NURS 8410 Week 2: Applying Complex Reasoning Strategies

You likely make countless decisions in your day-to-day practice—many with significant consequences. How do you gather and assess information? Evaluate its significance? Weigh possible actions? As a DNP-prepared nurse, it is essential to engage in self-reflection and further your awareness of how your decision-making processes and use of professional judgment can promote the application of effective practices in your specialty area.

Reasoning strategies guide current practice as well as the development and adoption of new, innovative approaches to improve practice in the specialty areas—a topic that will be explored in depth during upcoming weeks of this course.

This week you begin to develop your small-scale Evidence-Based Practice (EBP) Project in your practicum setting. In Application 1—the first in a series of assignments in which you will convey your insights and analysis of the EBP Project—you are asked to identify an issue related to practice in which an outcome is different from what would be expected according to the research literature. This issue provides the foundation for future development of the project.

Learning Objectives for NURS 8410 Week 2: Applying Complex Reasoning Strategies

Students will:

Apply reasoning strategies in a nursing specialty area
Evaluate outcomes in a specialty practice area that differ from the research evidence

Photo Credit: [Science Photo Library – PASIEKA]/[Brand X Pictures]/Getty Images

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

Terry, A. J. (2018). Clinical research for the doctor of nursing practice (3rd ed.). Burlington, MA: Jones & Bartlett Learning.

Chapter 1, “The Importance of Research in the Doctor of Nursing Practice Degree”
Read pages 12-18 beginning with “The DNP Graduate With an Aggregate Focus”In this section of Chapter 1, the author explains relationship between the DNP clinician, the research process, and developing an effective evidence-based practice. The author also discusses facilitating change in practice based on critically appraised and validated evidence. In addition, Carper’s four essential patterns of “knowing” in nursing and Rosswurm and Larrabee’s six-phase model for reviewing research are highlighted. NURS 8410 Week 2: Applying Complex Reasoning Strategies

Balakas, K., Sparks, L., Steurer, L., & Bryant, T. (2013). An outcome of evidence-based practiced education: Sustained clinical decision-making among bedside nurses. Journal of Pediatric Nursing, 28, 479-485.

Note: You will access this article from the Walden Library databases.

Harkanen, M., Voutilainen, A., Turunen, E., & Verhvilainen-Julkunen, K. (2016). Systematic review and meta-analysis of educational interventions designed to improve medication administration skills and safety of registered nurses, Nurse Education Today, 41, 36-43.

Note: You will access this article from the Walden Library databases.

Lee, J., Lee, Y., Bae, J., & Seo, M. (2016). Registered nurses clinical skills and reasoning process: A think-aloud study. Nurse Education Today, 46, 75-80.

Note: You will access this article from the Walden Library databases.

Simmons, B. (2010). Clinical reasoning: Concept analysis. Journal of Advanced Nursing, 66(5), 1151-1158.

Note: You will access this article from the Walden Library databases.

Discussion: Reasoning in a Specialty Area

Bring to mind an important practice-related decision you have made recently. How did you approach this decision? What aspects of your specialty expertise informed your decision-making?

Evaluate your decision now in light of the principles of clinical reasoning presented in the Learning Resources this week. What new insights arise about your decision making as you look at it through this lens? What questions emerge as you reflect how you use reasoning in your practice?

In this Discussion, you and your colleagues examine the application of reasoning strategies in your specialty area of practice, particularly as it is connected to your EBP Project question.

To prepare for NURS 8410 Week 2: Applying Complex Reasoning Strategies:

Consider the definition of clinical reasoningand how it is distinguished from other terms in the Simmons article.
Bring to mind key characteristics of your specialty area. Is the concept of clinical reasoning relevant and sufficient to describe the processyou utilize as you make decisions and solve problems in your area of specialization? Why or why not? If not, what terminology would be more useful for defining or characterizing this process?
Review the literature to identify at least two specific examples of reasoning strategies used in your specialty area. These may be part of your literature review related to your EBP Project question(s).
Reflect on your EBP Project question(s). Reexamine your project question(s) through this lens of clinical, or alternately termed, reasoning.

