Tag: Clinical-Nursing

Nursing Interest and Experience – physical restraints Essay

My personal research interest is to determine the most effective interventions that can prevent the use of physical restraints on children in the inpatient psychiatric unit. Physical restraints are used in psychiatric facilities to prevent patients from harming themselves or others. However, I feel that the use of physical restraints on children can be prevented most of the time if there is a protocol in place that is based on the patient’s age and level of psychological development. The patient population that is of specific interest to me are children between the ages of 6-12 that have been admitted to an inpatient psychiatric facility.

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I feel that determining these interventions is important because utilizing physical restraints during inpatient treatment can cause injuries, cause embarrassment and humiliation, and can cause severe psychological distress for the patient, (Eblin, 2019). Nursing Interest and Experience – physical restraints Essay. I also feel that it can cause the child to have a negative view of inpatient treatment which will discourage them from seeking help in the future. Based on my experience, it can delay treatment and prolong the length of stay because the patient may no longer be cooperative. These are all factors that can prevent us from having the best outcome for the patient.

I feel that this clinical problem is of importance because all patients have the right to compassion, respect, and effective treatment. Based on my experience and as stated in the text, some clinical practices are based on tradition or unit culture. These practices are in place because that is the way they have always been done and there is no evidence to support it, (Polit & Beck, 2017). Nursing Interest and Experience – physical restraints Essay. When a practice can possibly do more harm than good to a patient it should be evaluated. I feel that because children are still in the early developmental stage, they should have a treatment plan specifically designed to help them thrive in the environment.

This target population should be studied because children with mental illnesses will eventually become adults with mental illnesses and as health care providers, we can assist them with becoming productive members of society. These patients will require long-term care and I feel that it is our responsibility to develop a positive culture around mental health treatment while they are young. Putting patients in a position that will cause them more psychological distress is exactly the opposite of what we should do. We need to focus on developing interventions that are clinically significant and be sensitive to each patient’s needs, (Polit & Beck, 2017) Nursing Interest and Experience – physical restraints Essay.

The specific interventions that I am interested in addressing for this population include, having the staff with the best rapport with the patient intervene before situations escalate. Also, to include the child’s parent(s) as a resource in the treatment plan. Based on my clinical experience, I have seen patients escalate to uncontrollable behaviors when certain staff are present as opposed to others. The staff members that have developed a good rapport with the patient can deescalate these situations without any additional interventions. It is also my experience that the parents are not very involved during treatment. Nursing Interest and Experience – physical restraints Essay I feel that if the parent is a positive influence on the child they should be used as a resource to possibly calm, orient, and help their child cope and express their feelings throughout treatment.

In conclusion, I feel that any treatment or intervention that can cause additional psychological distress, trauma, or humiliate a patient should be avoided. As health care providers we should desire to maintain our patient’s dignity at all times regardless of age. Children with mental illnesses are still developing and we should strive to provide care that promotes their desire for wellness as they grow Nursing Interest and Experience – physical restraints Essay. This will help them see treatment as a positive enforcement in their lives.

References

Eblin, A. (2019). Reducing seclusion and restraints on the inpatient child and adolescent behavioral health unit: A quality improvement study.
Journal of Child & Adolescent Psychiatric Nursing
,
32
(3),
122–128
. https://doi-org.ezproxy.fiu.edu/10.1111/jcap.12248

 

Polit, D. F., Beck, C. T., & Polit, D. F. (2017).
Resource manual for Nursing research, generating and assessing evidence for nursing practice, tenth edition
(pp.7-8). Philadelphia, PA: Wolters Kluwer. Nursing Interest and Experience – physical restraints Essay.

 

Responses

Response 1: Physical restraints

The post is informative in its introduction of the rationalizations for reducing the use of physical restraints among children between 6 and 12 year of age in inpatient psychiatric units as the nursing research topic of interest. In fact, the proposed research focus shows a depth of knowledge and understanding of a problem that plagues psychiatric care of children. It proposes that developing and applying a protocol to guide the use of physical restraints based on the patient’s age and psychological development will ensure that they are only used when necessary and the negative impacts are minimized. This is a novel approach since it is noted that although physical restraints are an important tool within the inpatient psychiatric care environment to prevent harm to the patients and others, their use is not necessary in some cases Nursing Interest and Experience – physical restraints Essay. This is of particular concern since the use of physical restraints is associated with injuries, embarrassment, humiliation and psychological distress to the patients as negative consequences, all issues of concern in as far as ensuring favorable health care outcomes is concerned. In addition, the selection of the study population has been justified through noting that children have a large potential to be productive as adults and the proposed strategy creates a positive culture that supports them towards this objective. This is an understandable point since children are impressionable and it is only right to plan their care with a view to reducing their psychiatric concerns rather than increasing them. This is an indication that the researcher intended to realize meaningful change. Nursing Interest and Experience – physical restraints Essay. The research outcome is anticipated to present a roadmap that concludes the debate on how to safely use physical restraints in psychiatric care of children. Overall, addressing the research topic is of value to nursing care since it acknowledges that physical restraints are necessary in the psychiatric care of children, but notes that they have negative consequences that can be minimized through the use of practice protocols (Babbie, 2016).

Response 2: Depression

The post focuses on strategies for improving treatment of depression among adolescents (between 15 and 19 years of age) within primary care settings as the research topic of interest. It brings attention to depression as a condition of concern, especially in the face of increasing prevalence among adolescent and young adults. Adolescents are identified as the patients of interest since they are at heightened vulnerability and susceptibility for being underdiagnosed and left untreated thereby confounding the depression as a psychiatric issue even as the individual grows older. It proposes that the issue of depression among adolescents should be addressed through promotion, prevention, detection and treatment programs. Nursing Interest and Experience – physical restraints Essay. Such programs would acknowledge the occurrence of depression among adolescents and proactively apply the appropriate interventions. Although the proposed solution addresses the issue of concern, an indication that the researcher intendeds to bring about meaningful change to psychiatric care, it does not highlight the position that nurses can play in the solution. It talks of using training to improve nurses’ proficiency in managing the programs, but does not discuss how this is related to increasing screening rates. Having skills does not automatically imply that they will be applied Nursing Interest and Experience – physical restraints Essay. As a nursing research interest, there is a need to explore the value of nurses in the solution. For instance, proposing protocols in which the trained nurses play significant roles, or highlighting the nurse-patient relationship and how nurses can initiate the relationship through trust and applying communication skills in ongoing care. The research outcome is anticipated to present a roadmap that advances psychiatric care in general, and care for depression among children (Babbie, 2016).

Reference

Babbie, E. (2016).
The basics of social research
(7
th
ed.). Boston, MA: Cengage Learning. Nursing Interest and Experience – physical restraints Essay

NURS 6052 wk 5 Assignment: EBP, Part 3: Advanced Levels of Clinical Inquiry and Systematic Reviews

Assignment: Evidence-Based Project, Part 3: Advanced Levels of Clinical Inquiry and Systematic Reviews

Your quest to purchase a new car begins with an identification of the factors important to you. As you conduct a search of cars that rate high on those factors, you collect evidence and try to understand the extent of that evidence. A report that suggests a certain make and model of automobile has high mileage is encouraging. But who produced that report? How valid is it? How was the data collected, and what was the sample size?

In this Assignment, you will delve deeper into clinical inquiry by closely examining your PICO(T) question. You also begin to analyze the evidence you have collected.

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To Prepare:

• Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry.

• Develop a PICO(T) question to address the clinical issue of interest for the Assignment.

• Use the key words from the PICO(T) question you developed and search at least four different databases in the Walden Library. Identify at least four relevant systematic reviews or other filtered high-level evidence, which includes meta-analyses, critically-appraised topics (evidence syntheses), critically-appraised individual articles (article synopses). The evidence will not necessarily address all the elements of your PICO(T) question, so select the most important concepts to search and find the best evidence available. NURS 6052 wk 5 Assignment: EBP, Part 3: Advanced Levels of Clinical Inquiry and Systematic Reviews

• Reflect on the process of creating a PICO(T) question and searching for peer-reviewed research.

The Assignment (Evidence-Based Project)

Part 3: Advanced Levels of Clinical Inquiry and Systematic Reviews

Create a 6- to 7-slide PowerPoint presentation in which you do the following:

• Identify and briefly describe your chosen clinical issue of interest.

• Describe how you developed a PICO(T) question focused on your chosen clinical issue of interest.

• Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected.

• Provide APA citations of the four peer-reviewed articles you selected.

• Describe the levels of evidence in each of the four peer-reviewed articles you selected, including an explanation of the strengths of using systematic reviews for clinical research. Be specific and provide examples.

