Tag: Clinical-Nursing

Data-information-knowledge-wisdom (DIKW) continuum essay

NURS-6051C-8, Transforming Nursing and Healthcare through Technology

Reducing Blood Culture Contamination Using the Data-Information-Knowledge-Wisdom Continuum

The data-information-knowledge-wisdom (DIKW) continuum is a concept introduced by Blum in 1986 as a structure to better understand clinical informatics and how it affects health care (American Nurses Association, 2015). The DIKW framework in nursing helps nurses improve understanding on how wisdom can be applied in their clinical practice from all available data which are organized into information, then synthesized to form relationships known as knowledge. By discussing the interrelationships within the DIKW continuum, the framework has become a vehicle in transporting and educating the health care industry towards making nursing interventions visible (Charlene, Currie, & Rodney, 2016). Data-information-knowledge-wisdom (DIKW) continuum essay.

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Nursing has undergone changes in the recent years and now, there are high expectations from nurses to keep their practice up to date to improve nursing processes. Questions are developed in the clinical areas seeking for answers to help enhance the quality of patient care. The use of the DIKW paradigm in solving clinical questions assists nurses to practice with wisdom and apply wisdom to practice. The purpose of this paper is to identify a clinical question relevant to the emergency department and discuss the answer through the progression of the methods of the DIKW framework Data-information-knowledge-wisdom (DIKW) continuum essay. Applying the knowledge obtained from this method in the clinical setting will demonstrate how informatics is instrumental to gain wisdom.

Clinical Question

Blood cultures are laboratory tests to discern the presence of microorganisms in the blood and identify the disease-causing agents for the infection (Reed, 2017). Contaminated blood cultures have negative impact to patients and hospitals in terms of unnecessary antibiotic therapy, superfluous hospitalization, and an extended hospital length of stay. In my area of practice, the blood culture contamination rate for November is more than three percent. Current national average of contamination rates is between two to three percent (Bentley, Thakore, Muir, Baird, & Lee, 2016). The clinical question to explore in this paper is:
What are the best ways to reduce blood culture contamination rates in the emergency department?
It is necessary to find out the factors that affect the elevated contamination rate so that interventions could be implemented to reduce or eliminate the problem. Data-information-knowledge-wisdom (DIKW) continuum essay.

Using the DIKW Continuum to Address the Clinical Question

The DIKW continuum first utilizes data, which is defined as facts obtained through observation with no interpreted meaning (McGonigle & Mastrian, 2018). The November data of the blood culture contamination rate in the emergency department and the national average are two distinct data that are available at this stage of the paradigm.

Using the Walden Library, I conducted a search using
Cinahl Plus with Full Text
from the six recommended nursing databases. I chose this database because it contains peer-reviewed literatures and evidence-based articles that have full texts as described in the database description. The key words that were used were blood culture contamination that yielded 103 articles. The search was further narrowed down to 52 after limiting the time period from 2013-2018. To obtain articles that are relevant to my specialty field, emergency department were used as additional key words that produced 14 articles. From the last selection, I researched the titles that would help obtain information to answer the clinical question.

 

 

Data to Information

Information are gathered by integrating data points to give structure to the group of data that are available (McGonigle & Mastrian, 2018). Data for blood culture contamination from the infection control department of the hospital showed that emergency department has the following contamination rates: September- 3.24%, October- 3.76%, and November- 3.89%. The information showed an upward trend. The national average rate is between two to three percent, thus, compared to the national standards, the department’s rate is high in the past three months. Additional information learned from the infection control department said poor site preparation is the main cause of the problem. Lack of education on proper blood culture collection was also identified as another cause. Data-information-knowledge-wisdom (DIKW) continuum essay The data reveals the information that there are two main factors that caused the increased contamination rates in the department.

Information to Knowledge

Knowledge is derived from the synthesis of cluster of information where patterns and relationships are established (McGonigle & Mastrian, 2018). The information gathered leads to the conclusion that improper insertion site preparation in obtaining blood culture and lack of education in proper blood culture collection caused the upward trend of the department’s contamination rate. From the articles reviewed in the nursing database, best practices were identified regarding blood culture collection. It is necessary to look for strategies that are evidence-based to overcome the issues identified in the department. Some of the recommendations in the research study by Constance, Coleman, and Cunningham (2015) said that staff education with return demonstration, use of sand timers to provide accurate time for cleaning blood culture collection site, and utilization of a blood culture kit are effective strategies in reducing contamination rates. Another article recommended the use of optimum skin antisepsis, sterile glove protocol, and training a set of dedicated staff members who will draw blood culture specimens (Denno & Gannon, 2013). The use of knowledge in answering the clinical question is done through analyzing which best practice is relevant to the department based on the main factors that were causing the problem.

Knowledge to Wisdom

Wisdom is the use of knowledge to implement solutions to the problem (McGonigle & Mastrian, 2018). This step is the application of the knowledge obtained from the interpreted and organized data and information. There were two identified causes of the problem. To apply knowledge into wisdom, the best practices that were identified which should be implemented in the emergency department based on practicality and cost-effectiveness are the use of blood culture kits and implementation of staff education on proper blood culture collection followed by a return demonstration to verify competencies of the nurses and emergency department technicians. There is no single cause for blood culture contamination, thus, facilities need to identify the unique contributors to contamination and develop a tailored strategy based on the available resources. Data-information-knowledge-wisdom (DIKW) continuum essay.

Summary

The American Nurses Association (2015) recognizes the significance of data, information, knowledge, and wisdom to nurses in all specialty areas. Utilizing the DIKW continuum, decision-making process is facilitated to arrive at a sound nursing judgment when faced with a clinical problem. Nursing informatics, as a nursing specialty, helps gain wisdom in nursing practice. Answering the clinical question on the best method of reducing blood culture contamination was made intelligently through the progression of the DIKW paradigm. In my future practice as an acute care nurse practitioner, the DIKW model will be used to guide me in my clinical practice and decision-making. Data-information-knowledge-wisdom (DIKW) continuum essay.

References

American Nurses Association. (2015).
Nursing informatics: Scope and standards of practice
(2nd ed.). Silver Spring, MD: Author.

Bentley, J., Thakore, S., Muir, L., Baird, A., & Lee, J. (2016). A change of culture: Reducing blood culture contamination rates in an emergency department.
BMJ Quality Improvement Reports
,
5
(1). doi: 10.1136/bmjquality.u206760.w2754

Bowen, C. M., Coleman, T., & Cunningham, D. (2015). Reducing blood culture contaminations in the emergency department: It takes a team.
Journal of Emergency Nursing
,
42
(4), 306-311. doi:10.1016/j.jen.2015.10.021

Denno, J., & Gannon, M. (2013). Practical steps to lower blood culture contamination rates in the emergency department.
Journal of Emergency Nursing
,
39
(5), 459-464.  
https://doi.org/10.1016/j.jen.2012.03.006

McGonigle, D., & Mastrian, K. G. (2018).
Nursing informatics and the foundation of knowledge
(4th ed.). Burlington, MA: Jones and Bartlett Learning.

Ronquillo, C., Currie, L. M., & Rodney, P. (2016). The evolution of data-information-knowledge-wisdom in nursing informatics.
Advances in Nursing Science
,
39
(1), e1-e18. doi: 10.1097/ANS.0000000000000107 Data-information-knowledge-wisdom (DIKW) continuum essay

Steed, L. L. (2017). Reducing blood culture contamination.
Clinical Lab Product
. Retrieved from

Reducing Blood Culture Contamination

Discussion: Interview Format

Develop formats for initial interviews of mental health clients To prepare for this Discussion:

Review the Learning Resources.

Develop an interview format you would use for an initial interview of a client.

