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Evidence-Based Practice: Crafting Effective PICOT Research Questions (2023 Update)

Evidence-Based Practice: Crafting Effective PICOT Research Questions

In the ever-evolving field of healthcare, evidence-based practice (EBP) stands as a cornerstone. It empowers healthcare professionals to make informed decisions, deliver quality care, and improve patient outcomes. At the heart of EBP lies the PICOT research question—a powerful tool used to structure research and guide healthcare interventions. In this comprehensive guide, we’ll delve deep into the world of EBP, explore the significance of PICOT questions, provide examples, and offer tips for optimizing your practice. Let’s embark on this evidence-based journey together.

Table of Contents

  1. Introduction
  2. What is Evidence-Based Practice?
  3. The Role of Evidence-Based Practice PICOT Questions
  4. Components of a Evidence-Based Practice PICOT Question
  5. Examples of Evidence-Based Practice PICOT Questions
  6. Creating a Evidence-Based Practice PICOT Question: Step-by-Step
  7. Optimizing Your PICOT Question for SEO
  8. FAQs about Evidence-Based Practice PICOT Questions
  9. Conclusion

Introduction

Evidence-based practice (EBP) is the conscientious integration of clinical expertise, patient values, and the best available evidence in the decision-making process for patient care. It’s about ensuring that healthcare decisions are made not just on tradition or intuition but grounded in research and clinical knowledge.

At the heart of EBP lies the PICOT research question, a structured approach to defining a research problem or clinical question. This powerful tool provides a clear framework for healthcare professionals and researchers to identify and explore the key components of a clinical issue. In this blog post, we’ll explore the world of EBP, delve into the significance of PICOT questions, provide you with examples, and offer valuable insights into crafting effective PICOT questions for your healthcare practice.

What is Evidence-Based Practice?

Evidence-based practice (EBP) is an approach to healthcare that combines clinical expertise, patient preferences and values, and the best available evidence to make informed decisions about patient care. The goal is to provide the highest quality of care while considering individual patient needs and preferences. EBP is a dynamic and iterative process, requiring healthcare professionals to continually update their knowledge and practices based on the latest research findings.

Key principles of EBP include:

  • Integration of Research Evidence: EBP relies on the most current and relevant research evidence to inform clinical decisions.
  • Clinical Expertise: Healthcare professionals bring their clinical expertise and experience to the decision-making process.
  • Patient Values and Preferences: Patient input and preferences are essential in tailoring care to individual needs.
  • Continuous Improvement: EBP encourages ongoing evaluation and adaptation of practices based on new evidence.

The Role of Evidence-Based Practice PICOT Questions

PICOT questions play a central role in the EBP process. They serve as the foundation for:

  1. Defining the Problem: PICOT questions help healthcare professionals clearly define the clinical issue or research problem they want to address.
  2. Formulating a Search Strategy: They guide the search for relevant research evidence in databases, ensuring that the search is focused and productive.
  3. Evaluating Evidence: PICOT questions assist in evaluating the quality and relevance of research studies to determine their applicability to the clinical or research context.
  4. Making Informed Decisions: Based on the evidence gathered, healthcare professionals can make informed decisions about patient care or research directions.
  5. Continuous Improvement: PICOT questions facilitate ongoing assessment and adaptation of practices in light of new evidence.

Now, let’s break down the components of a PICOT question.

Components of a Evidence-Based Practice PICOT Questions

A PICOT question is typically structured as an acronym, with each letter representing a specific component of the question. The components include:

  1. P: Patient Population/Problem: This component specifies the population or patient group of interest. It defines who the question is about and may include details like age, gender, or relevant characteristics.
  2. I: Intervention: This component outlines the intervention or exposure being studied. It can be a specific treatment, therapy, or diagnostic test.
  3. C: Comparison: In some cases, a PICOT question includes a comparison group or alternative intervention. This helps assess the effectiveness of the intervention of interest compared to another.
  4. O: Outcome: The outcome component specifies the outcome or result that the intervention is expected to achieve. It defines what you want to measure or observe.
  5. T: Time: Time refers to the duration over which the intervention’s effects are measured or the time frame in which the study is conducted.

An effective PICOT question is specific, clear, and focused. It narrows down the research or clinical inquiry to a manageable scope, making it easier to find relevant evidence and make decisions.

Examples of Evidence-Based Practice PICOT Questions

Let’s explore some examples of PICOT questions to illustrate how they can be applied in various healthcare scenarios:

Example 1: Clinical Intervention

P: In adult patients with Type 2 diabetes
I: Does regular exercise
C: compared to no exercise
O: lead to better blood glucose control
T: over a 3-month period?

In this example, the PICOT question explores the impact of regular exercise on blood glucose control in adult Type 2 diabetes patients over a specific time frame.

Example 2: Diagnostic Test

P: In children with suspected appendicitis
I: Does the use of ultrasound
C: compared to CT scans
O: result in more accurate and timely diagnosis
T: in the emergency department?

This PICOT question investigates the use of ultrasound as a diagnostic tool for suspected appendicitis in children and compares it to the traditional CT scan method.

Example 3: Healthcare Policy

P: In patients eligible for Medicaid
I: Does the expansion of Medicaid coverage
C: compared to no expansion
O: lead to increased access to primary care services
T: over a five-year period?

Here, the PICOT question examines the impact of expanding Medicaid coverage on patients’ access to primary care services over a specified time frame.

Example 4: Nursing Practice

P: In elderly patients residing in long-term care facilities
I: Does the implementation of hourly rounding by nursing staff
C: compared to standard care without hourly rounding
O: result in a decrease in falls
T: over a six-month period?

This PICOT question explores the effects of implementing hourly rounding by nursing staff on fall rates among elderly residents in long-term care facilities.

Example 5: Public Health

P: In pregnant women
I: Does receiving the influenza vaccine during pregnancy
C: compared to not receiving the vaccine
O: lead to a reduction in the incidence of influenza in newborns
T: during the flu season?

Here, the PICOT question investigates the impact of maternal influenza vaccination on the incidence of influenza in newborns during the flu season.

These examples demonstrate how PICOT questions can be tailored to address various healthcare issues, from clinical interventions and diagnostic tests to healthcare policies, nursing practices, and public health measures. The specificity of each question helps guide the research or decision-making process effectively.

Creating a PICOT Question: Step-by-Step

Now that we’ve seen examples of PICOT questions, let’s walk through the process of creating one step-by-step. Whether you’re a healthcare practitioner, researcher, or student, following these steps will help you formulate a clear and focused PICOT question:

Step 1: Identify the Patient Population/Problem (P)

Begin by defining the specific patient population or problem you want to address. Consider factors like age, gender, clinical condition, or relevant characteristics. Be as specific as possible.

Step 2: Describe the Intervention (I)

Next, specify the intervention or exposure you are interested in studying. This could be a treatment, therapy, diagnostic test, or healthcare practice. Clearly outline what you want to investigate.

Step 3: Determine the Comparison (C)

Decide if your question involves a comparison group or an alternative intervention. Not all PICOT questions require a comparison, but including one can enhance the robustness of your research or decision-making.

Step 4: Define the Outcome (O)

Clearly state the outcome or result you are looking to measure or observe. This component should align with the goal of your research or clinical inquiry. Be specific about what success or improvement means in your context.

Step 5: Specify the Time Frame (T)

Lastly, set a time frame for your study or research. Determine the duration over which you will measure the intervention’s effects or the period during which the study will take place.

Putting it All Together

Now, combine the components from each step to form your PICOT question. Remember to keep it concise and focused. Here’s an example of the final question:

P: In [patient population/problem]
I: Does [intervention]
C: compared to [comparison]
O: result in [outcome]
T: over [time frame]?

By following these steps, you can create a well-structured PICOT question that serves as a roadmap for your research or clinical decision-making process.

FAQs about PICOT Questions

1. What is the purpose of a PICOT question?

The primary purpose of a PICOT question is to provide a structured framework for defining a research problem or clinical question. It helps healthcare professionals and researchers narrow down their focus, formulate search strategies, evaluate evidence, and make informed decisions.

2. Are PICOT questions only for research?

No, PICOT questions are not limited to research. While they are commonly used in research to guide study design and literature reviews, they are also valuable in clinical practice. Healthcare practitioners use PICOT questions to frame clinical questions, make evidence-based decisions, and improve patient care.

3. Can a PICOT question have more than one outcome?

Yes, a PICOT question can have multiple outcomes, but it’s important to keep them focused and relevant to the research or clinical context. Each outcome should be clearly defined and align with the overall objective of the question.

4. Is it necessary to include all five components (P, I, C, O, T) in a PICOT question?

Not all PICOT questions require all five components. The components you include depend on the specific research or clinical question you are addressing. Some questions may omit the comparison (C) component if it’s not relevant to the inquiry.

5. How can I ensure my PICOT question is specific enough?

To ensure specificity, carefully define each component of your PICOT question. Use clear and concise language, and avoid vague terms. Consider consulting with a mentor or colleague for feedback on the specificity of your question.

Conclusion

Evidence-based practice is a foundational approach in healthcare, enabling healthcare professionals to make informed decisions and improve patient outcomes. At the heart of this practice lies the PICOT research question, a powerful tool that structures research and clinical inquiries.

By understanding the components of a PICOT question and following a step-by-step approach, you can create focused and effective questions that guide your research or clinical practice. Additionally, optimizing your PICOT questions for SEO ensures that your valuable content reaches a broader audience and remains accessible to those seeking evidence-based information.

In the ever-evolving world of healthcare, evidence-based practice and well-crafted PICOT questions continue to drive improvements in patient care, research, and healthcare policy. As you embark on your journey of evidence-based practice, remember that the right question can lead to transformative answers and better healthcare for all.

