Clinical Guidelines and Nursing Sensitive Outcomes

Clinical Guidelines and Nursing Sensitive Outcomes
Clinical Guidelines and Nursing Sensitive Outcomes

Clinical Guidelines and Nursing Sensitive Outcomes

Order Instructions:

This paper is critical and the writer must make sure that all details are taking into consideration. every question must have a detail respond. hear below are the instructions and also some resources that will be use for this paper , let the writer reference to all the resources are he writes the paper . Take note that each section must have 3 cited sources from pear review scholarly articles.

This paper is in two section just as some of my other papers. It should have a reference list at the end of each section, and proper grammar must be used to complete this paper. It has been cited in most of my papers that proper grammar and spellings was not applied and that has caused me a lot of points in this class. As we come to the end of this particular class I want you guys to pay attention to details. Read the instructions and respond accordingly. Take note that all points must be detaily explained. For section A you will use the clinical guidelines which is included hear below to respond to this section of the paper. The link is provided below and you must also quote a minimum of 3 sources for each section.

SECTION A (1.5 pages minimum)

Clinical Guidelines and Nursing Sensitive Outcomes
Clinical focus
The falls clinical guideline in reference is meant for health care professionals. There is a summary regarding the assessment and screening of falls among the elderly (focused history, physical examinations, functional assessment, and environmental assessment). There are also recommendations for old people in different care settings. The guideline can be obtained from

Clearly describe the best practice or clinical guideline above and provide a working link to resource that is helpful in understanding this practice or guideline.
1. Discuss why this best practice or guideline should be utilized in nursing practice. Why do they lead to improved patient outcomes? What are the nursing actions identified in the guideline? What are the nursing sensitive outcomes?
2. End your discussion with suggestions as to how you might implement this evidence-based best practice or clinical guideline in your health care setting. As you do so, identify any potential barriers you might anticipate and offer ways to overcome these barriers.
3. Provide at least three citations with full references to credible nursing scholarly articles supporting your definitions and discussion.

SECTION B (1.5 pages minimum)

Collaboration for Research and Evidence-based Practice
1. Consider the role of the nurse as an interdisciplinary team member in completing research and using research findings to inform health care practices.
2. Using insights gained from visiting the Women’s Health Initiative retrieved from and by reading the article on collaborative strategies by Engelke and Marshburn (2006):
3. Discuss the role of the advanced practice nurse as an interdisciplinary research collaborator and member of the interdisciplinary team obligated to co-participate in the implementation and use of evidence-based practice.
4. End your discussion by providing an example of an evidence-based change that would require the collaborative efforts of nursing and at least two other health care disciplines and that would lead to quality improvement in healthcare.
5. Provide at least three citations with full references to credible nursing scholarly articles supporting your definitions and discussion.

Resources for this paper

Required Activities

• From your textbooks, read:
• Introduction to Nursing Research Incorporating Evidence-Based Practice
• Chapter 15: “Application of EBP”
• Please retrieve and read the following journal articles.
• Engelke, M.K., & Marshburn, D. M. (2006). Collaborative strategies to enhance research and evidence-based practice. Journal of Nursing Adminstration, 36(3), 131–135.
• Booth, J., Tolson, D., Hotchkiss, R., & Schofield, I. (2007). Using action research to construct national evidence-based nursing care guidance for gerontological nursing. Journal Of Clinical Nursing, 16(5), 945–953.
• Hoss, B., & Hanson, D. (2008). Evaluating the evidence: web sites. AORN Journal, 87(1), 124.
• Munroe, D., Duffy, P., & Fisher, C. (2008). Research for practice. Nurse knowledge, skills, and attitudes related to evidence-based practice: before and after organizational supports. MEDSURG Nursing, 17(1), 55-60.
• Harvath, T., Flaherty-Robb, M., White, D., Talerico, K., & Hayden, C. (2007). Best practices initiative: nurturing partnerships that promote change. Journal Of Gerontological Nursing, 33(11), 19–26.
• Reavy, K., & Tavernier, S. (2008). Nurses reclaiming ownership of their practice: implementation of an evidence-based practice model and process. Journal Of Continuing Education In Nursing, 39(4), 166–172.
• Review these Web resources.
• Revisit Clinical Guidelines and Best Practices such as the following:
• National Institute for Health and Clinical Excellence©. Retrieved from
• Revisit Nursing Sensitive Patient Outcomes
• Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Retrieved from
• National Database of Nursing Quality Indicators. Retrieved from
• Nursing Sensitive Patient Outcomes (ONS). Retrieved from
• Collaboration
• Physician-Nurse Collaboration in Research in the 21st Century. Retrieved from


