Develop a clinical question relating to one of the patient care/nursing intervention in the case study using PICO format (problem, intervention, comparison of interventions, outcome). Describe and discuss your rationale for this question. Conduct and discuss a literature search and review the literature relating to your defined question. Critically evaluate the literature found. Select one research article from your literature search that relates to your clinical question and the case study; identify the research design, method and results including a level of evidence. Include this article should be included as an appendices. Critically evaluate the strengths, limitations, and remaining knowledge gaps form the research study, making recommendations for further research in this area.

Case study:

John Ryan is an 85 year old lady who has been admitted to the general ward of a 70 bedded private hospital in the south east suburbs of Melbourne. The hospital is part of large organisation that has many facilities across the state of victoria. Joan had a fall at home in the early hours of this morning resulting in a mid-shaft fracture of her left femur on admission. She is waiting to go to theatre for surgery. On admission Joan was in pain with a pain score of 8/10. She has a small sore on her left hip from lying on the floor. Joan is otherwise fit and well. So far Joan has some analgesia and dry dressing put on her hip. There is falls assessment form in Joan's notes but it has not been completed. Joan is being nursed on a standard hospital mattress and as yet has not had a pressure sore risk assessment done. The ward Joan is on has 30 beds. Mixed medical and surgical. The nurse unit manager trained in the early 1970s and is not a great fan of change however her assistant unit manager is a 2 year post graduate and just loves research. There are 5 part time assistant managers. The ward has succeeded in retaining around 30% of their graduates due to supportive environment and skill mix. 70 % of the staff has worked for the organization for over 10 year; they are predominantly part time females with school age children. The internet is available but is mainly used for handover notes and playing solitaire. Time out for study, attendance at conferences and anything not directly part of the patients nursing care is frowned upon by the unit manager.

Part B

Relating your work to assessment 1A of the report, discuss and reflect on the strategies, resources and barriers that could affect the implementation of the research findings (evidence based practice in the case study).