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Unpacking Evidence-Based Practice: A Comprehensive Guide

Title: Unpacking Evidence-Based Practice: A Comprehensive Guide

Outline:

  1. Introduction
  2. What is Evidence-Based Practice? 2.1 Defining Evidence-Based Practice 2.2 The Importance of Evidence-Based Practice
  3. The Steps of Evidence-Based Practice 3.1 Formulating a Clinical Question 3.2 Searching for Evidence 3.3 Appraising the Evidence 3.4 Applying the Evidence 3.5 Evaluating the Outcome
  4. Common Misconceptions about Evidence-Based Practice 4.1 Misconception #1: Evidence-Based Practice is Rigid 4.2 Misconception #2: Evidence-Based Practice Ignores Clinical Experience 4.3 Misconception #3: Evidence-Based Practice Means Following Guidelines Blindly
  5. Challenges in Implementing Evidence-Based Practice 5.1 Resistance to Change 5.2 Limited Access to Evidence 5.3 Lack of Skills in Appraising Evidence
  6. The Role of Guidelines and Clinical Pathways
  7. FAQ about Evidence-Based Practice
  8. Conclusion

Introduction

In today’s ever-evolving healthcare landscape, healthcare professionals are continuously seeking ways to enhance the quality of patient care. Evidence-based practice (EBP) is a cornerstone of modern healthcare, but it’s often misunderstood and faces various challenges in implementation. This comprehensive guide aims to shed light on EBP, debunk common misconceptions, and provide practical insights for its effective utilization.

What is Evidence-Based Practice?

2.1 Defining Evidence-Based Practice

EBP is an approach that integrates the best available evidence from research, clinical expertise, and patient preferences to inform healthcare decision-making. It emphasizes the use of scientific evidence as a foundation for clinical practice, ensuring that patients receive the most effective and appropriate care possible.

2.2 The Importance of Evidence-Based Practice

EBP offers several advantages:

  • Improved Patient Outcomes: By basing decisions on robust evidence, EBP can lead to better patient outcomes and enhanced overall quality of care.
  • Efficient Resource Allocation: It helps healthcare institutions allocate resources wisely, focusing on interventions with proven effectiveness.
  • Reduced Variability in Care: EBP standardizes care protocols, reducing unwarranted variations in practice that can compromise patient safety.
  • Enhanced Accountability: EBP promotes transparency and accountability in healthcare by requiring practitioners to justify their choices based on evidence.

The Steps of Evidence-Based Practice

EBP is not a one-size-fits-all approach; instead, it follows a structured process to guide healthcare professionals in making informed decisions. These steps are often referred to as the “5 A’s”:

3.1 Formulating a Clinical Question

The first step in EBP involves crafting a clear and focused clinical question. This question should specify the patient population, intervention or exposure, comparison, and expected outcome (PICO framework). A well-defined question ensures that the subsequent steps are focused and relevant.

3.2 Searching for Evidence

Once the question is formulated, healthcare professionals search for relevant evidence. This involves systematically reviewing the literature, using databases like PubMed, Cochrane Library, and others, to find research studies, systematic reviews, and clinical guidelines related to the question.

3.3 Appraising the Evidence

Not all evidence is created equal. In this step, practitioners critically evaluate the quality and relevance of the gathered evidence. Common tools like the GRADE framework are used to assess the strength of recommendations and the quality of evidence.

3.4 Applying the Evidence

Having assessed the evidence, healthcare providers apply it to their specific clinical scenario, taking into consideration patient preferences and values. This step requires clinical judgment and expertise to tailor the evidence to individual patients.

3.5 Evaluating the Outcome

After implementing the evidence-based intervention, practitioners must assess the outcomes and monitor the patient’s progress. This step completes the EBP cycle and informs future decision-making.

Common Misconceptions about Evidence-Based Practice

4.1 Misconception #1: EBP is Rigid

One common misconception is that EBP is inflexible and mandates a one-size-fits-all approach. In reality, EBP encourages individualized care and emphasizes clinical judgment alongside evidence.

4.2 Misconception #2: Evidence-Based Practice Ignores Clinical Experience

Some believe that EBP disregards the importance of clinical experience. However, it actually values clinical expertise and integrates it with evidence to make informed decisions.

4.3 Misconception #3: Evidence-Based Practice Means Following Guidelines Blindly

EBP does involve following clinical guidelines, but not blindly. Guidelines are based on the best available evidence, and practitioners should consider them as a starting point while still accounting for individual patient needs.

Challenges in Implementing Evidence-Based Practice

5.1 Resistance to Change

Resistance to change within healthcare organizations can hinder the adoption of EBP. Addressing this resistance requires effective communication and education to demonstrate the benefits of EBP.

5.2 Limited Access to Evidence

Access to up-to-date and relevant evidence can be challenging, especially in resource-constrained settings. Healthcare institutions should invest in providing easy access to evidence-based resources.

5.3 Lack of Skills in Appraising Evidence

Not all healthcare professionals are proficient in appraising evidence. Training and support in critical appraisal skills are crucial to EBP implementation.

The Role of Guidelines and Clinical Pathways

Clinical guidelines and pathways provide standardized, evidence-based recommendations for specific conditions or interventions. They serve as valuable tools to guide healthcare professionals in delivering consistent and high-quality care. Guidelines are typically developed by expert panels who rigorously review the evidence and offer recommendations based on their findings.

FAQ about Evidence-Based Practice

Q1: Is EBP only relevant for physicians?

No, EBP is relevant to all healthcare professionals, including nurses, therapists, pharmacists, and more. It’s a multidisciplinary approach to improve patient care.

Q2: How can I stay updated with the latest evidence?

To stay updated, healthcare professionals can subscribe to relevant journals, attend conferences, join professional organizations, and use evidence-based databases and tools.

Q3: Does EBP apply to alternative medicine?

EBP can be adapted to alternative medicine, but it requires robust scientific evidence to support its effectiveness, just like conventional medicine.

Q4: Can patients participate in EBP decisions?

Absolutely. EBP encourages shared decision-making, where patients actively participate in their care by considering their preferences and values.

Conclusion

Evidence-Based Practice is a powerful tool that empowers healthcare professionals to provide the best possible care to their patients. By following a systematic approach to integrate evidence, clinical expertise, and patient values, EBP enhances the quality of care, reduces variations in practice, and ultimately improves patient outcomes. Overcoming challenges and addressing misconceptions is essential to fully realize the potential of EBP in healthcare, ensuring that every patient receives the highest standard of care possible. Embracing EBP is not only a responsibility but also a commitment to continuously improve the quality of healthcare services worldwide.

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Nursing shortage in the US

Nursing shortage in the US

Introduction: Impact of Nursing Shortage in the US

The nursing shortage in the United States is a significant problem that has far-reaching consequences for patient care. According to recent data, the nursing shortage crisis in the USA is expected to last through 2030. The American Nurses Association estimates that more than a million new nurses will be needed by 2022 to meet the rising demand for healthcare. As the baby boomer generation ages and the need for healthcare grows, the shortage of registered nurses (RNs) is expected to intensify. This shortage is compounded by the fact that nursing schools across the country are struggling to expand capacity to meet the rising demand for nurse. The shortage of nurses has frightening implications for patient safety, as it leads to long wait times and lower care quality. Nurses play a crucial role in healthcare, and the nursing shortage affects every aspect of the healthcare system. In this comprehensive guide, we will examine the causes and consequences of the nursing shortage crisis and discuss strategies to address the problem.

Overview of the Nursing Shortage in the US

The nursing shortage in the US is a critical issue that affects patient care, healthcare facilities, and the nursing profession. The shortage is projected to intensify as Baby Boomers age and the need for healthcare grows.

Here are some factors contributing to the nursing shortage:

  • Aging population: As the population ages, the demand for healthcare services increases, which leads to a higher demand for nurses.
  • Increased demand for healthcare services: The demand for healthcare services is expected to grow at a faster rate (9%) than all other occupations from 2016 through 2026, leading to a higher demand for nurses
  • Challenges in recruiting and retaining nurses: There is a lack of potential educators, high turnover, and inequitable workforce distribution in the nursing profession. Nursing faculty are experiencing a shortage, which leads to enrolment limitations, limiting the number of nurses that a nursing school can generate. Decreased and limited faculty can cause fewer students, and the overall quality of the education offered to suffer. Nursing shortages lead to errors, higher morbidity, and mortality rates. In hospitals with high patient-to-nurse ratios, nurses experience burnout, dissatisfaction, and the patients experienced higher mortality.
  • Struggling nursing schools: Nursing schools across the country are struggling to expand capacity to meet the rising demand for nurses, which compounds the nursing shortage problem.

The nursing shortage is a complex issue that requires a multifaceted approach to address. The shortage of nurses has frightening implications for patient safety, as it leads to long wait times and lower care quality. Efforts to address the nursing shortage must focus on recruiting and retaining nurses, bolstering educational programs, offering monetary incentives, and changing scope of practice laws

Causes and Challenges of the Nursing Shortage in the United States

The nursing shortage in the US is a complex issue that has various causes, including:

  • Aging nursing workforce: Many senior nurses are approaching retirement age, which contributes to the nursing shortage problem.
  • Inadequate staffing ratios: Hospitals with high patient-to-nurse ratios put a strain on nurses, leading to burnout, dissatisfaction, and higher mortality rates for patients.
  • Burnout and job dissatisfaction: Nurses are experiencing burnout and job dissatisfaction, leading to high turnover rates.
  • Limited resources for nursing education: Nursing schools are struggling to expand capacity to meet the rising demand for nurses. The nursing faculty is experiencing a shortage, which leads to enrolment limitations, limiting the number of nurses that a nursing school can generate.

Addressing the nursing shortage in the United States presents various challenges for healthcare organizations, policymakers, and nursing professionals. Some of these challenges include:

  1. Limited resources: Healthcare organizations and nursing professionals are struggling with limited resources, making it difficult to address the nursing shortage problem effectively.
  2. Lack of potential educators: There is a shortage of potential nursing educators, which makes it difficult to expand the capacity of nursing schools to meet the rising demand for nurses.
  3. High turnover rates: High turnover rates among nurses make it challenging for healthcare organizations to maintain adequate staffing levels.
  4. Inequitable workforce distribution: The nursing shortage problem is compounded by inequitable workforce distribution, which makes it difficult to ensure access to safe patient care in some regions.
  5. Need for multiple solutions: The nursing shortage problem is complex, and addressing it requires multiple solutions

Addressing the problem requires a collaborative effort between healthcare organizations, policymakers, and nursing professionals. This effort should focus on improving working conditions, increasing resources for nursing education, and implementing strategies to recruit and retain nurses.

