill p a tie n t. The incorrect calculation o f flu id balance means t h a t every p a tie n t m anagem ent decision utilising these flu id balance data was influenced by inaccurate inform ation. Perren et al.1″ 1 performed a similar study in Switzerland and expressed th e ir concern a b o u t th e accuracy o f flu id balances in critically ill patients.1111 Additionally, the significant association between inaccurate fluid balance calcula­ tio n and diuretic administration (p=0.01) suggests that when diuretics are adminis­ tered, there is a higher chance o f thecalculated fluid balance being incorrect.This finding supports the researcher’s concern th a t a careful and accurate approach to fluid balance does not enjoy high priority in managing critically ill patients in this context. Diuretic therapy is a commonly prescribed therapeutic modality; in this study, 38.8% (40/103) of critically ill patients had diuretics recorded as being adminis­ tered during the first 48 h o f their admission. Inaccurate fluid balance data may result in inappropriate application o f diuretic therapy, resulting in fluid imbalances that affect the haemodynamic stability o f patients. The findings of this study are limited by the focus on one hospital group and may be regarded as a pilot study for further development. Conclusions in this study, the m ajority o f audited 24-h flu id balance calculations were shown to be incorrect; 79% (81/103) o f the original recorded fluid balance calculations deviated by >50 mL from the audited calculation. The accuracy o f th e 24-h balance calculated is questionable, w ith only 21% o f the original flu id balance to ta ls d e v ia tin g by <50 mL from the audit calculations. This is o f great concern. Several s tu d ie s 14’81 have noted a re la tio n s h ip betw een flu id im balance and m o rta lity in c ritica lly ill patients. The findings indicate th a t treatm ent decisions are often based on inaccurate fluid balance in fo rm a tio n, w hich may lead to negative consequences for the patient. A significant association was shown between the administration of diuretics and inaccurate 24-h fluid balance calculations. With diuretics prescribed specifically to manage fluid imbalance, this finding indicates that the accuracy o f the calculated fluid balance must be confirmed prior to diuretics being prescribed or administered.Within the context o f lim ited resources, any clinical recommendations must be realistic and p ra c tic a l. One suggested exam ple is in s titu tin g a system o f checking flu id balance calculations at specific intervals, such as du rin g p a tie n t handover at sh ift change, d u rin g th e p a tie n t assessment process or d u rin g p a tie n t m anagem ent discussions. Awareness around th e poten­ tial consequences o f calculation errors must be reinforced du rin g p a tie n t discussions and continuing education sessions. The requirement to provide accurate, correct fluid balance m onitoring and recording as part of the patient’s vital sign data must be established as a fundamental standard o f practice fo r every nurse practising in an ICU. Regular outcome- driven audits w ill assist in identifying where and when errors occur, allowing for specific interventions to be designed and implemented. Further studies may assist in refining the particular challenges o f accurate fluid balance recording, for instance cumulative fluid balance over more than 24 h. References 1. Culleiton AL, Simko LC. Keeping electrolytes and fluids in balance. Nursing2013 Critical Care 2011;6(2):30-35. [h ttp :// dx.doi.org/10.1097/01 :CCN.0000394395.67904.4d] 2. Scales K, Pilsworth J. The im portance o f fluid balance in clinical practice. Nursing Standard 2009;22(47):50-57. [http://dx.doi.org/10.7748/ns2008.07.22.47.50.c6634] 3. Elliot D, Aitken L, Chaboyer W. ACCCN’s Critical Care Nursing, 1st ed. Marrickville, Australia: Mosby Elsevier, 2007:440,445-446. 4. Vincent JL, Sakr Y, Sprung CL, et al. Sepsis in European intensive care units: Results o f the SOAP study. Crit Care Med 2006;34(2):344-353. 5. Alsous F, Khamiees M, DeGirolamo A, Amoateng-Adjepong Y, Manthous CA. Negative flu id balance predicts survival in patients w ith septic shock: A retrospective study. Chest 2000;117(6):1749-1754. 6. Boyd JH, Forbes J, Nakada T, Walley K, Russell JA. Fluid resuscitation in septic shock: A positive flu id balance and elevated central venous pressure are associated w ith increased mortality. Crit Care Med 2011;39(2):259-265. [http://dx.doi.Org/10.1097/CCM.0b013e3181 fe e b l 5] 7. Payen D, de Pont AC, Sakr Y, e t al. A positive flu id balance is associated w ith a worse outcome in patients w ith acute renal failure. Crit Care 2008;12(3):R74. h ttp://c cforum .com / content/1 2/3/R74 (accessed 27 October 2014). [h ttp :// dx.doi.org/10.1186/cc6916] 8. Rosenberg AL, Dechert RE, Park PK, Bartlett RH, National Institutes o f Health-National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome Network. A review o f a large clinical series: Association o f cumulative flu id balance on o utcom e in acute lung in ju ry: A retrospective review o f the ARDSnet tidal volume study cohort. J Intensive Care Med 2009;24(1):35-46. [h ttp :// dx.doi.org/10.1177/0885066608329850] 9. South African Nursing Council. R2598, Regulations relating to th e scope o f practice o f persons w h o are registered or enrolled under th e Nursing Act, 1978. Regulation o f the Nursing Act, 2005 (Act No. 33 o f 2005). Pretoria: Government Gazette, 491,2006:34. 10. South African Government. Children’s Act 38 o f 2005. h ttp ://w w w .ju stice.g ov.za/le gis lation/acts/2 00 5-0 38% 20 childrensact.pdf (accessed 27 Octobe r 2014). 11. Perren A, Markmann M, Merlani G, Marone C, Merlani P. Fluid balance in critically ill patients. Should we really rely on it? Minerva Anestesiol 2011;77(8):802-811. SAJCC November 2 0 1 4 , Vol. 3 0 , No. 2 57 Copyright ofSouthern AfricanJournalofCritical Careisthe property ofHealth &Medical Publishing Groupanditscontent maynotbecopied oremailed tomultiple sitesorposted toa listserv without thecopyright holder’sexpresswrittenpermission. However,usersmayprint, download, oremail articles forindividual use.
