Part A
Evidence-based practice (EBP) aims to close the gap between research and nursing practice. The gap is bridged when evidence is applied in practice. The concept of EBP is advancing since healthcare systems demand that healthcare providers practice from a research base. As such, healthcare professionals require adequate research and appraisal knowledge. The health professionals should have skills on how to evaluate evidence using systematic processes of critique. These skills enable the healthcare providers to use evidence in making clinical decisions. EBP is fundamental to nursing practice because it improves patient outcomes and enhances safety in the delivery of care. For the achievement of these goals, health care institutions should create a culture of EBP in a clinical context. Due to this fact, organisational leaders should set expectations that nurse engage in research. This expectation should be buttressed through nursing development, mentoring, access to scientific and nursing journals, and provision of required resources. This assignment is based on the case study of Wasim, a university student. It consists of two sections, part A and part B.
Hildt, E., Lieb, K., & Franke, A. G. (2014). Life context of pharmacological academic performance enhancement among university students – a qualitative approach. BMC Medical Ethics, 15(1), 23-23. doi:10.1186/1472-6939-15-23
The authors are specialists in two academic fields, philosophy and psychiatry. Hence, they have comprehensive knowledge of the human brain and behaviour. Based on their expertise, the authors can understand the motivation and the effects of the use of smart drugs. Hildt works in the department of philosophy at the Johannes Gutenberg University of Mainz while Leib and Franke work in the department of psychiatry and psychotherapy at the University Medical Center. The affiliation of the authors and experience working with university students can be used to predict their credibility. The authors assert that they have no competing interest (Hildt, Lieb, & Franke, 2014).
The study aimed to examine the phenomenon of academic enhancement through the use of prescription and illicit stimulant among university students. Further, the study wished to investigate student’s experience, the impacts of intake on university students and other impacts like pressure to attain good performance in their academic as well as in their private lives. Five research questions were used in this study. Firstly, why do university students consume stimulants in an academic context? Secondly, what experiences are felt by users? Thirdly, does the intake of stimulants in academic setting offer advantages? Fourthly, how does the use of stimulants affect the student’s lives? Finally, what side-effects do users experience? (Hildt, Lieb, & Franke, 2014).The authors justified the study by noting that there was no evidence-based data on the effects of the use of stimulants in an academic context.
Evidence One
The sampling method was used for this study to select the participants who were university students. A sample is a subset of the population chosen to represent the whole population. Sampling technique is used to get unbiased results (Suresh, Thomas, & Suresh, 2011). In this study, 18 healthy university students were included. The students who had an experience of using stimulants were then subjected to a face-to-face interview. The sampling method was effective for this research because it is cost-effective and the inclusion of all eligible respondents in the study is impossible (Greenhalgh, Bidewell, Crisp, Lambros, & Warland, 2017).
The findings have answered the research questions. The authors found that students use stimulants in an academic context to improve academic performance. However, the authors did not find a direct relationship between the use of stimulants and academic performance. They found that stimulants have other effects such as enabling students to memorise, maximise time and have a higher motivation (Hildt, Lieb, & Franke, 2014).
The main strength is that the findings can be generalised to represent the entire university population. This advantage is based on the fact that all candidates in the target population had equal chances to be chosen in the sample (Elfil & Negida, 2017). The weakness is that face-to-face interview is time-consuming and it was not practical to interview a large number of students.
Munro, B. A., Weyandt, L. L., Marraccini, M. E., & Oster, D. R. (2017). The relationship between nonmedical use of prescription stimulants, executive functioning and academic outcomes. Addictive Behaviors, 65, 250-257. doi:https://ift.tt/2fDSHfZ
The authors have a background in different academic disciplines and are affiliated with different universities making them well suited to study the topic of stimulants in an academic context. Munro and Weyandt are experts in neuroscience. Hence, they know how the human brain and nerves function and can discern when the brain is under the influence of stimulants. Marraccini is an expert in medicine. Her expertise in medicine is a major contribution to the study of stimulants. Lastly, Oster is an expert in psychology. The authors are affiliated with different institutions with the primary institution being the University of Rhode Island, United States.