Impact of the Nursing Shortage on the United States Healthcare System

The nursing shortage in the United States has a significant impact on the overall healthcare system. Here are some consequences of the nursing shortage:

  • Increased patient wait times: With a shortage of nurses, patients may experience longer wait times for medical attention, which can lead to delays in care and worsen health outcomes.
  • Compromised patient care quality: The shortage of nurses can lead to lower care quality, as nurses may be overworked and unable to provide adequate care to patients. Studies have shown a direct correlation between patient mortality and the shortage of nurses.
  • Heightened healthcare costs: The nursing shortage can lead to increased healthcare costs, as healthcare facilities may need to hire temporary or agency nurses to fill staffing gaps, which can be more expensive than retaining permanent staff.
  • Increased nurse burnout and dissatisfaction: Nurses are experiencing burnout and dissatisfaction, which can lead to high turnover rates and exacerbate the nursing shortage problem

Real-life examples or case studies can illustrate the consequences of the nursing shortage:

  • In 2018, the University of Missouri Health Care reported that the nursing shortage was causing delays in patient care and a decline in patient satisfaction.
  • In 2019, Florida Hospital reported that the nursing shortage was affecting patient care, education, and nurse burnout. The facility was experiencing staffing shortages, which led to longer wait times, increased patient transfers, and longer lengths of stay for patients.
  • In 2021, the American Nurses Association reported that the nursing shortage was leading to increased healthcare costs and lower care quality. The association estimated that the nursing shortage cost the US healthcare system $17 billion per year

Addressing the nursing shortage requires a collaborative effort between healthcare organizations, policymakers, and nursing professionals to improve working conditions, increase resources for nursing education, and implement strategies to recruit and retain nurses

Strategies to Address the Nursing Shortage in the US

The nursing shortage in the United States is a complex issue that requires a multifaceted approach to address. Here are some strategies and initiatives that are being implemented to alleviate the nursing shortage:

  • Increasing nursing education capacity: Nursing schools are expanding their capacity to meet the rising demand for nurses. Some nursing schools are offering online programs, accelerated programs, and other options that make it easier for aspiring nurses to get the education they need.
  • Enhancing recruitment and retention programs: Healthcare organizations are implementing recruitment and retention programs to attract and retain nurses. Some programs include loan repayment, sign-on bonuses, and other incentives.
  • Improving working conditions for nurses: Healthcare organizations are working to improve working conditions for nurses to reduce burnout and dissatisfaction. Some measures include creating a healthy work environment, providing work schedule flexibility, and offering stress injury continuum programs.
  • Increasing wages: Increasing wages for nurses is essential to retain and attract nurses. Many hospitals have increased pay for nurses, and some are offering incentives such as loan repayment and sign-on bonuses.
  • Prioritizing workplace culture: Prioritizing workplace culture increases retention and attracts more nurses. Nurses want to work in a supportive environment that values their contributions and provides opportunities for professional growth.
  • Increasing diversity in the nursing workforce: Increasing diversity and representation in nursing can help address workforce shortages and improve patient care quality

Successful programs, policies, or interventions that have shown promising results include:

  • The Partners for Nurse Staffing initiative was created to address the nursing shortage crisis. The initiative identified six priority areas that could provide immediate relief to nursing workforce challenges, including enhancing workplace culture, increasing diversity, equity, and inclusion, and providing work schedule flexibility.
  • The Nurse-Family Partnership program is a successful program that pairs new mothers with registered nurses for home visits. The program has shown to improve health outcomes for mothers and children and can help address nursing shortages by creating job opportunities for registered nurses.
  • The Nurse Residency Program is a successful program that provides new nurses with additional support and training during their first year of practice. The program has shown to increase nurse retention and improve patient care quality

In conclusion, addressing the nursing shortage in the US requires a multifaceted approach that includes increasing nursing education capacity, enhancing recruitment and retention programs, improving working conditions for nurses, increasing wages, prioritizing workplace culture, and increasing diversity in the nursing workforce. Successful programs and policies that have shown promising results include the Partners for Nurse Staffing initiative, the Nurse-Family Partnership program, and the Nurse Residency Program.

 

Nursing Career and Advancement

Nursing is a rewarding career that offers numerous benefits, including job stability, competitive salaries, and opportunities for professional growth. Here are some benefits of pursuing a nursing career:

  • Good compensation: Nurses enjoy competitive salaries and benefits, making it a financially rewarding career.
  • Exciting and rewarding work: Nursing is a fulfilling career that provides opportunities to make a difference in people’s lives.
  • Flexible scheduling: Nurses can choose from various work schedules that suit their personal and family-oriented lifestyles.
  • Varied career options: Nursing offers a wide range of career paths, including specialized areas, advanced practice roles, and leadership positions.
  • Upward career mobility: Nurses can advance their careers through continuing education, professional development, and certification programs

Different career paths within nursing include:

  • Specialized areas: Nurses can specialize in various areas, such as pediatrics, oncology, critical care, and emergency nursing, among others.
  • Advanced practice roles: Advanced practice registered nurses (APRNs) can work as nurse practitioners, nurse anesthetists, nurse-midwives, and clinical nurse specialists, among others.
  • Leadership positions: Nurses can advance to leadership positions, such as nurse manager, chief nursing officer, and nurse executive, among others.

Successful strategies to advance a nursing career include:

  • Pursuing higher education: Continuing education, earning a higher degree, or obtaining certification can increase job security, salary, and opportunities for professional growth.
  • Exploring different career paths: Nurses can explore different career paths within nursing to find the one that best suits their interests and career goals.
  • Networking: Building professional relationships with colleagues, mentors, and other healthcare professionals can open doors to new opportunities and help advance a nursing career

In conclusion, nursing is a great career that offers many benefits, including good compensation, flexible scheduling, and opportunities for professional growth. Different career paths within nursing include specialized areas, advanced practice roles, and leadership positions. Pursuing higher education, exploring different career paths, and networking are successful strategies to advance a nursing career.

Policy and Advocacy in Addressing the Nursing Shortage

The nursing shortage in the US is a complex issue that requires policy and advocacy efforts to address. Here are some ways policymakers, professional organizations, and advocacy groups can play a role in addressing the nursing shortage:

  • Advocating for policies that support nursing education: Policymakers can advocate for policies that increase funding for nursing education, provide loan forgiveness programs for nursing students, and offer incentives for nursing faculty.
  • Improving working conditions: Policymakers and healthcare organizations can work together to improve working conditions for nurses, such as reducing workload, increasing staffing levels, and providing better benefits.
  • Enhancing the nursing workforce: Professional organizations and advocacy groups can work to enhance the nursing workforce by promoting nursing as a career, providing mentorship and career development programs, and advocating for policies that support the nursing profession.

Successful policy and advocacy efforts to address the nursing shortage include:

  • The Nursing Community Coalition is an advocacy group that represents nursing organizations and advocates for policies that support the nursing profession. The coalition works to increase funding for nursing education, enhance the nursing workforce, and promote nursing as a career.
  • The American Nurses Association (ANA) is a professional organization that advocates for policies that support the nursing profession. The ANA works to improve working conditions for nurses, increase funding for nursing education, and promote nursing as a career.
  • The Nurse Reinvestment Act is a federal law that provides funding for nursing education, loan forgiveness programs, and other initiatives to address the nursing shortage

In conclusion, addressing the nursing shortage in the US requires policy and advocacy efforts from policymakers, professional organizations, and advocacy groups. Advocating for policies that support nursing education, improve working conditions, and enhance the nursing workforce can help address the nursing shortage crisis. Successful policy and advocacy efforts include the Nursing Community Coalition, the American Nurses Association, and the Nurse Reinvestment Act.

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Importance of Nursing Education in Addressing the Nursing Shortage Crisis

Nursing education plays a vital role in addressing the nursing shortage crisis in the US. Here are some ways nursing education can help alleviate the nursing shortage:

  • Expanding nursing education capacity: Nursing schools can expand their capacity to meet the rising demand for nurses. Some nursing schools are offering online programs, accelerated programs, and other options that make it easier for aspiring nurses to get the education they need.
  • Preparing more baccalaureate-prepared nurses: Preparing more baccalaureate-prepared nurses can help ensure access to safe patient care. Research has shown that baccalaureate-prepared nurses have better patient outcomes, reduce patient mortality rates, and are more prepared to meet the complex healthcare needs of patients.
  • Addressing the shortage of nursing instructors: There is a shortage of nursing instructors, clinical sites, and preceptors, which contributes to the nursing shortage crisis. Nursing schools can address this shortage by offering incentives to attract and retain nursing faculty, creating more clinical sites, and providing more support to preceptors.
  • Promoting nursing as a career: Nursing schools can promote nursing as a career to attract more students to the profession. Promoting nursing as a career can help address the nursing shortage by increasing the number of students who enter nursing programs.

Successful initiatives to address the nursing shortage through nursing education include:

  • The Nurse Reinvestment Act provides funding for nursing education, loan forgiveness programs, and other initiatives to address the nursing shortage.
  • Nursing schools are expanding their capacity to meet the rising demand for nurses by offering online programs, accelerated programs, and other options that make it easier for aspiring nurses to get the education they need.
  • Promoting nursing as a career through outreach programs and mentorship can attract more students to the nursing profession.

The nursing shortage in the US is a critical issue that demands immediate attention. Throughout this comprehensive guide, we have explored the causes, challenges, and impacts of the shortage on the healthcare system. It is evident that action must be taken to address this crisis.

The shortage of nurses affects the quality and accessibility of healthcare services, putting patient care at risk. It also places a heavy burden on existing nurses, leading to burnout and job dissatisfaction. The consequences of the nursing shortage are far-reaching and affect us all.

To combat this problem, it is crucial for individuals, organizations, and policymakers to come together and support initiatives aimed at resolving the nursing shortage. This can include advocating for policies that improve working conditions, increase funding for nursing education, and enhance recruitment and retention programs.

Additionally, if you are considering a career in nursing or know someone who is, now is the time to act. Pursuing a nursing career not only offers stability and competitive salaries but also provides an opportunity to make a difference in the lives of others. Spread awareness about the nursing shortage and encourage others to consider this rewarding profession.

By supporting initiatives, pursuing nursing careers, and spreading awareness about the nursing shortage, we can collectively address this crisis and ensure that our healthcare system remains strong and capable of meeting the needs of the population.

Remember, the nursing shortage affects us all, and it requires a collaborative effort to overcome. Together, we can make a positive impact and secure a healthier future for everyone.