By Day 3

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Post:

Attach the interview format document you would use for an initial interview of a client.

Describe what interview format your preceptor uses for the initial interview of a client.

Describe which element of your interview format is most helpful in your practice. Discussion: Interview Format

Electronic Health Records (EHR) Essay Examples

Week 5: Electronic Health Record

Main Post

Introduction

Electronic Health Records (EHR) are the cause of a major force that is creating change in the health care industry. Dramatic changes, apprehension, excitement, along with fear and concern are the focus of a new era from paper charting to a new electronic health record system. This research paper will examine benefits and challenges electronic health records face, along with resistance to change and fear many have toward this new system. Electronic Health Records (EHR) Essay Examples.

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Electronic Health Record Initiation

The transition from paper based charting to electronic base charting has shown to be very complex and difficult. Not many years ago, there was only one method of keeping medical records and this was utilizing paper charts. These charts, although still used in many practices today, have slowly been replaced by a more advanced method called electronic health record or EHR. The Centers of Medicare and Medical Services (CMS), defines “electronic health records as an electronic version of a patient’s medical history, that is maintained by the provider over time, and may include demographics, progress notes, problems, medication, vital signs, past medical history, immunizations, laboratory data, and radiology reports” (CMS.gov, 2012).   Resistance to change is always a crucial challenge for the success of any innovation. Research has found that physician resistance is a challenge in the implementation of a new EHR system when switching from a paper-based practice.

In my organization where I work, I was concerned about incomplete documentation and double entry during EHR transition. For instance, “medication wasn’t documented in the computer because somebody didn’t have time, or somebody didn’t know how.” Also, I m worried about diminishing eye contact between doctor and patients and computer crashes. For some nurses, changes tend to be less resistance who are more tech savvy, those who grew up with a computer, can type quickly and are comfortable clicking around a screen. Some doctors have difficulty adjusting to the use of new electronic charting. Most problems are about their typing skills. Some staff stated, “comfort level with the program and allocating an appropriate amount of time for training will have an impact on the patient volume and overall budget.” Similarly, another staff stated, “medical assistants and nurses will be expected to use the new EHR; there may be lots of variation in technology comfort level among support staff. Training these peoples adequately and making sure they are comfortable with the EHR are significant.”

Challenges

Regardless of the many benefits, EMRs have some challenges. The first significant challenge of EMRs is the high costs. Deltev (2007) reports that electronic record management systems are extremely costly to acquire, and is this is the significant barrier for implementing EMRs on clinical practices. For instance, ongoing training is a big concern and a hidden cost.

Another challenge in implementation of EHR is the potential privacy threat. The high levels of accessibility and portability of EMRs also tend to increase the risk of unauthorized access or data theft. Paper records may be tedious and inefficient, but they don’t face threats from cyber-attacks. Such security breaches could cause substantial harm to patients, as well as result in legal issues to providers. According to the previous study, the common privacy concerns with EHRs are unauthorized access to records, tampering with records and the risk of losing information due to a natural disaster. Since EHRs allow for easier access to sensitive information, there is an increased risk of privacy violations Electronic Health Records (EHR) Essay Examples. These may include intentional “prying” or may be accidental by using improper security measures.

The last major essential challenge is the use of copy and paste. Because documentation is more involved with EHRs, physicians may rely on the copy and paste function as a shortcut, particularly for routine or follow-up visits. While this may save time for the physician, this puts the patient’s safety at risk and impairs quality of care as updates or changes between visits can be overlooked or not documented properly.

Strategies

COST – EHR systems can be expensive. Finding the capital to invest in the infrastructure, personnel, training and support required to install and maintain an EHR system can be a barrier, especially for small to mid-sized practices. Uncertainty over the long-term return on investment can exacerbate this concern. Associated costs, such as increased physician time requirements and decreased patient visits during EHR implementation, can affect providers’ bottom lines (USFHealth, n.d.) Electronic Health Records (EHR) Essay Examples.

Privacy concerns – There are ways in which electronic health record entities can provide superior security and privacy solutions once the EHR is implemented such as; Guide employees through the stringent privacy and security training process, provide identification and verification requirements to all system users, Issue specified punishments to employees not following compliance guidelines, and disguise all data inside medical files through cryptography. Reliable electronic health records companies apply these enhanced security and privacy protocols. Perhaps the most important security protocol is data encryption, which causes data to become unreadable to outside sources. Electronic health records specialists also provide remote storage and data backup systems. While this may not necessarily present as strong of a defense against hackers and data breaches as data encryption, it provides security for healthcare organizations against the potential of software failures or natural disasters that could destroy or damage files.

Copy and Paste Issue – according to The Joint Commission, the American Health Information Management Association recommended the strategies to prevent copy and paste errors in EHR. These includes: development of a policies and procedures addressing the proper use of the copy and paste function (CPF) to assure compliance with governmental, regulatory and industrial standards; addressing the use of features such as copy-and-paste in the organization’s information governance processes; providing comprehensive training and education on proper use of cop-and-paste, to all EHR users; and monitoring compliance and enforce policies and procedures regarding use of of copy-and-paste, and institute corrective action as needed (The joint commission, 2014).     The advantages of EHRs to the clinicians and patient alike are considerable. To avoid these issues, hospitals and healthcare systems must perform a thorough evaluation of the EHR system before purchase and implementation. To truly achieve the type of change that health care staff seek, tighter clinical integration across practice settings is a must. I believe these challenges could be addressed with proper education and training. Electronic Health Records (EHR) Essay Examples

References

CMS.gov (2012). Electronic health records. Retrieved from:
https://www.cms.gov/Medicare/E-Health/EHealthRecords/index.html?redirect=/EhealthRecords/

Deltev, S. B. (2007). The executive’s guide to electronic health records
.

New York: Health            Administration Press.

The Joint commission (2014. Preventing copy and paste in EHR. Retrieved from:             
https://www.jointcommission.org/assets/1/23/Quick_Safety_Issue_10.pdf

USFHealth (n.d.). Overcoming Hurdles Faced During HER Implementation. Retrieved from:            

EHR Implementation Plan: Your Guide to Conquering EHR Hurdles

 

Week 7 Assignment

 

Information technology (IT) has quickly assimilated into healthcare improving patient care and reducing costs by tracking patient care. The nursing population as a whole resists change, set in their ways nurses have specific routines that propel them through the shift efficiently. As a nurse facilitator, one may encounter an individual resistance when everyday routines are threatened. The purpose of this paper is to use Rogers’s diffusion of innovation (relative advantage, compatibility, complexity, trialability, and observability) as a tool to facilitate a smooth transition into the world of electronic health records (EHR) for nurses in a working hospital setting.

Efficacious execution of new IT involves overcoming the fears and resistance to change most people display, especially if change means learning a new process for a skill you have already mastered. In the world of nursing time, management is crucial in patient care. The American Recovery and Reinvestment Act (ARRA), mandated that U.S. hospitals are to become meaningful users of EHR (Kelley, Brandon, & Docherty, 2011). The U.S. government apportioned an estimated $19 billion for hospitals and ambulatory settings to carry out the necessary application of EHR (Murphy, 2011). The challenge is demonstrating the positive outcomes EHR’s will provide, ease of use when accessing patient information and clear, concise physician orders. Electronic Health Records (EHR) Essay Examples.

Relative Advantage

Rogers (2003) defined relative advantage as “the degree to which an innovation is perceived as being better than the idea it supersedes” While presenting an innovative way of patient care providing evidence to the potential user that the EHR will be an improvement to the outmoded systems. Illustrating the how and why the innovation will benefit all who are concerned with the project. Providing the nursing staff as well as physicians, with efficient, time-saving ways to review patient charts, diagnostic results, and reduced charting time. The CORE Measures and Patient Safety Goals set by the Joint Commission mandates the timeliness and effectiveness of care for specific conditions. By employing the use of EHR, tracking compliance will save healthcare institutions millions of dollars every year Electronic Health Records (EHR) Essay Examples.

