Foundations of Evidence Based Practice

Foundations of Evidence Based Practice

Write a 4 page APA paper addressing the following questions

1. Identify a project from a department at your place of employment that demonstrates a commitment to an improvement in patient care.  (Prefer pertaining to an inpatient PEDIATRIC UNIT)

2. Why is this project/study important?

3. What role would an APN play in this project?

4. Identify a PICOT question that you could use to guide the research of the identified problem.

5. Provide 5 databases that you might use for your research,and give a short description of each.

6. Provide 15 – 20 PEER reviewed references in APA format.

7. What barriers do you foresee in implementing this project?

Requirements for Paper:

• APA Format, 6th
• 4 pages in length, not including the title and reference page. (points will be deducted for papers over or under required length)

Note from teacher:   4 pages in length, not including the title and reference page. (points will be deducted for papers over or under required length)    PEER reviewed references do not go in the body of the paper but in the reference section.  That should give you enough space for the paper.  You do not have to incorporate all of the references into the paper. You just need to provide a list of appropriate references that you would use in researching the paper.

SAMPLE ANSWER

Foundations of Evidence Based Practice

Pediatric department of the health institution I currently work in has come up with a project to improve patient outcome through interventions in communication. The project management team will implement the plan through the use of a communication system that can put all the health caregivers on the same page (Berwick, 2016). The new communication system will include the use of whiteboards on the bedsides to indicate the daily objectives, the use of a dashboard for performance, and a note format for the daily progress of the residents (Lotz, Daxer,  Jox, Borasio, & Führer, 2017). The project will give families and patents who are excluded from rounds the courage to ask questions as well as express their concerns about the care plan.

Foundations of Evidence Based Practice

Why the Project is Important

Most of the breakdowns of teamwork and communication errors result in reduced patient outcome, increased costs, and prolonged losses in healthcare facilities. To solve these issues, the children’s department aims at improving communication to decrease medical errors during daily rounds (Katkin, et al. 2017). The project will begin by training healthcare workers on the rounds basics to help them conceptualize easily on its implementation (Gathara, et al. 2015). The project expectations are to increase the satisfaction of health care providers by more than 80 %. Besides, the project will be crucial in improving teamwork among health care providers, especially nurses, by reducing the number of nurses who multitask on bedsides during daily rounds (Hill, Knafl, &Santacroce, 2018). I will also reduce interruptions during presentations of the patients.

The role that an APN play in the project

Advanced Practice Nurses are those nurses with advanced certification and training with mostly a master’s degree and doctorates. Because of their advanced knowledge, APNs will play a crucial role in the implementation of the project. To begin with, the information on the bedside daily whiteboards will be verified by the APNs to ensure its high level of legitimacy in enhancing the highest quality of the patient outcome (Swan, Ferguson, Chang,  Larson&Smaldone, 2015).Besides, APNs will be involved in the project planning to ensure that the plan will be sound in meeting the goals and objectives of the project (Scotten, Manos,  Malicoat, & Paolo, 2015). APNs can work in the albescence of a doctor and other health practitioners because of their danced knowledge in nursing practice. Therefore, they will be useful in case of emergencies (Bryant‐Lukosius, et al. 2016). APNs will also have the role to educate and mentor other health practitioners on the best ways to implement the project primarily through teamwork and quality communication skills among healthcare professionals in the institution.

Foundations of Evidence Based Practice

PICOT question

Will the use of whiteboards on the bedsides to indicate the daily objectives, the use of a dashboard for performance and a note format for daily progress of the residents improve patient care within one year of project implementation?

Databases I might use for my research

1. CINAHL Plus

CINAHL Plus is an advanced version of CINAHL index, and it provides a vast number of cited and full-text references and records. It includes nurse educators, nurses, researchers, students, and other health professionals with advanced literature in healthcare practice(Glanville, Dooley, Wisniewski, Foxlee, & Noel‐Storr, 2019). It provides easy access to high content that dates back to the late 1030s and a considerable number of healthcare journals. The database covers a wide variety of topics such as medicine, nursing, health sciences, biomedicine, complementary medicine, allied health disciplines, and consumer health, among others. The database would help conduct my search on how to improve communication to increase the quality of patient care.

Foundations of Evidence Based Practice

1. Cochrane Library

Cochrane Library is an excellent source of quasi-randomized and randomized reports on controlled trails. It also provides other details such as the source, year of publication, and the author (English, Hillier & Lynch, 2017). However, they only give the summary of the report mostly through abstracts; that is, they do not provide the full text of the report. Cochrane Library will be a useful database for finding evidence-based information.

• MEDLINE

MEDLINE is a library premier databases for medicine. The database provides the names of the authors and bibliographical citations and abstracts of the authors from about 4700 and above biomedical journals that are published in the United States and other countries (Duffy, de Kock, Misso, Noake, Ross, &Stirk, 2016). Some of the main topics covered in MEDLINE include nursing, medicine, veterinary, dentistry, pre-clinical sciences, and allied health. MEDLINE will be an accessible database when doing my research on the project to improve the quality of patient care.0

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1. Nursing Reference Plus

Nursing Reference Plus is a database that is designed specifically for nurses. It educates nurses about nursing best practices and evidence-based practice(Oermann, et al. 2018). It mainly ensures that nurse educators, nurses, nursing students, and newly graduated nurses in the field have quick and easy access to the recent information in health practice to provide a maximum level of quality patient care.

