Tag: Clinical-Nursing

Mutual-aid agreements Essay – Program Evaluation and Policy analysis for Missouri Mutual aid agreement

44.090. Mutual-aid agreements

Background of Missouri Emergency Response efforts

The state of Missouri

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Program Overview

Missouri first mutual aid agreement in legislative was in 1990, this began as a statewide fire response mutual aid agreement. Instead of each individual department belonging to a certain town or jurisdiction they are all considered to be a part of Missouri Fire Mutual Aid System. The system includes all the resources that those fire departments have and their specialized teams such as wildland, hazmat, and rescue. The only separation they have is by split into regions where each is led by a fire-based regional coordinator, regions followed by State Trooper regions. Upon the tested fire service showing success and achievement with mutual aid assistance others followed suit. The agreement later amended to include law enforcement, emergency medical services, and public works. Mutual-aid agreements Essay – Program Evaluation and Policy analysis for Missouri Mutual aid agreement.

Inputs

Activities

Outcomes

 

https://dfs.dps.mo.gov/about/

NUR 699 GC Week 1 Discussion 1 – NUR 699 Evidence-Based Practice Project

What is the difference between research- and evidence-based practice projects? Provide an example of each one and the reason for the difference. Why should nurses be interested in learning about EBP?

NUR 699 GC Week 1 Discussion 2

How would a nurse practitioner and a nurse manager differ with regard to how they use and incorporate EBP in their areas of practice?

NUR 699 GC Week 2 Discussion 1

Review the “General Appraisal Overview for All Studies,” available in Appendix B in the textbook. You should save this tool and use it throughout the development of the PICOT question, problem description, and literature review. NUR 699 Evidence-Based Practice Project

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Begin the development of your PICOT question, using the following resources:

1. “Appendix A: Template for Asking Clinical Questions,” available in the textbook appendix

2. Text readings

Formulate your PICOT question and post it to the main forum. Respond to at least four other statements, providing feedback. Review the statements to see if the clinical issue is clearly defined and that all aspects are identified. Also refer to the “PICOT: Components of an Answerable, Searchable Question” table, located in chapter 2 of the text. If one PICOT statement has at least three feedback posts, move to another statement.

You will be using the feedback to make revisions to your PICOT question before using it in your “Section B: Problem Description” assignment. NUR 699 Evidence-Based Practice Project

NUR 699 GC Week 2 Discussion 2

What strategies will you use in your new practice as an advance practice nurse to review and critique literature pertinent to your practice?

NUR 699 GC Week 3 Discussion 1

What levels of evidence are present in relation to research and practice, and why it is important regardless of the method you use?

NUR 699 GC Week 3 Discussion 2

What factors must be assessed when critically appraising quantitative studies (e.g., validity, reliability, and applicability)? Which is the most important? Why?

NUR 699 GC Week 4 Discussion 1

What are some of the obstacles or barriers to implementing EBP in nursing? Provide a rationale for your answer. Since there are numerous topics on the issue, it is not appropriate to repeat one that has already been mentioned unless providing new information.

NUR 699 GC Week 4 Discussion 2

Conducting research projects while ensuring the protection of human subjects is necessary. What are some methods to protect personal rights of someone in one of the groups that is labeled as vulnerable? Justify your rationale.

NUR 699 GC Week 5 Discussion 1

Why is it important to incorporate a theory or model related to change when implementing practice changes? Does the benefit of incorporating a change model outweigh the time and effort it took to include it?

NUR 699 GC Week 5 Discussion 2

Identify barriers to the implementation of evidence-based practice. What are two ways to address this problem?

NUR 699 GC Week 6 Discussion 1

When reviewing the literature and different types of evidence, there are often gaps in the findings. Are such gaps a help or a hindrance when wanting to create a change?

NUR 699 GC Week 6 Discussion 2

What is the difference between statistically significant evidence and clinically significant evidence? How would each of these findings be used to advance an evidenced-based project?

NUR 699 GC Week 7 Discussion

Research and EBP projects can be communicated in many ways. Which method do you think is most effective to get to the staff nurse level? To the advance practice nurses? How will you ensure that all appropriate audiences receive your information?

NUR 699 GC Week 8 Discussion 1

Post your “Evidence-Based Practice Proposal Project Presentation.” Review all of the presentations but provide critical commentary only to five others posted. Address the strengths of the proposal as well as recommendations for improvement. If a post already has five feedback posts then move on to another one. You will be responsible for responding to each peer’s feedback that is posted to your original presentation post.

NUR 699 GC Week 8 Discussion 2

There is power in having data to support change. The EBP process is one way of advancing improvements in healthcare. Identify three strategies that you will now incorporate into your practice based on this course. Explain your rationale.

NUR 699 GC Week 2 Assignment 1

Evidence-Based Practice Proposal – Section A: Organizational Culture and Readiness Assessment

Details:

Before making a case for an evidence-based project, it is essential to understand the culture of the organization in order to begin assessing its readiness for EBP implementation.

1. Complete the “Organizational Culture and Readiness for System-Wide Integration of Evidence-Based Practice Survey,” located in the textbook appendix.

2. Develop an analysis of 250 words from the results, addressing your organization’s readiness level, possible project barriers and facilitators, as well as how to integrate clinical inquiry.

3. Make sure to include the rationale for the survey categories scores that were significantly high and low, incorporating details and/or examples. Also explain how to integrate clinical inquiry into the organization, providing strategies that strengthen the organizations weaker areas.

4. Submit a summary of your results. The actual survey results do not need to be included.

Prepare this assignment according to the APA 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 Turnitin. Please refer to the directions in the Student Success Center.

Upon receiving feedback from the instructor, revise “Section A: Organizational Culture and Readiness Assessment” for your final paper submission. This will be a continuous process throughout the course for each section.

NUR 699 GC Week 2 Assignment 2

Evidence-Based Practice Proposal – Section B: Problem Description

Details:

Write a paper of 500-750 words (not including the title page and reference page) on your proposed problem description for your EBP project. The paper should address the following:

1. Describe the background of the problem. Tell the story of the issue and why it deserves attention.

2. Identify the stakeholders/change agents. Who, or what organizations, are concerned, may benefit from, or are affected by this proposal. List the interested parties, patients, students, agencies, Joint Commission, etc.

3. Use the feedback from the Topic 2 main forum post and refine your PICOT question. Make sure that the question fits with your graduate degree specialization.

4. State the purpose and project objectives in specific, realistic, and measurable terms. The objective should address what is to be gained. This is a restatement of the question, providing focus. Measurements need to be taken before and after the evidence-based practice is introduced to identify the expected changes.

5. 5) Provide supportive rationale that the problem or issue is an important one for nursing to resolve using relevant professional literature sources.

6. Develop an initial reference list to assure that there is adequate literature to support your evidence-based practice project. Follow the “Steps to an Efficient Search to Answer a Clinical Question” box in chapter 3 of the textbook. Use “NUR-699 Search Method Example” to assist you.