Compatibility

Electronic health records must fit the knowledge base of every healthcare organization. Rogers (2003) stated that “compatibility is the degree to which an innovation is perceived as consistent with the existing values, past experiences, and needs of potential adopters” User-friendly programs geared to fit the individual requirements of every unit and department in the hospital or any other healthcare setting. A straight forward, restructured data flow that is repurposed over and over again simply by adding the information into the EHR system allowing access to anyone that logs into the patient record (Friedman, Parrish, & Ross, 2013). Molding the program to correspond to the individual needs of the users is a prerequisite of any new concept. Demonstrating the ease of use and time-saving convenience by charting electronically can alleviate the trepidation of the staff.

Complexity

Rogers (2003) defined complexity as “the degree to which an innovation is perceived as relatively difficult to understand and use”. An individual or individuals can determine whether or not the modernization of patient information will benefit the nurses as well as the patient. A decision stage is a “full use of innovation as the best course of action available” (Rogers, 2003). Determining the level of expertise employees have with computers can establish the degree of training that is required and determine the intensity and success of the training it entails. Specifically targeting older adults that may not have experienced technology in a way the newer generations have. What seems simple to a computer user may be difficult to comprehend for a person with no exposure to technology. Another issue that sways nurse’s decisions is the possibility that technology will pull nurses away from having a personal patient-focused care experience. Nurses are concerned that the advent of modern technology will overstep the abilities of the RN to care for the patient (Gregory & Buckner, 2014). Overcoming the preconceived ideas about EHR, allowing the nurses to have hands on experience before the rollout navigating the program to get a feel for the process. Also encouraging input on how the program can be streamlined to fit the needs of the individual departments. All of these processes can assist the staff in making a sound decision. Electronic Health Records (EHR) Essay Examples.

Trialability

According to Rogers (2003), “Trialability is the degree to which an innovation may be experimented with on a limited basis”. This is the stage where the trialability of the product comes into play. This is where all of the “bugs” are worked out. With most new startups there will be hiccups in the process of actually managing the workload. Some in trepidation and negative opposition will arise in this stage. “The innovation loses its distinctive quality as the separate identity of the new idea disappears” (Rogers, 2003). As a unit facilitator, the encouragement of the process will have a large impact on the negative feelings that begin to appear. Identifying the problematic areas and creating solutions by ironing out the glitches as a unit.

Observability

Rogers (2003) defined observability as “the degree to which the results of an innovation are visible to others”. The use of technology is an observable process, and although problems may arise, there is often a solution. At this point, the level of enthusiasm may wane, and an attitude of detachment may occur (Hayrinen, Saranto, & Nykanen, 2008).  At this point of the innovation, some employees may choose not to stay with the facility, even though the inevitability of working with EHR in the near future in another setting is definitive. Peer observation is elementally a motivating factor in the adaptation of the diffusion of technology (Frattini, 2010). Relating knowledge to peers on the unit will encourage the nurses to overcome the obstacles. Employing members of the nursing staff to create a “super user” team to troubleshoot any problems with operating the programs so the workflow of the units will not be interrupted. Electronic Health Records (EHR) Essay Examples.

Summary

By using Rogers’ five determinants of success, innovations complications, difficulties, and setbacks are identified before their occurrence. The feasibility of implementing a once thought too complicated system was made possible through the identification of factors before the execution of the electronic health record program. Successful acceptance brought on by the realization of benefits to nurses, physicians, general nursing staff and most of all the patients. Improving patient care is what nursing is all about; the electronic age is upon us and will always be a part of our modern civilization. The key to introducing and successful transitioning of innovations is total involvement in the process. Nurses worldwide will use technology to develop new skill sets that will impact the future of the medical profession. Acquiring the skills to work with programs that deliver a safer environment for patients will be an invaluable asset to the nursing world (Furst et al.,2013).

References

Best, M. F., & Thurston, N. E. (2004). Measuring Nurse Job Satisfaction. 
JONA: The Journal of Nursing Administration
, 
34
(6), 283-290. doi:10.1097/00005110-200406000-00007

Frattini, F. (2010). Achieving Adoption Network and Early Adopters Acceptance for Technological Innovations. 
Gaining Momentum
, 81-120. doi:10.1142/9781848163553_0003

Friedman, D. J., Parrish, R. G., & Ross, D. A. (2013). Electronic Health Records and US Public Health: Current Realities and Future Promise. 
Am J Public Health
, 
103
(9), 1560-1567. doi:10.2105/ajph.2013.301220

Furst, C. M., Finto, D., Malouf-Todaro, N., Moore, C., Orr, D. A., Santos, J., … & Tipton, P. H. (2013). Changing times: enhancing clinical practice through evolving technology. 
Medsurg Nursing
, 
22
(2), 131.

Gregory, D., & Buckner, M. (2014). Point-of-Care Technology. 
Critical Care Nursing Quarterly
, 
37
(3), 268-272. doi:10.1097/cnq.0000000000000030

Harrison, J. (2004). Addressing increasing patient acuity and nursing workload. 
Nursing Management
, 
11
(4), 20-25. doi:10.7748/nm2004.07.11.4.20.c1984

Hayrinen, K., Saranto, K., & Nykanen, P. (2008). Definition, structure, content, use and impacts of electronic health records: A review of the research literature.
International Journal of Medical Informatics
, 
77
(5), 291-304. doi:10.1016/j.ijmedinf.2007.09.001

Pravikoff, D. S., Tanner, A. B., & Pierce, S. T. (2005). Readiness of U.S. Nurses for Evidence-Based Practice. 
AJN, American Journal of Nursing
, 
105
(9), 40-51. doi:10.1097/00000446-200509000-00025 Electronic Health Records (EHR) Essay Examples.

 

References

Kelley, T. F., Brandon, D. H., & Docherty, S. L. (2011). Electronic Nursing Documentation as a Strategy to Improve Quality of Patient Care. 
Journal of Nursing Scholarship
, 
43
(2), 154-162. doi:10.1111/j.1547-5069.2011.01397.x

Murphy, J. (2011). HITECH Programs Supporting the Journey to Meaningful Use Of EHRs.
CIN: Computers, Informatics, Nursing
, 
29
(2), 130-131. doi:10.1097/ncn.0b013e318210f0fc

Rogers, E. M. (2003). 
Diffusion of innovations
 (5th ed.). New York, NY: New York Free Press.

Stokowsk, L. (2013, September 12). Electronic Nursing Documentation: Charting New Territory. Retrieved from http://www.medscape.com/viewarticle/810573_3 Electronic Health Records (EHR) Essay Examples

Asset-Based Approach in Nursing and Healthcare

Asset-Based Approach

Objectives

• Describe the asset-based approach

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Assignment Overview

In this writing assignment, you will use the asset-based approach to understanding the strengths of a population.

Deliverables

1. A one-page (250-word) paper that summarizes the asset-based approach

a. Write a paper.