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Quality Improvement Initiatives

Quality Improvement Initiatives

You have been asked to prepare and deliver an analysis of an existing quality improvement initiative at your workplace. The QI initiative you choose to analyze should be related to a specific disease, condition, or public health issue of personal or professional interest to you. The purpose of the report is to assess whether specific quality indicators point to improved patient safety, quality of care, cost and efficiency goals, and other desired metrics.

Your target audience consists of nurses and other health professionals with specializations or interest in your selected condition, disease, or issue. In your report, you will define the disease, analyze how the condition is managed, identify the core performance measurements used to treat or manage the condition, and evaluate the impact of the quality indicators on the health care facility:

Note: Remember, you can submit all, or a portion of, your draft to Smarthinking for feedback, before you submit the final version of your analysis for this assessment. However, be mindful of the turnaround time for receiving feedback, if you plan on using this free service.

The numbered points below correspond to grading criteria in the scoring guide. The bullets below each grading criterion further delineate tasks to fulfill the assessment requirements. Be sure that your Quality Improvement Initiative Evaluation addresses all of the content below. You may also want to read the scoring guide to better understand the performance levels that relate to each grading criterion.

  1. Analyze a current quality improvement initiative in a health care setting.
    • Evaluate a QI initiative and explain what prompted the implementation. Detail problems that were not addressed and any issues that arose from the initiative.
  2. Evaluate the success of a current quality improvement initiative through recognized benchmarks and outcome measures.
    • Analyze the benchmarks that were used to evaluate success. Detail what was the most successful, as well as what outcome measures are missing or could be added.
  3. Incorporate interprofessional perspectives related to initiative functionality and outcomes.
    • Integrate the perspectives of interprofessional team members involved in the initiative. Detail who you talked to, their professions, and the impact of their perspectives on your analysis.
  4. Recommend additional indicators and protocols to improve and expand quality outcomes of a quality initiative.
    • Recommend specific process or protocol changes as well as added technologies that would improve quality outcomes.
  5. Communicate evaluation and analysis in a professional and effective manner, writing content clearly and logically with correct use of grammar, punctuation, and spelling.
  6. Integrate relevant sources to support arguments, correctly formatting citations and references using current APA style.

Submission Requirements

  • Length of submission: A minimum of five but no more than seven double-spaced, typed pages.
  • Number of references: Cite a minimum of four sources (no older than seven years, unless seminal work) of scholarly peer reviewed or professional evidence that support your interpretation and analysis.
  • APA formatting: Resources and citations are formatted according to current APA style and formatting.

 

CONTEXT:

The purpose of the report is to assess whether specific quality indicators point to improved patient safety, quality of care, cost and efficiency goals, and other desired metrics. Nurses and other health professionals with specializations and/or interest in the condition, disease, or the selected issue are your target audience.

 

QUESTIONS TO CONSIDER:

As you prepare to complete this assessment, you may want to think about other related issues to deepen your understanding or broaden your viewpoint. You are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of your professional community. Note that these questions are for your own development and exploration and do not need to be completed or submitted as part of your assessment.

Reflect upon data use in your organization as it relates to adverse events and near-miss incidents.

  • How does your organization manage and report on adverse events or near-miss incidents?
  • What data from your organization’s dashboards help inform adverse events and near-miss incidents?
  • What additional metrics or technology are you aware of that would help ensure patient safety?
  • What changes would you like to see implemented to help the interprofessional team better understand data use and data trends as quality and safety improvement tools?

 

SAMPLE ANSWER

Quality Improvement Initiative Evaluation

            A Quality Improvement (QI) program is a set of activities designed to monitor, analyze and improve the quality of procedures in healthcare facilities in order to improve health outcomes for all stakeholders involved. Despite their proliferation, QI initiatives take place in the background and are incorporated in the organization’s day-to-day activities (Abrampah et al. 2018). Often times, patients never realize that a QI program is in effect. QI initiatives are critical because they strive to improve outcomes for patients, maintain staff efficiency and reduce waste due to process failures. Effective QI programs have set targets that focus on improving safety, effectiveness, access and are patient-centered (Abrampah et al. 2018). Additionally, effective QI programs always align their priorities with the organization’s strategic plan and provide detailed key performance indicators to track progress towards goal achievement.

In line with its goal of improving operations and reducing wastage, Bethany health center initiated the “no to tubes” program focused on reducing the use of catheters in the facility. After conducting an annual audit of the facility’s operations, the health center realized that catheters were being given to patients who did not need them. More alarming than that was the fact that these catheters were being left in for longer periods of time. In line with this realization, the facility developed the “no to tubes” program with the aim of reducing the increasing number of catheter-associated urinary tract infections (CAUTI) caused by catheters that are left in for too long. In addition, the QI program aimed at reducing resource wastage and improving overall operations at the facility. Using the “no to tubes” QI program as an example, the report will assess how specific quality indicators improve patient outcomes, reduce costs and improve organizational efficiency.

Analysis of the Quality Improvement Initiative

The “no to tubes” QI initiative was designed to reduce the occurrence of CAUTI at

Bethany Health Center. Over the following couple of months, the facility implemented a new system of nursing documentation and clinician orders. The nursing documentation system ensured that the patients who needed catheters received them and when the time came for them to be removed, the system would send alerts to nurses prompting them to remove the catheters. The initiative successfully reduced CAUTI rates in the facility from 3.2 per month to less than 1 per month. In addition to implementing the nursing documentation system, the nurses carried out regular and systemic check-ins. The check-ins further reduced infection rates and improved overall quality of care. To further reduce infection rates at the facility, the “no to tubes” initiative implemented an electronic health record catheter identification system, interdisciplinary training was also conducted and clinician education heightened. Measuring the rate of CAUTI is challenging and resource intensive. To mitigate the challenges, Bethany Health Center implemented an electronic CAUTI surveillance system. The system monitored the presence of urinary catheters and fever in patients and used natural language processing (NLP) to include subjective symptoms which were documented in clinical notes (Sanger et al. 2017).

Quality Improvement Initiatives

To evaluate the “no to tubes” initiative, the analysis will use benchmarks and outcome measures.

Evaluation of the QI Initiative through Recognized Benchmarks and Outcome Measures

Quality of healthcare initiatives is usually assessed by using processes and outcome measures. Measuring outcomes of QI initiatives facilitates the decision-making process and improves public accountability (Kampstra et al. 2018). The key feature of benchmarking is to integrate with comprehensive quality improvement policies. Additionally, benchmarking involves measuring results and comparing them to set standards to evaluate organizational performance. There are two key benchmarking activities that Bethany Health Center employed to measure the results of the “no to tubes” initiative. They include: internal benchmarking which identifies best practices in the organization and compares them to the current initiative; external or competitive benchmarking that involves the use of comparative data between healthcare facilities to gauge performance of the initiative and identify areas for improvement (Lovaglio, 2014). Patient quality has always been at the forefront of all the activities at Bethany Health Center. It is with this goal in mind that the facility has successfully implemented previous QI initiatives and used them to benchmark the “no to tubes” initiative.

Outcome measures are changes in the health of individuals, groups of people or populations that are attributed to interventions or series of interventions by the healthcare facility. Effectiveness of care outcome measures evaluate compliance with the best care practices and analyzes achieved outcomes (Kampstra et al. 2018). After implementing the nursing documentation system and the CAUTI surveillance system, Bethany Health Center experienced reduced rates of CAUTIs. Additionally, patient-reported outcome measures (PROMs) were used to measure patient experiences. The patient’s experiences and their perceptions about the care they received at the facility were analyzed. The results showed that patients were generally satisfied with the “no to tubes” initiative and the care they received from healthcare professionals at the facility.

Quality Improvement Initiatives

Interprofessional Perspective on Initiative Functionality and Outcomes

Interprofessional collaboration occurs when healthcare workers from different professional backgrounds unite and work together with patients, their families and the community to deliver high quality care (Garth et al. 2018). Interprofessional teamwork is a core clinical skill that identifies the benefits of collaboration to address the unmet needs of healthcare systems. With the goal of integrating quality improvement and maintaining patient safety efforts with graduate medical education, Scottsdale Healthcare facility participated in the Alliance of Independent Academic Medical Centers (AIAMC) National Initiative IV between 2013 and 2015. The AIAMC implemented several initiatives to reduce unnecessary use of urinary catheters in hospitals. The initiative focused on a multidisciplinary medical education conference that centered on CAUTI prevention (Bell, Alaestante & Finch, 2016). In addition, the facility embarked on the emergency department initiative that saw emergency department nurses and physicians receive intensive education on the reduction of urinary catheter use. Patient tracking was also involved in the initiative and the patients who had urinary catheters were tracked and the information uploaded in the nursing staff daily management system. The results of the initiative show that by incorporating all the stakeholders, Scottsdale Healthcare facility saw a dramatic decrease in urinary catheter insertions and an overall decline in CAUTI cases (Bell, Alaestante & Finch, 2016). The study results further prove that interdisciplinary interaction and collaboration in healthcare further improve patient outcomes and reduce the spread of infections.

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The “no to tubes” initiative would benefit from analyzing staff perspectives towards CAUTI. According to an analysis carried out by Niederhauser at colleagues (2018), there are significant changes in staff perceptions after the implementation of evidence-based interventions. Efforts should therefore be directed towards sustaining the changes so that the intervention implemented becomes an integral part of the organization’s culture. To maintain this culture, staff knowledge about the intervention, their perception of current practices, self-reported responsibility and behavior determinants should be regularly assessed (Niederhauser et al. 2018). To further strengthen the “no to tubes” initiative and obtain the best results, Bethany Health Center should implement a multimodal bundle of interventions that incorporates an evidence-based intervention, daily re-evaluation of catheter use, training and education of all healthcare providers.

Additional Indicators and Protocols to Improve Quality Outcomes

By introducing a nursing documentation system and an electronic health record catheter identification system and encouraging a culture of interdisciplinary training and education, Bethany Health Center has successfully reduced the rate of CAUTI infections and has improved overall quality of care offered to patients. While both the internal and external benchmarking tools have been used to gauge success of the “no to tubes” initiative, additional indicators of quality can improve quality outcomes. The goal of healthcare systems is to improve the quality of care they offer to patients. Successful quality improvement might be challenging. However, by implementing key essentials of success quality improvement can be maintained.

