Nursing Practice Problem For an Evidence-Based Practice Project Essay

PICOT Draft

Name_____________________________________

Part 1: Propose a relevant nursing practice problem for an evidence-based practice project. Explain why you selected this topic and how it is relevant to advance nursing practice. Include one research article that demonstrates support for the nursing practice problem.

Part II: In the table below, describe the population and the intervention. (You will continue drafting the PICOT, completing the shaded areas in Topic 3.) Nursing Practice Problem For an Evidence-Based Practice Project Essay

Author, Journal (Peer-Reviewed), and Permalink or Working Link to Access Article
Article Title and Year Published
Research Questions/ Hypothesis, and Purpose/Aim of Study
Design (Quantitative, Qualitative, or other)
Setting/Sample
Methods: Intervention/ Instruments
Analysis/Data Collection
Outcomes/Key Findings
Recommendations
Explanation of How the Article Supports Your Proposed EBP Practice Project Proposal
Goodman, D. J., Saunders, E. C., & Wolff, K. B.
BMC Pregnancy and Childbirth
https://doi.org/10.1186/s12884-020-02872-5.
In their own words: A qualitative study of factors promoting resilience and recovery among postpartum women with opioid use disorders
2020. What are the factors that improve recovery and resilience in postpartum women with OUD? Qualitative/descriptive Northern New England
10 women enrolled in a program for substance use disorder treatment, who had OUD and had continued treatment to postpartum. Substance use therapy for pregnant and postpartum women.
Semi-structured interviews to explore the women’s experiences regarding social support and access to care. Applied a HyperResearch program for the content analysis. Coded items into barriers and facilitators based on the grounded theory approaches. The study findings showed that before pregnancy the women had challenges accessing OUD care due to lack of insurance and cash to pay, and long waiting queues. Nursing Practice Problem For an Evidence-Based Practice Project Essay

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During pregnancy, the women stated they felt motivated to seek and maintain care. They were also able to develop relationships with healthcare providers. Also, they obtained support from their families. Besides, the program addressed the logistical issues that barred them from obtaining OUD care.
Programs that are offered to pregnant women with opioid use disorder at the community level can address access barriers and promote pregnancy and postpartum outcomes. The article supports the opioid addiction treatment in pregnant and postpartum women as in the proposed EBP practice project’s PICOT.
Mazel, S., Alexander, K., Cioffi, C., & Terplan, M.
Substance Abuse and Rehabilitation
https://doi.org/10.2147/SAR.S375652. Interventions to support engagement in addiction care postpartum: Principles and pitfalls. 2023

What are some of the clinical, policy, and research strategies for improving postpartum care in women with substance use disorder (SUD) and the barriers to uptake of evidence-based interventions? Scoping Review 41 articles published as of February 2023
The articles were about OUD, SUD, addiction, and adherence/engagement to treatment Interventions for SUD management and structures, including medication for OUD (buprenorphine), Nursing Practice Problem For an Evidence-Based Practice Project Essay
care models-integrated and collaborative care models, and
harm reduction, such as overdose responses The researchers analyzed the 41 articles and categorized them based on the interventions. The researchers found that most articles researched medication for OUD and collaborative/team-based care. However, there were few studies supporting harm reduction principles. The authors recommended combining medications for OUD, with the right care models and incorporating harm reduction strategies for optimal care for pregnant and postpartum women. The article supports the EBP project PICOT which aims to investigate comprehensive care delivered in an integrated and coordinated approach for opioid addiction in pre-, intra, and postpartum.
Meinhofer, A., Hinde, J. M., & Ali, M. M.
Journal of Substance Abuse and Treatment.
https://doi.org/10.1016/j.jsat.2019.12.005. Substance use disorder treatment services for pregnant and postpartum women in residential and outpatient settings. 2020 What is the prevalence/availability of SUD treatment services for pregnant and postpartum women in the U.S.? Retrospective descriptive study 2007-2018 data from the National Survey of Substance Abuse Treatment Services (N=165350) Specialized care services for pregnant and postpartum women (PPW) The researchers analyzed time trends (2007 to 2018) of the treatment facilities with services for PPW with SUD.
They also investigated the geographical distribution across U.S states to determine availability
They also analyzed the offered services, including screening, treatment, ancillary services, delivery mode, and payer acceptance (including out-of-pocket payments and free services) The results indicated an increase in the number of outpatient facilities offering PPW services from 2013 onwards. They also showed significant variation in the distribution of the services with some U.S districts having lower coverage than others. Nursing Practice Problem For an Evidence-Based Practice Project Essay
The findings also highlighted that medications were the most offered intervention in facilities that had PPW services. A few provided ancillary services, such as social assistance and referrals for SUD treatment. Comprehensive care that is integrated and collaborative is effective in addressing SUD in pregnant and postpartum. However, social and economic barriers to accessing the treatment services occur. Healthcare organizations and states that have low distribution of these programs should strive to increase the number to improve maternal and child outcomes in the wave of the opioid epidemic. The article acknowledges the problem presented in the EBP project proposal. It highlights the need for comprehensive maternal care for pregnant and postpartum women with OUD.
Parlier-Ahmad, A. B., Eglovitch, M., Martin, S., Svikis, D.S., & Martin, C. E.
Journal: Children (peer-reviewed)
https://doi.org/10.3390/children10020359