Clinical Guidelines and Nursing Sensitive Outcomes

Section A

The guidelines are developed by the geriatrics societies in America and Britain and are based on evidence based trials among other players in areas such as occupational therapy, physical therapy, home care, pharmacy and hospice. They aim at assisting care providers on fall prevention after older patients’ recurrent falls, difficulty in walking or after acute falls. They may be implemented in caring for older persons in communities, long term care and for those with cognitive impairment (The Panel on Prevention of Falls in Older Persons, American Geriatrics Society and British Geriatrics Society, 2011).

Discuss why this best practice or guideline should be utilized in nursing practice

The best practice guideline should be utilized in nursing practice because there is need to reduce the risk of falls among older persons who are more susceptible to falls than younger patients. Falls are also related to higher rates of morbidity and mortality among older patients and it is thus imperative that nurses apply the guidelines to reduce the rates of death and illness. The guidelines on preventing falls are also imperative in preventing impairment of older persons’ overall functioning as well as untimely admission in longer term care settings (Feder, Donovan, & Carter, 2000). The following link to a resource is helpful in understanding this guideline (

Why do they lead to improved patient outcomes?

The guidelines result in improved patient outcomes because they bridge the theory-practice gap. They are particularly essential because uncertainty about care is rampant in nursing care for older patients. The guidelines are developed through a participatory approach which gives nurses confidence in caring for older patients. Patients provide experiential information about their falls and health practitioners evaluate appropriate interventions among those provided in the best practices guidelines. This approach reduces medical errors and results in better quality of care.

What are the nursing actions identified in the guideline?

Nursing actions that are required include a multifactorial risk assessment on patients’ history, physical balance, functional abilities and their environment.  After assessing the risks, nurses recommend interventions to reduce the risk factors such as minimizing medications, incorporating an exercise program and treating vision impairment, administering vitamin D supplements. Providing education on fall prevention is also imperative among other interventions like modifying the home environment, addressing foot wear problems, managing heart rhythm problems and postural hypotension (, 2010).

What are the nursing sensitive outcomes?

The nurse sensitive outcomes emanate from the fact that the guidelines are developed by a mixture of nurses from the diverse areas of gerontological practice and other experts in healthcare. The outcomes are that nurses provide safe and error free interventions. They assess the risk and offer interventions that are supported by tacit knowledge rather than mindlines. When nurses lack formal clinical guidelines, they base their decision making on mindlines. Mindlines as knowledge developed instinctively from their interactions with colleagues, opinion leaders and patient and practice experiences can be unsafe for older patients (Booth, Tolson, Hotchkiss, & schofield, 2007).

The guidelines are applicable in an acute health setting admitting older patients with cardiovascular conditions. It would require a variety of interventions to verify whether the reported falls are as a result of syncope or postural hypotension (The Panel on Prevention of Falls in Older Persons, American Geriatrics Society and British Geriatrics Society, 2011). One setback or barrier is that it would call for prolonged patient observation to ascertain the cause of the falls. However, admission in a home care setting may be necessary to verify the reasons for recurrent falls and execute appropriate interventions such as cardiac pacing and exercise to reduce the risk for falls.


Booth, J., Tolson, D., Hotchkiss, R., & Schofield, I. (2007). Using Action research to Construct National Evidence Based Nursing Care Guidance for Gerontological Nursing. Journal of Clinical Nursing, 16, 945-953.