The objective of the research was to investigate the relationship between prescription stimulant misuse and effective functioning (EF) among a sample of college students. The first hypothesis was that college students who have preexisting EF deficiency would be more likely to report nonmedical use of prescription stimulants (NMUPS) compared to those with normal EF (Munro, Weyandt, Marraccini, & Oster, 2017). This hypothesis was developed based on the literature that difficult in time-management results in NMUPS (Moore, Burgard, Larson, & Ferm, 2014). The second hypothesis was that NMUPS mediate the relation between effective functioning and academic results. The authors justified this study by noting that there is no literature on the relationship between NMUPS and EF in an academic context.
Authorship
This study used sampling method whereby eligible students were recruited through Facebook webpages and email. The authors used a secure and encrypted website to gather student feedback. After collection of the students’ feedback, a stimulant survey questionnaire (SSQ) was used to determine the prevalence of NMUPS. Self-reported information was used making this method appropriate. Also, the Barkley deficit in executive functioning scale (BDEFS) was used to determine EF deficit scores of the participants. The BDEFS was effective for the study because it is cost-effective and offers critical information on the dimension of EF in daily life actions (Barkley, 2011).
The findings answer the two stated hypothesis. For hypothesis one, the authors found that students who have EF deficits are more likely to report NMUPS than those with normal EF. In hypothesis two, the findings hold that there is no clear relationship between the NMPUS and academic outcomes (Munro, Weyandt, Marraccini, & Oster, 2017).
The study used a cost-effective method, which is the main strength. There were two weaknesses in this study. Self-reported information gotten from the SSQ might be incomplete or inaccurate. Additionally, the administration of the questionnaires creates an unnatural setting that might alienate respondents (Bamberger, Rugh & Mabry, 2011).
Despite the advances in nursing research, some factors slow the adoption of evidence in practice. The barriers for the application of evidence in nursing practice arise from institutional factors, inefficient system for nurses’ development and personal factors (Kajermo et al., 2008). Besides, personal characteristics and demographics including the lack of adequate skills in research methods and interpretation of research findings limit the application of evidence in practice. Another barrier is lack of interest among the nurses. There is lack of interest among the nurses in relation to transferring research findings to practice (Chan et al., 2011). The lack of interest can be due to different reasons such as development and appreciation of the nursing profession. Personal interests and patients’ reliability hinder the application of evidence in nursing practice.
Inadequate knowledge in nursing research is a barrier to the application of evidence in practice. A significant number of nurses have insufficient understanding of evidence-based practice. They do not have sufficient preparation for the application of the research findings, which amplify the barriers of adopting research findings (Malik, McKenna & Plummer, 2015). Nurses’ attitudes towards performing research and organisational positions further hinder the application of evidence in nursing practice. In some healthcare institutions, there might be lack of administrator’s support for the utilisation of research findings. This case happens in the hospital where the administration does not believe in the application of new treatments and interventions. In some instances, there might be the lack of financial support, lack of participation of colleagues, inadequate staff and low reliability of research findings. Nurses’ dependence on managers and physicians in clinical decision-making might prevent nurses from using research outcomes (Hajbaghery & Salsali, 2005). Some nurses fail to read nursing journals and recent clinical findings. Huge workloads, unavailability of supervisor for guiding the nurses and the lack of incentives inhibits the application of evidence in practice.
How closely the research studies provided align with the PICO question/elements
Research Aims
PICO question is also referred as PICO format where P is population, I is intervention, C is comparison, O is outcome and T is time. After the formulation of a research question, a literature search is performed to search for evidence (Yensen, 2013). The PICO should include all the elements of the research (Richardson-Tench, Taylor, Kermode, & Roberts, 2016). In the research, P is university students, I is stimulants, and O is academic performance. The provided evidence has strived to align with the PICO question. In the first evidence, Hildt and colleagues used university students as the population and stimulants as the intervention. This aspect of the evidence seems to align to the PICO question. However, the study focused on all the effects of stimulants in university rather than academic performance only. In the second evidence, Munro and colleagues used college students as the population, stimulants as the intervention and academic performance as the outcome. Hence, the second evidence seemed to align itself more to the PICO questions than the first evidence. Despite this deviation from the PICO elements, the evidence answers Wasim’s question.