Project BETTER: A family-centered, technology-delivered intervention for pregnant people with opioid use disorder
2023 How does a family-centered intervention delivered through technology to pregnant people using medication for opioid use disorder influence the transition from pregnancy to postpartum?
The study aimed to describe the development of a project “BETTER” (Bringing Education Through Technology, Empathic Listening, and Research), and pilot testing before being evaluated in a randomized controlled trial. The intervention focused on family and was delivered using technology. A qualitative, descriptive study Study conducted at a perinatal addiction clinic
The expert panel for reviewing the educational project was 15. Nursing Practice Problem For an Evidence-Based Practice Project Essay
The sample for pretesting the modules was n=9 patients.
Three modules of intervention: The intervention was developed based on the principles of motivational interviewing (person-centered, non-confrontational, and empathetic)
Semi-structured interviewer-led questionnaires used for the pilot testing
Recorded interviews with patients were analyzed
Reviewers feedback was also analyzed
The results were recorded to inform intervention improvement The reviewers appraised the intervention positively. They noted that it was engaging and informative. Also, they highlighted the use of technology as a good innovation to enhance study participation.
The patients in the pretesting stated they appreciated the intervention because they could learn without being judged. Also, they identified the intervention as a good complementary to the standard education they receive during prenatal clinics. Person-centered educational intervention for enabling pregnant people with opioid use disorder (OUD) to transition to post-partum should be provided to all pregnant women with OUD. Parlier-Ahmad et al. (2023) article supports the proposed EBP practice project because it describes the development and pretesting of an intervention for pregnant women with OUD.
Rizk, A. H., Simonsen, S. E., Roberts, L., Taylor‐Swanson, L., Lemoine, J. B., & Smid, M. Journal of Midwifery Women’s Health
https://doi.org/10.1111/jmwh.13019. Maternity care for pregnant women with opioid use disorder: A Review.
2019 What are the aspects of care for antepartum, intrapartum, and postpartum in women with opioid addiction? Nursing Practice Problem For an Evidence-Based Practice Project Essay

Clinical case study B. L. a patient who presented for the antenatal clinic at 22 weeks and had a history of illicit substance abuse A combination of interventions, including screening for SUD, intervention, and referral for treatment, pregnancy care, and intrapartum and postpartum treatment care. Researchers analyzed the case study and used literature evidence to support and evaluate interventions applied. The findings indicated that pregnant women with OUD experience multiple challenges. Multidisciplinary care that meets the specific patient needs improves the outcomes of the patient in the Screening in the antenatal clinic enabling healthcare providers to tailor the care to the patients’ health needs. Comprehensive care that combines screening, brief intervention, and referral treatment in collaborative and integrated care models should be implemented to address the challenges of women with OUD in antepartum, intrapartum, and postpartum. The article answers the PICOT question as the case study analysis focuses on interventions for women with OUD before, during, and after childbirth.
Singleton, R., Rutz, S., Day, G., Hammes, M., Wilson, A. S., Herrick, M., Mazut, C., Brunner, L., Prince, J., Desnoyers, C., Shaw, J., Hirschfeld, M., Palis, H., & Slaunwhite, A.
Journal of Addiction Medicine
https://doi.org/10.1097/ADM.0000000000000987 Nursing Practice Problem For an Evidence-Based Practice Project Essay