Quality Improvement Initiatives

The first requirements is that health facilities should have a culture of adaptive leadership and governance. Individuals within the health system should have the aptitude to make continuous improvements. Likewise, staff members should be dedicated to the organization and its goals. However, individual efforts are not enough to sustain quality (Tinker & Hough, 2016). There needs to be senior leadership support, an adaptive learning culture and data-driven initiatives for quality improvement. Analytics is a crucial ingredient used to sustain quality in the quality improvement lifecycle. Analytics is incorporated into baseline measurements, problem descriptions and system implementation processes. Analytics should never be mistaken for measurements. The third and critical essential to improve quality is the adoption of evidence and consensus-based best practices. Evidence-based practices are the foundation upon which best practices that improve quality are built (Tinker & Hough, 2016). While the aforementioned practices are designed to improve quality, they will not be successful unless resources are dedicated to implement outcome initiatives. Bethany Health Center should set aside resources towards performance evaluation practices and organizational incentives.

The Lean Six Sigma model is a combined toolkit that provides a systemic approach to help organizations improve their problem-solving skills. The model is based on a scientific method that supports organizations that are looking to improve their problem-solving culture (Lighter, 2014). By adopting the Lean Six Sigma model, Bethany Health center will be able to streamline the “no to tubes” initiative results and improve patient satisfaction levels. Additionally, the model will help the facility engage staff members, improve staff morale and standardize processes. The model will also help the facility better understand the current state of affairs and remove barriers to success. The model focuses on eliminating defects, improving patient safety and maintaining quality. By using the Define-Measure-Analyze-Improve-Control five-step process improvement structure, the Lean Six Sigma model improves patient experiences and makes sure processes consistently deliver desired results (Lighter, 2014).

Quality Improvement Initiatives

Conclusion

Despite their importance and proliferation, quality improvement initiatives often go on in the background and are integrated into the day-to-day operations of healthcare facilities. Quality improvement initiatives are the primary means for improving operations and maintaining high quality care. QI initiatives like the “no to tubes” initiative designed to reduce the rate of CAUTIs set targets aimed at improving patient safety, access to care and guarantee delivery of effective and patient-centered care. To ensure success of QI initiatives, healthcare facilities must evaluate their effectives by using recognized internal and external benchmarks and outcome measures. To reduce the risk of failure, QI initiative must incorporate interprofessional perspectives and set protocols and indicators that are relevant to the implemented QI initiative. Lastly, evidence-based models like the Lean Six Sigma model will help healthcare facilities eliminate defects and maintain staff morale.

 

 

References

Abrampah, N.M. et al. (2018). Quality Improvement and Emerging Global Health Priorities. International Journal for Quality in Health Care, 30(suppl 1), 5-9. Doi: 10.1093/intqhc/mzy007

Bell, M.M., Alaestante, G. & Finch, C. (2016). A Multidisciplinary Intervention to Prevent Catheter-Associated Urinary Tract Infections using Education, Continuum of Care and System wide Buy-in.  The Ochsner Journal, 16(1), 96-100. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4795513/

Garth, M., Millet, A., Shearer, E. et al. (2018). Interprofessional Collaboration: A Qualitative Study of Non-Physician Perspectives on Resident competency. Journal of General Internal Medicine, 33(4), 487-492. Doi: 10.1007/s11606-017-4238-0

Kampstra, N.A. et al. (2018). Health Outcomes Measurement and Organizational Readiness Support Quality Improvement: A Systematic Review. BMC Health Services Research, 18(1005). Doi: 10.1186/s12913-018-3828-9

Lovaglio, P.G. (2014). Benchmarking Strategies for Measuring the Quality of Healthcare: Problems and Prospects. The Scientific World Journal Volume, 13. Doi: 10.1100/2012/606154

Lighter, D.E. (2014). The Application of Lean Six Sigma to Provide High-Quality, Reliable Pediatric Care. International Journal of Pediatrics and Adolescent Medicine, 1(1), 8-10. Doi: 10.1016/j.ijpam.2014.09.009

Niederhauser, A., Zuillig, S., Marschall, J. et al. (2018). Change in Staff Perspectives on indwelling Urinary Catheter use after Implementation of an Intervention Bundle in Seven Swiss Acute Care Hospitals: Results of a before/after Survey Study. BMJ Open, 9(10). Doi: 10.1136/bmjopen-2018-028740

Sanger, P.C., Granich, M. et al. (2017). Electronic Surveillance for Catheter-Associated Urinary Tract Infection Using Natural Language Processing. AMIA Annual Symposium Proceedings, 1507-1516. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5977673/

Tinker, A. & Hough, L. (2016). The Top Five Essentials for Outcomes Improvement. Health Catalyst. Retrieved from https://www.healthcatalyst.com/outcomes-improvement-five-essentials

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Role of a graduate-level nurse in Technology Implementation

Role of a graduate-level nurse in Technology Implementation

Assume you are a nurse manager on a unit where a new nursing documentation system is to be implemented. You want to ensure that the system will be usable and acceptable for the nurses impacted. You realize a nurse leader must be on the implementation team.

To Prepare:

  • Review the steps of the Systems Development Life Cycle (SDLC) and reflect on the scenario presented.
  • Consider the benefits and challenges associated with involving a nurse leader on an implementation team for health information technology.

The Assignment: (2-3 pages)

In preparation of filling this role, develop a 2- to 3-page role description for a graduate-level nurse to guide his/her participation on the implementation team. The role description should be based on the SDLC stages and tasks and should clearly define how this individual will participate in and impact each of the following steps:

  • Planning and requirements definition
  • Analysis
  • Design of the new system
  • Implementation
  • Post-implementation support

 

SAMPLE ANSWER

Transforming Nursing and Healthcare through Technology

Introduction

Leadership is important for the implementation of systems in the nursing practice. Nurse leaders are responsible for taking action to achieve preferred results, providing guidance for solving complex issues and creating structures that facilitate processes and healthcare delivery (Marie, Rokstad, Vatne & Selbaek, 2014). During the introduction of new systems, nurse leaders participating in interdisciplinary teams play a crucial role in the design, planning, analysis, implementation and evaluation stages of the systems. Nurses’ involvement in all phases of the Systems Development Life Cycle during the introduction of new systems and technologies facilitates a smooth transition of the technology use and increases nurses’ participation.

Role of a graduate-level nurse in Technology Implementation

Nurses’ Involvement in the Planning and Requirements Definition

Nurse leaders play a critical role in the selection, implementation and adoption of technologies by healthcare facilities. Nurse leaders achieve this objective by creating a culture of shared decision making and encouraging staff members to participate in the technology planning process (Qin et al. 2017). The nurse leader should advocate for the appropriate technology to be selected and influence top management about practice issues and infrastructure needs. During the planning stage, nurse leaders partner with key vendors to manage technology decisions. Additionally, they offer multidirectional input and provide feedback to top executives from staff and interdisciplinary colleagues. Working with the interdisciplinary team, the nurse leader is responsible for determining project requirements, including both clinical and technical requirements. In this phase, contact information is clarified, facility backup is determined and a training facility identified (Weckman & Janzen, 2010). The nurse leader is also responsible for selecting the roll-out site for the nursing documentation system and establishing training needs for all stakeholders affected. The planning stage is the most important stage in the Systems Development Life Cycle.

Nurses’ Involvement in the Analysis Stage

Nurses are better placed to serve as leaders during the introduction of new technologi+es. Their involvement in all stages of the health information technology design and implementation has positive impacts on the SDLC process (Waneka & Spetz, 2010). In the system analysis stage, the nurse leader is responsible for considering all the functional requirements of the new system being implemented. Additionally, the nurse leader should analyze the needs of the end users to ensure that the system being developed meets all their expectations. Nurse leaders are in touch with all nurses in the facility. Therefore, they are best placed to work on the source of the problem. Being part of the implementation team, nurse leaders should provide possible solutions to the identified problems and identify whether the functional requirements of the system are in line with the facility’s goals (Waneka & Spetz, 2010). The nurse leader should also design a timeline for all the parties involved in the system.

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Nurses’ Involvement in the Design Stage

The design phase describes the necessary specifications and operations of the system that are designed to satisfy user requirements. The nurse leader plays a critical role in the design stage since they represent the end users of the nursing documentation system. In this role, nurse leaders provide specific needs for the proposed system (Weckman & Janzen, 2010). The information provided by the nurse leader is used when essential components and structures are considered. System processes and procedures are also set in this stage. Nurses’ involvement in this stage makes the system simpler and effective for nurses to use. The nurse leader’s involvement in the design phase will prevent early system problems and save on time and resources (Weckman & Janzen, 2010). The nurse leader acts as a bridge between the nurses and the technical team thus avoiding technology-related stresses.

Nurses’ Involvement in the Implementation State

The nurse leader is in an excellent position to provide feedback to the implementation team regarding the system during the trial periods and after the system is implemented. The nurse leader together with other members of the implementation team should provide support throughout the implementation process. During this stage, the new components of the program are obtained and installed. The users of the system are then trained in its use. To facilitate the training process, the nurse leader must identify resource trainers; locate training space and other training resources (Rokstad et al. 2014). The system is then tested and adjustments made. Feedback is essential at this stage and the nurse leader must engage with other nurses to obtain their feedback. After testing and training is completed, the system is deployed and incorporated into the facility. System deployment can be done in phases where it is slowly introduced as the old system is phased out. The success of the system is highly dependent on effective communication between nurses and the system implementation team.

Role of a graduate-level nurse in Technology Implementation

Nurses’ Involvement in Providing Post-Implementation Support

After the system is implemented, it should be evaluated to determine its overall performance. To facilitate this process, nurse leaders should organize focus groups with care nurses to determine whether their concerns were met (Rokstad et al 2014). On-site support should be provided for users who are not completely comfortable with the system. System changes should also be implemented and other new requirements deployed. In the case of residual errors, the nurse leader in collaboration with the implementation team should collaborate to resolve them.

 

References

Marie, A., Rokstad, M., Vatne, S. & Selbaek, G. (2014). The Role of Leadership in the Implementation of Person-Centred Care using Dementia Care Mapping: a Study in Three Nursing Homes. Journal of Nursing Management, 23(1). Doi: 10.1111/jonm.12072

Rokstad, A.M., Vatne, S., Engedal, K. & Selbaek, G. (2014). The Role of Leadership in the Implementation of Person-centered Care Using Dementia Care Mapping: A Study in Three Nursing Homes. Journal of Nursing Management, 23(1). Doi: 10.1111/jonm.12072

Qin, Y. Et al. (2017). The Effect of Nursing Participation in the Design of a Critical Care Information System: A Case Study in a Chinese Hospital. BMC Medical Informatics and Decision Making, 17.

