Question: After discussion with your mentor, name one financial aspect, one quality aspect, and one clinical aspect that need to be taken into account for developing the evidence-based practice project. Explain how your proposal will directly and indirectly impact each of the aspects.
Statement 1:Many considerations need to be made for any evidence-based practice study. I am researching how patient education provided by nurses will impact patient compliance with fluid gains between treatments. Pulmonary edema, pleural effusion, heart failure and associated symptoms are just a few of the many complications affected by fluid overload (Assimon, Nguyen, Katsanos, Brunelli, Flythe, 2016). Improving fluid gains can decrease hospitalizations and improve mortality rates (Assimon, Nguyen, Katsanos, Brunelli, Flythe, 2016). These improved outcomes would obviously improve quality of life and decrease symptoms associated with fluid overload and complications. This is not the most financially straining project, because depending how it is implemented it can be done in a very cost-effective way. As discussed last week, there is a multitude of technological resources that can also be used for patient education that could drive up costs. To start I would stress more personal education plans instead of using expensive tools. One of the only mandatory expenses would be the time, which equates to money, that would need to be taken by the nursing staff. However, the amount that would be paid for the nursing education time would be far outweighed by the savings for the healthcare system overall. Over 250 million dollars in the United States a year are spent on hospitalization and comorbidities that result from fluid overload in dialysis patients (Assimon, Nguyen, Katsanos, Brunelli, Flythe, 2016).
Assimon, M. M., Nguyen, T., Katsanos, S. L., Brunelli, S. M., & Flythe, J. E. (2016). Identification of volume overload hospitalizations among hemodialysis patients using administrative claims: a validation study. BMC Nephrology, 17, 173. http://doi.org/10.1186/s12882-016-0384-6
175 word response also with source APA required
Statement 2: My evidence-based practice (EBP) project is to educate as many soldiers as possible about post-traumatic stress disorder treatment (PTSD) treatments available, and ways to access them. The education also is hoped to eradicate the stigma of PTSD, so more soldiers have the courage to seek and ask for help. For this, I have decided to make a presentation. I need a power point (PP) presentation, which will not cost money. I also plan to make fliers of information, which depending on the number of prints and type of paper, will cost me less than a hundred dollars, or even free if I use regular paper and print them from my place of work.
The Institute of Medicine initiated six framework points of quality, including patient safety, effectiveness of service, patient-centered care, timely manner, efficient, and equitable (Agency for Healthcare Research and Quality, 2016). For the quality aspect of my EBP project, I chose improvement in the timely manner because delays in treatment may harm patients and their loved ones.
For the clinical aspect for my EBP project, I choose to have a patient-centered care, specific to each individual’s needs, values, and preference. Instead of asking what is the matter of the patient’s visit, we should focus on what matters to the patient most (U.S. Department of Veterans Affair, 2018).
Agency for Healthcare Research and Quality. (2016). The six domains of health care quality. Retrieved from https://www.ahrq.gov/professionals/quality-patient…
U.S. Department of Veterans Affair. (2018). Whole health for life. Retrieved from https://www.va.gov/PATIENTCENTEREDCARE/clinicians/…
175 word response also with source APA required
Statement 3
My Evidence-Based Practice (EBP) proposal is to provide increased training and education to families of pediatric patients needing home health care. Increasing the parents ability to assess their child’s condition and provide the needed care will ideally reduce the rates of health complications and re hospitalization. One financial aspect to consider is the cost of the education and training sessions for the families. Since these will be provided by the home health care agency rather than as outpatient education from a hospital, the organization will have to pay for staff to educate and demonstrate, any costs of training devices and resources, and for the locations and travel expenses. These costs can be minimized by getting donations or borrowing supplies from local hospitals and public health organizations and getting volunteers for the training sessions. By having nurses and therapists volunteer to do the educate sessions that take place in their area, it also reduces the travel expenses. Although there are ways to minimize the costs, creating an ideal cost breakdown will help when communicating the need versus reward to the management team.
The quality aspect focuses on the improved care the patient will receive from the parents after education and training is provided. By doing so, it also should reduce the chances of complications and improving the patient outcomes. It has been shown that pediatric patients often do not receive the level of care they require in the home due to lack of proper transition from formal care in a hospital to care in the home. Even in the case of patients with home health nurses, parents are still responsible for the care of their children, but are often unprepared (Kelo & Martikainen, 2013). This education program will equip them to care for their children and improve their safety with the goal of improved outcomes.
In considering the clinical aspect, the goal is improving the patient-centered care based on the individual needs of each child and their health conditions. Since many patients within our organizations have respiratory conditions or tracheotomies, this is my particular focus. Proving trach care, trach changes, and ventilation usage instructions are all specific identified needs of many families. By understanding their needs and education deficits, we can specify the education and skills training to meet the child’s needs.