To begin my research, I located the Walden library database and selected nursing in the subject resource. Under the nursing databases the one that caught my attention the most is CINAHL plus with full text, this database has a large collection of journals on many nursing topics. Under the CINAHL plus full text search engine, I typed in keywords hand hygiene and infection control. It took me almost two hours to complete the search because I had to try searching with different new keywords that describe my topic. I was able to get some literature after breaking the topic into keywords. I had the challenge of finding literature below five years, but with the help of the data slider, I was able to narrow my result to just a few journals. I noticed that finding scholarly articles may not be as easy as I had thought. Searching the Walden Library data base has increased my searching techniques. I am now confidence in conducting a literature research using the library resources. NURS 6052 wk 5 Assignment: EBP, Part 3: Advanced Levels of Clinical Inquiry and Systematic Reviews

My initial search resulted in 220 articles. With such a large result, I found it difficult to select articles that support my PICO question. To narrow my search further, I typed in the search engine handwashing, this narrowed my search to 20 articles. I was then able to choose 5 articles that support my PICO question which is “How does handwashing among nursing staff reduce hospital acquired infections (HAIs) in healthcare setting?”

Below is a breakdown of my PICO question:

P- stands for the target population which in this case is either the patient or the problem HAIs.

I-is the intervention used to solved the clinical issues that needs change, in my PICO question, the intervention is handwashing.

C-represent comparison. In my case I compare handwashing to other hand hygiene methods such as Alcohol hand rub.

O-is simply the outcome which is ultimately the reduction of HAIs NURS 6052 wk 5 Assignment: EBP, Part 3: Advanced Levels of Clinical Inquiry and Systematic Reviews

CINAHL plus full text has features that allows you to select full text, find article by publication dates and peer reviewed journals.

Another database that I found helpful in this research is the PubMed database, this database has more that 30 million citation from biomedical literature some of which are from MEDLINE and others are from life science journals. Under the PubMed database I selected journals that most address my PICO question.

The Boolean Operator and Nest search engine enabled me to combine words and phrases which resulted in more specific research result.

Below are four peer reviewed journal to support my PICO question

Ford, C., & Park, L. J. (2018). Hand hygiene and handwashing: key to preventing the transfer of pathogens. British Journal of Nursing, 27(20), 1164–1166. https://doi-org.ezp.waldenulibrary.org/10.12968/bjon.2018.27.20.1164

Hovi, T., Ollgren, J., & Savolainen-Kopra, C. (2017). Intensified hand-hygiene campaign including soap-and-water wash may prevent acute infections in office workers, as shown by a recognized-exposure -adjusted analysis of a randomized trial. BMC Infectious Diseases, 17, 1–9. https://doi-org.ezp.waldenulibrary.org/10.1186/s12879-016-2157-z NURS 6052 wk 5 Assignment: EBP, Part 3: Advanced Levels of Clinical Inquiry and Systematic Reviews

Kingston, L. M., O, C. N. H., & Dunne, C. P. (2018). A comparative study of hand hygiene and alcohol-based hand rub use among Irish nursing and medical students. Nurse Education Today, 63, 112–118. https://doi-org.ezp.waldenulibrary.org/10.1016/j.nedt.2018.01.022

https://www-sciencedirect-com.ezp.waldenulibrary.org/science/article/pii/S0260691718300492?via%3Dihub

Halm, M., & Sandau, K. (2018). Skin Impact of Alcohol-Based Hand Rubs Vs Handwashing. American Journal of Critical Care, 27(4), 334–337. https://doi-org.ezp.waldenulibrary.org/10.4037/ajcc2018727

Below are the research databases I used to conduct my research

Walden University Library. (n.d.-b). Evidence -based practice research: CINAHL Search help.

Retrieved September 6, 2019, from

https://academicguides.waldenu.edu/library/healthevidence/medlinesearchhelp NURS 6052 wk 5 Assignment: EBP, Part 3: Advanced Levels of Clinical Inquiry and Systematic Reviews

Library of Congress. (n.d.). Search /browse help-Boolean Operators and nesting

Retrieved September 19, 2018, from,

https://catalog.loc.gov/vwebv/ui/en_US/htdocs/help/searchKeyword.html

Walden Library. (n.d.) PubMed: Getting Started. Retrieved September 19, 2019 from,https://www-ncbi-nlm-nih-gov.ezp.waldenulibrary.org/pubmed/?otool=mnwullib NURS 6052 wk 5 Assignment: EBP, Part 3: Advanced Levels of Clinical Inquiry and Systematic Reviews

Difference between “common practice” and “best practice” EBP assignment project

Part 2-Analysis

Student’s Name

Institution of Affiliation

Course Name

Date

Grayson, M. L., Stewardson, A. J., Russo, P. L., Ryan, K. E., Olsen, K. L., Havers, S. M.,  & National Hand Hygiene Initiative. (2018). Effects of the Australian National Hand Hygiene Initiative after 8 years on infection control practices, health-care worker education, and clinical outcomes: a longitudinal study. The Lancet Infectious Diseases, 18(11), 1269-1277.

Relation To The Clinical Issue

This article similarly highlights how Healthcare-Associated infections hinder patient safety, increases mortality and morbidity rates prolong hospital stays and increases medical costs. The researchers further acknowledge compliance of hand hygiene among healthcare providers as a significant strategy to maintain patient safety especially with regards to methicillin-resistant staphylococcus Aureus. However, very few national programs have been sustained and integrated successfully into the national-health structure. Based on the results of the NHHI (National Hand Hygiene Initiative), hand hygiene reduces the risks of healthcare-associated infections which continue to be a major public health concern. Difference between “common practice” and “best practice” EBP assignment project

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Aim of the Study

The study aimed at evaluating the outcomes of the NHHI including its effect on the incidences of healthcare-associated Staphylococcus Aureus and hand hygiene compliance. This study aim was influenced by the background knowledge that a healthcare provider’s compliance with hand hygiene is a significant national strategy for patient safety.

Research Methodology

This was a quantitative longitudinal study where the outcomes of the NHHI eight years after implementation were assessed. The assessment included the extent of hand hygiene guidelines compliance and the hospital’s participation, costs, and association with healthcare-associated Staphylococcus Aureus and educational engagement. Difference between “common practice” and “best practice” EBP assignment project

Strengths of Research Methodologies

Wide population data were used to evaluate the clinical impact of NHHI, specific, statistical analysis was done comparisons of proportions (χ² or t-test), with a p-value of 0·05 or less (two-tailed) which was considered to be statistically significant and increased the accuracy of results. Besides, hand hygiene and compliance data were assessed for errors and consistency using a standard process for review and validation. To maximize the validity and accuracy of data, two systems were established including representative hospital samples and the poorly performing sites.

Munoz-Figueroa, G. P., & Ojo, O. (2018). The effectiveness of alcohol-based gel for hand sanitizing in infection control. British Journal of Nursing, 27(7), 382-388.

Relation To The Clinical Issue

The article addresses a similar clinical issue by acknowledging Healthcare-Associated Infections as a public health concern for the health sector across the globe according to NICE. Some of the commonly identified infections include surgical, respiratory and urinary tract infections. This calls for the implementation of better strategies to control infections including education, reinforcing knowledge to the public, healthcare providers and individuals at high risk of infections in all areas of nursing practice.

Aim of the Study

The study aimed at evaluating the effectiveness of alcohol-based gel for hand rubs in controlling infections in the clinical setting. The article was specific to renal nursing following a growth in the focus of evidence-based practice.

Research Methodology

The EBP process for clinical decision making was reviewed for effective literature on the effectiveness of alcohol-based gel and the results published recently concerning the findings of the best model.

Strengths of Research Methodologies

The review utilizes the steps of EBP and numerous articles relevant to the review purpose are used to justify the information shared.

General Comment

When compared to approaches that use detergents and disinfectants that can result in pathogen dissemination, alcohol when adequately used is even more effective. Therefore, hand rubs should be at every patient’s bedside, ward entrance and hospital for use after, before and when performing all activities related to care

Halm, M., & Sandau, K. (2018). Skin Impact of Alcohol-Based Hand Rubs vs Handwashing. American Journal of Critical Care, 27(4), 334-337.

Relation To The Clinical Issue

The researchers refer to the guidelines by the CDC and WHO which have been driven hand hygiene practices for more than ten years. According to these guidelines, when hands are deeply soiled with body fluids or blood or after visiting the toilet with suspected Clostridium difficile pathogens, the most preferred way to manage and control infections is through Handwashing with soap and water. However, for all other clinical scenarios, the researchers recommend that routine hand hygiene should be maintained with alcohol-based hand rubs. This discussion on infection prevention perfectly resonates with my clinical issue to be addressed.

Aim of the Study

According to the researchers, frequent Handwashing is a major cause of contact dermatitis thus rarely preferred by healthcare providers in clinical settings as a way of managing and controlling infections.  On the other hand, alcohol-based hand rubs are notably effective in bacterial reduction and causes less skin irritation. These perceptions greatly influence the degree of staff compliance to hand hygiene guidelines which ultimately impacts the rates of HAIs. Therefore, the study aimed to determine the impact of ABHRs supplemented by the use of creams and lotions on health outcomes.

Research Methodology

The study was a systematic review of literature that used qualitative methods approach.  The researchers searched the databases of MEDLINE and CINAHL using the keywords ABHR, contact dermatitis, dermatitis, and Handwashing. This search was limited to articles that had been published within the last 10 years. Only original articles were considered. The findings were presented in the form of tables to show outcomes and comparisons.

Strengths of Research Methodologies

The comprehensive literature search that was conducted was within the limit of 10 years. This aimed at ensuring that the findings could still be applied to current clinical practice and were in line with the recommended practice guidelines. Besides, the researchers used the following keywords to conduct the literature search: hand hygiene, ABHR, hand washing, dermatitis, and contact dermatitis. This ensured that only studies that were relevant to the clinical issue were addressed.