Weckman, H. & Janzen, S. (2010). The Critical Nature of Early Nursing Involvement for Introducing New Technologies. The Online Journal of Issues in Nursing, 14(2). Doi: 10.3912/OJIN.Vol14No02Man02

Waneka, R. & Spetz, J. (2010). Hospital Information Technology Systems’ Impact on Nurses and Nursing Care. Journal of Nursing Administration, 40(12), 509-514. Doi: 10.1097/NNA.0b013e3181fc1a1c

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Organizational development

Organizational development

Respond to at least two of your colleagues’ postings and continue the Discussion through Day 7. Expand on this Discussion by providing additional insights or alternative perspectives to colleagues who were assigned different scenarios than you. For example, if you were assigned Scenario 1, respond to colleagues who were assigned Scenario 2 and Scenario 3.

 

SAMPLE ANSWER

Discussion Peer Responses

Organizational development is focused on improving the efficiency and effectiveness of a workplace. As part of this process, strategic planning professionals often work with leadership teams to develop strategies for short-term and long-term organizational development, including workforce planning and succession planning. This helps ensure that health care organizations recruit, train, and retain employees that are capable of meeting strategic objectives. For this Discussion, examine the following scenarios and suggest strategies for organizational development, workforce planning, and succession planning.

Scenario 1: Park Post-Acute Care Services has been providing quality nursing home and home health services for 70 years in rural Texas. It is a family-owned business that has been passed down through the generations to family members eager to provide service to citizens in the community. About three years ago, the leadership team created a five-year strategic plan in anticipation of some members of the leadership team retiring after fully accomplishing the plan. The remaining members committed to serving as chief executives of larger health care organizations. However, the strategic plan failed to include a succession plan for identifying talented professionals who will be able to lead the organization after the long-standing leadership team of 15 years vacate their positions in two years.

 

Week 6: Scenario 1/Abigail

An acute care services providing care in rural Texas is family-owned and recently, the some of the senior leadership is preparing for retirement.  The rest of the senior leadership is prepared to continue with their administrative duties, but there are currently no plans for succession once the other administrators retire.

There are strategies for the short and long-term organizational development and succession planning for this Texas acute care service.  The short-term strategy for the administrators is to list the responsibilities of those retiring.  Perhaps a sub-committee can be formed to create a more formalized job description.  For example, if one of the retiring administrators has been responsible with finances, then the specific tasks can also be listed such as preparation of annual budget, management of supply and demands of the facility while maintaining the budget, etc (Harvard Business Publishing, 2009).

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The long-term strategy to assist with this issue is to either use the same sub-committee or a different sub-committee to initiate recruitment.  Advertising and marketing of the positions is vital to attract the appropriate people in the roles.  Recruitment can take months to years to complete, especially for administrative roles (Rahardjo, S., 2014).

Having short and long-term strategy plans are necessary to achieve goals.  It also takes significant amount of meetings to ensure that all key players are engaged are aware of the same goals.

Rahardjo, S. (2014). New roles of human resources in facing the changing challenge of business environment. International Journal of Management Research and Reviews, 4(4), 464-470.

Harvard Business Publishing (Producer). (2009). Be strategic with your workforce [Video file]. Retrieved from http://www.youtube.com/watch?v=Yny-PWy64li4

 

RESPONSE

Leadership succession planning is imperative to any organization for the continuity of the vision set by the management. It is therefore important to ensure leadership development among the new generations that would take over the management. Leadership development is the main component of training and preparing individuals to managerial positions (Ellinger et al, 2014). Succession planning should begin with a review of the organizational’ s strategic plan. This would enable the management to create a career ladder and identify key positions that would require succession plans. In addition, before making plans for external recruitments, it is important to consider the existing employees. Therefore, the employee profiles including their education and talents should be identified. The goals of the identified employees should align with the short term and long-term goals of the organization.

Reference

Ellinger, L., Trapskin, P., Black, R., Kotis, D., & Alexander, E. (2014). Leadership and Effective Succession Planning in Health-System Pharmacy Departments. Hospital Pharmacy, 49(4), 369-375. doi: 10.1310/hpj4904-369

Organizational development

 

Scenario 2: Whitesville Medical Center has been providing quality patient care in Louisiana for over 100 years. However, during the last five years, the organization has experienced significant turnover in middle management positions in the Housekeeping Department. In fact, the average tenure of a middle manager is only six months, and there is a current vacancy in the day and evening shifts. Because of the unstable management team, no one has been able to hold supervisors accountable for facilitating appropriate orientation of new staff, ongoing training of the seasoned employees, and routine audits of the employees’ performance. Unfortunately, the breakdown in management oversight has led to a lack of employee training in cleaning and sanitizing patient rooms, surgical suites, and public areas including the restrooms and waiting areas. The lack of cleanliness and sanitation has led to an outbreak of nosocomial infections impacting several patients and causing them to remain in the hospital for a longer period of time. The Centers for Medicare & Medicaid Services and the Joint Commission have received anonymous tips about this outbreak and have sent survey teams to conduct unannounced visits at the facility, which could lead to fines until the issue is fully resolved by the medical center.

 

Wk6 Discussion/ Jacquelyne Atakora 

Whitesville Medical Center has been providing patient care in Louisiana for over 100 years, but in the past five years they have had serious problems with management and has experienced significant turnover. Management is the foundation of any medical center, and because of the breakdown in management has led to lack of training in employees. The lack of cleanliness has led to an outbreak of nosocomial infections, causing longer patient stays and unannounced visits to the facility.  One-way productivity of quality care could be measure is through employee and patients’ surveys. Patients could be asked to fill out surveys at the end of their visits online or at the office to see what they thought about their physician. Employees could fill out self-assessments on how they personally felt their visits with patients are going. This could help with productivity by giving operations insight on how they could better train incoming employees and on what patients want from their physicians. Adding accounts on sites like yelp and google by allowing patients to leave reviews could also help evaluate productivity. Since patient satisfaction is a main goal, why not let patients tell you what they need from their provider. Six Sigma was developed in the 1980s and has been used to define quality strategies for many organizations. General Electric is one of the many companies who have gained much success using the Six Sigma methodology. The focus us on “eliminating defects through removal of variance in business systems” (McLaughlin & Olsen, 2017). The Six Sigma is an infrastructure that is hierarchical with all employees as the foundation. Using this system could create some organization and a better foundation for new employees. If the system is organized, employees will be more satisfied in their positions, thus decreasing turnover rates. Using benchmarking or “comparison of internal data to those of outside organizations for purposes of evaluating an organization’s performance”, will allow Whitesville to look within their organization as compared to others and see what tactics other organizations are using to gain success.

Reference:

McLaughlin, D. B., & Olson, J. R. (2017). Health care operations management (3rd ed.). Chicago, IL: Health Administration Press.

Measuring healthcare productivity – from unit to system level. (2016). International Journal of Health Care Quality Assurance, (3), 288. https://doi-org.ezp.waldenulibrary.org/10.1108/IJHCQA-04-2015-0050

Walston, S. L. (2018). Strategic healthcare management: Planning and execution (2nd ed.). Chicago, IL: Health Administration.

 

RESPONSE

High healthcare employee turnover is a major challenge in the healthcare sector. Rising healthcare employee turnover not only impacts healthcare provider, but it also impacts on the patient outcomes (Collini, Guidroz & Perez, 2015). Hospitals require a skilled, reliable and stable workforce to provide effective and continuous patient care. Healthcare organizations should address the main drivers of healthcare employee turnover to ensure their operations and patient outcomes are not negatively impacted employees leaving the organization. Managers at healthcare organizations should understand the needs of their employees to prevent voluntary turnover. Conducting regular performance recognition and feedback discussions in addition to annual performance evaluations are key to ensure employee retention. Receiving employee feedback is also critical to lowering turnover rates. Managers should understand how employees receive and perceive feedback. Employees should have communication channels available to provide suggestions regarding the organization, their individual jobs, and how their decisions impact their work.

Reference

Collini, S., Guidroz, A., & Perez, L. (2015). Turnover in health care: the mediating effects of employee engagement. Journal Of Nursing Management23(2), 169-178. doi: 10.1111/jonm.12109

 

 

 

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Standardized Nursing Terminologies

Standardized Nursing Terminologies

Among the Resources in this module is the Rutherford (2008) article Standardized Nursing Language: What Does It Mean for Nursing Practice? In this article, the author recounts a visit to a local hospital to view the recent implementation of a new coding system.

During the visit, one of the nurses commented to her, “We document our care using standardized nursing languages but we don’t fully understand why we do” (Rutherford, 2008, para. 1).

How would you respond to a comment such as this one?

To Prepare:

  • Review the concepts of informatics as presented in the Resources, particularly Rutherford, M. (2008) Standardized Nursing Language: What Does It Mean for Nursing Practice?
  • Reflect on the role of a nurse leader as a knowledge worker.
  • Consider how knowledge may be informed by data that is collected/accessed.

The Assignment:

In a 2- to 3-page paper, address the following:

  • Explain how you would inform this nurse (and others) of the importance of standardized nursing terminologies.
  • Be sure to support your paper with peer-reviewed research on standardized nursing terminologies that you consulted from the Walden Library.

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.

  • Chapter 25, “The Art of Caring in Technology-Laden Environments” (pp. 525–535)
  • Chapter 26, “Nursing Informatics and the Foundation of Knowledge” (pp. 537–551)

American Nurses Association. (2018). Inclusion of recognized terminologies supporting nursing practice within electronic health records and other health information technology solutions. Retrieved from https://www.nursingworld.org/practice-policy/nursing-excellence/official-position-statements/id/Inclusion-of-Recognized-Terminologies-Supporting-Nursing-Practice-within-Electronic-Health-Records/

Macieria, T. G. R., Smith, M. B., Davis, N., Yao, Y., Wilkie, D. J., Lopez, K. D., & Keenan, G. (2017). Evidence of progress in making nursing practice visible using standardized nursing data: A systematic review. AMIA Annual Symposium Proceedings, 2017, 1205–1214. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5977718/

Office of the National Coordinator for Health Information Technology. (2017). Standard nursing terminologies: A landscape analysis. Retrieved from https://www.healthit.gov/sites/default/files/snt_final_05302017.pdf

Rutherford, M. A. (2008). Standardized nursing language: What does it mean for nursing practice? Online Journal of Issues in Nursing, 13(1), 1–12. doi:10.3912/OJIN.Vol13No01PPT05.

