Evidence based practice

 

CASE SCENARIO

As a nurse in a healthcare organization, it has become evident that patient outcome data have been consistently declining in some patient care settings. Some of the outcomes under inspection include patient Hospital Acquired Pressure Injury (HAPI), (4% increase in the last 6 months) .

You have been asked to investigate contributing factors to the declining outcomes and participate with a team approach to developing an evidence-based practice project. As you started this exploration, you came across this article Aiken Article titled “The effects of nurse staffing and nurse education on patent deaths in hospital with different nurse work environment” , which served as a starting point for the assignment you have been given. You may need to secure some current articles to support you as you develop the clinical question. For example, you may want to retrieve peer review articles on patient HAPI.

1. Access the link to the Aiken article above and read the article. This article will provide some background information that links nurse-patient ratios to patient outcomes. The article is provided to get you started on the development of an evidence-based project (EBP).

2. Refer to the Iowa Model  to serve as a guide in the development of the EBP project. Be sure to explain, in detail, how each step of the Iowa Model supports your project development.

3. Based on the information in the article, develop a PICO question to address the problem of a decline in patient outcomes.

4. Use the format below to develop the PICO:

5. Include additional articles as background information to provide information for the problem areas identified.

6. Discuss the influence of Scripture on the imperative for utilizing current evidence to deliver safe and quality patient care.

 

  PICO  FORMAT

Patient/Problem/Population: 

______________________________________________________________________________________________________________________________________________

Intervention: ________________________________________________________________________________________________________________________________________________

Comparison: (if applicable) ____________________________________________________________________________________________________________________________________________________

Outcome: ____________________________________________________________________________________________________________________________________________________

I. Based on the content above, write out your question in sentence format: ____________________________________________________________________________________________________________________________________

II. Based on your work above, make a list of possible search terms that may be used in the literature search:

___________________________ ________________________________

___________________________ ________________________________ 

__________________________ ________________________________

Health Assessment

  • Differentiate normal from abnormal findings.
  • Describe how the nurse can teach and counsel during a health assessment.

Reply to my peers

Begin reviewing and replying to peer postings/responses early in the week to enhance peer discussion. See the rubric for participation points. Participate in the discussion by asking a question, providing a statement of clarification, providing viewpoints with a rationale, challenging aspects of the discussion, or indicating relationships between two or more lines of reasoning in the discussion. Always use constructive language, even in criticism, to work toward the goal of positive progress.

Peer 1

Vulnerable populations are those whose health issues may be enhanced by social factors and experience greater risk factors, worse access to care, and increased morbidity and mortality compared to the general public (Joszt, 2018). This can include the chronically ill and disabled, low-income or homeless individuals, certain geographical communities, LGBTQ+ populations, and the very old and very young.

In my community I can tell you about our Georgia Pines Behavioral Center that is state funded to provide mental health services from counseling to referrals for crisis interventions. To be eligible for services you need a valid Georgia ID, proof of household income, and Medicaid or Medicare documentation, If you do not have Medicaid or Medicare they do offer payment assistance.

Two other facilities that are located in my community are the Georgia Farm Worker Health Clinic and Primary Care of Southwest Georgia. These two clinics are very similar in that they are both federally funded and base service fees off of a sliding scale from proof of income. Each clinic offers a variety of different services, but are essentially equal in primary care. The differences are Primary Care of Southwest Ga is considered an FQHC, which is a Federally Qualified Community Health Center and serves the entire community. The Farm Worker Health Clinic only serves people that work in agriculture and can show proof of income from agriculture work. Anyone who lives in the same household as them also qualify. Having facilities in my community are a blessing since there are so many counties and towns that do not have any access to health care near them.