7. 7) The majority of references should be research articles. However, national sources such as Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), Department of Health and Human Resources (HHS), or the Agency for Healthcare Research and Quality (AHRQ) and others may be used when you are gathering statistics to provide the rationale for the problem.

8. Once you get into the literature, you may find there is very little research to support your topic and you will have to start all over again. Remember, in order for this to be an evidence-based project, you must have enough evidence to introduce this as a practice change. If you find that you do not have enough supporting evidence to change a practice, then further research would need to be conducted.

Prepare this assignment according to the APA 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 Turnitin. Please refer to the directions in the Student Success Center.

Upon receiving feedback from the instructor, refine “Section B: Problem Description” for your final submission. This will be a continuous process throughout the course for each section.

NUR 699 GC Week 3 Assignment

Evidence-Based Practice Proposal – Section C: Literature Support

Details:

To begin, work through the reference list that was created in the “Section B: Problem Description” assignment in Topic 2. Appraise each resource using the “Rapid Critical Appraisal Checklists,” available in the textbook appendix. The specific checklist you use will be determined by the type of evidence within the resource.

Develop a research table to organize and summarize the research studies. Using a summary table allows you to be more concise in your narrative description. Only research studies used to support your intervention are summarized in this table. Refer to the “Evaluation Table Template,” available in the textbook appendix. Use the “Evaluation Table Template” as an adaptable template.

Write a narrative of 750-1,000 words (not including the title page and references) that presents the research support for the projects problem and proposed solution. Make sure to do the following:

1. Include a description of the search method (e.g., databases, keywords, criteria for inclusion and exclusion, and number of studies that fit your criteria).

2. Summarize all of the research studies used as evidence. The essential components of each study need to be described so that readers can evaluate its scientific merit, including study strengths and limitations.

3. Incorporate a description of the validity of the internal and external research.

It is essential to make sure that the research support for the proposed solution is sufficient, compelling, relevant, and from peer-reviewed professional journal articles.

Although you will not be submitting the checklist information or the evaluation table you design in Topic 3 with the narrative, the checklist information and evaluation table should be placed in the appendices for the final paper.

Prepare this assignment according to the APA 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 Turnitin. Please refer to the directions in the Student Success Center.

Upon receiving feedback from the instructor, refine “Section C: Literature Support” for your final submission. This will be a continuous process throughout the course for each section. NUR 699 Evidence-Based Practice Project

NUR 699 GC Week 4 Assignment

Evidence-Based Practice Proposal – Section D: Solution Description

Details:

Write a paper of 500-750 words (not including the title page and reference page) paper for your proposed evidence-based practice project solution. Address the following criteria:

1. Proposed Solution: (a) Describe the proposed solution (or intervention) for the problem and the way(s) in which it is consistent with current evidence. Heavily reference and provide substantial evidence for your solution or intervention. (b) Consider if the intervention may be unrealistic in your setting, too costly, or there is a lack of appropriate training available to deliver the intervention. If the intervention is unrealistic, you may need to go back and make changes to your PICOT before continuing. NUR 699 Evidence-Based Practice Project

2. Organization Culture: Explain the way(s) in which the proposed solution is consistent with the organization or community culture and resources.

3. Expected Outcomes: Explain the expected outcomes of the project. The outcomes should flow from the PICOT.

4. Method to Achieve Outcomes: Develop an outline of how the outcomes will be achieved. List any specific barriers that will need to be assessed and eliminated. Make sure to mention any assumptions or limitations which may need to be addressed.

5. Outcome Impact: Describe the impact the outcomes will have on one or all of the following indicators: quality care improvement, patient-centered quality care, efficiency of processes, environmental changes, and/or professional expertise.

Prepare this assignment according to the APA 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 Turnitin. Please refer to the directions in the Student Success Center. NUR 699 Evidence-Based Practice Project

Upon receiving feedback from the instructor, refine “Section D: Solution Description” for your final submission. This will be a continuous process throughout the course for each section.

NUR 699 GC Week 5 Assignment 1

Evidence-Based Practice Proposal – Section E: Change Model

Details:

In 500-750 words (not including the title page and reference page), apply a change model to the implementation plan. Include the following:

1. Roger’s diffusion of innovation theory is a particularly good theoretical framework to apply to an EBP project. However, students may also choose to use change models, such as Duck’s change curve model or the transtheoretical model of behavioral change. Other conceptual models presented such as a utilization model (Stetler’s model) and EBP models (the Iowa model and ARCC model) can also be used as a framework for applying your evidence-based intervention in clinical practice. NUR 699 Evidence-Based Practice Project

2. Apply one of the above models and carry your implementation through each of the stages, phases, or steps identified in the chosen model.

3. In addition, create a conceptual model of the project. Although you will not be submitting the conceptual model you design in Topic 5 with the narrative, the conceptual model should be placed in the appendices for the final paper.

Prepare this assignment according to the APA 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 Turnitin. Please refer to the directions in the Student Success Center.

Upon receiving feedback from the instructor, refine “Section E: Change Model” for your final submission. This will be a continuous process throughout the course for each section. NUR 699 Evidence-Based Practice Project

NUR 699 GC Week 5 Assignment 2

Evidence-Based Practice Proposal – Section F: Implementation Plan

Details:

In 500-750 words (not including the title page and reference page), provide a description of the methods to be used to implement the proposed solution. Include the following:

1. Describe the setting and access to potential subjects. If there is a need for a consent or approval form, then one must be created. Although you will not be submitting the consent or approval form(s) in Topic 5 with the narrative, the consent or approval form(s) should be placed in the appendices for the final paper.

2. Describe the amount of time needed to complete this project. Create a timeline. Make sure the timeline is general enough that it can be implemented at any date. Although you will not be submitting the timeline in Topic 5 with the narrative, the timeline should be placed in the appendices for the final paper. NUR 699 Evidence-Based Practice Project

3. Describe the resources (human, fiscal, and other) or changes needed in the implementation of the solution. Consider the clinical tools or process changes that would need to take place. Provide a resource list. Although you will not be submitting the resource list in Topic 5 with the narrative, the resource list should be placed in the appendices for the final paper.

4. Describe the methods and instruments, such as a questionnaire, scale, or test to be used for monitoring the implementation of the proposed solution. Develop the instruments. Although you will not be submitting the individual instruments in Topic 5 with the narrative, the instruments should be placed in the appendices for the final paper.

5. Explain the process for delivering the (intervention) solution and indicate if any training will be needed.

6. Provide an outline of the data collection plan. Describe how data management will be maintained and by whom. Furthermore, provide an explanation of how the data analysis and interpretation process will be conducted. Develop the data collection tools that will be needed. Although you will not be submitting the data collection tools in Topic 5 with the narrative, the data collection tools should be placed in the appendices for the final paper. NUR 699 Evidence-Based Practice Project

7. Describe the strategies to deal with the management of any barriers, facilitators, and challenges.

8. Establish the feasibility of the implementation plan. Address the costs for personnel, consumable supplies, equipment (if not provided by the institute), computer related costs (librarian consultation, database access, etc.), and other costs (travel, presentation development). Make sure to provide a brief rationale for each. Develop a budget plan. Although you will not be submitting the budget plan in Topic 5 with the narrative, the budget plan should be placed in the appendices for the final paper.