Conclusion
This paper has appraised evidence on the use of stimulants in an academic context to improve academic performance. The evidence investigates the misuse of both illicit and prescribed stimulants with the aim of recording better performance. Based on the evidence, students assert that they misuse stimulants. However, the evidence found that there is no positive relationship between the use of stimulants and academic performance. Students who use stimulants have recorded positive outcomes in relation to memorisation and time management. Objective academic results were not recorded by university students who use stimulants. Thus, Wasim should not use smart drugs for academic achievement. This assignment presents an idea on the importance of inquiry in health care and evidence-based practice. Nurses should always be guided by evidence in their practice. There are however several barriers that inhibit the application of evidence in practice. These barriers can be generalised as personal interest, knowledge, attitudes and organisational factors. While some nurses have inadequate knowledge in evidence-based practice, those who have pertinent knowledge might be inhibited by organisational factors such as the lack of resources.
References
Bamberger, M., Rugh, J., & Mabry, L. (2011). RealWorld evaluation: Working under budget, time, data, and political constraints. sage.
Barkley, R, A. (2011). The Barkley deficits in executive functioning scale. New York, NY: Guilford Press.
Chan, G. K., Barnason, S., Dakin, C. L., Gillespie, G., Kamienski, M. C., Stapleton, S., … & Li, S. (2011). Barriers and perceived needs for understanding and using research among emergency nurses. Journal of Emergency Nursing, 37(1), 24-31.
Elfil, M., & Negida, A. (2017). Sampling methods in Clinical Research; an Educational Review. Emergency, 5(1), e52. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5325924/
Greenhalgh, T.M., Bidewell, J., Crisp, E., Lambros, A., & Warland, J. (2017). Understanding research methods for evidence-based practice in health 1e Wileyplus learning space Wiley e-text powered by Vitalsource. Wiley. Retrieved from https://ift.tt/2xjnxVh 1ACU&search_scope=61ACU_All&tab=61acu_all&lang=en_US
Hajbaghery, M. A., & Salsali, M. (2005). A model for empowerment of nursing in Iran. BMC health services research, 5(1), 24.Retrieved from https://doi.org/10.1186/1472-6963-5-24
Hildt, E., Lieb, K., & Franke, A. G. (2014). Life context of pharmacological academic performance enhancement among university students – a qualitative approach. BMC Medical Ethics, 15(1), 23-23. doi:10.1186/1472-6939-15-23
Kajermo, K. N., Undén, M., Gardulf, A., Eriksson, L. E., Orton, M. L., Arnetz, B. B., & Nordström, G. (2008). Predictors of nurses’ perceptions of barriers to research utilization. Journal of Nursing Management, 16(3), 305-314.
Malik, G., McKenna, L., & Plummer, V. (2015). Perceived knowledge, skills, attitude and contextual factors affecting evidence?based practice among nurse educators, clinical coaches and nurse specialists. International journal of nursing practice, 21(S2), 46-57.
Moore, D. R., Burgard, D. A., Larson, R. G., & Ferm, M. (2014). Psychostimulant use among college students during periods of high and low stress: an interdisciplinary approach utilizing both self-report and unobtrusive chemical sample data. Addictive behaviors, 39(5), 987-993. Retrieved from <https://www.pugetsound.edu/files/resources/addictive-behaviors-revise-resubmit_rev.pdf>
Munro, B. A., Weyandt, L. L., Marraccini, M. E., & Oster, D. R. (2017). The relationship between nonmedical use of prescription stimulants, executive functioning and academic outcomes. Addictive Behaviors, 65, 250-257. doi:https://ift.tt/2fDSHfZ
Richardson-Tench, M., Taylor, B., Kermode, S., & Roberts, K. (2016). Inquiry in health care (5th [ACU] ed.). South Melbourne, Australia: Cengage Learning.
Suresh, K., Thomas, S. V., & Suresh, G. (2011). Design, data analysis and sampling techniques for clinical research. Annals of Indian Academy of Neurology, 14(4), 287. doi: 10.4103/0972-2327.91951
Yensen, J. (2013). PICO search strategies. Online J. Nurs. Inform., 17(3). Retrieved from https://ojni.org/issues/?p=2860
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