1. V) EMBASE

Embase is a pharmacological and biomedical database that contains more than 20 million articles and records that are published across the world (Bramer, Giustini,  Kleijnen, & Franco, 2018). It provides abstracts, citations, and indexing from peer-review journals and biomedical articles. Most of the quotes have summaries that are written by the authors. Some of the main topics covered by EMBASE include pediatrics, oncology, general clinical medicine, dermatology, and intensive care.

Barriers in implementing the project

Some of the barriers that may make the implementation of the project include; one, lack of full cooperation from the healthcare team members due to such factors as the conflict of interest or unwillingness to act according to the requirements of the project.

Foundations of Evidence Based Practice

Second, the costs involved incomplete implementation of the project may be higher, especially in redesigning the communication system in the institution. The administration of the institution may be reluctant in providing finances for designing bedside whiteboards and paying extra fees to the project management team (Friedman, Howard, Shaw, Cohen, Shahidi& Ferrante, 2016). This may hinder the successful implementation of the project.

Conclusion

Improving patient outcome through communication intervention is critical in the children’s department to improve communication among physicians and decrease medical errors during daily rounds. Developing and implementing a plan to facilitate communication between physicians and nurses will help reduce medical errors that result in reduced patient outcome, increased costs, and prolonged losses in healthcare facilities. APNs will play a crucial role in the implementation of the project, such as project planning and during education and mentoring program.  Databases such as CINAHL Plus, Cochrane Library, MEDLINE, Nursing Reference Plus, and EMBASE will provide more evidence on the interventional strategy including its application and importance. The major barriers during the implementation of the project will involve lack of full cooperation from the healthcare team members and the involved incomplete implementation of the project.

References

Berwick, D. M. (2016). Era 3 for medicine and health care. Jama, 315(13), 1329-1330.doi:

10.1001/jama.2016.1509.

Bramer, W. M., Giustini, D., Kleijnen, J., & Franco, O. H. (2018). Searching Embase and MEDLINE by using only major descriptors or title and abstract fields: a prospective exploratory study. Systematic reviews, 7(1), 200.doi: 10.1186/s13643-018-0864-9.

Bryant‐Lukosius, D., Spichiger, E., Martin, J., Stoll, H., Kellerhals, S. D., Fliedner, M., … & Schwendimann, R. (2016). Framework for evaluating the impact of advanced practice nursing roles. Journal of Nursing Scholarship, 48(2), 201-209.doi: 10.1111/jnu.12199.

Duffy, S., de Kock, S., Misso, K., Noake, C., Ross, J., & Stirk, L. (2016). Supplementary searches of PubMed to improve currency of MEDLINE and MEDLINE In-Process searches via Ovid. Journal of the Medical Library Association: JMLA, 016 Oct; 104(4): 309–312.doi: 10.3163/1536-5050.104.4.011

English, C., Hillier, S., & Lynch, E. (2017). Cochrane Corner. Stroke, 48, e275-e276. doi: 10.1002/14651858.CD007513.pub3.

Friedman, A., Howard, J., Shaw, E. K., Cohen, D. J., Shahidi, L., & Ferrante, J. M. (2016). Facilitators and barriers to care coordination in patient-centered medical homes (PCMHs) from coordinators’ perspectives. The Journal of the American Board of Family Medicine, 29(1), 90-101.  doi: 10.3122/jabfm.2016.01.150175.

Gathara, D., Nyamai, R., Were, F., Mogoa, W., Karumbi, J., Kihuba, E., … & Todd, J. (2015). Moving towards routine evaluation of quality of inpatient pediatric care in Kenya. PloS one, 10(3), e0117048.doi: 10.1371/journal.pone.0117048.

Glanville, J., Dooley, G., Wisniewski, S., Foxlee, R., & Noel‐Storr, A. (2019). Development of a search filter to identify reports of controlled clinical trials within CINAHL Plus. Health Information & Libraries Journal, 36(1), 73-90.doi: 10.1111/hir.12251.

Lam, M. T., De Longhi, C., Turnbull, J., Lam, H. R., &Besa, R. (2018). Has Embase replaced MEDLINE since coverage expansion?. Journal of the Medical Library Association: JMLA, 106(2), 227. doi: 10.5195/jmla.2018.281.

Lotz, J. D., Daxer, M., Jox, R. J., Borasio, G. D., & Führer, M. (2017). “Hope for the best, prepare for the worst”: A qualitative interview study on parents’ needs and fears in pediatric advance care planning. Palliative medicine, 31(8), 764-771.doi: 10.1177/0269216316679913.

Katkin, J. P., Kressly, S. J., Edwards, A. R., Perrin, J. M., Kraft, C. A., Richerson, J. E., … & Wall, L. (2017). Guiding principles for team-based pediatric care. Pediatrics, 140(2), e20171489.doi: 10.1542/peds.2017-1489.

Oermann, M. H., Nicoll, L. H., Chinn, P. L., Ashton, K. S., Conklin, J. L., Edie, A. H., … & Williams, B. L. (2018). Quality of articles published in predatory nursing journals. Nursing Outlook, 66(1), 4-10. doi: 10.1016/j.outlook.2017.05.005.

Scotten, M., Manos, E. L., Malicoat, A., & Paolo, A. M. (2015). Minding the gap: Interprofessional communication during inpatient and post discharge chasm care. Patient Education and Counseling, 98(7), 895-900.doi: 10.1016/j.pec.2015.03.009.

Swan, M., Ferguson, S., Chang, A., Larson, E., &Smaldone, A. (2015). Quality of primary care by advanced practice nurses: a systematic review. International Journal for Quality in Health Care, 27(5), 396-404. doi: 10.1093/intqhc/mzv054.

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