General Comments

To promote the use of ABHRs and lessen the occurrence of contact dermatitis, nurses should be taught that Handwashing after and before using ABHRs removes emollients and sebum layers thus increasing the risk of contact dermatitis

Loftus, R. W., Dexter, F., & Robinson, A. D. (2018). High-risk Staphylococcus aureus transmission in the operating room: a call for widespread improvements in perioperative hand hygiene and patient decolonization practices. American journal of infection control, 46(10), 1134-1141.

Relation To The Clinical Issue

The article discusses how an increase in the awareness and epidemiology of pathogen transmission can help to expand compliance with intraoperative infection control measures. This was specific to the risk of transmitting Staphylococcus Aureus during operations which are associated with high transmission rates, antibiotic resistance, and virulence. It was also attributed to a significant growth pathogen spread within acute care settings to healthy community dwellers in community settings. The researchers further discuss evidence-based solutions that can be used to address this issue to improve patient safety.

Aim of the Study

The researchers acknowledged Healthcare-Associated Infections to be an overwhelming issue related to antibiotics resistance. It is for this reason that healthcare providers have been urged to ensure compliance with some of the most basic prevention measures to prevent the unnecessary use of antibiotics and prevent infections. The study was specific to reducing the incidence of surgical site infections through the preoperative decolonization of staph Aureus through improvement measures in novel hand hygiene. Therefore, the study aimed to characterize the epidemiology of sequence types  of  Staphylococcus Aureus in the operating environment.

Research Methodology

The study used quantitative research methods where Staphylococcus
Aureus
species that were isolated and collected from three medical centers underwent biofilm absorbance, genome analysis, and API (analytical profile indexing). 274 case pairs were randomly selected using a computer-generated list from a total of three medical centers in the US.  178 species of Staphylococcus Aureus were isolated. Of these, 173 were associated with the possibility of transmissions. The researchers also conducted an assessment on the virulent, antibiotic-resistant and hyper transmissible and strains of staphylococcus Aureus.  Statistical analyses using X
2
tests and Poisson regression with variances were used for statistical analyses.

Strengths of Research Methodologies

The researchers used randomization of study participants and a large study sample which increased chances of applicability of the results to wide-population settings. Besides, randomization helped to establish a cause and effect relationship between the variables that were being studied. The researchers also used conceptual frameworks to list the possible courses of action regarding the concept that was an understudy. When conducting the statistical analyses, χ2 tests were used in examining the possible associations of covariates previously mentioned variates about transmission.

General Comments

Intraoperative strains of Staphylococcus Aureus are pathogenic and hyper-transmissible. To control their spread, compliance with hand hygiene and patient decolonization are essential.

References

Grayson, M. L., Stewardson, A. J., Russo, P. L., Ryan, K. E., Olsen, K. L., Havers, S. M., … & National Hand Hygiene Initiative. (2018). Effects of the Australian National Hand Hygiene Initiative after 8 years on infection control practices, health-care worker education, and clinical outcomes: a longitudinal study. 
The Lancet Infectious Diseases, 18
(11), 1269-1277.

Halm, M., & Sandau, K. (2018). Skin Impact of Alcohol-Based Hand Rubs vs Handwashing. 
American Journal of Critical Care, 27
(4), 334-337.

Loftus, R. W., Dexter, F., & Robinson, A. D. (2018). High-risk Staphylococcus aureus transmission in the operating room: a call for widespread improvements in perioperative hand hygiene and patient decolonization practices. 
American journal of infection control, 46
(10), 1134-1141.

Munoz-Figueroa, G. P., & Ojo, O. (2018). The effectiveness of alcohol-based gel for hand sanitizing in infection control.
British Journal of Nursing, 27
(7), 382-388.

Assignment: Evidence-Based Project

Is there a difference between “common practice” and “best practice”?

When you first went to work for your current organization, experienced colleagues may have shared with you details about processes and procedures. Perhaps you even attended an orientation session to brief you on these matters. As a “rookie,” you likely kept the nature of your questions to those with answers that would best help you perform your new role.

Over time and with experience, perhaps you recognized aspects of these processes and procedures that you wanted to question further. This is the realm of clinical inquiry.

Clinical inquiry is the practice of asking questions about clinical practice. To continuously improve patient care, all nurses should consistently use clinical inquiry to question why they are doing something the way they are doing it. Do they know why it is done this way, or is it just because we have always done it this way? Is it a common practice or a best practice?

In this Assignment, you will identify clinical areas of interest and inquiry and practice searching for research in support of maintaining or changing these practices. You will also analyze this research to compare research methodologies employed.

To Prepare:

Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry.

Based on the clinical issue of interest and using keywords related to the clinical issue of interest, search at least four different databases in the Walden Library to identify at least four relevant peer-reviewed articles related to your clinical issue of interest.

Review the results of your peer-reviewed research and reflect on the process of using an unfiltered database to search for peer-reviewed research.

Reflect on the types of research methodologies contained in the four relevant peer-reviewed articles you selected.

Part 1: An Introduction to
Clinical Inquiry

Create a 4- to 5-slide PowerPoint presentation in which you do the following:

Identify and briefly describe your chosen clinical issue of interest.

Describe how you used keywords to search on your chosen clinical issue of interest.

Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected.

Provide APA citations of the four peer-reviewed articles you selected.

Part 2: Identifying Research Methodologies

After reading each of the four peer-reviewed articles you selected, use the Matrix Worksheet template to analyze the methodologies applied in each of the four peer-reviewed articles. Your analysis should include the following:

The full citation of each peer-reviewed article in APA format. Difference between “common practice” and “best practice” EBP assignment project

A brief (1-paragraph) statement explaining why you chose this peer-reviewed article and/or how it relates to your clinical issue of interest, including a brief explanation of the ethics of research related to your clinical issue of interest.

A brief (1-2 paragraph) description of the aims of the research of each peer-reviewed article.

A brief (1-2 paragraph) description of the research methodology used. Be sure to identify if the methodology used was qualitative, quantitative, or a mixed-methods approach. Be specific.

A brief (1- to 2-paragraph) description of the strengths of each of the research methodologies used, including reliability and validity of how the methodology was applied in each of the peer-reviewed articles you selected.

References

Halm, M., & Sandau, K. (2018). Skin Impact of Alcohol-Based Hand Rubs Vs Handwashing. 
American Journal of Critical Care
, 
27
(4), 334–337. https://doi-org.ezp.waldenulibrary.org/10.4037/ajcc2018727

Munoz-Figueroa, G. P., & Ojo, O. (2018). The effectiveness of alcohol-based gel for hand sanitising in infection control. 
British Journal of Nursing
, 
27
(7), 382–388.
https://doi-org.ezp.waldenulibrary.org/10.12968/bjon.2018.27.7.382

Lim, K., Kilpatrick, C., Storr, J., & Seale, H. (2018). Exploring the use of entertainment-education YouTube videos focused on infection prevention and control. 
American Journal of Infection Control
, 
46
(11), 1218–1223.
https://doi-org.ezp.waldenulibrary.org/10.1016/j.ajic.2018.05.002

Grayson, M. L., Stewardson, A. J., Russo, P. L., Ryan, K. E., Olsen, K. L., Havers, S. M., … Cruickshank, M. (2018). Effects of the Australian National Hand Hygiene Initiative after 8 years on infection control practices, health-care worker education, and clinical outcomes: a longitudinal study. 
Lancet Infectious Diseases
, 
18
(11), 1269–1277.
https://doi-org.ezp.waldenulibrary.org/10.1016/S1473-3099(18)30491-2

Loftus, R. W., Dexter, F., & Robinson, A. D. M. (2018). High-risk Staphylococcus aureus transmission in the operating room: A call for widespread improvements in perioperative hand hygiene and patient decolonization practices. 
American Journal of Infection Control
, 
46
(10), 1134–1141. https://doi-org.ezp.waldenulibrary.org/10.1016/j.ajic.2018.04.211 Difference between “common practice” and “best practice” EBP assignment project

Matrix Worksheet Template

 

Citation

Article #1

Article #2

Article #3

Article #4

Munoz-Figueroa, G. P., & Ojo, O. (2018). The effectiveness of alcohol-based gel for hand sanitising in infection control. 
British Journal of Nursing, 27
(7), 382-388.

 

 

 

 

Grayson, M. L., Stewardson, A. J., Russo, P. L., Ryan, K. E., Olsen, K. L., Havers, S. M., … & National Hand Hygiene Initiative. (2018). Effects of the Australian National Hand Hygiene Initiative after 8 years on infection control practices, health-care worker education, and clinical outcomes: a longitudinal study. 
The Lancet Infectious Diseases, 18
(11), 1269-1277.

 

Halm, M., & Sandau, K. (2018). Skin Impact of Alcohol-Based Hand Rubs vs. Handwashing. 
American Journal of Critical Care, 27
(4), 334-337.