9. Describe the plans to maintain, extend, revise, and discontinue a proposed solution after implementation.

Prepare this assignment according to the APA 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 Turnitin. Please refer to the directions in the Student Success Center.

NUR 699 GC Week 6 Assignment NUR 699 Evidence-Based Practice Project

Evidence-Based Practice Proposal: Section G: Evaluation of Process

Details:

In 500-750 words (not including the title page and reference page), develop an evaluation plan to be included in your final evidence-based practice project. Provide the following criteria in the evaluation, making sure it is comprehensive and concise:

1. Describe the rationale for the methods used in collecting the outcome data.

2. Describe the ways in which the outcome measures evaluate the extent to which the project objectives are achieved.

3. Describe how the outcomes will be measured and evaluated based on the evidence. Address validity, reliability, and applicability.

4. Describe strategies to take if outcomes do not provide positive results.

5. Describe implications for practice and future research.

Prepare this assignment according to the APA 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. NUR 699 Evidence-Based Practice Project

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.

Upon receiving feedback from the instructor, refine “Section G: Evaluation” for your final submission. This will be a continuous process throughout the course for each section.

NUR 699 GC Week 7 Assignment 1

Benchmark – Evidence-Based Practice Proposal Final Paper

Details:

Throughout this course you will be developing a formal, evidence-based practice proposal.

The proposal is the plan for an evidence-based practice project designed to address a problem, issue, or concern in the professional work setting. Although several types of evidence can be used to support a proposed solution, a sufficient and compelling base of support from valid research studies is required as the major component of that evidence. Proposals are submitted in a format suitable for obtaining formal approval in the work setting. Proposals will vary in length depending upon the problem or issue addressed; they can be between 3,500 and 5,000 words. The cover sheet, abstract, references page, and appendices are not included in the word limit.

Section headings and letters for each section component are required. Responses are addressed in narrative form in relation to that number. Evaluation of the proposal in all sections is based upon the extent to which the depth of content reflects graduate-level critical-thinking skills. NUR 699 Evidence-Based Practice Project

This project contains seven formal sections:

1. Section A: Organizational Culture and Readiness Assessment

2. Section B: Problem Description

3. Section C: Literature Support

4. Section D:
Solution Description

5. Section E: Change Model

6. Section F: Implementation Plan

7. Section G: Evaluation of Process

Each section (A-G) will be submitted as separate assignments so your instructor can provide feedback (refer to applicable modules for further descriptions of each section).

The final paper will consist of the completed project (with revisions to all sections), title page, abstract, reference list, and appendices. Appendices will include a conceptual model for the project, handouts, data and evaluation collection tools, a budget, a timeline, resource lists, and approval forms.

Use the “NUR-699 EBP Implementation Plan Guide” and “NUR-699 Evidence-Based Practice Project Student Example” to assist you. Also refer to “NUR-699 Evidence-Based Practice Project Proposal Format.”

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is 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 Turnitin. Please refer to the directions in the Student Success Center.

NUR 699 GC Week 7 Assignment 2

Evidence-Based Practice Presentation

Details:

Develop a presentation no longer than 10-12 minutes with comprehensive speaker’s notes that covers all of the major areas of your proposal.

You will need to post your Evidence-Based Practice Presentation to the main forum in Topic 8 as directed by the instructor for class discussion and peer feedback.

While APA format is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center. NUR 699 Evidence-Based Practice Project

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 not required to submit this assignment to Turnitin. NUR 699 Evidence-Based Practice Project

You have learned that the grieving process can be a healthy experience for people who have experienced a life-changing event in their lives. Explain why you think nurses need to establish a trusting relationship with the grieving person before moving on to aid them in their grieving process. You may use other resources than your book for information. It may help to think of a loved one or friend you know that has experienced a life-changing event and how that person may have reacted to a nurse, clergy, or other third party wanting to help them through the grieving process. Discussion – Is Grieving Healthy?

For this Population Health and Healthy People 2020 Analysis Essay assignment, you will select a Healthy People 2020 goal and consider the role of public health nurses in achieving this goal. Select a goal and a specific population that is impacted by this goal and the health issue it targets. In a 1,250-1,500 word paper, provide an analysis of the population and discuss how the goal and related health issue affects them. Include the following:

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Describe the issue and the population that it affects. Why is this a vulnerable population? Include demographics of the population and why this issue is prevalent in this population.

Analyze the vitality and social determinants of health for the population. Consider indicators of social and economic conditions, health resources, environmental conditions related to health, social functioning, and attitude toward health care.

Discuss a proposed intervention and discuss how its benefits the target population. Consider any drawbacks or shortcomings of the intervention as well. Include in your discussion evidence that the intervention is in line with the core functions and ten essential public health services. Population Health and Healthy People 2020 Analysis Essay.

Cite at least five resources in your response.

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 Population Health and Healthy People 2020 Analysis Essay assignment to LopesWrite. Please refer to the directions in the Student Success Center.

Discussion: Clinical Supervision Essay

Personal reflection and discussion with colleagues is essential to your development as a psychiatric mental health nurse practitioner. In Week 8, you collaborated with colleagues as you participated in your first Clinical Supervision. This week, you have the opportunity to continue your collaboration as you reflect on and discuss your experiences with counseling older adults. Keep in mind that although there may be challenges to counseling this population, these clients offer unique learning opportunities. For this Clinical Supervision, consider an older client you are counseling whom you do not think is adequately progressing according to expected clinical outcomes.Students will:

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Assess clients presenting for psychotherapy

Evaluate effectiveness of therapeutic approaches for clients

receiving psychotherapy

Review this week’s media and consider the insights provided.

Reflect on the clients you are currently counseling at your practicum site.

Describe an older client you are counseling whom you do not think is adequately progressing according to expected clinical outcomes.

Explain your therapeutic approach with the client, including the perceived effectiveness of your approach.

Identify any additional information about this client that may potentially impact expected outcomes Discussion: Clinical Supervision Essay.

NUR 699 EBP Section C: Literature Support Example Essay

NUR 699 GC Week 3 Section C Literature Support

Evidence-Based Practice Proposal – Section C: Literature Support

Details:

To begin, work through the reference list that was created in the “Section B: Problem Description” assignment in Topic 2. Appraise each resource using the “Rapid Critical Appraisal Checklists,” available in the textbook appendix. The specific checklist you use will be determined by the type of evidence within the resource.

