In this fast and computerized world, we are living in a world with numerous information. What does it affect healthcare? Patients can search for information on any topic online using a search engine. It is important for healthcare personnel to provide evidence-based practice information to patients.  This paper is a continuation of my previous work on a nursing concern identified in an earlier course. In this paper, the topic will be outlined with the evidence-based information reflecting my nursing concern with the formation of a PICO question. The steps used to conduct a literature review for this EBP proposal will be followed as well as a theoretical framework.

Evidenced-Based Practice

Evidence-based practice and research are similar terms that can cause confusion. Conner (2014) clarifies that evidence-based practice is an act that a nurse is taking using what has been presented through research and translating it into clinical decision making. To be more specific, it is one of the nursing processes starts with a question and involves research to find the best available evidence (Conner, 2014). On the other hand, research is a process which generates new knowledge through systematic and scientific inquiry to answer a research question (Conner, 2014).

Evidence-based practice cannot be done without research. Although I am an experienced nurse, I always come up with questions at work. I quickly find a resource person or look up information online using a reliable source. Moreover, sometimes I come up with a burning clinical question, and I research and collect the best evidence available. Using the data, I can use apply it to my practice and share it with my colleagues. I think this is why evidence-based practice is so important in the development of professional nursing.

Evidence-based practice promotes positive changes within my future practice setting. It will help guide me to be up to date and allows the highest level of quality care to patients.

Nursing Concern to be Improved

The nursing concern selected for improvement is the management of side effects in the cancer patients. Cancer patients suffer from many side effects after receiving chemotherapy: fatigue, loss of appetite, nausea, vomiting, peripheral neuropathy, pain, anxiety, and depression (Musanti & Murley, 2016). As FNP, it is crucial to help them manage the side effects. Therefore, they are able to focus on exercise which promotes positive benefits of increased energy, improved outlook, and healthier habits. Heston, Schwartz, Justice-Gardiner, and Hohman (2015) reports engaging in exercise during active treatment improves fatigue, weakness, nausea, depression, anxiety, and quality of life. I think it is important that health care providers aware what is beneficial to patients and recommend the best practice to patients. If we know it is evidence-based and proven, practitioners need to be more active in introducing and referring exercise programs.

American Cancer Society [ACS] has guidelines for cancer patients. It is recommended that cancer patients should be physically active and be as lean as possible. Specifically, at least 150 minutes of moderate exercise or 75 minutes of vigorous activity each week is recommended (ACS, 2016). Patient education will be crucial, so I will discuss the importance of exercise with patients and family members. ACS also recommend to have a balanced diet, and they have some food choice suggestions.

American College of Sports Medicine and American Cancer Society provide information on certified cancer exercise trainers. They are sports trainers who pass the board and worked with cancer patient population more than 1,000 hours (Musanti & Murley, 2016). I would recommend starting exercising with trainers instead of exercising alone. It would be important to teach the family regarding the benefits of exercise.

PICO question and Literature Search Process

For my EBP project proposal, I will use a quantitative approach. I will use the cancer-related fatigue indicator to research if exercise is effective for cancer patients. One of the top side effects that cancer patients experience is fatigue, so I think the cancer-related fatigue indicator will be a useful tool to compare the effectiveness of the exercise.

A PICO question stands for the five steps which are population, intervention, comparison, and outcome. The PICO question I came up with for this project proposal is, “can breast cancers patients benefit from exercise compared to those who do not and feel less fatigued?”

The elements for my question are as follows:

• Population: breast cancer patients who received chemotherapy
• Intervention: exercise recommended by American College of Sports Medicine and American Cancer Society?
• Comparison: breast cancer patients who did not exercise while recovering from chemotherapy
• Outcome: decrease in the cancer-related fatigue indicator with exercise

It is crucial that NPs suggest the right way to overcome the side effects of chemotherapy. The role of FNP will be essential because they connect inpatient care and outpatient care.

The library database that was used to gather data was Medline (OVID) via Chamberlain College of Nursing website and Google Scholar. The key term entered as a criteria were cancer patients, breast cancer, exercise, preventions, and cancer-related fatigue indicator. The minor search terms used were: exercise programs, community, and walking. To find exercise program information, I visited the websites of American Cancer Society and American College of Sports Medicine.

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