Assessing the impact of prenatal medication for opioid use disorder on discharge home with parents among infants with neonatal opioid withdrawal syndrome.
2022 Does access to medication for OUD (MOUD) affect maternal and neonatal outcomes?
What is the impact of prenatal MOUD on the discharge of neonates with opioid withdrawal syndrome to parents? Quantitative, retrospective longitudinal study Setting: Three Alaska hospitals
Sample: 91 mothers that received MOUD during pregnancy
Second sample: n=190 for neonates discharged (to biological parents or foster care). Measures:
Medication for opioid use disorder (buprenorphine, methadone)
Discharge to biological parents
Independent variables:
Maternal health attributes- health status and demographics
Prenatal care elements
Newborn discharge characteristics- presence of biological parents during the hospitalization period
Instrument: Web application for managing surveys Nursing Practice Problem For an Evidence-Based Practice Project Essay
Data recorded in the web platform (ANTHC REDCap Survey platform) were analyzed using R-software. Descriptive and inferential statistics were completed. The relationships between the independent and dependent variables were established and results were recorded. The results indicated that mothers who received MOUD were likely to be present during the hospitalization of their newborns with withdrawal syndrome compared with those who did not or were on opioids. The mothers who were on MOUD were also likely to be allowed to take their newborns. The authors recommended providing MOUD therapy to pregnant women to prepare them for postpartum care and handling their newborns with opioid withdrawal syndrome. The article contributes to the proposed EBP project because it supports special care for women with OUD. It recommends pharmacological treatment for addiction to improve maternal and child outcomes. Nursing Practice Problem For an Evidence-Based Practice Project Essay

References
Goodman, D. J., Saunders, E. C., & Wolff, K. B. (2020). In their own words: A qualitative study of factors promoting resilience and recovery among postpartum women with opioid use disorders. BMC Pregnancy and Child Health, 20(178), 1-10. https://doi.org/10.1186/s12884-020-02872-5.
Mazel, S., Alexander, K., Cioffi, C., & Terplan, M. (2023). Interventions to support engagement in addiction care postpartum: Principles and pitfalls. Substance Abuse and Rehabilitation, 14, 49-59. https://doi.org/10.2147/SAR.S375652.
Meinhofer, A., Hinde, J. M., & Ali, M. M. (2020). Substance use disorder treatment services for pregnant and postpartum women in residential and outpatient settings. Journal of Substance Abuse and Treatment, 110, 9-17. https://doi.org/10.1016/j.jsat.2019.12.005.
Parlier-Ahmad, A. B., Eglovitch, M., Martin, S., Svikis, D.S., & Martin, C. E. (2023). Project BETTER: A family-centered, technology-delivered intervention for pregnant people with opioid use disorder. Children, 10(359), 1-8.https://doi.org/10.3390/children10020359.
Rizk, A. H., Simonsen, S. E., Roberts, L., Taylor‐Swanson, L., Lemoine, J. B., & Smid, M. (2019). Maternity care for pregnant women with opioid use disorder: A Review. Journal of Midwifery & Women’s Health, 64(5), 532–544. https://doi.org/10.1111/jmwh.13019.
Singleton, R., Rutz, S., Day, G., Hammes, M., Wilson, A. S., Herrick, M., Mazut, C., Brunner, L., Prince, J., Desnoyers, C., Shaw, J., Hirschfeld, M., Palis, H., & Slaunwhite, A. (2022). Assessing the impact of prenatal medication for opioid use disorder on discharge home with parents among infants with neonatal opioid withdrawal syndrome. Journal of Addiction Medicine, 16(6), 366-373. https://doi.org/10.1097/ADM.0000000000000987.

The purpose of this assignment is to provide research evidence in support of the PICOT you developed for your selected topic. Nursing Practice Problem For an Evidence-Based Practice Project Essay

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Conduct a search for 6 peer-reviewed, translational research articles published within the last 5 years that demonstrate support for your PICOT. You may include research articles from assignments completed previously in this course. Use the “Literature Evaluation Table” provided to evaluate the articles and explain how the research supports your PICOT.

Once your instructor returns this assignment, review the feedback and make any revisions necessary. If you are directed by your instructor to select different articles in order to meet the assignment criteria or to better support your PICOT, make these changes accordingly. You will use the literature evaluated in this assignment for all subsequent assignments you develop as part of your evidence-based practice project proposal in this course and in NUR-590, during which you will synthesize all of the sections into a final written paper detailing your evidence-based practice project proposal. Nursing Practice Problem For an Evidence-Based Practice Project Essay

Refer to “Evidence-Based Practice Project Proposal – Assignment Overview,” located in Class Resources, for an overview of the evidence-based practice project proposal assignments.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are not required to submit this assignment to LopesWrite. Nursing Practice Problem For an Evidence-Based Practice Project Essay