ORDER A CUSTOM-WRITTEN, PLAGIARISM-FREE PAPER NOW

Develop a research table to organize and summarize the research studies. Using a summary table allows you to be more concise in your narrative description. Only research studies used to support your intervention are summarized in this table. Refer to the “Evaluation Table Template,” available in the textbook appendix. Use the “Evaluation Table Template” as an adaptable template. NUR 699 EBP Section C: Literature Support Example Essay.

Write a narrative of 750-1,000 words (not including the title page and references) that presents the research support for the projects problem and proposed solution. Make sure to do the following:

Include a description of the search method (e.g., databases, keywords, criteria for inclusion and exclusion, and number of studies that fit your criteria).

Summarize all of the research studies used as evidence. The essential components of each study need to be described so that readers can evaluate its scientific merit, including study strengths and limitations.

Incorporate a description of the validity of the internal and external research.

It is essential to make sure that the research support for the proposed solution is sufficient, compelling, relevant, and from peer-reviewed professional journal articles.

Although you will not be submitting the checklist information or the evaluation table you design in Topic 3 with the narrative, the checklist information and evaluation table should be placed in the appendices for the final paper. NUR 699 EBP Section C: Literature Support Example Essay.

Prepare this assignment according to the APA 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 Turnitin. Please refer to the directions in the Student Success Center.

Upon receiving feedback from the instructor, refine “Section C: Literature Support” for your final submission. This will be a continuous process throughout the course for each section. NUR 699 EBP Section C: Literature Support Example Essay.

 

Evidence-Based Practice Proposal, Section C: Literature Support

Literature Support – Narrative

Prevention of inpatient falls remains a priority for medical centers across the country. While one should want to have zero falls, it is not a reality. The most commonly reported adverse event in hospitals are patient falls. In the United States, there are hundreds of thousands of patient falls in the hospitals. Of those falls, approximately 30-50% of these events result in injuries (Mitchell, 2015). Eliminating falls is ideal but even with all of the tools and equipment provided, it seems like the work of preventing falls is in vain. Rather than focusing on patients that are at risk of falling, nurses and healthcare workers need to focus on patients that are at risk of injury if they fall. This distinction protects the patients from injury, which is, after all, what every healthcare worker would like to avoid. One tool that has helped in identifying the at risk patients is the Hester-Davis Fall Risk Assessment Scale.

University of Arkansas for Medical Sciences Journal

In the article, ‘Falls and Frailty: Finding Who’s at Risk and Keeping Them Safe (2014),’ Katrina Dupins speaks with Amy Hester, R.N., clinical services manager and Dee Davis, R.N., advanced practice partner about their risk assessment tool, the Hester-Davis Scale. Hester and Davis, who work at UAMS, began looking into falls and falls with injuries in 2010. Together, they developed a tool to assess falls and the risk of falls for patients. The tool that they came up with, not only addresses the patient’s risk of falling, but also includes interventions and care plans as a comprehensive way to prevent falls. NUR 699 EBP Section C: Literature Support Example Essay. The Hester-Davis Scale decreased the falls rates at UAMS by 11 percent, decreased falls with injuries by 60 percent and continue to have decreases in both areas (Dupins, 2014). Not only were they able to save the hospital $1.27 million in costs related to falls, they were also able to save them $330,000 in sitter costs (Dupins, 2014) NUR 699 EBP Section C: Literature Support Example Essay. Through their collaboration, they have created HD Nursing, a business that Amy Hester and Dee Davis began through UAMS BioVentures.

University of Mississippi Medical Center

Cummins wrote, ‘Patient Falls: First Predict, Then Prevent,’ in 2015, which supports use of the Hester-Davis Scale in University of Mississippi Medical Center (UMMC). There are over 900 nurses at UMMC that are dedicated to preventing falls. In March, 2015, they began using the Hester-Davis Falls Risk Assessment Scale (HDS). Based on the nurses’ documentation, the HDS creates an individualized care plan for each patient. This care plan predicts the patient’s risk of falling. Furthermore, the plan includes interventions, like signage, bed or chair alarms, falls mats, etc., that are meant to be tailored to the patient’s needs based on their risk level. After the Centers for Medicare and Medicaid Services rated UMCC a 10 (the worst score) on serious patient complications (based on data that was two years old), UMMC decided to aggressively and proactively work at lowering the falls incidence using the HDS. Prior to implementing the HDS, UMMC was averaging 30 to 40 falls a month (Cummins, 2015), but since use of the HDS, they have had zero falls with injury in four months. UMMC chose the HD Scale because it is proven by research and evidence-based.

Amy Hester and Dee Davis

Amy Hester and Dee Davis wrote about their Hester-Davis Falls Risk Scale in, ‘Validation of the Hester Davis Scale (HDS) for Falls Risk Assessment in a Neurosciences Population (2013).’ Being that the fall risk assessment is an essential component in any falls prevention program, Hester and Davis decided to trial their HDS in a neurosciences population. The goal was to validate the HDS in an acute care setting for falls risk assessment. Using 1,904 patients on a neurosciences unit, the HDS was prospectively validated. The results reflected that, “Using an initial cute score of seven produced a sensitivity of 100% and specificity of 24.9%. Receiver Operating Characteristics Analysis evidenced a cut score of ten that would produce a more desirable sensitivity and specificity of 90.9% and 47.1%, respectively,” (Hester & Davis, 2013). The evaluation and validation of the HDS supported use in clinical practice.

Inpatient Falls Prevention Programs as a Patient Safety Strategy: A Systematic review

           
Miake-Lye, Hempel, Ganz, and Shekelle, (2013) wrote the article, ‘Inpatient fall prevention programs as a patient safety strategy: A systematic review,’ for Annals of Internal Medicine. This article was written to address the problem of falls in acute care hospitals, which reported a rate of 1.3 to 8.9 per 1000 bed days (Miake-Lye, et al., 2013). Based on their research, they found that using multicomponent interventions can reduce the risk of falls by approximately 30 percent (Miake-Lye, et al., 2013). While this study did not establish a falls bundle, it recommended risk assessments for the patients, staff and patient education, signage and wristband alerts, non-skid footwear, etc. They also found that there are other important factors that affect the success with implementation. These factors include, “leadership support, engagement of the front-line clinical staff in the design of the intervention, guidance by a multidisciplinary committee, pilot-testing the intervention, and changing nihilistic attitudes about falls,” (Miake-Lye, et al., 2013) NUR 699 EBP Section C: Literature Support Example Essay.

Searching is time consuming but it is the only way to complete the project. Terms used during the search process were Hester Davis, Falls Risk Scale, Falls Prevention, and fall interventions. Databases searched were CINAHL and GCU’s library.

In conclusion, there are several reasons that one would want to use another risk assessment tool to identify patients at risk for injury/fall. Nurses and other healthcare providers are tasked with patient safety while patients are hospitalized. However there are other factors that can affect the patient’s risk for falls and injury (i.e., medication, immobility, etc.). Through the implementation of a new falls risk assessment scale and following the care plans, nurses are able to protect their patients from falls and injuries from falls. Safety of the patients is priority. NUR 699 EBP Section C: Literature Support Example Essay.