Difference between “common practice” and “best practice” EBP assignment project

 

Loftus, R. W., Dexter, F., & Robinson, A. D. (2018). High-risk Staphylococcus Aureus transmission in the operating room: a call for widespread improvements in perioperative hand hygiene and patient decolonization practices. 
American journal of infection control, 46
(10), 1134-1141.

 

Relations with Clinical Issue and the ethics of research in Relation to the Clinical Issue

The article addresses a similar clinical issue by acknowledging Healthcare-Associated Infections as a public health concern for the health sector across the globe according to NICE. Some of the commonly identified infections include surgical, respiratory and urinary tract infections. This calls for the implementation of better strategies to control infections including education, reinforcing knowledge to the public, healthcare providers and individuals at high risk of infections in all areas of nursing practice.

This article similarly highlights how Healthcare Associated infections hinder patient safety, increases mortality and morbidity rates prolong hospital stays and increases medical costs. The researchers further acknowledge compliance of hand hygiene among healthcare providers as a significant strategy to maintain patient safety especially with regards to methicillin-resistant staphylococcus Aureus. However, very few national programmes have been sustained and integrated successfully into the national-health structure. Based on the results of the National Hand hygiene Initiative, hand hygiene reduces the risks of healthcare associated infections which continue to be a major public health concern.

The article highlights how Handwashing with soap and water is the most preferred way to manage and control infections.

The article discusses how an increase in the awareness and epidemiology of pathogen transmission can help to improve compliance with intraoperative measures for infection control. This was specific to the risk of transmitting Staphylococcus Aureus during operations.

 

Difference between “common practice” and “best practice” EBP assignment project

Aim of Study

To evaluate the effectiveness of alcohol-based gel for handrubs in the control of infections in clinical settings. The article was specific to renal nursing following a growth in the focus of evidence-based practice.

The study aimed at evaluating the outcomes of the National Hand Hygiene Initiative including its effect on the incidences of healthcare associated staphylococcus Aureus and hand hygiene compliance. This study aim was influenced by the background knowledge that healthcare provider’s compliance with hand hygiene is a significant national strategy for patient safety.

To examine the impact of  alcohol based handrubs supplemented with the use of lotions influences health outcomes among healthcare providers

 

 

 

To characterize the epidemiology of Staphylococcus Aureus sequence types in the operating environment.

Research methodology

The EBP process for clinical decision making was reviewed for effective literature on the effectiveness of alcohol based gel and the results published recently with respect to the findings of the best model.

 

However, in a systematic review conducted by

 

 

 

 

 

 

 A longitudinal study where the outcomes of the NHHI eight years after implementation were assessed. The assesment included compliance with hand hygiene and the hospital’s participation, costs and association with heathcare-associated staphylococcus Aureus and educational engagement.

 

 

The researchers searched the databases of MEDLINE and CINAHL using the keywords ABHR, contact dermatitis, dermatitis and Handwashing. This search was limited to the past 10 years.

 

 

 

Staphylococcus
Aureus
species that that were isolated and collected from three academic medical centers underwent biofilm absorbance, genome analysis and analytical profile indexing. An assessment on the virulent, antibiotic-resistant and hyper transmissible and strains of staphylococcus Aureus was done.

 

 

 

Strengths of the Study, reliability and Validity

The review utilizes the steps of EBP and numerous articles relevant to the review purpose are used to justify the information shared.

Wide population data was used to evaluate the clinical impact of NHHI, specific, statistical analysis was done comparisons of proportions (χ² or t test), with a p value of 0·05 or less (two-tailed) considered statistically significant.

A comprehensive literature search that was conducted was within the limit of 10 years. The following key words were used in the literature search: hand hygiene, ABHR, hand washing, dermatitis, and contact dermatitis.

Randomization of study participants, a large study sample which increased chances of applicability to wide-population settings, χ2 tests were used to in examining the possible associations of c covariates previously mentioned variates in relation to transmission.

General Comments

When compared to approaches that use detergents and disinfectants that can result to pathogen dissemination, alcohol when adequately used is even more effective. Therefore, handrubs should be provided at the bedside, ward entrances and hospital for use when the hands are not visibly dirty, after, before and when performing all activities related to care.

 

 

 

 

 

The NHHI has been linked to significant improvement in hand hygiene compliance and a reduction in the incidence of HA-SAB. For a sustained central coordination and standardized approach for integration in hospital accreditation standards, several features should be observed.

Difference between “common practice” and “best practice” EBP assignment project

In order to promote the use of  ABHRs and reduce the prevalence of contact dermatitis, nurses should be taught that Handwashing after and before  using ABHRs removes emollients and sebum layers thus increasing the risk of contact dermatitis

 

 

Intraoperative strains of staphylococcus Aureus are pathogenic and hyper-transmissible. In order to control their spread, compliance with hand hygiene and patient decolonization are essential.

 

 

 

 

References

Grayson, M. L., Stewardson, A. J., Russo, P. L., Ryan, K. E., Olsen, K. L., Havers, S. M., … & National Hand Hygiene Initiative. (2018). Effects of the Australian National Hand Hygiene Initiative after 8 years on infection control practices, health-care worker education, and clinical outcomes: a longitudinal study. 
The Lancet Infectious Diseases
, 
18
(11), 1269-1277.

Halm, M., & Sandau, K. (2018). Skin Impact of Alcohol-Based Hand Rubs vs Handwashing. 
American Journal of Critical Care
, 
27
(4), 334-337. Difference between “common practice” and “best practice” EBP assignment project

Loftus, R. W., Dexter, F., & Robinson, A. D. (2018). High-risk Staphylococcus aureus transmission in the operating room: a call for widespread improvements in perioperative hand hygiene and patient decolonization practices. 
American journal of infection control
, 
46
(10), 1134-1141.

Lim, K., Kilpatrick, C., Storr, J., & Seale, H. (2018). Exploring the use of entertainment-education YouTube videos focused on infection prevention and control. 
American journal of infection control
, 
46
(11), 1218-1223.

Munoz-Figueroa, G. P., & Ojo, O. (2018). The effectiveness of alcohol-based gel for hand sanitising in infection control. 
British Journal of Nursing
, 
27
(7), 382-388. Difference between “common practice” and “best practice” EBP assignment project

Evidence-Based Project, Part 1: An Introduction to Clinical Inquiry and Part 2: Research Methodologies

 

Use this document to complete
Part 2
of the Module 2 Assessment,
Evidence-Based Project, Part 1: An Introduction to Clinical Inquiry and Part 2: Research Methodologies

 

 

Full
citation
of selected article

Article #1

Article #2

Article #3

Article #4

 

 

 

 

Why
you chose this article and/or
how it relates
to the clinical issue of interest (include a brief
explanation of the ethics
of research related to your clinical issue of interest)

 

 

 

 

ORDER A PLAGIARISM-FREE PAPER HERE

Brief
description of the aims
of the research of each peer-reviewed article

 

 

 

 

Brief description of the
research methodology
used Be sure to identify if the methodology used was
qualitative
,
quantitative
, or a
mixed-methods
approach. Be specific.

 

 

 

 

 

 

 

 

 

 

A brief description of the
strengths
of each of the research methodologies used, including
reliability
and
validity
of how the methodology was applied in each of the peer-reviewed articles you selected.

 

 

General Notes/Comments

 

 

 

 

 

 

 

NURS_6052_wk_3_assignment_Matrix_Worksheet_Template_replaced

Assignment: Evidence-Based Project

Is there a difference between “common practice” and “best practice”?

When you first went to work for your current organization, experienced colleagues may have shared with you details about processes and procedures. Perhaps you even attended an orientation session to brief you on these matters. As a “rookie,” you likely kept the nature of your questions to those with answers that would best help you perform your new role.

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Over time and with experience, perhaps you recognized aspects of these processes and procedures that you wanted to question further. This is the realm of clinical inquiry.

Clinical inquiry is the practice of asking questions about clinical practice. To continuously improve patient care, all nurses should consistently use clinical inquiry to question why they are doing something the way they are doing it. Do they know why it is done this way, or is it just because we have always done it this way? Is it a common practice or a best practice? Assignment: Evidence-Based Project

In this Assignment, you will identify clinical areas of interest and inquiry and practice searching for research in support of maintaining or changing these practices. You will also analyze this research to compare research methodologies employed.

To Prepare:

Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry.

Based on the clinical issue of interest and using keywords related to the clinical issue of interest, search at least four different databases in the Walden Library to identify at least four relevant peer-reviewed articles related to your clinical issue of interest.

Review the results of your peer-reviewed research and reflect on the process of using an unfiltered database to search for peer-reviewed research.

Reflect on the types of research methodologies contained in the four relevant peer-reviewed articles you selected.

Part 1: An Introduction to Clinical Inquiry

Create a 4- to 5-slide PowerPoint presentation in which you do the following:

Identify and briefly describe your chosen clinical issue of interest.

Describe how you used keywords to search on your chosen clinical issue of interest.

Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected.

Provide APA citations of the four peer-reviewed articles you selected.

Part 2: Identifying Research Methodologies

After reading each of the four peer-reviewed articles you selected, use the Matrix Worksheet template to analyze the methodologies applied in each of the four peer-reviewed articles. Your analysis should include the following:

The full citation of each peer-reviewed article in APA format.