Reference

 Joszt, L. (2018). 5 vulnerable populations in healthcare. American Journal of Managed Care. Retrieved from https://www.ajmc.com/views/5-vulnerable-populations-in-healthcare

Peer 2

The population that I chose to research resources were the homeless people in the my area. The three organizations I found were Western Tidewater Community Services Board, Social Services and For Kids. All three of these organizations are non-profit organizations that assist with the community. The CSB  helps the homeless population with medication, case management services, food vouchers, financial assistance vouchers, clothes. Social services also helps the homeless with money and food. They link them to other resources as well. For Kids assist with shelters (they have homes), money, food, clothes (Good Mojo Store), crisis line, job coaching, mental health coordination and case management. 

Each organization is funded similar and differently at times. The CSB is funded through donations and state issued grants. They also get reimbursements from Medicaid when they provided certain services. Social services is funded by local and state funds. Lastly, For Kids is funded my grants from both local and state pools. They also use donations due to them being a non-profit. 

I think that all three organizations are able to provide good services/ support to the homeless because each one of them might know other services that can assist. Also, if they work together can provide a better solution for the population. 

References

For Kids. (n.d.). Family Homelessness | ForKids | Norfolk, VA. ForKids. Retrieved October 13, 2020, from https://www.forkids.org/

Social Services | Suffolk, VA. (n.d.). Suffolk Social Services. Retrieved October 13, 2020, from http://www.suffolkva.us/760/Social-Services

Western Tidewater CSB. (2020, October 8). Western Tidewater Community Services Board: Forward, Together. Western Tidewater Community Services Board. https://www.wtcsb.org/

DNP-DPI Project- QUALITY IMPROVEMENT PROJECT

I need these questions answered in about 200 words each  

DNP PROJECT UNIT 5 DQ

This week’s discussion post asks you to consider what a DPI project is and how you are incorporating the Christian worldview into the project. As a Christian university, GCU integrates faith, learning, work, and service in an effort to honor God in all that it does, and encourages others to join in these endeavors. In what ways does your project reflect this?

DNP PROJECT UNIT 6 DQ

How are you incorporating technology at your site to enhance your project? What technology will you use to gather data and analyze the data?

DNP PROJECT UNIT 7 DQ

This week’s discussion post is on how to write your abstract. Go to the DC Network and in the DNP Program Documents you will see the abstract template to help learners. Write the abstract and share it with your peers. You will not have the data, but you can practice writing the abstract as it is expected to be written for AQR. (You do not get scored by AQR 1 on this process.) (Template is Attached)

  

As we work on this week’s work Please take some time to respond to the follow questions

1. Does your site have an IRB or Nursing QI/Research council you have to go through for approval of your project? Make sure to state which one if there is one as well as how much time you will need for them to review your project before you get approval. This is important because you will need to get through that before you can get through GCU IRB

2. Does your project use an instrument or tool? Have you gotten permission to use it if it is copyrighted? or needs permission to use? Has it been used in other similar project or other research on your topic

3. How will you collect your data on your outcome? will you need other people to do it for you? will it be done by your site? is it pulling aggregate  of electronic health record data ? Self report by your population?

4. How will you protect your data? Will you collect HPI? What will you do with the data once your project is over? A lot of you did not discuss this in your postings and it is an important part of ethical consideration.

CRITICAL THINKING

 Consider the question: “Why do physicians and nurses kill more people than airline pilots?” Apply your critical thinking skills to this argument and critique the statement. First, do you think it’s true? If it is, what do you think about their rationale? How would you address it if the question were posed to you in a forum?  PLEASE INCLUDED IN-TEXT CITATION AND REFERENCE

6 NURSING CARE PLAN

 nursing diagnosis

1. Decreased Cardiac Output  related to Altered myocardial contractility 

2. Risk for Impaired Skin Integrity related to immobility

3. Activity Intolerance related to immobility

 4. Risk for Infection related to Inadequate primary defenses: broken skin, traumatized tissues; environmental exposure

5.  Risk for Impaired Gas Exchange related to Alveolar/capillary membrane changes: interstitial, pulmonary edema, congestion

6.  Excess Fluid Volume related to  increased antidiuretic hormone (ADH) production, and sodium/water retention.