References

Agency for Healthcare Research and Quality (AHRQ). (2015). New tools help health providers reduce patients’ risk of falls. Retrieved from http://www.ahrq.gov/patients-consumers/patient-involvement/patients-risk-of-falls.html

Agency for Healthcare Research and Quality (AHRQ). (2014). Never events.
Patient Safety Network.
Retrieved from https://psnet.ahrq.gov/primers/primer/3/never-events

Centers for Disease Control (CDC). (2016). Important facts about falls. Retrieved from http://www.cdc.gov/HomeandRecreationalSafety/Falls/adultfalls.html NUR 699 EBP Section C: Literature Support Example Essay

Cummins, R. (2015). Patient falls: First predict, then prevent.
University of Mississippi Medical Center
. Retrieved from https://www.umc.edu/News_and_Publications/Press_Release/2015-02-23-00_Patient_falls__First_predict,_then_prevent.aspx

Dupins, K. (2014). Falls and frailty: Finding who is at risk and keeping them safe.
UAMS Journal
. Retrieved from http://journal.uams.edu/article/falls-and-frailty-finding-whos-at-risk-and-keeping-them-safe/

Hester, A.L. & Davis, D.M. (2013). Validation of the Hester Davis Scale for fall risk assessment in a neurosciences population.
Journal of Neuroscience Nursing. 45
(5), pp. 298-305. doi: 10.1097/JNN.0b013e31829d8b44. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/24025469

jointcommission.org. (2015). Sentinel event: Preventing falls and fall-related injuries in health care facilities. Retrieved from http://www.jointcommission.org/assets/1/18/SEA_55.pdf

Miake-Lye, I.M., Hempel, S., Ganz, D.A., Shekelle, P.G. (2013). Inpatient fall prevention programs as a patient safety strategy: A systematic review.
Annals Intern Medicine,
158(5), pp. 390-396. doi:10.7326/0003-4819-158-5-201303051-00005. Retrieved from http://annals.org/article.aspx?articleID=1656443&utm_medium=referral&utm_source=pulsenews#Discussion

Mitchell, K. (2015). Is zero falls the right target? Retrieved from http://www.ihi.org/communities/blogs/_layouts/ihi/community/blog/itemview.aspx?List=7d1126ec-8f63-4a3b-9926-c44ea3036813&ID=177 NUR 699 EBP Section C: Literature Support Example Essay

NUR 699 EBP Section B: Problem Description

Evidence-Based Practice Proposal—Section B Problem Description

A nurse on a medical-surgical floor in a northeast hospital examined a study regarding the reason for falls within the hospital environment. Reviewing a computerized data retrieval system that recorded falls relating to call light usage in a 15-month study, she found a fall rate of approximately as high as 3.37 patients per every 1000 patients per day (Olrich, Kalman, & Nigolian, 2012). The main reasons given for using the call light were for patient care needs, such as, toileting, the need for pain control, and repositioning (Olrich, Kalman, & Nigolian, 2012). When call lights go off and they are not answered in a timely manner, the patient will often become inpatient and instead of waiting for help, they will get up on their own, which puts them at a high risk for injury or a fall (Mitchell, M. D., Lavenberg, J. G., Trotta, R., & Umscheid, C. A. 2014). NUR 699 EBP Section B: Problem Description.

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Fall prevention intervention, include an act of everyone getting involved, from the patient, family, nurses, other staff members and leadership that practice a safe fall prevention plan, which includes education and changes in attitudes that understand the importance to follow a fall prevention program that has been put in place (Goldsack, Bergey, Mascioli, & Cunningham, 2015). After incorporating hourly rounding into a fall prevention plan, it was determined that hourly rounding on patients did reduced falls significantly in the hospital setting (Goldsack et al., 2015) NUR 699 EBP Section B: Problem Description.

Along with the general public, a variety of stakeholders that include administrators, physicians, nurses, accrediting agencies, professional associations, student nurses, and legislative groups are concerned about patient safety and are responsible to make sure that care is delivered safely to the patient. These stakeholders are responsible for taking certain actions and making specific decisions that encourages safe care (ECRI Institute, 2014). A qualitative study was conducted that focused on the patient experiences during hospitalization, AIDET (Acknowledge, Introduce, Duration, Explanation, and Thank you), and hourly rounding. After the data was collected, transcribed and coded; the outcome findings presented a common theme that all residents who participated in this study felt that their emotional needs were met NUR 699 EBP Section B: Problem Description

 

PICO Question

On a medical-surgical hospital unit, how does implementing hourly nursing rounding, compared to no scheduled rounding, affect patient safety, within 6 months of implementing?

The Purpose and Objective of the Project

To educate nurses and other staff members that participating in a hourly rounding routine will decrease hospital falls in the hospital setting and will create a safer environment for the patient. This EBP has been proven to improve a safer outcome for patients and it also has increased patient satisfaction by decreasing anxiety from not having to have to use the call light as frequent and knowing that there would be someone there to check on them frequently during their stay in the hospital NUR 699 EBP Section B: Problem Description.

The project literature research will be measured through using the interactive online DISCERN, which allows the researcher to follow a brief questionnaire for assessing the quality of literature and other published articles online regarding EBP research. This online tool consists of 15 questions that includes a rating system for quality information on literature research (The DISCERN Instrument, 1997).

Reference

Allen, T., Rieck, T., &  Salsbury, S., (2016). Patient Perceptions of an AIDET and Hourly Rounding Program in a Community Hospital: Results of a qualitative study.
Patient Experience Journal
. (3)1.  Retrieved from http://pxjournal.org/cgi/viewcontent.cgi?article=1115&context=journal

​ECRI Institute (2014). Patient safety, risk, and quality.
Healthcare Risk Control
. Retrieved from
https://www.ecri.org/components/HRC/Pages/RiskQual4.aspx

Goldsack,J., Bergey, M., Mascioli, S., & Cunningham,J., (2015). Hourly rounding and patient falls: What factors boost success
? Nursing Journal

2017
, 45(2), 25-30. Retrieved from NUR 699 EBP Section B: Problem Description
http://journals.lww.com/nursing/Fulltext/2015/02000/Hourly_rounding_and_patient_falls__What_factors.10.aspx

Mitchell, M. D., Lavenberg, J. G., Trotta, R., & Umscheid, C. A. (2014). Hourly Rounding to Improve Nursing Responsiveness: A systematic review.
The Journal of Nursing Administration
,
44
(9), 462–472.
http://doi.org/10.1097/NNA.0000000000000101

Olrich,T., Kalman, M., & Nigolian, C. (2012). Hourly Rounding: A replication study. MedSurg Nursing, 21(1), 23. Retrieved from
http://search.proquest.com/openview/78664e73c9de01b6ca2b1580c98ca4b6/1?pq-origsite=gscholar&cbl=30764

The DISCERN Instrument (1997). DISCERN Online: quality criteria for consumer health information. British Library and the University of Oxford. Retrieved from
http://www.discern.org.uk/discern_instrument.php#feedback
 NUR 699 EBP Section B: Problem Description

 

 

Evidence-Based Practice Proposal—Section B Problem Description

Today, maternal depression can be as common as one in every seven women during their third or fourth trimester’s. Postpartum depression (PPD) is a mental health condition that can start before delivery or right afterwards. If postpartum symptoms are not recognized, it can become very serious if it goes undiagnosed. It is important to educate the mother, significant other, and family members to recognized the symptoms of PPD so that symptoms may be detected early and seek help right away because PPD can have a very negative impact on mother, family and the baby. . (Fitelson, Baker, & Leight,, 2011).