A brief (1-paragraph) statement explaining why you chose this peer-reviewed article and/or how it relates to your clinical issue of interest, including a brief explanation of the ethics of research related to your clinical issue of interest.

A brief (1-2 paragraph) description of the aims of the research of each peer-reviewed article.

A brief (1-2 paragraph) description of the research methodology used. Be sure to identify if the methodology used was qualitative, quantitative, or a mixed-methods approach. Be specific.

A brief (1- to 2-paragraph) description of the strengths of each of the research methodologies used, including reliability and validity of how the methodology was applied in each of the peer-reviewed articles you selected.

 

References

Halm, M., & Sandau, K. (2018). Skin Impact of Alcohol-Based Hand Rubs Vs Handwashing. 
American Journal of Critical Care
, 
27
(4), 334–337. https://doi-org.ezp.waldenulibrary.org/10.4037/ajcc2018727

Munoz-Figueroa, G. P., & Ojo, O. (2018). The effectiveness of alcohol-based gel for hand sanitising in infection control. 
British Journal of Nursing
, 
27
(7), 382–388.
https://doi-org.ezp.waldenulibrary.org/10.12968/bjon.2018.27.7.382

Lim, K., Kilpatrick, C., Storr, J., & Seale, H. (2018). Exploring the use of entertainment-education YouTube videos focused on infection prevention and control. 
American Journal of Infection Control
, 
46
(11), 1218–1223.
https://doi-org.ezp.waldenulibrary.org/10.1016/j.ajic.2018.05.002

Grayson, M. L., Stewardson, A. J., Russo, P. L., Ryan, K. E., Olsen, K. L., Havers, S. M., … Cruickshank, M. (2018). Effects of the Australian National Hand Hygiene Initiative after 8 years on infection control practices, health-care worker education, and clinical outcomes: a longitudinal study. 
Lancet Infectious Diseases
, 
18
(11), 1269–1277.
https://doi-org.ezp.waldenulibrary.org/10.1016/S1473-3099(18)30491-2

Loftus, R. W., Dexter, F., & Robinson, A. D. M. (2018). High-risk Staphylococcus aureus transmission in the operating room: A call for widespread improvements in perioperative hand hygiene and patient decolonization practices. 
American Journal of Infection Control
, 
46
(10), 1134–1141. https://doi-org.ezp.waldenulibrary.org/10.1016/j.ajic.2018.04.211 Assignment: Evidence-Based Project

Matrix Worksheet Template

 

Use this document to complete
Part 2
of the Module 2 Assessment,
Evidence-Based Project, Part 1: An Introduction to Clinical Inquiry and Part 2: Research Methodologies

 

 

Full
citation
of selected article

Article #1

Article #2

Article #3

Article #4

 

 

 

 

Why
you chose this article and/or
how it relates
to the clinical issue of interest (include a brief
explanation of the ethics
of research related to your clinical issue of interest)

 

 

 

 

ORDER A PLAGIARISM-FREE PAPER HERE

Brief
description of the aims
of the research of each peer-reviewed article

 

 

 

 

Brief description of the
research methodology
used Be sure to identify if the methodology used was
qualitative
,
quantitative
, or a
mixed-methods
approach. Be specific.

 

 

 

 

 

 

 

 

 

 

A brief description of the
strengths
of each of the research methodologies used, including
reliability
and
validity
of how the methodology was applied in each of the peer-reviewed articles you selected.

 

 

General Notes/Comments

 

 

 

 

 

 

 

Assignment: Evidence-Based Project

NURS_6052_wk_3_assignment_Matrix_Worksheet_Template

 

Use this document to complete
Part 2
of the Module 2 Assessment,
Evidence-Based Project, Part 1: An Introduction to Clinical Inquiry and Part 2: Research Methodologies

 

ORDER A PLAGIARISM-FREE PAPER HERE

Full
citation
of selected article

Article #1

Article #2

Article #3

Article #4

 

 

 

 

Why
you chose this article and/or
how it relates
to the clinical issue of interest (include a brief
explanation of the ethics
of research related to your clinical issue of interest)

 

 

 

 

Brief
description of the aims
of the research of each peer-reviewed article

 

 

 

 

Brief description of the
research methodology
used Be sure to identify if the methodology used was
qualitative
,
quantitative
, or a
mixed-methods
approach. Be specific.

 

 

 

 

 

 

 

 

 

 

A brief description of the
strengths
of each of the research methodologies used, including
reliability
and
validity
of how the methodology was applied in each of the peer-reviewed articles you selected.

 

 

General Notes/Comments

 

 

 

 

 

 

 

NURS_6052_wk_3_assignment_Matrix_Worksheet_Template

NURS_6052_wk_3_assignment_Matrix_Worksheet_Template

Assignment: Evidence-Based Practice and the Quadruple Aim sample essay

Healthcare organizations continually seek to optimize healthcare performance. For years, this approach was a three-pronged one known as the Triple Aim, with efforts focused on improved population health, enhanced patient experience, and lower healthcare costs.

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More recently, this approach has evolved to a Quadruple Aim by including a focus on improving the work life of healthcare providers. Each of these measures are impacted by decisions made at the organizational level, and organizations have increasingly turned to EBP to inform and justify these decisions.

To Prepare:

• Read the articles by Sikka, Morath, & Leape (2015); Crabtree, Brennan, Davis, & Coyle (2016); and Kim et al. (2016) provided in the Resources.

• Reflect on how EBP might impact (or not impact) the Quadruple Aim in healthcare.

• Consider the impact that EBP may have on factors impacting these quadruple aim elements, such as preventable medical errors or healthcare delivery. Assignment: Evidence-Based Practice and the Quadruple Aim sample essay

To Complete:

Write a brief analysis (no longer than 2 pages) of the connection between
EBP and the Quadruple Aim
.

Your analysis should address how EBP might (or might not) help reach the Quadruple Aim, including each of the four measures of:

• Patient experience

• Population health

• Costs

• Work life of healthcare providers

By Day 7 of Week 1

Submit your anaylsis.

Resources

https://qualitysafety-bmj-com.ezp.waldenulibrary.org/content/24/10/608

https://qualitysafety-bmj-com.ezp.waldenulibrary.org/content/24/10/608

https://insights-ovid-com.ezp.waldenulibrary.org/crossref?an=00006216-201807000-00009

https://www-sciencedirect-com.ezp.waldenulibrary.org/science/article/pii/S1541461219300941?via%3Dihub

http://acc.aacnjournals.org/content/30/2/185

https://journals.stfm.org/familymedicine/2019/february/marker-2018-0276/ Assignment: Evidence-Based Practice and the Quadruple Aim sample essay

https://qualitysafety-bmj-com.ezp.waldenulibrary.org/content/24/10/608

https://insights-ovid-com.ezp.waldenulibrary.org/crossref?an=00006216-201904000-00008

 

Relation between EBP and the Quadruple Aim

Evidence-based practice heavily relies on the use of available scientific evidence for decision making in the clinical setting. Ever since its formal introduction in the 1990s, evidence-based practices have continued to gain ground in management, the formation of public policies, education and nursing practice. As one of the most effective problem-solving approach in clinical settings, evidence-based practice integrates the best available evidence from well-designed scientific studies, the preferences, and values of patients and the expertise of clinicians to make decisions regarding patient care (Crabtree et al., 2016). Assignment: Evidence-Based Practice and the Quadruple Aim sample essay As a result, the main aim of evidence-based providers is to ensure that patients are provided with high quality and safe healthcare services. For high chances of success, EBP embraces an interprofessional model where shared decision making is greatly emphasized. Similarly, different actors at the state, federal and local levels are essential for the adoption and implementation of evidence-based practice. According to Crabtree et al., (2016), nurses have widely embraced a positive attitude towards evidence-based practice and its providers and the majority are ready to acquire the necessary skills and knowledge for its adoption into clinical practice.

The quadruple aim has four major goals mainly: improving patient experience, population health, the work-life of healthcare providers and reducing healthcare-associated costs (Sakallaris et al., 2016). The quadruple aim purposes to achieve the aforementioned goals through the redesigning of healthcare facilities. However, a major setback in achieving these goals in the wider health sector is improving population health while at the same time containing/reducing healthcare-related costs, which requires a high level of efficiency and effectiveness (Bodenheimer & Sinsky, 2014).  A highly productive health workforce is mandatory for an effective healthcare system. This is what promoted the translation of the triple aim to the quadruple aim through the addition of a fourth goal which is improving healthcare providers’ work-life. Assignment: Evidence-Based Practice and the Quadruple Aim sample essay

The Impact That EBP May Have On Factors Influencing These Quadruple Aim Elements.

The development and adoption of evidence-based practice is mainly to improve the quality of healthcare services that patients receive and places a lot of value inpatient care in clinical settings. Similarly, evidence-based practice has a direct impact on the work-life of healthcare providers since, to receive high quality and safe healthcare services, staff needs to be very productive. The purpose of every healthcare institution is to ensure that the life of patients, as well as that of healthcare staff providing healthcare services, is improved.

