nursing

Reply to classmates’ post, at least 125 words each and 1 scholarly reference within last 5 years for each

POST1

The identification and filling of evidence gaps is a central interest of a scientific society and a professional association in order to further develop the discipline, transfer the knowledge and to assure evidence-based diagnostics and therapy for the patients (Dreier and Lohler, 2016).

Personally I did not find too many gaps in the literature research in regards to my topic as a whole, but rather when I started to do my comparison. My proposed PICOT statement is for ICU patients sedated and on mechanical ventilation, can daily assessments and interventions of delirium compared to no assessment or intervention decrease ventilator days by 1.2 in the course of six months. When I was doing research, I found a lot of data about delirium assessments and decreased days on ventilator by performing awakening trials, but what was not in most of the research was the “C” in my PICOT in regards to comparing it to performing no assessment.

The identification of gaps from systematic reviews is essential to the practice of evidence-based research. Health care research should begin and end with a systematic review. A comprehensive and explicit consideration of the existing evidence is necessary for the identification and development of an unanswered and answerable question, for the design of a study most likely to answer that question, and for the interpretation of the results of the study (Robinson, Akinyede, and Dutta, 2013). So retrospectively I should have thought about changing my comparison in my PICOT statement. Although it was not a huge gap , because I did gather some information but just not a lot.

Robinson, Akinyede and Dutta (2013) also state that It is not only important to identify research gaps but also to determine how the evidence falls short, in order to maximally inform researchers, policy makers, and funders on the types of questions that need to be addressed and the types of studies needed to address these questions.

POST2

Project overview: Initiating a breastfeeding education program during the antenatal period to address the needs of pregnant women for increased breastfeeding intentions and numbers.

The World Health Organization (WHO) and the United Nations Children Fund (UNICEF) since the launch of the Baby-Friendly Hospital Initiative (BFHI) in 1991 have expanded efforts to increase the number of facilities adopting the Ten Steps to Successful Breastfeeding. The role of these maternity facilities is focused on protecting, promoting and supporting breastfeeding by having breastfeeding policies, having adequately trained staff to implement the policy, supporting mothers through breastfeeding activities, encouraging bonding and establishing support groups to assist mothers post-discharge (WHO, 2018).

During the literature review to gather the evidence most relevant to the project, it was noted that many studies referenced an education program influenced by the BFHI as appropriate to address the issues of breastfeeding. However, information relating to the period of pregnancy during which these education programs were delivered was lacking since most of the breastfeeding education initiatives took place during the post-partum period. It was also observed that information about adequately trained staff outside of the hospital setting (e.g. clinic) was lacking.  This lack of prenatal initiatives was also reflected in qualitative studies that aimed to investigate mothers’ perspectives of the support provided by birthing facilities and facilitators and barriers that affected their breastfeeding intentions and activities.

These gaps are significant to encourage further research on breastfeeding attitudes, self-efficacy, availability of facility support, initiation of a structured education program, and formal training of staff outside of the in-patient hospital setting. The identified gaps highlight the need to ensure that facilities are meeting the needs of families who intend to breastfeed and are providing all pregnant women with evidence-based breastfeeding information to assist them in making the best nutrition decisions for their infants. These two gaps are factors that can influence how the education provided to mothers is received and processed. That can also help to determine when is the most effective period of pregnancy to initiate education, as well as the impact a lack of trained professionals (in the clinics) can have on breastfeeding outcomes. In a study to standardize breastfeeding in the clinic setting Seibenhener & Minchew (2016) suggested the timing of education plays a key role in breastfeeding success and a lack of breastfeeding knowledge among providers may lead to inconsistent or absent breastfeeding education.