Feder, G., Donovan, S., & Carter, Y. (2000). Guidelines for the Prevention of Falls in People Over 65. British Medical Journal, 321, 1007-1011. (2010, July). Prevention of Falls in Older Persons: AGS/BGS Clinical Practice Guideline. Retrieved August 7, 2014, from

The Panel on Prevention of Falls in Older Persons, American Geriatrics Society and British Geriatrics Society. (2011). Summary of the Updated American Geriatrics Society/British Geriatrics Society Clinical Practice Guideline for Prevention of Falls in Older Persons. Journal of the American Geriatrics Society, 59(1), 148

Section B

Nurses are increasingly collaborating in interdisciplinary research initiatives. For nurses’ participation in research to work well, there is need to ensure that open lines of communication are in existence. It is also imperative to ensure clear communication about goals, objectives, roles, processes and outcomes is issued at the onset of the research. It is also imperative that the interdisciplinary dynamics also entrench mutual trust and respect as well as value for the unique expertise that nurses and other members contribute (Houldin, Naylor, & Haller, 2004).

Nurses must use evidence based research findings as the basis of their health care practices in education, management and direct patient care. Implementing the evidence based practices have proven to provide safe, cost effective and personalized interventions to patients. Participation in collaborative research and implementation of the findings also develops nurses’ communication and critical thinking skills and leadership abilities to a significant extent. Nurses’ participation also increases their enthusiasm for work leading to increased practice ownership and greater appreciation for evidence based practice (Reavy & Tavernier, 2008).

There is a growing need for service and academia collaboration in research that informs evidence based practice (Engelke & Marshburn, 2006).Educators entrench utopia in nursing practice while healthcare settings cope with the reality of care on a daily basis. It is therefore important that nurse and educators share their perspectives to develop a shared understanding that bridge the gap between practice and education. For example, students can access an externship program that requires that they work the same shifts as their designated preceptors. Such an arrangement facilitates a mentorship relationship because students are not bombarded with new coworkers in every shift.  Students must also report to a faculty member to access counseling on problems and learn effective team work strategies. A collaborative experience between preceptors and faculty members allows students to gain clinical experience which is an important form of evidence based practice (Horns, Czaplijski, Engelke, Marshburn, McAuliffe, & Baker, 2007).

The advanced practice nurse plays a collaborative and a co-participatory role in interdisciplinary in research and implementation. This is because partnership is an increasingly important value in organizational life. Advanced practice nurses continuously interact with other researchers in research and also use research results in practice (Harvath, Flahherty-Robb, White, Amann, & Hayden, 2007).  The Women’s Health Initiative constitutes one of the collaborative research undertaking involving health care providers such as physicians, nurses, psychologists, nutritionists, epidemiologists and biostaticians for over a decade. The diversity in expertise of the team was imperative in adequately addressing the scientific and operational goals of the longitudinal, multifactorial observational study. It involved randomized controlled clinical trials that were made possible through the teams’ collaborative effort (Houldin, Naylor, & Haller, 2004).

Advanced practice nurses require making clinical decisions using the best research evidence, draw on their clinical experience and patient preferences. An example of collaborative effort in wound care evidence based change in a veteran wound care unit would incorporate nurses, pharmacists and dermatologists. The team would conduct a review of literature on pressure ulcer and venous stasis ulcer management to inform their research based treatment protocol. The dermatologists would provide insight on the most effective care strategies, the pharmacist would provide vital information on dosage in the different medicines while the advanced practice nurse would monitor nurses to ensure that policies and practices at the unit are evidence-based.


Engelke, M. K., & Marshburn, D. (2006). Collaborative Strategies to Enhance Research and Evidence-based Practice. Journal of Nursing Administration:, 36(3), 131-135.

Harvath, T. A., Flahherty-Robb, M., White, D. L., Amann, K., & Hayden, C. (2007). Best Practices Initiative: Nurturing Partnerships that Promote Change. Journal of Gentological Nursing, 33(11), 19-26.

Horns, P. N., Czaplijski, T. J., Engelke, M. K., Marshburn, D., McAuliffe, M., & Baker, S. (2007). Leading Through Collaboration: A Regional Academic /Service Partnership That Works. Nursing Outlook, 55(2), 74-78.

Houldin, A. D., Naylor, M. D., & Haller, D. G. (2004). Physician-Nurse Collaboration in Research in the 21st Century. Journal of Clinical Oncology, 22(5), 774-776.

Reavy, K., & Tavernier, S. (2008). Nurses Reclaiming Ownership of Their Practice: Implementation of an Evidence-Based Practice Model and Process. The Journal of Continuing Education in Nursing, 39(4), 166-172.

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