 Patient experience

All strategies used in evidence-based practice permit healthcare providers to translate the findings of research into clinical practice. By utilizing efficient searching skills of literature and formally applying the rules that guide evidence to evaluate the findings of research, nurses and other healthcare providers can efficiently apply existent scientific knowledge to clinical practice based on individual patient needs (Jacobs et al., 2018). As a result, this improves the quality of healthcare services that patients receive. In recent times, most healthcare institutions are embracing evidence-based practice to solve clinical issues that directly impact patient care and this is what has led to improved patient experiences Assignment: Evidence-Based Practice and the Quadruple Aim sample essay.

Population health

Evidence-based practices purpose to educate populations on the individual health determinants, the benefits, and limitations of specific treatments, cultural and healthcare practices.  Those integrating evidence-based practices in various population settings also purpose to ensure the equitable distribution of resources to achieve specific aims (Sakallaris et al., 2016). Populations can be classified based on its needs as identified by socioeconomic status, the support received from family and individual health status, and this promotes equity and efficiency in the allocation and distribution of resources for health promotion. All evidence-based processes involved in care have been specifically designed to address individual patient needs as opposed to shaping healthcare patterns based on subgroups.

Costs

           
A major challenge for most healthcare facilities is directly related to the measure of per capita costs of healthcare as it needs all healthcare expenditures to be captured, measurement of actual costs and indexing the costs to the healthcare market. According to Sakallaris et al., (2016), the most common method used to measure actual costs is discounts and pricing. Therefore, for most healthcare institutions, it is a huge challenge to provide safe and quality healthcare services at lower healthcare costs. When an institution embraces the use of the latest technology to improve efficiency and most recent treatment methods as revealed through evidence-based practice, the quality of care, as well as the costs, automatically increases.

The work-life of healthcare providers

The key components of a conducive healthcare environment should support interprofessional collaboration. Interprofessional collaboration has been evidenced to improve patient health outcomes and the satisfaction of healthcare providers. It also reduces provider burnout and turnover rates, which promotes staff productivity (William et al., 2016). The three major components of such an environment include the structural and policy elements and actively engaging the workforce in shared decision making. Assignment: Evidence-Based Practice and the Quadruple Aim sample essay.

References

Bodenheimer, T., & Sinsky, C. (2014). From triple to quadruple aim: care of the patient requires care of the provider.
The Annals of Family Medicine
,
12
(6), 573-576.

Crabtree, E., Brennan, E., Davis, A., & Coyle, A. (2016). Improving Patient Care Through Nursing Engagement in Evidence‐Based Practice.
Worldviews on Evidence
‐
Based Nursing
,
13
(2), 172-175.

Jacobs, B., McGovern, J., Heinmiller, J., & Drenkard, K. (2018). Engaging employees in well-being: moving from the triple aim to the quadruple aim.
Nursing administration quarterly
,
42
(3), 231-245 Assignment: Evidence-Based Practice and the Quadruple Aim sample essay.

Sakallaris, B. R., Miller, W. L., Saper, R., Jo Kreitzer, M., & Jonas, W. (2016). Meeting the challenge of a more person-centered future for US healthcare.
Global advances in health and medicine
,
5
(1), 51-60.

William Jackson Epperson Md, M. B. A., Facmpe, S. F. C., & Wilhoit, G. (2016). Provider burnout and patient engagement: the quadruple and quintuple aims.
The Journal of medical practice management: MPM
,
31
(6), 359. Assignment: Evidence-Based Practice and the Quadruple Aim sample essay

Population & Community Health Promotion Sample Essay

What are specific actions that health professionals can take regardless of their practice area and site to promote population and community health?

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Population and Community Health Promotion

Specific actions that health professionals can take regardless of their practice area and site to promote population and community health

Planning and implementation Health education programs

Health education is a major approach for implementation of disease prevention and health promotion programs.  Health professionals can plan and implement health education programs to offer education to populations and communities on how they can become responsible for their development and protection of their health all their lives. Population & Community Health Promotion Sample Essay According to Kabasakal and Kublay (2017), health education, which provides structured learning opportunities, partly includes communication approaches projected at promoting health literacy practices, like the increase in the levels of knowledge along with the advancement of life skills to assist improve community and individual health.

Health care education can be offered through sharing of information, as well as motivating and encouraging trust and certain skills, which are influential in bringing improvement to the health of people Population & Community Health Promotion Sample Essay. Kabasakal and Kublay (2017) state that if health care professionals working in institutions that offer primary health care have the necessary skills, experience and knowledge to promote health, they can inform communities by counselling them about appropriate lifestyle behaviors that promote health.

Getting involved assessment of community needs and health planning  

Community health planning starts with health professional diagnoses. Health professionals design goals aimed at resolving potential or existing health concerns.  Recognition of potential or specific health issues with premeditated action to attain anticipated outcomes offers the data and framework for community needs assessment.  As Edelman, et al (2017) indicate, community involvement in health planning enables effectual assignment of priorities. As recipients of health services, community members endeavor for services that are high-quality and reasonably priced. Residents intend to attain suitable benefits for the concerns and needs of the populations. Health planning highlights the promotion and protection of population health and thus the definition of problems, actions, and solutions occur at the group level. Population & Community Health Promotion Sample Essay.

Planned change is as a result of efforts by groups and individuals and entails fundamental changes in behavior. Individuals function as agents of their personal health conditions and community health goals usually relay on dynamic decisions to alter their lifestyles. Endeavors to impact and reinforce transformations in community health behavior is the emphasis of effectual risk reduction programs. According to Edelman et al (2017), promotion of community health via risk reduction programs entails community members become more responsible of their personal health, becoming more active in the adoption of healthy lifestyles, and monitoring resources within the community to accomplish healthy behaviors Population & Community Health Promotion Sample Essay.

Advocating for social change

Health professionals can advocate for policies that can improve social conditions which influence the health of disadvantaged and poor populations.   Economically and socially disadvantaged populations have a less likelihood of being in good health, less likelihood to access quality healthcare services and a high likelihood of dying prematurely compared to economically and socially advantaged populations. According to Williams et al (2018), economically and socially disadvantaged populations are greatly affected by public policy and can thus gain from policies intended at improving social conditions that influence health. Nurses, physicians, and other health professionals can advocate for the proper social policies to promote fairness, justice and health parity and adequately, addresses social determinants of health.

Health professionals have an influential voice and can s articulate on the health effects of social challenges to inspire wider policy responses and impact what goes onto the local agenda. As Andermann (2016) alleges, health professionals can participate in activism through supporting political parties and social movements that lobby for affordable childcare, progressive taxation, basic income, along with other measures to lessen health disparities. they can undertake locally pertinent research and utilize data on social determinants intercede in their personal context in a better way and produce evidence as a pedal for advocacy. Williams et al (2018) claim that the appropriate policies and right interventions can interpose the cycle of disadvantage, poor health, and poverty. Evidence-based, effectual policies can result in healthier communities and tackle inability to access material and social resources that act as the source of health inequities Population & Community Health Promotion Sample Essay.

 

 

References

Andermann, A. (2016). Taking action on the social determinants of health in clinical practice: a framework for health professionals.
Canadian Medical Association Journal
, 188(17-18): E474-E483.

Edelman, C., Mandle, C., & Kudzma, E. (2017).
Health Promotion Throughout Life Span – E-Book
.  New York:  Elsevier Health Sciences.

Kabasakal, E., & Kublay, G. (2017). Health Education and Health Promotion Skills of Health Care Professionals Working in Family Health Centers.
International Journal of Medical Research   & Health Sciences,
6(3): 22-28.

Williams, S., Phillips, J., & Koyama, K. (2018). Nurse Advocacy: Adopting a Health in All Policies Approach.
The Online Journal of Issues in Nursing
, 23(3): 1. Population & Community Health Promotion Sample Essay

Rough Draft Qualitative Research Critique and Ethical Considerations

Quantitative Research Critique

Quantitative Study

“Chun-Hung, L., Jui-Hsiu, T., Shihn-Sheng, W., Yang-Pei, C., Yen-Hsia m W., Jian-Shing, L. & For-Wey, L. (2014). Quantitative comorbidity risk assessment of dementia in Taiwan: A population-based cohort study.
Medicine
, 97(15), e0298. doi: 10.1097/MD.0000000000010298”

Background of Study

The article contends that although dementia is acknowledged to be a burdensome ailment among elderly patients, management efforts have been hindered by limited knowledge on the multiple risk-factors for dementia. This is a source of concern since medical personnel can simply focus on controlling the risk factors to effectively manage dementia. The need for this information is further enhanced by the awareness that elderly persons suffer from age-based declines that make them prone to chronic ailments. Based on this knowledge, there is a need to develop a good understanding of the specific comorbidities for dementia among elderly persons with the intervention of presenting a simple, rapid and appropriate predictive tool. To facilitate the efforts, regression analysis fitted with Bayesian inference approach is discussed as a good tool for comparing multiple variables as is the present case. In this respect, the article quantitatively explores the comorbidities linked with dementia. Rough Draft Qualitative Research Critique and Ethical Considerations.