In your paper, address the following prompts:

i. Describe the asset-based approach in relation to a health care issue of your choice.

ii. Explain when the asset-based approach is used in relation to a health care issue of your choice.

iii. Explain three strengths of the asset-based approach in relation to a health care issue of your choice.

iv. Explain three weaknesses of the asset-based approach in relation to a health care issue of your choice. Asset Based Approach in Nursing and Healthcare

NURS 6051 Week 1 Discussion – To err is human essay

Even the best of us can make mistakes. We are all human.  Although in health care, mistakes can prove to be devastating, costly and in many cases deadly.  In 1999, the Institute of Medicine (IOM) published 
To Err Is Human: Building a Safer Health System
which called for a change in the practice of health care in the prevention of medical errors.  The study stunned the nation with its grim statistic estimating that up to 98,000 patients died per year from preventable medical errors in hospitals (Plawecki and Amrhein, 2009).  Medical errors as defined by IOM 1999 report, “is the use of a wrong plan of care to achieve an outcome or the failure of a planned action to be completed as intended” (Plawecki and Amrhein, p. 27, 2009). NURS 6051 Week 1 Discussion – To err is human essay. The landmark study also exposed that a major barrier to patient safety is the lack of awareness of how extensive medical errors are in the health care setting and how often they occur (Wakefield, 2008).  As Plawecki and Amrhein acknowledged, it doesn’t matter how many times a procedure has been performed or a medication given, there is always the potential of a preventable error (2009).  Faulty systems and processes have been shown to be the cause of most mistakes versus an individual’s behavior (IOM, 1999).  As health care providers, one of our biggest fear is that we can be fallible.  The IOM’s report although distressing, brought awareness and understanding about the weakness in our country’s health care system.  In response to this pivotal publication, the IOM proposed methods to transform the health care setting.  A call for action among all responsible parties in the health care system is needed to prevent the continual rise in medical errors.  The series known as
Crossing the Quality Chasm
 was developed to redesign how health care settings operate (Wakefield, 2008).  Wakefield discussed in the 
Quality Chasm Series
the simple rules with the 21st Century (2008) NURS 6051 Week 1 Discussion – To err is human essay.  It challenged the system to implement the major actions for achieving a safer, more effective, and efficient health care (Wakefield, 2008).

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To achieve the recommended goals, there are enormous potential for transforming health care using Health Information Technology (Cipriano & Murphy, 2011).  Additionally, web-based information has considerable potential to enhance patient knowledge and stimulate healthy behavior (Cipriano & Murphy, 2011).  According to new rule four from the
Quality Chasm Series,
 the sharing of knowledge and access to information, increased communication and encourage shared ideas with all participant of health care. The Magnet hospital that I work for utilizes electronic medical record (EMR) known as Cerner in all outpatient and inpatient units.  Through access of clinical information and data collection, communication improved among providers, and other health care members thus reducing errors.  Not only are the health care team members employing EMR but patients are also encouraged to sign up to access their own clinical records through the patient portal from the Internet or an application through their cell phones.  NURS 6051 Week 1 Discussion – To err is human essay. They can also communicate to their health care team, keep track of their appointments, or request appointments and medication refills.  Thus, allowing patients to be proactive in their own care.  The EMR also allowed providers to enter their own orders through the computerized physician order entry (CPOE) systems, therefore alleviating nurses from having to decipher handwritten orders or taking verbal ones which could lead to errors and misunderstanding.  Health information technology is constantly growing and improving, whether it’s in the design interface or increasing user friendliness or management of data.  One area of growth that is needed is through the management of chronic conditions remotely to patients who have difficulty traveling such as nursing home or homebound patients.  Implementation of virtual care and remote monitoring tools are still not widely utilized in critical populations.  Telehealth is limited to a select few.  In my hospital, it is available only to prisoners in a set location. NURS 6051 Week 1 Discussion – To err is human essay.  This is mainly due to issues with how to charge for services and the financial burden it poses to increase access to outside rural areas.

Overall information technology (IT) is a wonderful tool.  It has made advances in health care, improved the safety of patients, and the efficiency for effective care for better health outcomes for patients.  IT has enormous potential and growth.  It has the ability to provide critical information with ease of access and reduce miscommunication and delay in care if properly implemented, maintained, and updated.  The future of health informatics is exponential. NURS 6051 Week 1 Discussion – To err is human essay.

References:

Cipriano, P. F., & Murphy, J. (2011). Nursing informatics. The future of nursing and health IT: The quality elixir. 
Nursing Economic$,  29
(5), 282, 286–289.

Institute of Medicine. (1999). To err is human:  Building a safer health system.  Retrieved from the National Academies Press website:  http://www.nap.edu/catalog.php?record_id=9728

 

Plawecki, L. H., & Amrhein, D. W. (2009). Clearing the err. 
Journal of Gerontological Nursing, 35
(11), 26–29. Retrieved from the Walden Library database.

Wakefield, M. K. (2008). The Quality Chasm series: Implications for nursing. In R. G. Hughes (Ed.), 
Patient safety and quality: An evidence-based handbook for nurses
(Vol. 1, pp. 47–66). Rockville, MD: U. S. Department of Health and Human Services. NURS 6051 Week 1 Discussion – To err is human essay.

Artistic Expression: Caring Concept Assignment

Caring can be defined as “feeling or showing concern for other people” (Merriam-Webster, 2018). Historically, Florence Nightingale depicted “being caring” as one of the core values of nursing. She described in her writings that nursing is both an art and science and allows an individual to show a compassionate view of humanity (Wagner, 2010). Florence Nightingale’s framework has transcended into modern nursing and her ideas are still celebrated.

Importance of Caring

Knowledge on caring requires consideration, reflection, and passion. Caring is a mindful act that is learned, practiced, and improved upon. Caring is an interactive and vital part of a nurse and patient relationship (Thorton, 2013). It would be nearly impossible to tend to the physical needs of a patient without an attentive, caring relationship. The act of caring opens up a channel of communication between the patient and nurse and enables the nurse to assess the patient’s needs.

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Principles of Holistic Care

Holistic nursing practice includes not only the physical aspects of nursing but also the mental, emotional, cultural, and sexual needs of the patient. A nurse that utilizes the holistic approach views the patient as a whole rather than a disease or body system. A nurse practitioner acquires skills to make clinical decisions for patients based off of their holistic needs. Collaborating with patients as well as involving them in their care leads to better health outcomes and overall greater patient satisfaction. Artistic Expression: Caring Concept Assignment.

Perspective of Caring

The meaning of caring may be different from person to person but ideas of caring in nursing stay mostly consistent. A qualitative study examined holistic advanced practice nurses and reported several themes of caring-within-practice. The first theme, normalizing the environment, examined both internal and external factors that contribute to optimal patient care. The nurse practitioner is able to create the best care plan with patients by observing their thoughts, beliefs, and cultural preferences (Hines, 2017).

The art of being present was identified as another theme of caring in nursing. Being present focuses on more than just being there physically; it also creates a transpersonal connection with the patient. Making eye contact, minimizing distractions, and asking the patient’s input can all create a stronger connection (Gluyas, 2015).

Lastly, coaching the family as a caregiver establishes a caring demeanor in nursing, and improves the patient and family’s experience (Hines,2017). Often times, fears and anxieties about the patient’s care get blown out of proportion due to the lack of communication or presence from the care provider. Advanced nurses can offer a time to engage with the whole family by attending to questions or concerns. This gives the family a feeling of usefulness and support.

Artistic Expression

The artistic expression provided illustrates that caring can be defined in many different ways, but caring always comes from the heart. Caring is looking at a person as a whole despite his or her religious preferences, skin color, or ideas. It is coming together from different backgrounds to make one. Caring about people doesn’t mean you necessarily have to agree or like them, but you are there for them regardless.

Caring is sometimes defined as feeling or showing concern for people. Caring is a core value of nursing and creates a lasting interpersonal relationship with a patient and their family members. Advanced nurses develop skills to deliver best care with regards to a patient’s physical, mental, and spiritual needs. Artistic Expression: Caring Concept Assignment.