Note: You will access this article from the Walden Library databases.

Thew, J. (2016, April 19). Big data means big potential, challenges for nurse execs. Retrieved from https://www.healthleadersmedia.com/nursing/big-data-means-big-potential-challenges-nurse-execs

Topaz, M. (2013). The hitchhiker’s guide to nursing theory: Using the Data-Knowledge-Information-Wisdom framework to guide informatics research. Online Journal of Nursing Informatics, 17(3).

Note: You will access this article from the Walden Library databases.

Wang, Y. Kung, L., & Byrd, T. A. (2018). Big data analytics: Understanding its capabilities and potential benefits for healthcare organizations. Technological Forecasting and Social Change, 126(1), 3–13. doi:10.1016/j.techfore.2015.12.019.

Note: You will access this article from the Walden Library databases.

Required Media

Laureate Education (Executive Producer). (2012). Data, information, knowledge and wisdom continuum [Multimedia file]. Baltimore, MD: Author. Retrieved from http://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6051/03/mm/continuum/index.html

Laureate Education (Producer). (2018). Health Informatics and Population Health: Analyzing Data for Clinical Success [Video file]. Baltimore, MD: Author.

 

SAMPLE ANSWER

Standardized Nursing Terminologies

Introduction

Standardized nursing terminologies refer to a wide range of vocabularies that are used by nurses to describe standard care. The common language is understood by all nurses from different geographical areas and various health institutions. Nurses agree on a common form of communication to ensure that there is no confusion on patient health history even when given care by different nurses of health professionals in various hospitals, units, and countries. For instance, nurses document postpartum vaginal bleeding as large, moderate, or small. The terms small, large, and moderate describe a standard amount that is known by the nurse (Topaz, 2013). Thus, if a patient is treated in a different hospital by different nurses, their health information would remain clear without causing any confusion or inconveniences. This paper aims to review the concepts of informatics as described by Rutherford (2008), in “Standardized Nursing Language; What Does It Mean for Nursing Practice?”. The paper also describes the importance of standardized nursing terminologies.

In the “Standardized Nursing Language: What Does It Mean for Nursing Practice?”, the author describes how he visited a delivery and labor unit in a local community hospital with the aim of observing the implementation of the recent Nursing Outcome Classification and the Nursing Intervention Classification. One of the nurses commented that they document their care through the use of standardized nursing terminologies, but they do not understand why they do so. Therefore, Rutherford (2008) thought of writing an article describing the importance of Standardized Nursing Terminologies in improving patient care and evidence-based patient outcome for the nurses. Besides, based on various studies, there is a wide range of benefits of using the terminologies to both nursing practice and patient outcome.

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Benefits of Standardized Nursing Terminologies

Nurses should understand why they use standardized terminologies in documenting their care and their importance to nursing practice as well as patient outcome. Some of the benefits are outlined below:

  1. Improved Patient Care

The use of Standardized Nursing Terminologies helps in reducing misunderstandings and medical errors. The use of unstandardized data may cause a lot of challenges when it comes to data analysis and processing. When data is unstandardized, similar terminologies may have different meanings depending on the institutions since cultures and standards of care can considerably vary (Wang, Kung & Byrd, 2018). Medical errors and misunderstandings may lead to poor treatment of a patient which may lead to health emergencies such as the death of worsening of a patient’s health condition (Macieria, et al.2017). Therefore, nurses should be informed that its is highly beneficial to quality patient outcome.

  1. Improved communication among nurses and other health practitioners

The use of Standardized Nursing Terminologies enhances clear communication among health practitioners, such as administrators of health institutions and other health practitioners. For instance, through the use of the International Classification of Diseases, physicians can have a standard understating of various health conditions (Rutherford, 2008). The Diagnostic and Statistical Manual Disorders gives a common language for psychological disorders (Macieria, et al.2017). When a psychologist indicates the status of a patient on the patient chart using SNTs, other health practitioners, physicians, and nurses understand the diagnosis of the patient.

  • Enable Data Collection to Evaluate Nursing Care Outcomes

Application of Standardized Nursing Terminologies to document nursing care may provide the necessary consistencies when comparing care quality for different interventions. Many health organizations are adopting the use of electronic health records (Rutherford, 2008). When nursing care is documented electronically in a common language, data from large state, local and national institutions can be used for benchmarking with other institutions that give nursing care.

  1. Easy assessment of competencies in nursing

The use of Standardized Nursing Terminologies can be used in examining the competencies of nurses in the field. It is a requirement for the healthcare institutions by the joint commission to demonstrate the competency of the nursing staff (Macieria, et al.2017). The interventions which are described in the terminologies can be used to evaluate the competencies of nurses in performing those interventions (Rutherford, 2008). Besides, the documentation of care done by different nurses using the standardized language can be used to tell whether a nurse is giving the right care to a patient.

  1. Enhances the visibility of nursing interventions

Most nurses use non-formal notes or verbal communication when communicating with each other about patient care. Therefore, their interventions main remain invisible. Nurses need to understand that the use of Standardized Nursing Terminologies to document their care helps in making their interventions visible. Besides, the documentation of nursing interventions in computers helps describe their contributions to patient outcome, thereby making them more visible.

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Challenges in implementation of Standardized Nursing Terminologies

  1. Lack of professional practice understanding

One of the challenges in the implementation of Standardized Nursing Terminologies is that in most of the health institutions, nursing care is fails to be represented the documentation value of Standardized Nursing Languages (Topaz, 2013). Thus, there is no familiarity of nursing practice with Nursing Standardized Terminologies represented.

  1. Lack of proficiency with electronic health records and computers

Most nurses fail to understand the Standardized Nursing Terminologies. Besides, some nurses do not understand the application of Electronic health documentation and the use of computers (Topaz, 2013). Therefore, the implementation of the terminologies becomes a great challenge.

  • Technology and Information System barriers

Information System and technology barriers may include such factors as insufficient ability to retrieve or document nursing practice in form of Standardized Nursing Terminologies. Also,  its unavailability  in the Electronic Health Records poses great challenges during the implementation of SNTs. In addition, the Standardized Nursing Terminologies acts as one of the major challenges in the implementation of SNTs.

Conclusion

In conclusion, the nurses who commented that they do not understand why they document their care through Standardized Nursing Terminologies should first learn the importance of the common terminologies. They enhance easy communication between nurses, other health practitioners, and administrators in health institutions. The languages also reduce the instances of misunderstandings and medical errors when patients are treated by different health practitioners in different geographical areas and various health institutions. Besides, it is easy to assess the competencies of nursing interventions through the use of Standardized Nursing Terminologies. Data collection and benchmarking are also quickly done when Standardized Nursing Terminologies are used in healthcare.

 

References

Macieira, T. G., Smith, M. B., Davis, N., Yao, Y., Wilkie, D. J., Lopez, K. D., & Keenan, G. (2017). Evidence of Progress in Making Nursing Practice Visible Using Standardized Nursing Data: A Systematic Review. In AMIA Annual Symposium Proceedings (Vol. 2017, p. 1205). American Medical Informatics Association.

Rutherford, M. (2008). Standardized nursing language: What does it mean for nursing practice. OJIN: The Online Journal of Issues in Nursing13(1), 243-50.

Topaz, M. (2013). Invited Editorial: The Hitchhiker’s Guide to nursing informatics theory: using the Data-Knowledge-Information-Wisdom framework to guide informatics research. Online Journal of Nursing Informatics (OJNI)17(3).

Wang, Y., Kung, L., & Byrd, T. A. (2018). Big data analytics: Understanding its capabilities and potential benefits for healthcare organizations. Technological Forecasting and Social Change126, 3-13.

 

 

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Experiential Interventions

Experiential Interventions

Read “Topic 6: Vargas Family Case Study.” Develop three experiential interventions that you would use with the Vargas family.

It’s time to get creative! You have noticed that the Vargas family struggles with emotional expression, particularly with congruent emotional expression (i.e., words, actions, and body language being congruent). Using the Experiential Interventions Template, create three unique experiential interventions that you would use with the family and describe how they would be helpful to the family. It may be helpful to refer to the library articles for ideas and inspiration, but do not copy existing interventions. Be sure to fully address each section in the template for each of the three interventions in your paper:

1. Title of your Intervention

2. General Goals

3. Materials Needed

4. Advance Preparation Needed

5. Description of the Intervention with the Vargas family

6. Discussion of the Benefits of the Intervention to the Vargas Family

7. References (if any)

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

You are required to submit this assignment to LopesWrite. Refer to the directions in the Student Success Center.

 

SAMPLE ANSWER

PCN-521 Topic 6: Experiential Interventions

Intervention 1

Title of your Intervention:

Act and talk it out

General Goals:

-The main goal of this intervention is to allow the direct sharing of messages between family members.

-Additionally, the intervention aims to heighten emotional experiences between the Vargas family members

-enactments will redesign new interactions among the family members

-the intervention will create positive cycles of responsiveness

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Materials Needed:

-chairs

Advance Preparation Needed:

Critical knowledge of the family’s history will help the therapist know which family members have a problem with expressing their emotions. Additionally, an analysis of successful implementation of previous enactments in family therapy will help the therapist to customize activities for the Vargas family.

Description of the Intervention with the Vargas family:

The therapist will direct the family members to interact with each other to be able to observe presenting problems. Since every member of the family has narrated how they feel about each other, in this intervention, they will tell each other how they feel. For example, Elizabeth is disappointed in the way Bob counteracts her decisions about disciplining Frank. Instead of telling the therapist, Elizabeth should recreate the scenario during the picnic where she felt disrespected and tell Bob about it.