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Methods of Study

The research applied a quantitative approach that used a population-based cohort design. In this case, 4,749 dementia patients were recruited into the study. These participants had been diagnosed with the dementia between 2000 and 2009, based on the International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) diagnostic criteria (ICD-9-CM 290, 294.1–294.2, A210, A213, or A222). They were older than 64 years in 2000. Another inclusion criteria was that the participants had to have inpatient files for dementia. All the participants were recruited from the Taiwan National Health Insurance Research Database. Once the participants’ data was collected, it was subjected to a logistical regression model that applied Bayesian supervised learning inference. The model intended to assess the quantifiable effects of six comorbidity risk factors and socio-demographic features for dementia in elderly persons as identified in the Taiwan national longitudinal population-based database. The six comorbidity risk factors included senile cataract, diabetes mellitus, hearing loss, severe head injury, vascular disease, and depression. Rough Draft Qualitative Research Critique and Ethical Considerations. Other than the six comorbidity risk factors, analysis was also conducted for socio-demographic factors that included gender, age, monthly income and urban residence.

The research methodology is appropriate. That is because it allowed the study to access a large sample who were then recruited for the research. This implies that the right data could be collected and subjected to statistical analysis before interpretation. In essence, the methodology allowed for a true assessment of the factors that could influence depression parameters among elderly patients. In addition, the comprehensive exhibition of the research methodology expedites research replication efforts. Also, there is an indication that researcher bias was minimized by using data collected from a previous national survey so that the researcher did not need to prepare new data collection tools and only had to ‘copy and paste’ data that was already available. The only notable shortcoming that can be discerned in the methodology is that the authors do not mention if an independent third-party was approached to conduct verification and accuracy checks Rough Draft Qualitative Research Critique and Ethical Considerations. A second shortcoming is that there is no mention about the software that was applied for data analysis. This makes it difficult to verify the results in terms of truthfulness. The mentioned shortcomings are an indication that there were opportunities for bias in the research.

Results of Study

The study recruited 4,749 participants who met the inclusion criteria. Statistical analysis results from the model indicated that advanced age, female gender, urban residence and low income are socio-demographic risk factors for dementia among elderly persons. In addition, the results indicated that the odds of dementia had a direct correlation with the comorbidity and socio-demographic risk factors. This implies that one factor had lower odds ratio when compared to two or more factors with the odds increased with every increase in the number of factors that are present.

These results are valuable to nursing practitioners since they present evidence that support efforts to profile dementia. They show a clear correlation between the dementia and factors under review so that nurses will have evidence to support advice offered to patients with a plurality of factors, particularly when the advice is in relation to dementia management. Although the study does not make suggestions for future studies, it identifies limitations present in the current study. Addressing the mentioned limitations is an opportunity for future research. Rough Draft Qualitative Research Critique and Ethical Considerations.

Ethical Considerations

There is evidence to show that the research was carried out following ethical considerations. In fact, the study mentions that approval for the research was sought and received from all affiliated institutions. In addition, it mentions that although the requirement for informed consent was waived despite the research involving human subjects, seeking informed consent was unnecessary. That is because the data used was collected from a database and had been de-identified. The approval from the affiliated institutions shows that they were convinced that the research would not harm the participants and sufficient measures had been put in place for their protection. The four measures show that the research was conducted in an ethical manner.

Conclusion

The research sought to develop a good understanding of the specific comorbidities for dementia among elderly persons with the intervention of presenting a simple, rapid and appropriate predictive tool. This is based on the understanding that although dementia is acknowledged to be a burdensome ailment among elderly patients, management efforts have been hindered by limited knowledge on the multiple risk-factors for dementia. To facilitate the efforts, a quantitative approach was applied to include regression analysis fitted with Bayesian inference approach is discussed as a good tool for comparing multiple variables as is the present case. The participants had been diagnosed with the dementia between 2000 and 2009, and were recruited from the Taiwan National Health Insurance Research Database. In addition, they were older than 64 years in 2000 and had inpatient files for dementia. The model intended to assess the quantitative effects of six comorbidity risk factors and socio-demographic features for dementia in elderly persons to include senile cataract, diabetes mellitus, hearing loss, severe head injury, vascular disease, depression, gender, age, monthly income and urban residence. 4,749 participants who met the inclusion criteria were recruited Rough Draft Qualitative Research Critique and Ethical Considerations. The statistical analysis revealed that advanced age, female gender, urban residence and low income are socio-demographic risk factors for dementia. It also showed that odds of dementia had a direct correlation with the comorbidity and socio-demographic risk factors. These results are valuable to nursing practitioners since they present evidence that support efforts to profile dementia. They show a clear correlation between the dementia and factors under review so that nurses will have evidence to support advice offered to patients with a plurality of factors, particularly when the advice is in relation to dementia management.

 

Qualitative Research Critique

Qualitative Study

“McDermott, O., Orrell, M. & Ridder, H. M. (2014). The importance of music for people with dementia: the perspectives of people with dementia, family carers, staff and music therapists.
Aging & Mental Health
, 18(6), 706-716. doi: 10.1080/13607863.2013.875124” Rough Draft Qualitative Research Critique and Ethical Considerations

Background of Study:

I originally began this study on ways that pets could have a positive impact on the treatment of symptoms for the those that suffered from Alzheimer’s and Dementia, however discovered there was little known research even though I have witnessed the positive outcomes a fur baby can inflict on those suffering from such a brutal disease.  There was, however more to be said about how music therapy can positively impact the lives of these individuals.

The research study was conducted with the goal of identifying the value of using music-based interventions to treat dementia. The authors identified that music-based interventions are beneficial for managing dementia, particularly its psychological complications. Of interest is the fact that music features that include dancing, singing and listening are easily accessible and have presented positive results for home care of dementia patients since music can be enjoyed in its own right and as a social activity. In addition, it is noted that the cognitive functions related to music do not deteriorate for dementia patients. Despite this awareness, it is noted that previous studies on the value of music-based interventions in dementia management is that they do not provide a good link between theoretical frameworks and the applied model. The implication is that there is a need to contextualize research outcomes by developing a model for music use in dementia management. Based on this awareness, the present research approached dementia as a process of cognitive decline that worsens over time so that music is presented as an intervention that influences the process. Still, it concedes that experiences with music influences specific psychosocial fixed and tractable factors so that a study of the impact of music on dementia should evaluate the psychosocial factors with a focus on the how and why for the model. Rough Draft Qualitative Research Critique and Ethical Considerations As such, three goals are presented to include exploring the meaning and value of music for dementia patients, investigating how music is perceived for treating moderate to severe dementia, and exploring the link between dementia and psychosocial factors to guide the development of a theoretical model.

Method of Study:

The study applied a qualitative methodology that involved using interviews and focus group discussions as tools for collecting primary data. In fact, the two tools were managed by the lead researcher and presented to four group of participants. The first group of participants are dementia patient living in care homes as well as their family members. The second group of participants are staff at the care homes. The third group of participants are dementia patients visiting day hospitals. The final group of participants are music therapists. The study participants were recruited from two National Health Service care homes where the lead research was engaged as a music therapist. The two homes consented to be part of the research study. 69 residents in the two homes were persons with dementia, of which the first home had 45 dementia patients while the second home had 24 dementia patients. The dementia patients were approached for recruitment in the study with invitation letters sent to invite them and their family members. The participants were then subjected to individual interviews that included the family members for the patients who had cognitive impairment and unclear speech that could easily be misinterpreted. The focus group discussions were held for the four groups of participants within the two care homes. During the course of the study, music therapists with a minimum of four years’ experience were recruited from post graduate music therapy programs and asked to use an active model that entail the patients exploring musical instruments and voice-use during the therapy. The use of the active model was tailored for each patient based on individual needs as well as each the music therapist’s capabilities and experiences. The interviews and focus group discussions divided the participants into two groups. The first group was the dementia patient who were asked what music meant to them, what they thought about music therapy and if it was important to them. The second group comprised of family members, care home staff and music therapists who were asked the changes they observed in the patients following the use of music therapy, and how they knew whether music was meaningful for the patient. The primary data collection phase terminated when no new emerging themes could be identified in the interviews and focus group discussions. The focus group discussions and interviews were audio recorded before being subjected to thematic analysis. Rough Draft Qualitative Research Critique and Ethical Considerations.

Results of Study

The research approached 44 families that met the inclusion criteria of which 19 sent a reply. 15 of these families consented to participate in the study by attending the focus group discussions and interviews. Overall, 53 study participants were recruited to include 12 dementia patients who were residents in one of the two care homes, 4 dementia patients who visited day hospitals, 15 family carers, 14 care home staff, and 8 music therapists. These participants were divided into 17 interviews and 6 focus group discussions conducted at times convenient for the participants. The collected primary data was subjected to thematic analysis. The first theme used 61 transcription cards to note that music was a readily available medium that caused mental stimulation and an emotionally meaningful experience whether used for the immediate or short-term engagement. The second theme used 48 transcription cards to note that music relied on personal and cultural identity to facilitate memory retention, particularly when the lyrics are linked to personal history. The third theme used 40 transcription cards to show that music therapy is a novel experience that can build and sustain relationships while maintaining music connectedness. The fourth theme used 30 transcription cards to identify effects of music on the mood that included short-term mood improvement. The fifth theme used 21 transcription cards to note that music had an effect on the care home environment. The final theme used 34 transcription cards to note that music therapy improved communication. The article concluded that music therapy is more effective in dementia management when supported by personal music history, especially when the music and interpersonal connectedness is sustained to maintain the quality of life.