It is important to help the mother differentiate the different types of postpartum depression through proper education. Many mothers may experience the baby blues, which is very common amongst most women and have been known to affect up to 75% of new mothers. The baby blues usually will have an onset within ten days following the delivery of their baby and will only last for approximately two weeks. Symptoms are mild and will consist of mild emotional disturbance such as feeling fatigue, anxiety and tearfulness. Next is postpartum depression, which is often, inaccurately diagnosed for the baby blues at first because the symptoms are very similar to the baby blues but with more intensity and the symptoms can last up to six months and may interfere with mother’s ability to care for herself, her baby and many other task throughout the day. Next we have postpartum psychosis which is a extreme mental health condition that needs intervention immediately. Symptoms found with postpartum psychosis are severe mood swings, mothers can experience delusions and hallucinations, anxiety, mood changes and suicidal ideation to hurt themselves or homicidal ideation towards their baby and other children. (Fitelson, Baker, & Leight, 2011).

According to Zauderer, there has been several studies showing that bringing awareness about  postpartum depression through education and parenting classes has helped unprepared expecting moms and new mothers learn about unusual emotions that they may feel, what to watch for regarding postpartum depression and resources that they can seek if needed. By educating new moms and family, the hope is to give them the knowledge they need to empower them to speak up for help when they recognize possible symptoms of postpartum depression to seek the help that is needed (2009). NUR 699 EBP Section B: Problem Description

 

Along with the general public, a variety of stakeholders that include administrators, physicians, nurses, accrediting agencies, professional associations, student nurses, specialized Obstetricians, Pediatricians, APNs,  Mental Health and Social Service. Legislative groups are concerned about patient safety and are responsible to make sure that care is delivered safely to the patient. These stakeholders are responsible for taking certain actions and making specific decisions that encourages safe care (ECRI Institute, 2014). Much of the research and studies presented in the articles were empirical studies, systematic reviews and meta-analyses that were published between the years of 2009-2016.

PICO Question

Does postpartum education (I) during the third and fourth trimester (T) reduce the risk of postpartum depression (O) in mothers (P) compared to those who receive no form of education on postpartum depression (C). NUR 699 EBP Section B: Problem Description

The Purpose and Objective of the Project

To research data and provide data that there is evidence-base practice showing that there is a benefit to providing new moms and families education on postpartum depression compared to new mothers who do not receive any form of education on postpartum depression. Will education help decrease the risk of postpartum depression because the mother and family have been taught to recognize the symptoms in advance so that they may seek help as needed.

The project literature research will be measured through using the interactive online DISCERN, which allows the researcher to follow a brief questionnaire for assessing the quality of literature and other published articles online regarding EBP research. This online tool consists of 15 questions that includes a rating system for quality information on literature research (The DISCERN Instrument, 1997). NUR 699 EBP Section B: Problem Description

 
Reference

Ertel, K. A., Rich-Edwards, J. W., & Koenen, K. C. (2011). Maternal Depression in the United States: Nationally Representative Rates and Risks.
Journal of Women’s Health
,
20
(11), 1609–1617.
http://doi.org/10.1089/jwh.2010.2657

Field T (2017) Postpartum Depression Effects, Risk Factors and Interventions: A Review

3: 122. doi:10.4172/2572-0791.1000122

Fitelson, E., Kim, S., Baker, A. S., & Leight, K. (2011). Treatment of postpartum depression: clinical, psychological and pharmacological options.
International Journal of Women’s Health
,
3
, 1–14.
http://doi.org/10.2147/IJWH.S6938

Kettunen P, Koistinen E, Hintikka J (2014). Is postpartum depression a homogenous disorder: time of onset, severity, symptoms and hopelessness in relation to the course of depression
Is postpartum depression a homogenous disorder: Time of onset, severity, symptoms and hopelessness in relation to the course of depression. BMC Pregnancy Childbirth 14:1-18.

Warfa N, Harper M, Nicolais G, Bhui, K (2014). Adult attachment style as a risk factor for maternal postnatal depression: a systematic review. Retrieved from
 Adult attachment style as a risk factor for maternal postnatal depression: A systematic review. BMC Psychol 2: 56.
Zauderer, C. (2009). Postpartum Depression: How Childbirth Educators Can Help Break the Silence.
The Journal of Perinatal Education
,
18
(2), 23–31. http://doi.org/10.1624/105812409X426305 NUR 699 EBP Section B: Problem Description

Assignment 2: Practicum – Assessing Client Progress

Learning Objectives

Students will:

Assess progress for clients receiving psychotherapy

Differentiate progress notes from privileged notes

Analyze preceptor’s use of privileged notes

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To prepare:

Reflect on the client you selected for the Week 3 Practicum Assignment.

Review the Cameron and Turtle-Song (2002) article in this week’s Learning Resources for guidance on writing case notes using the SOAP format.

The Assignment 2: Practicum – Assessing Client Progress Assignment

Part 1: Progress Note

Using the client from your Week 3 Assignment, address the following in a progress note (without violating HIPAA regulations):

Treatment modality used and efficacy of approach

Progress and/or lack of progress toward the mutually agreed-upon client goals (reference the Treatment plan—progress toward goals)

Modification(s) of the treatment plan that were made based on progress/lack of progress

Clinical impressions regarding diagnosis and/or symptoms Assignment 2: Practicum – Assessing Client Progress

Relevant psychosocial information or changes from original assessment (i.e., marriage, separation/divorce, new relationships, move to a new house/apartment, change of job, etc.)

Safety issues

Clinical emergencies/actions taken

Medications used by the patient (even if the nurse psychotherapist was not the one prescribing them)

Treatment compliance/lack of compliance

Clinical consultations

Collaboration with other professionals (i.e., phone consultations with physicians, psychiatrists, marriage/family therapists, etc.)

Therapist’s recommendations, including whether the client agreed to the recommendations

Referrals made/reasons for making referrals

Termination/issues that are relevant to the termination process (i.e., client informed of loss of insurance or refusal of insurance company to pay for continued sessions)

Issues related to consent and/or informed consent for treatment

Information concerning child abuse, and/or elder or dependent adult abuse, including documentation as to where the abuse was reported

Information reflecting the therapist’s exercise of clinical judgment

Note: Be sure to exclude any information that should not be found in a discoverable progress note.

