Theory, Research, and Practice in Nursing

Theory 8
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Theory 8
Evidence-based practice (EBP) is the backbone of effective patient care, and as such, it is important to keep updating EBP to stay current on the best practices based on current research. It is also important to ensure that nurses and other healthcare professionals are incorporating recommended EBP in the provision of routine care. This paper identifies and explores an EBP topic concerned with healthcare-associated infections (HAIs) and the changes that need to be made to improve patient outcomes.
EBP Topic
In the course of hospitalization, patients may become exposed to infections that worsen their health outcomes and increase their hospital stay. As such, it is necessary to address some of the common infections, commonly known as HAIs, which occur during a hospital stay. One of the most common HAIs is ventilator-acquired pneumonia (VAP). According to Boltey et al. (2017), VAP is common among critically ill patients receiving mechanical ventilation. It involves an infection of the lungs at least two days after the patient starts receiving mechanical ventilation. This affects the patients' quality of life and threatens their health outcomes.
There are several EBPs that nurses can incorporate in caring for patients receiving mechanical ventilation to prevent VAP. These include effective oral hygiene care, minimized ventilator exposure, optimal positioning of patients, enhanced early mobility, and effective subglottic suctioning through coordinated care (Boltey et al., 2017). The implementation of these EBPs can go a long way in ensuring improved quality of care when dealing with mechanically ventilated patients.
Despite the existence of these EBPs, VAP continues to be a health and safety concern for mechanically ventilated patients. Specifically, VAP has a 10% mortality rate (Papazian et al., 2020; Boltey et al., 2017) and a 5-40% incidence rate (Papazian et al., 2020). Nurses have to incorporate best practices to prevent VAP and reduce VAP-associated deaths. This update on EBP focuses on the effectiveness of oral hygiene care on VAP and its incorporation into routine nursing care.
Theory, Research, and Practice in Nursing
There exists interconnectedness between theory, research, and practice in nursing. The three concepts are necessary for the development of nursing as a practice. According to Gray et al. (2018), theory can be described as a set of organized, structured ideas or concepts that are developed by theorists who seek to account for an existing phenomenon and create an explanation to improve understanding of the phenomenon. Theorists develop theories based on thought, experience, and research. As such, theory can be considered a product of the experiences and knowledge gained by nurses through nursing practice (Saleh, 2018). Theories are testable and are used to guide research on specific phenomena.
Research can be described as a systematic investigation of a problem to improve existing knowledge or create new knowledge about the problem (Gray et al., 2018). This knowledge is useful to nurses as it guides nursing practice. Research facilitates EBP because, as Saleh (2018) reveals, research informs clinical decision-making. Research also facilitates the testing of theories before they can be applied in nursing practice.
Practice can be described as the application of knowledge and skills (Saleh, 2018). Practice in nursing requires that nurses apply nursing knowledge and evidence obtained from research. It also requires the application and integration of theories into practice to make more informed clinical decisions. As such, effective nursing practice is informed by both theory and research. Practice also informs theory and research, and as such, the three must co-exist.
Theory
The theory that best correlates with the EBP practice change proposed in this paper is the theory of planned behavior (TPB). According to Butts and Rich (2022), TPB predicts the probability that an individual will engage in a specific behavior based on the individual’s intention. In most cases, this theory is applied to predict patients’ intention to engage in health-promoting behaviors. However, it can also be used to assess the intention of healthcare professionals, such as nurses, in engaging in behaviors that improve patient health, such as incorporating certain EBPs while providing routine care.
This theory is suitable in the case of oral hygiene care in mechanically ventilated patients because it sheds light on why there are still gaps between current practices and recommended EBPs. It is important to understand nurses’ behavioral intentions concerning the provision of oral hygiene care to prevent VAP among mechanically ventilated patients. As Butts and Rich (2022) share, TPB is based on the assumption that the behavior of a person is highly influenced by their intention. Further, the intention is influenced by attitude, subjective norm, and perceived behavioral control. As such, the attitude of nurses towards oral hygiene care, their subjective norm in terms of the perceived pressure to provide oral hygiene care, and their perceived control over the provision of oral hygiene care are some of the factors that can influence their intention to incorporate oral hygiene care as an EBP in preventing VAP.
Quantitative and Qualitative Research Articles
The article by Behzadi et al. (2018) is a quantitative research article investigating how an education program influences nurses’ performance and incorporation of oral care among mechanically ventilated children. This study used a quasi-experimental design to investigate the performance of nurses in a pediatric intensive care unit before and after receiving education on oral hygiene care and its role in reducing VAP. The sample was selected randomly, and one group ...