References

AHNCC. (2012). Core Essentials of Basic Holistic Nursing. Retrieved September 11, 2018, from http://www.ahncc.org/wp-content/uploads/2016/05/Core-Essentials-for-BASIC_HN_DEC_20_2012.pdf

 

Gluyas, H. (2015). Patient-Centered Care: Improving Health Outcomes. Retrieved September 10, 2018, from http://journals.rcni.com.chamberlainuniversity.idm.oclc.org/nursing-standard/patientcentred-care-improving-healthcare-outcomes-ns.30.4.50.e10186

 

Hines, M. (2017). Advanced Holistic Nursing Practice Narratives: A View of Caring Praxis. Retrieved from http://journals.sagepub.com/doi/abs/10.1177/0898010117715849 Artistic Expression: Caring Concept Assignment

 

Thorton, L. (2013). Essentials of Integrative Health Care: Fundamental Principles for Caring and Healing. Retrieved September 10, 2018, from https://chamberlainuniversity.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct&db=ccm&AN=107974261&site=eds-live&scope=site

 

Wagner, D. (2010). An Exploration of the Nature of Caring Relationships in the Writings of Florence Nightingale. Retrieved September 11, 2018, from https://ovidsp-tx-ovid-com.chamberlainuniversity.idm.oclc.org/sp-3.31.1b/

 

Webster, M. (2018). Caring Definition. Retrieved September 10, 2018, from http://www.learnersdictionary.com/definition/caring Artistic Expression: Caring Concept Assignment

Literature on Transitions of Care

One aspect of leadership is staying current on the latest research in your field. Healthcare is no exception. For your Week 4 and Module 2 Assignments, you are researching the role of the nurse leader in improving transitions of care. An annotated bibliography will help you keep track of your research and how you may use various sources within your research.

For this Literature on Transitions of Care Discussion, you will share one of the articles you located. This is an opportunity for professional discourse on the literature and sharing of ideas with colleagues.

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To prepare:

Select one of the articles you are using in your annotated bibliography this week.

By Day 3 of Week 4 (Post First)

Provide the citation and a brief summary of the article you selected. Explain what you learned about transitions of care and what area of the continuum of care you plan to address in your Module 2 Assignment.

Be sure to attach a PDF of your article or provide the library permalink so that your colleagues can fully review your article Literature on Transitions of Care.

Antibiotic Stewardship in Inpatient Settings Quality Improvement Proposal

Antibiotic Stewardship in Inpatient Settings Quality Improvement Proposal. 3 reference articles included in files

In a 1000 word paper, describe the problem or issue and propose a quality improvement initiative based on evidence-based practice, incorporate one of the following strategies : PDSA cycle, FADE, lean strategy, and Six Sigma in quality improvement in patient care related to this subject- antibiotic stewardship (pharmacists assistance)

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Include the following:

1. Provide an overview of the problem and the setting in which the problem or issue occurs. Antibiotic Stewardship in Inpatient Settings Quality Improvement Proposal.

2. Explain why a quality improvement initiative is needed in this area and the expected outcome.

3. Discuss how the results of previous research demonstrate support for the quality improvement initiative and its projected outcomes. Include a minimum of three peer-reviewed sources published within the last 5 years, not included in the course materials or textbook, that establish evidence in support of the quality improvement proposed. Antibiotic Stewardship in Inpatient Settings Quality Improvement Proposal.

4. Discuss steps necessary to implement the quality improvement initiative. Provide evidence and rationale to support your answer.

5. Explain how the quality improvement initiative will be evaluated to determine whether there was improvement.

6. Support your explanation by identifying the variables, hypothesis test, and statistical test that you would need to prove that the quality improvement initiative succeeded.

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 Antibiotic Stewardship in Inpatient Settings Quality Improvement Proposal.

Rough Draft Qualitative Research Critique and Ethical Considerations Examples

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.

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Use the practice problem and two qualitative, peer-reviewed research article you identified in the Topic 1 assignment to complete this assignment. Rough Draft Qualitative Research Critique and Ethical Considerations Examples.

In a 1,000–1,250 word Rough Draft Qualitative Research Critique and Ethical Considerations Examples 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 Rough Draft Qualitative Research Critique and Ethical Considerations Examples assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

 

Research Critique Guidelines – Part I

Qualitative Studies

Background of Study

Summary of studies. Include problem, significance to nursing, purpose, objective, and research question.

How do these two articles support the nurse practice issue you chose?

Discuss how these two articles willbe used to answer your PICOT question.

Describe how the interventions and comparison groups in the articles compare to those identified in your PICOT question.

Method of Study:

State the methods of the two articles you are comparing and describe how they are different Rough Draft Qualitative Research Critique and Ethical Considerations Examples.

Consider the methods you identified in your chosen articles and state one benefit and one limitation of each method.

Results of Study

Summarize the key findings of each study in one or two comprehensive paragraphs.

What are the implications of the two studies in nursing practice?

Ethical Considerations

Discuss two ethical consideration in conducting research.

Describe how the researchers in the two articles you choose took these ethical considerations into account while performing their research. Rough Draft Qualitative Research Critique and Ethical Considerations Examples.

 

Rough Draft Qualitative Research Critique and Ethical Considerations Examples – 1

Introduction and Background of the Study

Individuals aged 65 years and over exhibit a greater prevalence of the problem of multi-morbidity, or sufferance from multiple chronic health conditions, that require a multiplicity of medications for purposes of managing symptoms and preventing future problems. A combination of these healthcare needs, along with age-connected pharmacokinetic and pharmacodynamic changes often increase the complexity of medical prescription in this special patient population. Rough Draft Qualitative Research Critique and Ethical Considerations Examples.

Administration of inappropriate prescriptions is a common clinical problem affecting the population of elderly persons in primary nursing care. This reality has been the focus of a significant number of qualitative clinical research studies. Upon recognition of the reality that a limited number of studies have been design to qualitatively explore the phenomenon of potentially inappropriate prescribing, Clyne et al. (2016) conducted a qualitative study to investigate this clinical problem as well as its underlying mechanisms from the viewpoints of general practitioners. Their study aimed at a qualitative exploration of general practitioners’ perspectives concerning prescribing and the problem of inappropriate prescriptions in elderly primary nursing care patients. This was their main research problem and the focus their qualitative study (Clyne et al, 2016).

Having identified the research gap and research problem, the authors established their study’s significance by highlighting the public health concerns associated with inappropriate prescribing in elderly patients. According to Clyne et al (2016), the need to study the phenomenon of potentially inappropriate prescribing arises from the commonly reported consequences of such practice in elderly persons, including a potential for an increase in the prevalence of morbidity, increased hospitalization, and lower health-linked quality of life, as well as a rise in ADEs. According to the study, patients are also likely to face the healthcare risk of polypharmacy. These drugs may also lead to elderly falls that are likely to increase healthcare problems for patients.

There are a number of possible questions explored by the study. What is the prevalence of inappropriate prescribing in elderly persons? What are the clinical ramifications or healthcare consequences of inappropriate prescribing? How best can the problem be reduced? Finally, the paper’s primary focus is: what are the clinician perspectives with respect to the phenomenon of potentially inappropriate prescriptions? Rough Draft Qualitative Research Critique and Ethical Considerations Examples.

The purpose of Clyne et al (2016) research paper is conduct an exploration of the general practitioners’ perspectives concerning the inappropriate prescription and its impact in elderly primary care patients. There is a substantial connection between the research questions and the purpose of the study as demonstrated in their article.

Method of Study

The authors used semi-structured qualitative interviews as their method in order to investigate the perspectives of general practitioners in a randomized controlled trail design geared toward decreasing the prevalence of potentially inappropriate prescription in elderly patients that would lead to the capstone project’s primary concern of elderly falls and the associated comorbidities. While their focus was on the population of patients in Ireland that were 70 years or older, their application of the quality method was appropriate because the study sought to explore the opinions of general practitioners which, by and large, is a qualitative attribute than can be more effectively explored using the qualitative method. Rough Draft Qualitative Research Critique and Ethical Considerations Examples.