By Day 3

Post a cohesive scholarly response that addresses the following:

How are reasoning strategies most often applied in your specialty area? Provide at least two specific examples supported by the literature.
How can you apply reasoning strategies to the refinement of your EBP Project question(s)?

Read a selection of your colleagues’ responses.

By Day 6

Respond to two of your colleagues in one or more of the following ways:

Ask a probing question, substantiated with additional background information, evidence, or research.
Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
Offer and support an alternative perspective, using readings from the classroom and/or from your own research in the Walden Library.
Validate an idea with your own experience and additional research.
Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence. NURS 8410 Week 2: Applying Complex Reasoning Strategies

Return to this Discussion in a few days to read the responses to your initial posting. Note what you learned and/or any insights you gained as a result of the comments made by your colleagues.

Be sure to support your work with specific citations from this week’s Learning Resources and any additional sources.

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 2 Discussion Rubric

Post by Day 3 and Respond by Day 6

To participate in this Discussion:

Week 2 Discussion

Assignment: Application 1: Identification of a Practice Issue for the Evidence-Based Practice (EBP) Project

In many of the courses in the DNP program, you have been asked to analyze research literature when exploring issues in health care. Reflect now on an issue in your practice area that has different outcomes from what is supported by the literature. For example, the literature evidence notes that nosocomial infections are reduced when procedures such as hand washing, glove use, and isolation strategies are implemented. In your clinical area, you have implemented these strategies and you are not seeing a reduction in nosocomial infections.

For Application 1, you select an issue that will serve as the launching point for your Evidence-Based Practice (EBP) Project.

Before you proceed with this assignment, you may wish to review the overview of the full EBP Project assignment.

To prepare for Application 1:

Consider the specifics of your practicum setting, as well as practice-related challenges in your specialty area that interest you. Brainstorm practice issues in which an outcome is different from what would be expected according to the research literature. NURS 8410 Week 2: Applying Complex Reasoning Strategies
Select one issue to focus on for this assignment. This will be your issue for the entire EBP Project, so be sure it is one that will enable you to fulfill the project requirements (e.g., you can develop new approaches to practice). You may wish to speak with your Practicum Mentor about your selection.
Explore the research literature on this issue.

To complete:

In a 1- to 2-page paper, address the following:

Provide a summary of the selected practice issue in which the outcome is different from what would be expected according to the research literature. (Note:The issue you select must be suitable for completing the entire EBP Project.)

By Day 7

Application 1 is due.

Submission and Grading Information

KINDLY ORDER NOW FOR A CUSTOMIZED ACADEMIC PAPER

To submit your completed Assignment for review and grading, do the following:

Please save your Assignment using the naming convention “WK2Assgn+last name+first initial.(extension)” as the name.
Click the Week 2 Assignment Rubric to review the Grading Criteria for the Assignment.
Click the Week 2 Assignment You will also be able to “View Rubric” for grading criteria from this area.
Next, from the Attach File area, click on the Browse My Computer Find the document you saved as “WK2Assgn+last name+first initial.(extension)” and click Open.
If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
Click on the Submitbutton to complete your submission.

Grading Criteria

To access your rubric:

Week 2 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 2 Assignment draft and review the originality report.

Submit Your Assignment by Day 7

To submit your Assignment:

Week 2 Assignment

Practicum

As you begin your practicum activities, make sure that you have submitted and received approval for all of the required paperwork. Be sure to keep track of your practicum hours using the provided time log.

By Day 7 of Week 3

Reminder: You submit your time log and a journal entry during Week 3. See the Practicum Guidelines in the Practicum area of the Course Overview page for a complete description of the practicum. NURS 8410 Week 2: Applying Complex Reasoning Strategies

Week in Review

This week, you evaluated outcomes in a specialty practice area different from research evidence and applied reasoning strategies in a nursing specialty area.

Next week, you will examine the current state of science in your specialty area.

