Evidence-based practice plays a vital role in the provision of quality nursing care. Advances in technology have increased healthcare providers’ contact with vast information from up-to-date research studies. In addition, the research arena has made astonishing breakthroughs in the last few years, which have brought novel understandings of medical data. Evidence-based practice encompasses the application of high quality proof to boost patient outcomes (Melnyk, Gallagher‐Ford, Long, & Fineout‐Overholt, 2014). However, these truths can only be attained by separating useful information from mixed-up facts. Nursing informatics can be delimited as the integration of nursing skill, computer knowledge, and information science to manage and publicize data, information, knowledge, and wisdom in nursing practice (American Nurses Association, 2015). Nursing informatics is the pillar of knowledge generation in nursing and is based on four key concepts that are interrelated: data, information, knowledge, and wisdom (McGonigle & Mastrian, 2015). The purpose of this paper is to illustrate the application of the four conceptions of nursing informatics to solve the clinical problem of falls among geriatric patients.
Clinical Question
Improvements in standards of care have led to a significant rise in life expectancy, which has increased the proportions of the elderly population. One challenge when caring for elderly patients is the risk of falls. Falls are the leading cause of debilitation and mortality among people aged 65 years and older (Boltz, Podany, Hollenbeak, & Armen, 2015). The healthcare system spends approximately 20 billion dollars to treat fall-related injuries. This amount is expected to increase to about 50 billion by the year 2020 (Lee, Lee, & Khang, 2013). Some of the measures that are reported to lower the incidence of falls in this population include physical therapy, withdrawal of psychoactive drugs, providing patient and caregiver education, treating foot problems, wearing comfortable footwear, and taking extra vitamin D among others (Lee et al., 2013).
Out of these fall prevention measures, vitamin D supplementation offers great potential because of the additional benefits of the nutrient in the body. However, the incidents of falls continue to be reported even with the identification of fall prevention measures. The clinical question is “How effective is vitamin D supplementation in reducing the incidence of falls among geriatric patients?” I chose this question because having knowledge of the effectiveness of vitamin D in fall prevention would be a natural and healthy strategy of reducing the incidence of falls while reaping the additional benefits of vitamin D. Therefore, I wish to determine the effectiveness of this intervention in minimizing falls among elderly patients.
The first step would be looking up nursing databases in the Walden University Library because the clinical question affects nursing practice. Besides, I am interested in fall reduction measures that I can apply as an advanced nurse practitioner at my workplace.
Extracting relevant information from the papers would involve going through the titles of the publications retrieved to determine the most relevant editorials to my research question. The next step would be reading the abstracts to get an overview of the research. This step would be followed by recording key points from the articles, evaluating the literature, and generating a literature review matrix using the steps proposed by Melnyk et al. (2014). The literature review matrix would facilitate the organization of the information in a useful way, thus enabling me to make meaning out of the information. Thereafter, I would appraise the facts based on the strength of proof provided and compile key recommendations from the studies as well as their implications for nursing practice.
Data to Information
I selected the CINAHL plus database with full text. The rationale for selecting this database is that CINAHL contains a wide range of nursing, medical research, which can be retrieved as full-text articles. I used a predefined search strategy and keywords to search the selected database. The search words that I used included “Vitamin D,” “Falls,” and “Elderly.” I also limited the search to items published within the last five years by selecting the publication dates from January 2013 to March 2018. The search criteria yielded 37 papers. These editorials together with the information contained therein encompass data. However, there is little that one can do with all this data. The next step would be to convert the data into information by selecting relevant publications and taking out useful facts from the journals. Editorials that indicate the impact of vitamin D on falls would be checked and summarized based on the study design, objectives, methods, findings, conclusions, and recommendations. This information would be recorded in a table.
Knowledge
The next step would be to convert this information into knowledge. The findings and conclusions of the studies would be checked to find their implications for nursing practice. It would be possible to determine the exact connection between vitamin E supplementation and fall reduction by reading the gleaned information in this form. Such knowledge can guide a nurse towards recommending vitamin D supplementation for geriatric patients.
Wisdom
The Merriam-Webster Dictionary defines wisdom as knowledge collected from life experiences, the inborn capacity to fathom things that other people cannot comprehend, and good intellect (Wisdom, 2018). On the other hand, American Nurses Association (2015) defines wisdom as the proper application of knowledge to handle and find the underlying cause of human glitches. The data, knowledge, information, aspects of nursing informatics facilitate the acquisition of knowledge, whose appropriate use results in wisdom. However, wisdom is realized by the correct application of the information. Other factors that contribute to wisdom include day-to-day occurrences, intuition, and tact.
Conclusion
Informatics can be used to gain wisdom. Wisdom results from having adequate knowledge and using it appropriately (in the right place and at the right time). Nursing informatics facilitates the development of knowledge through the transformation of data to information and ultimately knowledge, which when used correctly leads to wisdom. Therefore, it can be concluded that nursing informatics can be used to gain wisdom. Advancing from knowledge to wisdom would involve applying the acquired knowledge to enhance patient outcomes. Since vitamin D is reported to reduce the incidence of falls, I would encourage elderly patients to take adequate vitamin D in their diet.
However, before the actual application of knowledge obtained from research, it would be important to decode the information and modify it to match the needs of my patients as well as my practice setting. This process is known as the translation of evidence into practice. Clinical settings differ in terms of the services provided and accessible resources, which could be financial or human resources. Additionally, different patients have varying needs. It is also evident that several fall prevention measures may need to be implemented simultaneously to reduce the incidence of falls. Therefore, it would be necessary to consider other fall prevention strategies. Decoding evidence to correspond to the needs of individual patients, as well as the available resources, permits the application of knowledge to make sound clinical decisions.
References
American Nurses Association. (2015). Nursing informatics: Scope & standards of practice (2nd ed.). Silver Springs, MD: American Nurses Association.
Boltz, M. M., Podany, A. B., Hollenbeak, C. S., & Armen, S. B. (2015). Injuries and outcomes associated with traumatic falls in the elderly population on oral anticoagulant therapy. Injury, 46(9), 1765-1771.
Lee, A., Lee, K. W., & Khang, P. (2013). Preventing falls in the geriatric population. The Permanente Journal, 17(4), 37-39.
McGonigle, D., & Mastrian, K. G. (2015). Nursing informatics and the foundation of knowledge (3rd Ed.). Burlington, MA: Jones and Bartlett Learning.
Melnyk, B. M., Gallagher‐Ford, L., Long, L. E., & Fineout‐Overholt, E. (2014). The establishment of evidence‐based practice competencies for practicing registered nurses and advanced practice nurses in real‐world clinical settings: Proficiencies to improve healthcare quality, reliability, patient outcomes, and costs. Worldviews on Evidence‐Based Nursing, 11(1), 5-15.
Wisdom. (2018). In Merriam-Webster’s dictionary. Web.