The authors identified a substantial number of qualitative as well as quantitative studies from literature that were relevant to their study and the focus of the research, and which focused on the clinical issue of inappropriate prescribing and the associated consequences and potential interventions. The literature used is largely based on peer-reviewed journal articles that are accessible in public databases such as PubMed, Google Scholar, and PubMed Central Rough Draft Qualitative Research Critique and Ethical Considerations Examples. The articles used in the study are largely current, although the authors have also relied on qualitative articles that date back to 2003, which is still acceptable within the qualitative criterion of article currency. The chosen articles are notably relevant to the topic of research.

Although the authors have used a broad range of relevant peer-reviewed articles, there is limited or no indication or evaluation of the potential weaknesses of the studies used. However, the article’s literature review relied upon adequate data and information on the subject of inappropriate prescribing and its consequences on the elderly population in an effort to build their logical arguments and lay out the results of their findings.  Moreover, the authors did not explicitly make develop a particular framework from findings of their study, though their study was based on the OPTI-SCRIPT evaluation process.

Results of Study

Clyne et al. (2016) conducted seventeen semi-structure qualitative interviews involving 13 males and 4 female participants. Results from the findings of their studies identified three primary interrelated themes including complex prescription environment, paternalistic relationships between doctors and patients, and the relevance of potentially inappropriate prescribing as a concept. Patient complexity—including multi-morbidity and polypharmacy, and prescriber complexity—seen in terms of the existence of multiple prescribers, restriction in autonomy, and poor communication were identified in the study as some of the main factors creating complexity in the prescribing setting in which there is a greater chance that potentially inappropriate prescription could possibly take place.

The study is an important contributor to the nursing knowledge with respect to the topic of inappropriate prescription in elderly persons. Its use of qualitative approach was instrumental to nursing literature and body of knowledge in the sense that it enabled the exploration of the complex clinical issues of inappropriate prescribing in elderly primary care in a manner that is unavailable to most quantitative studies. The study has identified a number of interrelated variables that influence the potential occurrence of inappropriate prescribing and older patient medication, which are important to nursing intervention and practice, including the need to improve the management of multi-morbidity and polypharmacy, and to achieve a decrease in potentially inappropriate prescriptions and medications that would lead to such consequences as falling in older persons. The findings of the study are also largely applicable to nursing education in terms of informing the general practitioners and clinicians of the need to understand the concept and processes of potentially inappropriate prescribing Rough Draft Qualitative Research Critique and Ethical Considerations Examples.

Ethical Considerations

Clyne et al (2016)’s study received ethical approval to conduct their research from the Irish College of General Practitioners’ Research Ethics Committee. The participants were provided with written information, and consented to participation into the research study. Although there is no reason to doubt it, there little information pointing to the protection of patient privacy

Conclusion

Potentially inappropriate medication is a common problem in elderly populations, and is linked to a rise in the number of injurious and sometimes fatal falls among this vulnerable patient population in primary care. Clyne et al. Rough Draft Qualitative Research Critique and Ethical Considerations Examples (2016) have conducted a clinically relevant qualitative study to identify factors that potentially influence the occurrence of this clinical problem including the prescription environment complexity, and paternalistic relationships between doctors and patients, as well as the little significance that general practitioners have attached to this growing public health concern. Thus, further research is needed to develop interventions that address the noted challenges and improve nursing care for elderly persons.

Good description.  Ultimately the goal of qualitative data analysis is to organize the data by theme.  This is done through reading and re-reading the transcripts to find the common themes. Rough Draft Qualitative Research Critique and Ethical Considerations Examples.

Reference

Clyne, B., Cooper, J. A., Hughes, C. M., Fahey, T., & Smith, S. M. (2016). ‘Potentially inappropriate or specifically appropriate?’ Qualitative evaluation of general practitioners views on prescribing, polypharmacy and potentially inappropriate prescribing in older people. BMC Family Practice, 17(1), 109

 

Rough Draft Qualitative Research Critique and Ethical Considerations Examples – 2

Research Critique: Compassion fatigue

Research on compassion fatigue has been completed identifying the problems faced by most oncology as well as emergency nurses. Compassion fatigue has been compared to burnout, displaced traumatization displaced traumatization, secondary disturbing stress disorder, compassion stress among other problem affecting the quality of service among nurses. Nurses experiencing compassion fatigue identified as having a contrasting view about the nursing practices and patient care. Study by Coetzee, & Klopper (2010), notes that “Nurses, self-identified as having compassion fatigue, described a change in their practice by which they began to shield and distance themselves from the suffering of patients and families.” That reduces the time that the nurses would have used to treat the patients and families. This creates a divide that affects not only the relationship between patients and nurses but also, the overall delivery of care.

Background of study

Among the problems facing the nursing practice today, compassion fatigue is the top problem affecting especially the oncology and emergency department nurses. The problem affects the overall healthcare leading to job dissatisfaction, poor quality of care and retention in nursing workforce. Different qualitative research has been completed addressing this problem and the factors contributing to the escalating cases of compassion fatigue. However, most methods used in these studies are not conclusive enough to provide results highlighting where this problem begin and which concrete measures need to be taken to solve the problem in the future of nursing practice. Rough Draft Qualitative Research Critique and Ethical Considerations Examples.

Problem statement

Given the increased cases of unproductivity in nursing practice, the study by Petleski, T. A. (2013) aimed to study the contributing factors leading to poor quality of services among nurses especially those working in emergency nurse department. Compassion fatigue, burnout, and compassion stress are identified as the leading factors affecting the nurses especially those working in busy and engaging departments. Rough Draft Qualitative Research Critique and Ethical Considerations Examples. Although efforts to address this problem has since been advocated and emphasized, little change has been experienced escalating the extents of this problem to other departments such as oncology nursing department. Increased nursing turnover, limited nursing staffs, working for long hours (overworking), lack of management are identified factors contributing to this problem.

Significance to nursing study

According to a qualitative research by Sheppard, K. (2016), “Frequently, nurses with compassion fatigue talk about sleepless nights as they worry about what they forgot to do at work or replay disturbing events in their minds.” This is just a tip of the iceberg of what the nurses experiencing compassion fatigue suffer from. Quantifying research has proven that addressing this problem not only has the potential of attracting more nurses into the workforce, but also improve patient’s outcome in the long run. Rough Draft Qualitative Research Critique and Ethical Considerations Examples The important of this study in nursing practice cannot be understated, it’s integral in the practice of nursing to solve the traumatic experiences nurses go through.

Purpose and Research questions

In a research study
Compassion Fatigue and Burnout. Clinical journal of oncology nursing,
a descriptive, cross-sectional study was carried out in inpatient nursing units and outpatient clinics in a cancer center in the midwestern United States. If compassion fatigue is identified before worsening, would nurse behavior change? Would patient’s outcome improve? Would the reputation of hospital health care improve? Studying how fast compassion fatigue can be identified in the nurses can appear to make the article a quantitative study, yet the study is conducted in a qualitative manner.

Discussion of method of study

The study by Maytum, Heiman, & Garwick, (2004) is a is a descriptive qualitative pilot research. The study interviewed about twenty experienced nurses working with kids affected by chronic conditions. The study sought to obtain their experiences regarding their daily work and how the work could have affected their personal lives. Compassion fatigue is mostly experienced by nurses working in engaging and busy units such as emergency nursing department and oncology department. The study however, concentrated on interviewing nurses working with children faced with chronic condition. Rough Draft Qualitative Research Critique and Ethical Considerations Examples. That would partially provide data establishing the cause and solution to the problem. Diversity of research in more than five departments is required to precisely determine a solution to this problem in today and in the future.