Discuss the benefits of the Intervention to the Vargas family:

-it will help them express their emotions better

-it will reduce stress

Citation for references (if any):

(Pagano, 2018)

Intervention 2

Title of your Intervention:

Soccer for the mind

General Goals:

-to reduce stress in the family

-to reduce symptoms of ADHD

-to reduce anxiety

Materials Needed:

-a ball

-playing field

Advance Preparation Needed:

-Bob will have to take time off work in the afternoon to play soccer with the family

Description of the Intervention with the Vargas family:

For three times a week, the family will meet up and play soccer for at least thirty minutes. Every family member will be expected to participate.

Discuss the benefits of the Intervention to the Vargas family:

-physical activity and more specifically soccer is a good way of reducing stress and depression

-soccer is fun and thus reduces anxiety

-Frank loves soccer, therefore, he will enjoy this activity

-the commitment to play soccer will increase family bonding and improve relationships among all family members

Citation for references (if any):

Sharma, Madaan & Petty, 2016

Intervention 3

Title of your Intervention:

Paint your feelings

General Goals:

-to examine emotional undertones in the paintings

-to help the family members better understand their feelings and behavior

Materials Needed:

-paint

-painting brush

-canvas

Advance Preparation Needed:

-there is no artistic talent needed for this exercise

Description of the Intervention with the Vargas family:

Color and texture play an important role in the therapeutic process. Painting and drawing will help the family reveal their thoughts and feelings. Every member of the family will be encouraged to participate in this intervention. During the next therapy session, canvas, paint and other materials will be provided and the family will engage in the activity for the duration of the therapy session. The therapist will not intervene during this activity.

Discuss the benefits of the Intervention to the Vargas family:

-relieves stress

-improves symptoms of anxiety

-it is fun for all family members especially Frank and Heidi

-helps every family member explore their emotions

Citation for references (if any):

Regev & Cohen-Yatziv, 2018

 

References

Pagano, C.J. (2018). Exploring the Therapist’s Use of Self: Enactments, Improvisation and Affect in Psychodynamic Psychotherapy. The American Journal of Psychotherapy, https://doi.org/10.1176/appi.psychotherapy.2012.66.3.205

Regev, D. & Cohen-Yatziv, L. (2018). Effectiveness of Art Therapy with Adult Clients in 2018-What Progress has Been Made? Frontiers in Psychology, 9, 1531. Doi: 10.3389/fpsyg.2018.01531

Sharma, A., Madaan, V. & Petty, F. D. (2016). Exercise for Mental Health. Priamry Care Companion to the Journal of Clinical Psychiatry, 8(3), 106.

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Qualitative Study

Qualitative Study

Write a critical appraisal that demonstrates comprehension of two qualitative research studies. Use the “Research Critique Guidelines – Part 1” document to organize your essay. Successful completion of this assignment requires that you provide rationale, include examples, and reference content from the studies in your responses.

Use the practice problem and two qualitative, peer-reviewed research article you identified in the Topic 1 assignment to complete this assignment.

In a 1,000–1,250 word essay, summarize two qualitative studies, explain the ways in which the findings might be used in nursing practice, and address ethical considerations associated with the conduct of the study.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

 

SAMPLE ANSWER

Qualitative Study

Study Protocol of ” Worth the Walk”: a randomized controlled trial of a stroke risk reduction walking intervention among racial /ethnic minority older adults with hypertension in community senior centers by Kwon, et al., (2015).

Background of the study

Stroke has become one of the leading causes of high mortality rates in the United States. Stroke is also responsible for disabling most of the minority seniors. Approximately 30% of the strokes are related to lack of physical activity, but most of the older generations in most of the ethnic groups in the United States tend to participate most in physical exercise.

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Significance of the study

Most of the African American, Chinese, Korean, and Latino seniors with hypertension are the most affected groups by stroke. As a result, the cost of health among the mentioned groups tends to be high, and yet the mortality rate continues to be high every year. Walking among the seniors can increase their physical activity, which can, in turn, reduce the risks of stroke, especially among those seniors suffering from hypertension.

The purpose of the study

To conduct a randomized controlled trial to assess the effects of a culturally designed walking intervention that is community-based to decrease the risk of stroke by increasing the rate of physical exercise among Latino, African American, Korean and Chinese seniors suffering from hypertension.

Research question

Does walking intervention reduce the risk of stroke among the racial/ethnic older adults with hypertension in senior community centers?

Research method

The researchers enrolled the minority seniors of the targeted groups at senior centers and used data collection with complete baseline. The selected groups were then assigned to receive the walking intervention randomly. The sample size was 120, which was obtained after a full 90 days follow up intervention. The researchers’ assigned trained case managers to conduct qualitative methods to answer the research questions. They implemented the intervention sessions two times a week for four consecutive weeks to the targeted intervention group. The measures for primary outcome included the stroke knowledge, mean steps per day for more than seven days, and self-efficacy for reducing the risk of stroke. The measures for exploratory and secondary measures include health-seeking, health-related quality of life, and biological markers for health. The researchers collected the outcome data from participants in the wait-list control and intervention participants three months after complete baseline data collection (Chiu, Bergeron,Williams, Bray, Sutherland & Krauss, 2015). The outcomes were then compared between the two groups using randomized trials data analytic methods. The facilitators and the barrios to the successful implementation of worth the walk were also assessed. The researchers did not indicate the weakness of the available studies and also did not include a conceptual framework in their research.

Qualitative Study

Results of the study

The randomized controlled trial demonstrated considerable improvements in knowledge about stroke and body exercise in the intervention group as compared to the control group (Chiu, et al. 2015). Nurses should consider the intervention as the primary prevention strategy for stroke among seniors in various minority ethnic or racial groups in the United States.

The findings of the study suggest that nursing education should highly consider training the nurses about physical exercise and implement the worth a walk intervention to improve patient outcome.

Ethical considerations

Patient confidentiality was considered in the study. Information regarding individual participants in the study was well handled to avoid its leakage to unauthorized persons. Also, the study was approved by the Institutional Review Board.

Conclusion

The risk of stroke is highly increased with the reduction of physical exercise, especially among the seniors in the minority ethnic or racial groups in the United States. Nursing practice should emphasize increased physical activity among the minority groups, especially the seniors with hypertension, to reduce the risks of stroke. It is the responsibility of the nurses to create awareness on the benefits of body exercise in minimizing the stroke cases, which can, in turn, reduce the treatment costs and reduce the mortality rates.

Quantitative Study

Comparison of the Dash (Dietary Approaches to Stop Hypertension) diet and a higher-fat Dash diet on blood pressure and lipids and lipoproteins: a randomized controlled trial, by Chiu, S., Bergeron, N., Williams, P. T., Bray, G. A., Sutherland, B., & Krauss, R. M. (2015).

Background of the study

The Dietary Approaches to prevent and stop hypertension include incorporation of a dietary pattern that is high in vegetables, fruits, and low in fats, especially dairy foods. The Dash enhances low-density lipoprotein, lowering of high blood pressure and cholesterol, that is high-density lipoprotein.

Significance of the study

Hypertension is a condition that is a highly experienced condition, especially among the aging generations. The leading causes of hypertension are reduced physical exercise and poor dieting. Hypertension increases health costs and also leads to high mortality rates, especially among the senior groups in society.

Purpose of the study

The main objective of the study was to examine the effects of substitution of full-fat with low-fat dairy food products in the DASH diet with a corresponding increase in fat and a decrease in the intake of sugar on plasma lipids, lipoproteins and blood pressure.

Qualitative Study

Research question

Do the DASH and HF-DASH diet lower high-density lipoprotein cholesterol, low-density lipoprotein, and high blood pressure?

Research methods

The researchers used a sample size of three health persons to conduct a randomized crossover trial based on three periods. The individuals consumed a standard Dash diet, a control diet, a lower carbohydrate modification of Dah diet, and a high-fat diet for three weeks each which was separated by two weeks’ periods for washouts (Kwon, et al. 2015). The researchers then conducted laboratory measurements that included the concentration of lipoprotein particles determined by the mobility of ions, which was established at the end of each experimental diet (Kwon, et al. 2015). The researchers used both dependent and independent variables. The dependent variable was high blood pressure, and the DASH and HF-DASH diet were the independent variables that were presented after the tests (Kwon, et al. 2015). The variables were shown on a graph with the high blood pressure being on the y-axes and the DASH and HF -DASH diets being on the x-axes. Each of the researchers analyzed the data using the Statistical Packages for Social Sciences and compared their results to eliminate the chances of personal bias and ensure the accuracy of results.

Results of the study

The participants of the study finished the three dietary periods. The HF-DASH and DASH diets profoundly reduced blood pressure compared to the control diet. There was a reduction in the concentration of medium and large very-low-density lipoprotein particles and triglycerides (Kwon, et al. 2015). The HF-DASH diet also increased the peak particle diameter of LDL and decreased the HDL cholesterol, LDL cholesterol, apolipoprotein A-I, large LDL particles Intermediate density lipoprotein and the width of LDL peak compared with the control diet. The researchers did not mention any limitations of the study.

Qualitative Study

Ethical considerations

The Institution Review Board approved the study. Also, the confidentiality of the participants in the study was highly maintained.

Conclusion

The DAS diet significantly lowered blood pressure to the same extent as the HF- DASH diet and also reduced the concentration of VLDL and plasma triglyceride without increasing the cholesterol. The findings of the study can help improve nursing practice in managing hypertension. Nurses should create awareness among patients and the community at large about the DASH and HF-DASH diet to help reduce the mortality rates and the costs of treatments.

 

References

Chiu, S., Bergeron, N., Williams, P. T., Bray, G. A., Sutherland, B., & Krauss, R. M. (2015). Comparison of the DASH (Dietary Approaches to Stop Hypertension) diet and a higher-fat DASH diet on blood pressure and lipids and lipoproteins: A randomized controlled trial–3. The American journal of clinical nutrition103(2), 341-347. https://www.ncbi.nlm.nih.gov/pubmed/26718414

Kwon, I., Choi, S., Mittman, B., Bharmal, N., Liu, H., Vickrey, B., Song, S., Araiza, D., McCreath, H., Seeman, T., Oh, S. M., Trejo, L., … Sarkisian, C. (2015). Study protocol of “Worth the Walk”: A randomized controlled trial of a stroke risk reduction walking intervention among racial/ethnic minority older adults with hypertension in senior community centers. BMC Neurology15, 91. https://bmcneurol.biomedcentral.com/articles/10.1186/s12883-015-0346-9

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