Comprehensive Integrated Psychiatric Assessment
July 27, 2019
Community Assessment and Analysis Presentation
July 27, 2019

Identify which aspects of the care delivered, if any, were based on evidence and provide your rationale.

Identify which aspects of the care delivered, if any, were based on evidence and provide your rationale.

 Evidence-based practice (EBP) has taken the best-researched information with the best results and putting them into practice. Currently, I work in an intensive care unit in one of the health care facilities in the city, and one of the significant EBP that we have

introduced, and critiquing is sepsis. The kind of technology installed within the facility automatically identifies patients with this condition based on the lab outcomes collected.

 The instant a patient is flagged for this condition then sepsis must be started

immediately. This comprises the administration of antibiotics, for example, Zosyn and drawing blood cultures. We also outline a lactic acid level before and after the fluid bolus. Medicines used should be completed soon after the arrival of patients to the ICU department. Fluid boluses should also be completed before one-hour elapses. These activities have been based on Evidence-Based Practices in the facility.

Evidence-Based Practice Supporting the condition

Research conducted from 10 community health facilities indicates that there was a decrease in mortality among patients suffering from sepsis when these facilities complied with the provisions on the sepsis bundle.  Many sepsis patients were treated in large numbers in the ICU department leading to a decrease of mortality rate from 30% to 11 %. This condition causes severe circulatory problems such as myocardial depression and vasodilation. Through the EBP, it has been discovered that aggressive fluid fights complications of hemodynamic instability (Mallory, 2010).

Background Question and PICOT Question

i.    Are antibiotics being overused when initiating them effectively since the patient is flagged as possible sepsis?

ii.    Is Coronary heart failure going to have an adverse effect after the fluid boluses?

iii.    Is drawing the level of lactic acid appropriate after the bolus of fluids giving an accurate outcome of oxygen perfusion?

PICOT Question

Is it appropriate to initiate fluid boluses immediately or would it be an advantage first to see what level of lactic acid comes back if elevated to initiate fluid boluses especially among patients having hemodynamic stability and a history of Coronary Heart Failure?

Critique how the policies, procedures, and culture in your organization may hinder or support the adoption of evidence-based practices.

Our policies, procedures, and culture in our organization offer a lot of support to the use and implementation of the Evidence-Based Practice. Researching any new development in the field of health care has always been a culture embraced by the registered nurses in our facility to enhance better clinical decisions for providing quality care among patients (Shivnan, 2011).

Barriers to implementing EBP

Lack of adequate time to research this condition has been a significant challenge in the implementation of a successful EBP in our organization. A lot of time is needed by researchers when going through various journals and articles trying to find out pertinent information on this condition. Another barrier to implement EBP is the high cost associated with the entire process of conducting research. We can overcome these challenges through working collaboratively with other research organizations that support EBP practice. Looking for donor funds through sponsors will also help us overcome the problem of cost in implementing the EBP.


Mallory, G. A. (2010). Professional nursing societies and evidence-based practice: Strategies to cross the quality chasm. Nursing Outlook, 58(6), 279–286.Retrieved from the Walden Library databases.

Shivnan, J. C. (2011). How do you support your staff? Promote EBP. Nursing Management, 42(2), 12–14. Retrieved from the Walden Library databases.

Adams, J. S. (2010). Utilizing evidence-based research and practice to support the infusion alliance. Journal of Infusion Nursing, 33(5), 273–277.

Retrieved from the Walden Library da



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