Data collection instrument

The research used standardized measurement tools to conduct qualitative surveys applying three regularly used assessment instruments, Professional Quality of Life Survey (ProQOL-V), The Self-Care Questionnaire, and Maslach Burnout Inventory Human Services Study (MBI-HSS) (Coetzee, & Klopper, 2010). The study employed these instruments to offer a chance for a greater sample size to provide quantifying study. The methods were well applied but most of the instruments used and their results would make this a quantitative research study. Rough Draft Qualitative Research Critique and Ethical Considerations Examples.

Theoretical framework

Although most authors outlined different concepts, beliefs and ideas which seemed to support the research, most study diverted from the main objective. For instance, the study by Coetzee, & Klopper (2010) introduced compassion fatigue regarding the study of burnout among health care professionals, but was never explained in this setting; it has since been approved as a substitute for secondary traumatic stress disorder, which is far removed from the original meaning of the term. The research therefore only gave a definition of compassion fatigue in the practice of nursing but never completed the qualitative research highlighting how the problem could be solved among staffs.

Discussion of the study results

The result of the study seemed to answer the researcher’s expectations regarding the causes of compassion fatigues in nursing. The result provided different areas which were highly considered as a contributing factor to nursing burnout and compassion. These areas included the leadership, management, understaffing, communication and coordination environmental and lifestyle and awareness (Coetzee, & Klopper, 2010). The qualitative study completed indicated the failing areas leading to compassion fatigue but never indicated a solution to each that could enhance the nursing field to overcome this problem in the future. Understaffing, lack of communication and coordination are among the leading factors leading to overworked nurses. Also, based on the results of the study, burnout nurses not only recognized as having a developed risk of stress but, also showed clinically significantly minor levels of mental QoL and clinically significantly higher levels of physical QoL (Coetzee, & Klopper, 2010).  Rough Draft Qualitative Research Critique and Ethical Considerations Examples. Additionally, 43.6% of nurses experienced <6 hours of sleep per night and thus may be identified as sleep deprived clinicians. Addressing these problems especially in busy and engaging units such as oncology and emergency nursing department is required to address the problem affecting large number of nurses in the country. Findings and implications for nursing practice The findings of the study can be described by increased levels of depression identified in clinicians experiencing compassion fatigue. Understaffing and lack of interdisciplinary coordination are identified as the leading factors escalating the levels of compassion fatigue among health care professionals. Most of these professionals are similarly never compensated for the time they overwork in their department. If the problem is not solved it has high potential affecting the future of nursing practice, yet, the study by Coetzee, & Klopper (2010), offered very few and almost obvious recommendations which are required to overcome this problem. More detailed research and recommendations to the problem are required if the problem is to be completely solved in the future of nursing. Ethical considerations In agreement with FDA regulations, “an IRB are authorized to support, recommend changes in (to secure support), or disapprove biomedical research.” (The U.S. Food and Drug Administration , 2017). Rough Draft Qualitative Research Critique and Ethical Considerations Examples.  However, the provided research studies do not mention any approval by IRB and the repudiation provided gave the views that don’t essentially indicate the policy of the United States government. The research did not provide evidence of the persons who were interviewed and the associations with certain healthcare organizations such as the Department of Veterans Affairs, was general statistics. Therefore, because of the unspecified and qualitative nature of the research used there is no concern for the ethical considerations of the participants used in the study. Conclusion Compassion fatigue and burnout is an existing problem that affect not only the nurses but, also patient’s outcomes and overall reputation of healthcare. There are different identified factors contributing and perpetuating this problem in the nursing practice. The qualitative research highlighted the problem and general solution required to overcome this problem. However, despite the effort invested in these studies, compassion fatigue remains a challenging problem facing the nursing practice today. More research addressing the problem is required to explicitly provide solution to the problem facing the nurses today. Rough Draft Qualitative Research Critique and Ethical Considerations Examples. References Coetzee, S. K., & Klopper, H. C. (2010). Compassion fatigue within nursing practice: A concept analysis. Nursing & health sciences , 12 (2), 235-243. Hooper, C., Craig, J., Janvrin, D. R., Wetsel, M. A., & Reimels, E. (2010). Compassion satisfaction, burnout, and compassion fatigue among emergency nurses compared with nurses in other selected inpatient specialties. Journal of emergency nursing , 36 (5), 420-427. Maytum, J. C., Heiman, M. B., & Garwick, A. W. (2004). Compassion fatigue and burnout in nurses who work with children with chronic conditions and their families. Journal of Pediatric Health Care , 18 (4), 171-179 Rough Draft Qualitative Research Critique and Ethical Considerations Examples. Nancy Aycock, R. N., & Deborah Boyle, R. N. (2009). Interventions to manage compassion fatigue in oncology nursing. Clinical journal of oncology nursing , 13 (2), 183. Petleski, T. A. (2013). Compassion fatigue among emergency department nurses . Gardner-Webb University. Potter, P., Deshields, T., Divanbeigi, J., Berger, J., Cipriano, D., Norris, L., & Olsen, S. (2010). Compassion Fatigue and Burnout. Clinical journal of oncology nursing , 14 (5). Rough Draft Qualitative Research Critique and Ethical Considerations Examples. Ray, S. L., Wong, C., White, D., & Heaslip, K. (2013). Compassion satisfaction, compassion fatigue, work life conditions, and burnout among frontline mental health care professionals. Traumatology , 19 (4), 255-267. Sheppard, K. (2016). Compassion fatigue: are you at risk? American Nurse Today , 11 (1), 53-55. The U.S. Food and Drug Administration (2017). IDE Institutional Review Boards (IRB). Retrieved from https://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/HowtoMarketYourDevice/InvestigationalDeviceExemptionIDE/ucm046745.htm Yoder, E. A. (2010). Compassion fatigue in nurses. Applied Nursing Research , 23 (4), 191-197. Rough Draft Qualitative Research Critique and Ethical Considerations Examples.

NRS 490 Capstone Project Topic Selection and Approval GCU Examples

In collaboration with your approved course mentor, you will identify a specific evidence-based practice proposal topic for the capstone project. Consider the clinical environment in which you are currently working or have recently worked. The capstone project topic can be a clinical practice problem, an organizational issue, a quality improvement suggestion, a leadership initiative, or an educational need appropriate to your area of interest as well as your practice immersion (practicum) setting. NRS 490 Capstone Project Topic Selection and Approval GCU Examples. Examples of the integration of community health, leadership, and an EBP can be found on the ”Educational and Community-Based Programs” page of the Healthy People 2020 website.

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Write a 500-750 word description of your proposed capstone project topic. Make sure to include the following:

The problem, issue, suggestion, initiative, or educational need that will be the focus of the project

The setting or context in which the problem, issue, suggestion, initiative, or educational need can be observed.

A description providing a high level of detail regarding the problem, issue, suggestion, initiative, or educational need.

Impact of the problem, issue, suggestion, initiative, or educational need on the work environment, the quality of care provided by staff, and patient outcomes.

Significance of the problem, issue, suggestion, initiative, or educational need and its implications to nursing.

A proposed solution to the identified project topic NRS 490 Capstone Project Topic Selection and Approval GCU Examples

You are required to retrieve and assess a minimum of 8 peer-reviewed articles. Plan your time accordingly to complete this assignment.

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

You are required to submit this NRS 490 Capstone Project Topic Selection and Approval GCU Examples assignment to LopesWrite. Please refer to the directions in the Student Success Center.

 

NRS 490 Capstone Project Topic Selection and Approval GCU Examples – 1

Problem the Project Will Focus On.