Part 2: Privileged Note

Based on this week’s readings, prepare a privileged psychotherapy note that you would use to document your impressions of therapeutic progress/therapy sessions for your client from the Week 3 Practicum Assignment. Assignment 2: Practicum – Assessing Client Progress

The privileged note should include items that you would not typically include in a note as part of the clinical record.

Explain why the items you included in the privileged note would not be included in the client’s progress note.

Explain whether your preceptor uses privileged notes, and if so, describe the type of information he or she might include. If not, explain why.

 

Question

Differentiate progress notes from privileged notes

Privileged records is a set of information which involves only two parties, the client and the therapist and this information remains confidential, and even the law does not permit forceful disclosure of the content. On the other hand, a progress note is a medical record where a medical practitioner or psychiatrist records details of a patient, the clinical status and the progress they have made during Assignment 2: Practicum – Assessing Client Progress therapy.

Question

Reflect on the client you selected for the Practicum Assignment.

Review the Cameron and Turtle-Song (2002) article on this week’s Learning Resources for guidance on writing case notes using the SOAP format.

 

Progress Note

 

Name of Patient:

Date:

Subjective

Amabella suffers from mental distress as a result of being in an abusive marriage for almost fifteen years. Due to the constant abuse, she has developed mild depression as well as anger issues. Her health has deteriorated which has led to weight loss caused by malnutrition.

I have gone through her past medical history in an attempt to investigate any medications she has been under in the past. I have also enquired about any family or social history that would have led to her condition. (Dick, S, 1999, 41) Assignment 2: Practicum – Assessing Client Progress

Objective

Her physical exam findings show that her body is bruised and full of stubborn scars which are a result of being forcefully grabbed or hit with blunt objects. Her neck also reveals that she has been chocked severally. Also, there is a fresh wound cut on her face.

Assessment

The therapeutic sessions have been productive. Amabella is collaborative and is improving. She is open when talking about why she thinks her husband is an animal and whether he can change or not. She does not get as angry and aggressive as she used to when our treatment sessions began. She is now calm, lively and happier. Her health is also improving.

Plan

I have found it very useful to involve a marriage counselor during the therapy to assist because marital issues are beyond my level. I recommended it to her, and she agreed. Afterwards, I have helped Amabella get a competent divorce lawyer who has legally advised her about the whole divorce process as well as her rights upon leaving the toxic marriage. She agrees to this for it is good for the safety of the children and her too. The divorce papers will be ready soon, and she will be moving to her new apartment in a few days. Assignment 2: Practicum – Assessing Client Progress

 

Privileged Note

Question

Based on this week’s readings, prepare a privileged psychotherapy note that you would use to document your impressions of therapeutic progress/therapy sessions for your

Answer

My client was troubled at the beginning of our sessions. She disclosed that apart from physical torture from the husband, she was also sexually abused. In fact, the children know what their dad was doing to their mother. She was almost reaching her breaking point, but after completing her therapy, her attitude has changed. Her being able to open up helped a lot. Assignment 2: Practicum – Assessing Client Progress

The above-privileged note includes vital information about abuse in Amabella’s marriage. Sensitive issues like rape are covered, which should be regarded as highly confidential information which should not be disclosed to any other party. (Steen, B, 1999,37)

My preceptor uses privileged notes because I prefer to discuss my issues with him alone because I like my right to privacy to be respected. If other people know my problems, it would increase my mental illness.

 

Reference

Dick, R, Steen, E (Editors): 1991. The Computer Based Patient Record; Washington DC, National Academy Press.

 

Practicum – Assessing Client Family Progress

Part 1: Progress Note

Subjective

The client admits that both psycho-educational and interpersonal therapies have been efficient considering his ability to manage his anger and depressive episodes. He reports that the family therapy has enabled him to change the perception of his diagnosis and drug regimen despite his inability to resume work. Assignment 2: Practicum – Assessing Client Progress. However, the client is concerned about the performance of his son who he thinks has been affected by his reckless behavior in the past. At 14 years and attending school, he believes that the boy may not benefit from the therapy. He also feels the same for his wife who is always busy at school or performing house chores in the evening. All members of his family are supposed to attend all therapy sessions for optimal outcomes. Consequently, he feels that he is presently not benefiting from the family therapy sessions since he can only benefit from supportive therapy considering the extent of his illness.

Objective

Mr. J.K maintained calmness throughout the sessions. He made sound remarks to approve the strategies aimed at improving his condition. Despite the few challenges during the meeting, the client demonstrated satisfaction and a willingness to continue with the therapy at the end. He claimed that he was prepared enough to overcome attempts to withdraw from the interventions. Of the three members of the family, he was the only one that attended all the sessions. His wife missed three, while the son missed five. Assignment 2: Practicum – Assessing Client Progress.

Assessment

In as much as the client presented a few episodes of weariness and sadness during the family therapy, the review of the system, physical evaluation, and the mental status exam did not reveal any abnormalities. The same can be said of the other members of his family who had been dressed appropriately for the day and session. They were all oriented to time, place and person. The patient presents to the session with alcohol use disorder and admits he uses tobacco and marijuana. He resorted to abusing alcohol after being diagnosed with stage two lung cancer. At the time the diagnosis was made, Mr. J.K felt that only alcohol consumption would enable him to overcome the grief and anxiety of having to live with the deadly disease. The support from his family has been insignificant, primarily due to the busy schedule of his wife as well as by the fact that she has suffered depression in recent months. She attributes the depression to her husband’s illness, alcohol consumption the burden of having to support the family single-handedly.

Plan

There is a need for the therapist to consider making changes to his schedule to ensure that all members of this family benefit from the sessions. Becvar & Becvar, (2017), share the same assertions in their article. The client’s wife who has reportedly suffered from depression will require to attend all the family therapy sessions so that she may find better ways of supporting her son and husband who has been reduced to supportive and palliative care by his illness. Assignment 2: Practicum – Assessing Client Progress. The therapy sessions also need to take into consideration the school timetable to enable the 14-year old boy to attend them. He has been affected adversely by the current illnesses that both his parents are suffering from in the last few years. The therapist should prescribe antipsychotics for the client’s wife to make sure that she can put her moods under control. However, there is a need for the family to make sure that they progress with the interpersonal and psychoeducation therapy for at least three weeks for better outcomes (Weitz et al., 2015). There is an immense need for each one of them to change their thoughts and general perception about life and resume the activities of daily living.