To go to the next week:

NURS 8410 Week 3: Translating Science in Advanced Nursing Practice

Health care is an increasingly complex field fueled by the explosion of information available at one’s fingertips. As technology, medical research, and information systems continue to evolve, more emphasis is being placed on incorporating science and effective practices into health care. Nurses are increasingly called upon to implement best practices based on scientifically sound evidence.

This week, you examine the current state of science in your specialty area. This is an essential step for being able to assess and promote evidence-based practice, whether or not you are directly involved in the delivery of patient care. For instance, you may investigate the latest research in leadership, economics, management, education, and so on, and apply that research in your specialty practice area.

Also this week, you submit your time log and a journal entry for your practicum experience.

Learning Objectives

Students will:

Evaluate the state of the current context of science in your specialty area in nursing and health care
Assess the practicum experience
Evaluate current literature pertaining to an issue in a specialty area NURS 8410 Week 2: Applying Complex Reasoning Strategies

Photo Credit: [GIPhotoStock]/[Cultura]/Getty Images

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

White, K. M., Dudley-Brown, S., & Terharr, M. F. (2016). Translation of evidence into nursing and health care practice (2nd ed.). New York, NY: Springer.

Chapter 1, “Evidence-Based Practice”
Chapter 2, “The Science of Translation and Major Frameworks”

Terry, A. J. (2018). Clinical research for the doctor of nursing practice (3rd ed.). Burlington, MA: Jones & Bartlett Learning.

Pages 15-18, “The Process of Translating Evidence Into Clinical Practice”
Chapter 3, “Conducting a Literature Review”

Djulbergovic, B. (2014). A framework to bridge the gaps between evidence-based medicine, health outcomes, and improvement and implementation science. Journal of Oncology Practice, 10(3), 200-202.

Note: You will access this article from the Walden Library databases.

Fineout-Overhold, E., Melnyk, B.M., Stillwell, S.B., & Williamson, K.M. (2010). Evidence-based practice step-by-step: Critical appraisal of the evidence: Part 1. American Journal of Nursing, 110(7), 47-52.

Note: You will access this article from the Walden Library databases.

Fineout-Overhold, E., Melnyk, B.M., Stillwell, S.B., & Williamson, K.M. (2010). Evidence-based practice step-by-step: Critical appraisal of the evidence: Part II. American Journal of Nursing, 110(9), 41-48.

Note: You will access this article from the Walden Library databases.

Fineout-Overhold, E., Melnyk, B.M., Stillwell, S.B., & Williamson, K.M. (2010). Evidence-based practice step-by-step: Critical appraisal of the evidence: Part III. American Journal of Nursing, 110(11), 43-51

Note: You will access this article from the Walden Library databases.

Guyatt, G., Oxman, A. D., Akl, E. A., Kunz, R., Vist, G., Brozek, J., Schünemann, H. J. (2011). GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables. Journal of Clinical Epidemiology, 64 (4), 383-394.

Note: You will access this article from the Walden Library databases.

Jeffs, L., Beswick, S., Lo, J., Campbell, H., Ferris, E., & Sidani, S. (2013). Defining what evidence is, linking it to patient outcomes, and making it relevant to practice: Insight from clinical nurses. Applied Nursing Research, 26, 105-109. NURS 8410 – Best Practices In Nursing Speciality – Weekly Discussion Essays

Note: You will access this article from the Walden Library databases.

Leung, K., Trevena, L., & Waters, D. (2014). Systematic review of instruments for measuring nurses’ knowledge, skills and attitudes for evidence-based practice. Journal of Advanced Nursing, 70(10), 2181–2195.

Note: You will access this article from the Walden Library databases.

Rosswurm, M. A., & Larrabee, J. H. (1999). A model for change to evidence-based practice. Journal of Nursing Scholarship, 31(4), 317-322.

Note: You will access this article from the Walden Library databases.

Additional Research

Conduct your own research on translational science and how it is utilized in your specialty area. Review your specialty area websites and search for articles on evidence-based practice that address the translation of research into practice. This information will inform the Discussion.

Optional Resources

Terry, A. J. (2018). Clinical research for the doctor of nursing practice (3rd ed.). Burlington, MA: Jones & Bartlett Learning.