Meeting with the mentor at my practicum site, we collaborated a problem that the facility was facing which is nurse turnover. My practicum site is a long-term or rehabilitation care that is majority occupied by geriatric patients, age 65 and older. Nurse turnover is one of the biggest problems many organizations faces due to work environment, staffing issues, or better salary at another facility. However, this facility has a tough time retaining nurse, because of the poor working environment, and inadequate staffing.

Setting

Like previously said, my practicum site is at a long-term care or rehabilitation center. This long-term care or rehabilitation center can house 99 residents, but currently has 92 resident that are 65 years of age and older. With that said, high turnover rates in a long-term care or rehabilitation center can result in the organization functioning ineffectively, and poor patient outcome (Black, 2015) NRS 490 Capstone Project Topic Selection and Approval GCU Examples.

Problem Description

Many nurses have intentions to seek new employment with an employer that can create a good working environment. Many nurses at this facility has said that they work under a lot of stress, because they are short of nurses, and have a larger workload (Foster,2015). These nurses reported that they get fatigued, and burnout because they must stay over to complete unfinished work or work extra to ensure patient care.

Moreover, the nurses reported that they lack the necessary equipment or resources to perform task, lack a specific role and autonomy, and have no support from management (Jones, 2014) NRS 490 Capstone Project Topic Selection and Approval GCU Examples.

Impact and Significant of Problem

When nurse cannot perform to the extent of their practice, patient care and outcome seems to be affected. Nurse satisfaction decrease along with their performance which adds to the poor working environment (Data, 2013). This problem is significant to the nursing practice because the nursing practice promotes quality patient care and improves patient outcome.

Proposal to Problem

The proposed solution to this problem is to recruit and retrain nurses. The facility has made the incentive to recruit nurses by attracting nurses with a sign-on bonus NRS 490 Capstone Project Topic Selection and Approval GCU Examples. However, sign-on bonus doesn’t necessarily cause a nurse to be committed to the facility or organization the sign to. Some other solution that can prevent nurse turnover, is managers engaging in management or leadership skills training to better support and lead staff (Maas, 20145), and adequate nurse to patient ratio to decrease nurse workload ( Sookyung, 2008).

References

Black, P. (2015). DEVELOPING AN ENHANCED PERSPECTIVE OF TURNOVER AND RETENTION OF NURSES AND HEALTH CARE AIDES IN LONG-TERM CARE HOMES. Perspectives: The Journal Of The Gerontological Nursing Association, 38(2), 25-30.

Sookyung, H., Bakken, S., Douglas, K., & Stone, P. W. (2008). Evidence-Based Staffing: Potential Roles for Informatics. Nursing Economic$, 26(3), 151-173.

Adams, Susan Louisa. 2016. “Influences of Turnover, Retention, and Job Embeddedness in Nursing Workforce Literature.” Online Journal Of Rural Nursing & Health Care 16, no. 2: 168-195. CINAHL Complete, EBSCOhost (accessed July 30, 2018).

Foster, S. (2015). Setting our sights on a Pathway to practice improvement. British Journal Of Nursing, 24(20), 1043. doi:10.12968/bjon.2015.24.20.1043 NRS 490 Capstone Project Topic Selection and Approval GCU Examples.

Nelson, I. E. (2017). Nurse Manager Perceptions of Work Overload and Strategies to Address It. Nurse Leader, 15406-408. doi:10.1016/j.mnl.2017.09.009

Maas, M. L., Specht, J. P., Buckwalter, K. C., Gittler, J., & Bechen, K. (2015). Nursing Home Staffing and Training Recommendations for Promoting Older Adults’ Quality of Care and Life Part 2. Increasing Nurse Staffing and Training. Research In Gerontological Nursing, 1(2), 134-152.

DATA BITS. Does Shift Length Affect Patient Outcomes and Nurse Satisfaction?. (2013). Kentucky Nurse, 61(4), 3.

Jones, T. L., Murry, N., & Hamilton, P. (2013). Unfinished nursing care, missed care, and implicitly rationed care: State of the science review. International Journal Of Nursing Studies, 52(6), 1121-1137 NRS 490 Capstone Project Topic Selection and Approval GCU Examples.

 

NRS 490 Capstone Project Topic Selection and Approval GCU
Examples
2

Identified Problem

After meeting with the approved mentor and reviewing current problems within the clinical practicum site. It was decided that Central Line Associated Bloodstream Infections (CLABSI) would be the focus of the research project. It was identified that this site has struggled with reaching its zero CLABSI goal.

Setting

           
The practicum site is a 640 bed multi-specialty, teaching level 1 trauma center. The hospital has an associated and attached clinical setting. There is also a level 4 neonatal intensive care unit (NICU) within the facility. The facility is stroke certified and is a primary heart attack center. The majority of the patients are adults. NRS 490 Capstone Project Topic Selection and Approval GCU Examples.

Problem Description

           
CLABSI’s are usually preventable and avoidable (Haddadin & Hariharan, 2019). It is estimated that as many as 250,000 CLABSI’s occur each year and that the average cost of treatment is around $46,000 per occurrence (Haddadin & Hariharan, 2019).  More than 30,000 of those infections occurring in Intensive Care Units (ICU) alone, in the United States (US) (Centers for Disease Control and Prevention [CDC], 2019).

Impact of the Problem

CLABSI’s increase the cost of healthcare and cause unnecessary patient deaths each year (Haddadin & Hariharan, 2019). This is such a large and preventable problem that Joint Commission has listed CLABSI as one of the problems affecting patient’s health in the US (Joint Commission, 2012). CLABSI’s increase the morbidity and mortality of hospitalized patients each year (CDC, 2019). NRS 490 Capstone Project Topic Selection and Approval GCU Examples.

Significance of the Problem

CLABSI’s increase length of stay and patient morbidity and mortality rates (CDC, 2019). Increased length of stay increases the burden on nursing to continue to care for acutely ill patients. Nursing is the patients first line of defense against CLABSI’s. Nurses maintain and often place central lines. Centers for Medicare and Medicaid (CMS) will not reimburse for CLABSI’s incurred in inpatient settings (CMS, 2018).

Proposed Solution

An approach from multiple angles seems to be the best option for the facility to reach its zero CLABSI goal. The first change in practice would be to implement the use of alternative venous access devices when appropriate. The initiation of a central line placement protocol and checklist as well as the use of a central line care bundle. Reducing the number of patients who have central lines in place by removing them as soon as the patient no longer requires central access for the prescribed treatment or by screening patients for the need before a central line is placed can greatly reduce CLABSI rates. NRS 490 Capstone Project Topic Selection and Approval GCU Examples. Central line placement protocols for nurse led vascular access teams requiring two nurses to be present during the placement of central lines along with a real time checklist can reduce the risk of CLABSI related to placement. The use of central line care bundles can help reduce CLABSI rates by notifying staff as soon as a central line is no longer needed, the use of a sterile central line dressing change kit and requirement of two nurses being present during all dressing changes can also greatly reduce CLABSI rates.

 

References

Centers for Disease Control and Prevention (2019). Blood infection event (Central-line associated bloodstream infection and non-central line associated bloodstream infection). Retrieved from https://www.cdc.gov/nhsn/pdfs/pscmanual/4psc_clabscurrent.pdf

Haddadin, Y., & Hariharan, R. (2019). Central line associated blood stream infections. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK430891/ NRS 490 Capstone Project Topic Selection and Approval GCU Examples

Joint Commission (2012). New monograph aims to decrease central line associated bloodstream infections. Retrieved from https://www.pwrnewmedia.com/2012/joint_commission/clabsi/

Centers for Medicare and Medicaid (2018). Hospital acquired condition reduction program. Retrieved from https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/HAC-Reduction-Program.html NRS 490 Capstone Project Topic Selection and Approval GCU Examples