Kelo, M., Martikainen, M., & Eriksson, E. (2013). Patient Education of Children and Their Families: Nurses’ Experiences. Pediatric Nursing 39(2) 1-9. Retrieved from http://www.pediatricnursing.net/ce/2015/article390…
175 word response also with source APA required
Question Now that you have completed a series of assignments that have led you into the active project planning and development stage for your project, briefly describe your proposed solution to address the problem, issue, suggestion, initiative, or educational need and how it has changed since you first envisioned it. What led to your current perspective and direction?
Statement 4
Newly licensed nurses are being exposed to many stressors as they transition into clinical practice. Many lack the confidence and struggle during the transitioning phase of student to nurse. The nursing profession is known for its high levels of stress, and new nurses have a hard time coping with it leading to high turnover rates. New nurses need mentors that can help them transition into practice without feeling as if they are alone. Many new nurses are exposed to lateral violence from their peers and only adds to the feeling of not belonging, affecting their confidence and patient care (Embree, Bruner, & White, 2013). Educating staff during unit meetings and hospital wide meetings about the effects of lateral violence and how it affects patient care and ratios is recommended. Developing a zero-tolerance policy and ways to report violence will help decrease incidences among nurses, especially new nurses.
During the beginning phases of this project I knew that new nurses struggled as they transitioned from school to actual clinical practice. Violence against this group from seasoned nurses was a major concern. I knew educating nurses about abuse was important, but I also found that new nurses that lack confidence are exposed to higher rates of abuse from peers. Mentoring programs can help new nurses boost their confidence as they enter practice, therefore decreasing their chances of abuse by peers. Nurses that are confident and have the support of a mentor are less likely to get bullied by peers as their professional confidence increases. (Zhang, Quian, Wu, Wen, & Zhang, 2015).
Embree, J.L., Bruner, D.A., & White, A. (2013). Raising the level of awareness of nurse-to-nurse lateral violence in a critical access hospital. Nursing Research and Practice, p. 1-7. http://dx.doi.org/10.1155/2013/207306
Zhang, Y. Qian, Y., Wu, J., Wen, F., & Zhang, Y. (2016). The effectiveness and implementation of mentoring program for newly graduated nurse: A systemic review. Nurse Education Today, 37, 136-144. http://dx.doi.org/10.1016/j.nedt.2015.11.027
175 word response also with source APA required
Statement 5
My proposed solution is education provided by nurses to improve dialysis patient fluid gains between treatments. After looking over lots of peer reviewed evidence-based research, I have decided to change a few things from my initial plan. I am now including sodium restriction as part of the fluid control education plan. As we know fluid and sodium are closely correlated, and therefore need to be discussed together. One of the other changes I have made is to include family or caregivers in the patient education process. The Asgari, Bahramnezhad, Zolfaghari, & Farokhnezhad (2015) article drove home the importance of family and social support on patient outcomes. I am also planning on focusing more on motivational interviewing as opposed to the traditional lecture style. The Crown, Vogel, & Hurlock-Chorostecki, (2017) study describe motivational interviewing as a conversational and collaborative way to provide patient-centered education that stimulates behavior modification and assists patients to identify and resolve their feelings of ambivalence to improve outcomes. This form of education helps patients become much more receptive and self-aware. The majority of my initial plan still stand, but these articles have helped me make the improvements necessary to get the best patient responses.
Asgari, P., Bahramnezhad, F., Zolfaghari, M., & Farokhnezhad Afshar, P., (2015). A Comparison of the impact of family-centered and patient-centered education methods on attitude toward and adherence to diet and fluid restriction in hemodialysis patients. Medical-Surgical Nursing Journal, Vol 3, 4, Pp 202-195, (4), 202.
Crown, S., Vogel, J. A., & Hurlock-Chorostecki, C. (2017). Enhancing self-care management of interdialytic fluid weight gain in patients on hemodialysis: A pilot study using motivational interviewing. Nephrology Nursing Journal, 44(1), 49-55.
Statement 6
My proposed solution to decreasing the incidences of sexually transmitted infections (STIs) on college campuses is promoting safe sex practices, educate on sexual health, and reinforce teaching on STIs. Studies have revealed that one in four college students has tested positive for an STI. The sexual lifestyle of students has progressively become risky due to a heightened number of partners, unprotected sex, and inconsistent safe sex practices. Other factors that contribute to high rates of STIs is insufficient knowledge of STIs and transmission mode. Knowledge deficit plays a significant role in the risky sexual behavior demonstrated among college students. As sexually transmitted infections continue to rise at a rapid pace, many students have revealed that they do not know what type of questions to ask or where to go to get information on STIs (Subbarao & Akhilesh, 2017).
Educating our students is a critical component of STI prevention and management. It is imperative to orient our students about sexual health and safe sex practices. It is important for colleges to be proactive in educating students and teaching prevention. Without proper education, the number of STI cases on college campuses will continue to increase.
Subbarao, N. T., & Akhilesh, A. (2017). Knowledge and attitude about sexually transmitted infections other than HIV among college students. Indian Journal of Sexually Transmitted Diseases, 38(1), 10–14. http://doi.org/10.4103/0253-7184.196888
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