Chapter 14, “Reducing 30-Day Hospital Readmission of the Patient with Heart Failure: An Evidence-Based Quality Improvement Project”
Chapter 15, “Reducing 30-Day Hospital Readmission of the Patient with Heart Failure: An Evidence-Based Quality Improvement Project”
Chapter 16, “The Impact of Evidence-Based Design”
Chapter 17, “The Lived Experience of Chronic Pain in Nurse Educators”

As you develop sections of your Project Premise, you may wish to review these examples of completed EBP project.

Discussion: The State of the Science in Practice

The phrase evidence-based practice may be most often thought of as a clinical reference; however, research evidence is applicable in every specialty area. What types of research evidence support your work environment? How does research evidence inform your practice?

Now, how current do you think the science is that underlies your practice? How current is the evidence that supports your specialty practice guidelines?

To prepare:

Bring to mind an issue related to your practice. You may use the issue you are exploring for your EBP Project, or another current issue in your specialty area.
If possible, examine practices and/or practice guidelines established to address your selected issue and determine how current the evidence is that supports them. NURS 8410 Week 2: Applying Complex Reasoning Strategies
Using the Walden Library, locate recently published articles that discuss research translated into evidence that applies to your selected practice issue. If you are unable to locate current articles (within the last five years), use the Internet to find evidence-based practice articles on this topic.
Consider the following questions:
- How current is the science that supported the practice or practice guidelines?
- What new evidence has emerged since the practice guidelines were crafted and adopted?

By Day 3

Post a cohesive scholarly response that addresses the following:

Discuss the state of the scientific underpinnings that relate to your selected issue.
How current is the science that supported the practice or practice guidelines?
What new evidence has emerged since the practice guidelines were crafted and adopted? Provide one or two examples that support your assessment.

Read a selection of your colleagues’ responses.

By Day 6

Respond to two of your colleagues in one or more of the following ways:

Ask a probing question, substantiated with additional background information, evidence, or research.
Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
Offer and support an alternative perspective using readings from the classroom and/or from your own research in the Walden Library.
Validate an idea with your own experience and additional research.
Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

Return to this Discussion in a few days to read the responses to your initial posting. Note what you learned and/or any insights you gained as a result of the comments made by your colleagues.

Be sure to support your work with specific citations from this week’s Learning Resources and any additional sources.

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 3 Discussion Rubric

Post by Day 3 and Respond by Day 6

To participate in this Discussion:

Week 3 Discussion

Practicum: Journal and Time Log

By Day 7

You will submit a journal entry (along with your time log) for Weeks 1-3. Journal entries need to connect your previous professional experience with your practice, competencies/concepts in the program, and the literature. Your journal entry should be week-based and sequential so that all journal entries are contained in one file.

Describe the observed activity.
Using an evidence-based approach, analyze the problem, issue, or situation. Address questions posed in the weekly practicum pages if appropriate. NURS 8410 Week 2: Applying Complex Reasoning Strategies
Reveal how the real-world might mirror or diverge from program-related evidence, concepts, and/or theories.
Time Log submission.

Submission and Grading Information

To submit your completed Practicum for review and grading, do the following:

Please save your Assignment using the naming convention “WK3Practicum+last name+first initial.(extension)” as the name.
Click the Week 3 Practicum
Next, from the Attach File area, click on the Browse My Computer Find the document you saved as “WK3Practicum+last name+first initial.(extension)” and click Open.
If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
Click on the Submitbutton to complete your submission.

Check Your Practicum Draft for Authenticity

To check your Practicum draft for authenticity:

Submit your Week 3 Practicum draft and review the originality report.

Submit Your Practicum by Day 7

To submit your Practicum:

Week 3 Practicum

Week in Review

This week, you assessed the practicum experience and evaluated current literature and the state of the current context of science in your specialty area in nursing and health care.

Next week, you will explore the interrelationships of nursing practice and how it influences evidence-based practice.

To go to the next week:

Week 4

NURS 8410 Week 2: Applying Complex Reasoning Strategies