Part 2: Privileged Note

Mr. J.K provides a perfect example of a person that is frustrated in life due to his reckless behavior. His excessive intake of alcohol has not only resulted in being sacked by four different employers but has also been arraigned in court for dangerous driving. Besides diagnosis of stage 3 lung cancer and spouse depression episodes complicates the family. The mental status examination does not reveal any incidences of him being suicidal or homicidal, but the actions make a justification. The failure to put in place therapeutic interventions for this patient may result in the loss of his life through reckless actions. Had the therapist visited the family a bit earlier, the family would not be experiencing the challenges they are in at present. The client would not have resorted to consuming alcohol in excess amounts as a strategy to overcome the grief and sorrow that comes with a lung cancer diagnosis. Assignment 2: Practicum – Assessing Client Progress.

The information presented in the privilege note could not be displayed in the progress note because of the HIPAA regulations concerning privacy and confidentiality Weitz et al., 2015). This information is intended for use by a therapist alone and no other party. It is not uncommon for my preceptor to use the privilege notes to preserve the information on the experiences of those with psychiatric conditions. This information guides the development of strategies that guide the treatment of these disorders (American Psychiatric Association, 2013).

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. Arlington: American Psychiatric Publishing.

Becvar, R. J., & Becvar, D. S. (2017). Systems theory and family therapy: A primer. Rowman & Littlefield.

Weitz, E. S., Hollon, S. D., Twisk, J., Van Straten, A., Huibers, M. J., David, D., … & Faramarzi, M. (2015). Baseline depression severity as moderator of depression outcomes between cognitive behavioral therapy vs. pharmacotherapy: an individual patient data meta-analysis. JAMA Psychiatry, 72(11), 1102-1109. Assignment 2: Practicum – Assessing Client Progress

NUR 699 EBP Section A: Organizational Culture and Readiness Assessment Essay Examples

Organizational Culture and Readiness Assessment-Section A

Organizational Culture Survey Tool

The selected organization culture survey tool for the assessment is “Organization Culture and Readiness for System-Wide Integration of Evidence-Based Practice” (Brown, 2014). The survey tools will help in the investigation, evaluation and identification of the organization’s readiness to involve itself in the EPB. NUR 699 EBP Section A: Organizational Culture and Readiness Assessment Essay Examples

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Organization’s Readiness Level

Basing o the findings of the Organizational Culture and Readiness evaluation, the organization has the readiness to participate in evidence-based practice. The nurses have the commitment to drive the evidence-based practice. Additionally, the physicians also have the passion for supporting the nursing staff in the evidence-based practice.  The organization also has a research department linked with the regional and national research centers with nurses who are dedicated having several published journals about the research topic (Brown, 2014). Furthermore, the organization has libraries with the dedication on evidence-based practices and research with a well-established mentoring program. NUR 699 EBP Section A: Organizational Culture and Readiness Assessment Essay Examples.

The Barriers

The barrier to the evidence-based practice includes both the organizational and human factors. The first barrier is less time in reading the literature because of heavy workload. The second barrier of the practice is little staff experience as most of the staff had less experience to participate in the evidence-based practice (Brown, 2014).  There is also lack of resources to facilitate the procedure of the evidence-based practice.

The Facilitators

The facilitators of the evidence-based practice as identified will help in the adoption of new cultures that improve the treatment of stress urinary incontinence in women (Jankowski et al., 2014). Facilitators include increased information access as well as the application of role modeling. NUR 699 EBP Section A: Organizational Culture and Readiness Assessment Essay Examples.

Conclusion

Conclusively, for the achievement of better treatment of the treatment of stress urinary incontinence, the adoption of an EBP culture is significant; the organization has the readiness for EBP.

 

References

Brown, C.G. (2014). The Iowa model of evidence-based practice to promote quality care: An illustrated example in oncology nursing.
Clinical Journal of Oncology Nursing, 18
(2): 157-9.

Jankowski, R., Werner, S., Snyder, S., Chancellor, M., Kultgen, P., & Pruchnic, R. (2014). Cell    therapy for treatment of stress urinary incontinence in women: potential dose effect of             autologous muscle-derived cells for urinary sphincter repair (AMDC-  USR). 
Cytotherapy
, 
16
(4), . NUR 699 EBP Section A: Organizational Culture and Readiness Assessment Essay Examples

 

When evaluating the culture of an organization, it is important to conduct a thorough evaluation and appraisal of the willingness for implementation by considering the evidence executed for that of evidence based practice (EBP). To successfully implement EBP and prevent failure there need to be essential fundamentals in place that will include a required set of time, having the necessary supplies and resources needed. When EBP is implemented the organizations’ culture needs to be identified and the motivation behind the implementation or change all while considering possible obstacles not matter when they might arise during any stage of the implementation process for an EBP (Houser, J., & Oman, K.S., 2011)

For Midland Memorial Hospital the result from the survey shows that they are ready for the change to the nurse intern program. The organization is ready for a change to help keep new nurse retention up. Most of the new nurses stay for the time needed to get experience then move on to other jobs in a more urban area. One barrier seen from this plan is, the increase of disgruntled experienced nurses who no longer due to the high turn around rate. Another barrier is having new trainers in place because they need to learn the new system themselves. However, they can also facilitate because they don’t know the old ways and are not stuck in how things were done. In the organization the culture is right for implementing a new nurse intern program. When implementing a new system staff and managers will be constantly engaged with the process. NUR 699 EBP Section A: Organizational Culture and Readiness Assessment Essay Examples.

References

Houser, J., & Oman, K.S., (2011). Evidence-Base Practice: An Implementation guide for Healthcare Organization. Retrieved from http://sgh.org.sa/Portals/0/Articles/Evidence-based%20Practice%20-%20An%20Implementation%20Guide%20for%20healthcare%20Organizations.pdf NUR 699 EBP Section A: Organizational Culture and Readiness Assessment Essay Examples.

BEST PRACTICES IN THE MANAGEMENT OF PEDIATRIC/ADOLESCENT OBESITY IN PRIMARY CARE CLINICS

Write concisely in detail.

Provide background information for the study including the objective of the proposed research, purpose, research question, hypothesis and other information deemed relevant.

• Provide background information on Childhood obesity

• Please number the objective of the proposed research (at least 4-5 objectives)

• Purpose of the project

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• Research question

Describe the research design of the study (i.e., state whether the study is correlational, experimental, etc. and define the variables).

• The tools to use in research of CHILDHOOD OBESITY (6-18)

• State references backing the tools

• What is going to be measured.

• what will happen in the intervention.

• Will parents be part of the educational intervention?

PICOT QUESTION

• P – Population/ Patient = Obese or overweight child or adolescent who attended a primary care pediatric setting- 6-18-year-old.

• I – Intervention/ Indicator = Implementation of a multidisciplinary pediatric obesity program.

• C – Comparator/control = no pediatric obesity program

• O – Outcome = 5 % decrease in Body Mass Index (BMI) and reduction in childhood obesity.

• T – Time = over a period of 6 months.

BEST PRACTICES IN THE MANAGEMENT OF PEDIATRIC/ADOLESCENT OBESITY IN PRIMARY CARE CLINICS