This assignment will be uploaded automatically to Turnitin upon submission to verify this is your original work and no parts were copied from another student.Turnitin is now more closely integrated wi
Hello everyone! I want to welcome you to your final assignment you have due for your NR439 course! Can you believe it? This is your last one, so Kudos to you! I have created for you a short tutorial for your week 6 reading research literature worksheet.  Your week 6 assignment is located in your week 6 module; if you click on the link it will take you to your guidelines and directions. As always, you will find your rationale and purpose for completing the learning activity. I created this worksheet assignment to help you demonstrate your understanding of how to read an original research article that has been assigned for you and then answer specific questions about the research study. The worksheet is designed to help you appreciate and value the importance of reading research literature. As a take away, you can use this worksheet to help you critique any research literature of interest in your future. The week 6 reading research literature assignment is based off of a culmination of your learning so far in your course. Please refer back to your learning in the course to help you with the questions for the activity. I designed this learning activity using your AACN standards for professional practice which requires a BSN to appreciate, read, and understand original nursing research literature as this is an essential for creating an evidence-base practice. The assignment directions and rubric are located under your week six assignment. It is essential that you read over the directions as these have key instructions and helpful hints to complete the required week 6 reading research literature worksheet. The worksheet is located here and you must use the worksheet that is assigned in your session you are taking the course. The worksheet can change from session to session and so it is important that you use the one that is assigned during the session you are taking the course. This assignment requires that you read an assigned research article that is located here and then answer the questions after you have read the article. Be sure you are using the assigned article for the session you are taking the course. The article can change from session to session so it is important you access the assigned article that is linked in the course located here. I encourage you to read all the directions first, and then read over your grading rubric which is located beneath the assignment directions. Be sure that you are using your grading rubric to complete the required assignment. Your instructor will use the grading rubric to evaluate each of the criteria you will be completing. You want to use the first column to be sure you are capturing all available points for that criteria. All assignments at Chamberlain require Academic Integrity which means the work that you produce is your own. As you know in practice and in school, integrity matters. Therefore, it is imperative you are using your own words to answer the questions after you have read the assigned article. You want to pay attention to the scholarly writing area and the APA area for the assignment. You can paraphrase some of the information you will discuss from the article. Paraphrasing means you are using your own words to describe what the author has discussed. You can use 1-2 short direct quotes but I highly encourage you to paraphrase instead in order to prevent any academic integrity concerns. You must use APA in-text citations which means you must cite the sentence you paraphrased using your own words. You can use other scholarly sources to support your answers to demonstrate your knowledge of how to read a research article. If you use an outside scholarly source or any other source, please list the resource below the worksheet. Listing the resource at the end without citing does not demonstrate integration of the resource. Be sure you are fully citing the resource; posting a link will not be accepted as a scholarly source as your instructor can not determine from a link the quality of the resource. The assignment is worth 200 points. I want to point out that you need to use scholarly writing, spelling, grammar, and complete sentences. Again, use your own words to write about the criteria to demonstrate your understanding of the article and use in-text APA citations for any sentences that you use from resources. It is important that you are using the assigned worksheet and article in the session you are taking the course; if you do not, points will be deducted from the elements listed here in your grading rubric. Resources: You can find APA resources as well as writing assistance in your resources tab and your Chamberlain library. Your Chamberlain library is a great database to find current evidence to support your writing. The link to the library is located here. Students, again Kudo’s to each of you for your persistence and all of your valuable work you are doing in NR439. We appreciate each of you and know that you are expanding your knowledge and skill set related to practicing as a BSN. The course was created to help support your knowledge, skills, and awareness of how to utilize and practice with an evidence-based approach and way of thinking as you move towards achieving your BSN. As always, please contact your NR439 instructor if you have any questions. Enjoy your final assignment!
This assignment will be uploaded automatically to Turnitin upon submission to verify this is your original work and no parts were copied from another student.Turnitin is now more closely integrated wi
Chamberlain College of Nursing NR439: Evidence-Based Practice Week 6: Reading Research Literature Worksheet Directions: Complete the following required worksheet using the required article for the current session. Name: Date: Purpose of the Study: Research & Design: Sample: Data Collection: Data Analysis: Limitations: Findings/Discussion: Reading Research Literature: 3/2020 ST 1

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