Ethical Considerations

The article presents details on the ethics procedure applied during the study. It first notes that ethical approval was sought from the National Research Ethics Service Committee for London East. Prior to inclusion in the study, informed consent was sought from all the participants to include the patients, family members, music therapists, and facility personnel. In this respect, the participants were protected during the course of the study with care taken to ensure that the research procedure was not harmful Rough Draft Qualitative Research Critique and Ethical Considerations.

Conclusion

The study applied a qualitative approach that relied on focus group discussion and interviews to collect primary data from selected participants. The intention was to identify the value of using music-based interventions to treat dementia. It concedes that although music therapy is acknowledged as effective, no acceptable theoretical model has been presented to explain the relationship. As such, the collected data was subjected to thematic analysis, which concluded that music therapy is more effective in dementia management when supported by personal music history, especially when the music and interpersonal connectedness is sustained to maintain the quality of life.

Alternative Therapies for Patients with Alzheimer’s and Dementia

As a nurse currently working on a Neuro floor, the devastation to family and loved ones trying to understand, as well as care for a their loved one that has been diagnosed with Dementia or Alzhiemers is most often times heartbreaking.   Nurses who are caring for this patient population are at the forefront and witness the devastation this disease brings to the family and their loved ones.  Often times treatment and or care for these patients results in using medications and, at times, restraints in order to keep the patient safe from harming themselves or others.  As a witness to so many tears cried, and questions asked, there is a definite need in finding ways to bring comfort and a sense of humanity back to this population of patients to have what every individual deserves, and that is to be able to leave this world with compassion and integrity. Rough Draft Qualitative Research Critique and Ethical Considerations.

The efforts of the NIA, (National Institute of Aging) is relentless as they continue to research the causes of this sad disease and hopes that by 2025 Prevent and Effectively Treat Alzheimer’s Disease.  The goals are to optimize quality of care and efficiency, reach out to more support to the families effected by Alzheimer’s and Dementia, increase public awareness, as well as be able to track the progress of the individuals who are suffering from this sad and crippling disease (nia.nih.gov)

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Proposed question for this research assignment:

Can the use of alternative therapies, such as pets therapy have a more positive outcome with patients that have been diagnosed with Alzheimer’s and Dementia.

Setting includes:   hospital, long term care facilities, and in their own home with family members.

Age and demographics:  Both male and female patients ranging from ages 65 and older, even though signs and symptoms can present at an earlier age. Rough Draft Qualitative Research Critique and Ethical Considerations.

Outcome is that the use of alternative methods such as pet therapy will show a positive impact on the quality of life for patients and families that live with the disease of Alzheimer’s and Dementia and leads to a better quality of life, even if only for brief moments of time.

Alzheimer’s disease is an irreversible, progressive brain disorder that slowly destroys memory and thinking skills and, eventually, the ability to carry out the simplest tasks. It is the most common cause of dementia in older adults. While dementia is more common as people grow older, it is not a normal part of aging. Alzheimer’s disease is currently ranked as the sixth leading cause of death in the United States, but recent estimates indicate that the disorder may rank third, just behind heart disease and cancer, as a cause of death for older people (nia.nih.gov).  Unfortunately, this disease can not be pre-diagnosed and once symptoms begin to show there seems to be little that can be done to minimize the impact it has on not only the patient but their families.

 

About Paws for People. (n.d.). Retrieved from
http://hai.tufts.edu/paws/about-paws-for-people/

Abstract:   Tufts Institute for Human-Animal Interaction is located at Tufts University in Medford Massachusetts.  The program Paws for People was first developed in 1998 by Dr. Gary Patronek of Tufts Center for Animals and Public Policy and started with only 10 volunteers.  Since then, with the ongoing support from the Tufts Center for Animals and Public Policy, Paw for People has grown and consists of over 100 animal/handler teams, who visit a variety of programs including elder care facilities, hospice centers, at-risk youth, adult and adolescent mental health care, hospitals, public schools, libraries, and others.  Continuing on with educational and research aspects of the human-animal bond has developed a strong and thriving program and has brought much interest from many to research more on the positive outcomes a pet can have on elderly patients with Alzheimer’s as well as those with other social and medical conditions.

 

Alzheimer’s Disease Fact Sheet. (n.d.). Retrieved from
https://www.nia.nih.gov/health/alzheimers-disease-fact-sheet

Abstract:   The only way that Alzheimer’s disease can be diagnosed is only after death, by linking clinical measures with an examination of brain tissue in an autopsy which treating and caring for this population of patients is even more complicated.  Other ways the medical professionals may be able to determine if a patient is suffering from this disease is to ask the person and a family member or friends questions that pertains to their overall health, past medical problems, ability to carry out daily activities, and changes in behavior and personality.  Issue tests that consist of recalling simple information, problem solving, and language. The use of certain medical tests, such as lab work or urine samples as well as performing brain scans such as CTs, MRIs or PET scans to rule out other possibilities for the presenting symptoms. Rough Draft Qualitative Research Critique and Ethical Considerations.

 

How Caregivers Can Use Pet Therapy to Care for Their Loved One. (2013, December 20). Retrieved from http://blog.alz.org/how-caregivers-can-use-pet-therapy-to-care-for-their-loved-one/

Abstract:  Pet therapy began in the 1860s, but unfortunately studies only began to be taken seriously was in 1980s. While the medical community is still waiting for scientific data that shows pet therapy can have long-term or behavioral change benefits, even famous nurse Florence Nightingale recognized that animals provided a level of social support in the institutional care of the mentally ill over 150 years ago. In an effort to prove the therapeutic benefits of pet therapy, the National Institutes of Health has funded grants to study scientific evidence-based research in therapeutic effects of not only children but of the elderly that suffer from Alzheimer’s and Dementia.

 

https://www.brightfocus.org/alzheimers/article/alzheimers-disease-magic-pets ntia.

Abstract:  There was a study conducted in 2002 on an Alzheimer’s special care unit, where researchers set out to determine the effects of a resident dog and a visiting dog and how they impacted the behavior of the patients.  Resident’s behavior during the day and during the evening were evaluated during the week before the dog was placed on the unit, and then for four weeks following the dog’s arrival. Even though there was little or no significant behavior changes that happened on the evening shift, there was a significant change in the behavior of those patients during the day shift. Rough Draft Qualitative Research Critique and Ethical Considerations.

 

Authors, N. (n.d.). Nonpharmacologic Interventions for Agitation and Aggression in Dementia – PubMed – NCBI. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/27099894

Abstract: Even though there have been several different trials done to determine effective nonpharmacologic interventions for agitation/aggression in dementia, which is an important topic, it has been found through evidence base is weak because of the different types of comparisons, measurement issues, and other methodological limitations. When there was sufficient evidence to draw conclusions about the effectiveness of interventions in a group, agitation/aggression outcomes were most often similar to those of control groups. Further research is needed to assist providers and caregivers in finding effective interventions for agitation/aggression in dementia.

Churchill M , et al. (n.d.).  – PubMed – NCBI. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/10218187

Abstract:  The use of a therapy doge can improve socialization skills in persons with Alzheimer’s.  Exposure to therapy dogs and cats can decrease the amount of agitation in persons that are institutionalized and suffer from Alzheimer’s disease, even during the period of agitation known as sundown syndrome. Use of therapy animals can be used along with other calming interventions Rough Draft Qualitative Research Critique and Ethical Considerations.

 

Rough Draft Qualitative Research Critique and Ethical Considerations instructions 

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

In a 1000-1,250 word essay, summarize the study, explain the ways in which the findings might be used in nursing practice, and address ethical considerations associated with the conduct of the study.

Refer to the resource ”Research Critique Guidelines” for suggested headings and content for your paper.

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

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

You are required to submit this assignment to Turnitin Rough Draft Qualitative Research Critique and Ethical Considerations

Historical Review of Epidemiology

Key individuals and historical events have helped shape the field of epidemiology. Research the following individuals and their roles in shaping contemporary epidemiology:

John Graunt

James Lind

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Edward Jenner

Ignaz Semmelweis

John Snow

Choose three of the individuals from your research. In a 1,000-1,250 word paper, describe the epidemiological advancements that were influenced by these individuals. Include the following:

Describe the disease and the event. Using descriptive epidemiology, discuss how common the disease was at the time, who was infected, when it occurred (time of year or season), and the mode of transmission. If the individual is not associated with a specific disease, discuss a significant disease happening during that period.

Discuss how the individuals influenced or advanced epidemiological methods and the process they used to describe and control disease. Discuss how their contributions helped to inform the definition of epidemiology. Consider whether they used qualitative, quantitative, or both types of data collection methods, and the approach they used to test their hypotheses Historical Review of Epidemiology.

Discuss how similar epidemiological methods have been used to understand one current public health issue (not one for each individual). Discuss the key research studies used to understand the risk factors associated with the problem or disease. Two potential examples include lung cancer (Doll and Hill, 1950) or cardiovascular disease and the Framingham Heart Study (Drawber, Meadors, & Moore, 1950; Kannel, 2000).

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 success. Please make sure you use public health and nursing articles

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