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NUR-590 Evidence-Based Practice Project

NUR-590

Online

4 Credits

NUR-590 Evidence-Based Practice Project Course Description

This course provides an opportunity for learners to complete their evidence-based practice (EBP) project proposal that addresses a problem, issue, or concern in their specialty area of professional practice.

Learners previously identified a problem amenable to a research-based intervention, searched the literature, and proposed a solution.

Now learners will explore implementation considerations and various evaluation methodologies, complete the project proposal by developing a plan to implement the solution into the intended practice area, and design an evaluation plan that will assess the EBP project proposal’s intended outcome(s). Prerequisite: NUR-550.

Class Materials

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Class Resources

NUR-590 Evidence-Based Practice Project Course Objectives

In this course, the learner will:

1. Explore research articles, nursing and related theories, applying levels of evidence, and theoretical frameworks to identify quality research studies.
2. Demonstrate understanding of scientific inquiry, knowledge generation, utilization, and dissemination in advanced nursing practice.
3. Evaluate the evidence for potential solutions/innovations that can potentially solve a health care issue and improve patient outcomes.
4. Identify gaps in nursing knowledge and evidence-based practice that can potentially be resolved by planning and implementing a practice change project proposal.

Advanced Nursing Research: From Theory to Practice

Tappan, R. M. (2016). Advanced nursing research: From theory to practice (2nd ed.). Jones & Bartlett Learning. ISBN-13: 9781284048308

View Resource

Library Walk-Through Tutorial

View the “Library Walk Through Tutorial.”

https://www.gcumedia.com/lms-resources/student-success-center/v3.1/#/media-element-view/general/Library_Walk_Through_Tutorial/C08DFB75-69DE-E611-A9AE-005056BD1ABC

Reading a Scientific Article

Read “Reading a Scientific Article,” located on the GCU Library website.

https://libguides.gcu.edu/ENG-456/ScientificArticles

Writing Center

• Refer to the resources located in the Writing Center for PowerPoint guidelines, APA style, writing and library tutorials, and research and writing assistance.

https://www.gcumedia.com/lms-resources/student-success-center/v3.1/#/tools/writing-center

GCU Library: Persistent Links

• Review “Persistent Links,” located on the GCU Library website, to learn how to locate persistent links for library articles, videos, etc.

http://libguides.gcu.edu/content.php?pid=415612

LopesWrite

• Refer to the LopesWrite webpage for guidance regarding assignments requiring submission to LopesWrite.

https://support.gcu.edu/hc/en-us/articles/201277380-LopesWrite

Evaluating Sources: What Is a “Scholarly” Source?

• Read “Evaluating Sources: What Is a ‘Scholarly’ Source?” located on the GCU Library website.

https://libguides.gcu.edu/EvaluatingSources

APA Writing Checklist

1. Use the “APA Writing Checklist” to act as a checklist for each paper you will write throughout your GCU graduate program.

MSN-APA Writing Checklist-Student.docx

GCU Library Research Guides: Citing Sources

Reference the “GCU Library Research Guides: Citing Sources” resource, located on the GCU Library website, for information on how to cite sources properly.

https://libguides.gcu.edu/CitingSources

Optional: ThinkingStorm

For additional information, the following is recommended:

ThinkingStorm is an online tutoring resource that provides flexible support to supplement traditional educational environments. The tutoring center is remotely accessible to GCU learners with a computer and an Internet connection and offers convenient hours for learners with busy schedules.

ThinkingStorm tutoring includes a writing center that offers 24/7 submission-based writing support, as well as live writing support across the curriculum.

If you are interested in utilizing ThinkingStorm’s writing support, submit your documents chapter by chapter, rather than as a full manuscript.

Read  more: https://www.thinkingstorm.com/GCUinfo.aspx

Evidence-Based Practice in Nursing and Healthcare : A Guide to Best Practice

Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing and healthcare: A guide to best practice (4th ed.). Wolters Kluwer. ISBN-13: 9781496384539

View Resource

Optional: Grammarly

For additional information, the following is recommended:

Grammarly is an online writing assistance app that reviews written submissions and suggests context-specific corrections for grammar, spelling, word usage, wordiness, style, punctuation, and plagiarism. The reasoning for each suggested correction is provided, allowing users to make informed decisions about how to correct writing issues.

Grammarly can be installed as free browser extension, though Grammarly Premium requires an annual subscription. This subscription is not a GCU-required purchase.

https://www.grammarly.com/premium

Academic Integrity

Read the “About LopesWrite” and “Plagiarism” sections of the Academic Integrity page of the GCU website.

http://students.gcu.edu/academics/academic-integrity.php

University Policy Handbook

Read the Code of Conduct and Academic Standards section of the University Policy Handbook.

http://www.gcu.edu/academics/academic-policies.php

The Writing Process

View “The Writing Process” media presentation for information on how to strengthen your writing for future assignments.

https://lc.gcumedia.com/unv104/the-writing-process/index.php

GCU Library: General Research Guide

Review the “General Research” guide, locate on the GCU Library website.

http://libguides.gcu.edu/content.php?pid=415913

Discussion Forum Guidelines and Example

Review the “Discussion Forum Guidelines and Example” document for your weekly discussion forum participation.

MSN-DiscussionForumGuidelinesandExample.docx

Advanced Practice Nursing: Essential Knowledge for the Profession

DeNisco, S. M. (Ed.). (2021). Advanced practice nursing: Essential knowledge for the profession (4th ed.). Jones & Bartlett Learning. ISBN-13: 9781284176124

View Resource

APA Writing Style

APA Style is required for all writing assignments in this course, where indicated. Please prepare these assignments according to the APA Style Guide, located in the in the Student Success Center.

You may want to consider purchasing a copy of the APA style guide as this will be a useful resource throughout your program.

NUR-590 Evidence-Based Practice Project Proposal Assignment Overview

Learners are required to develop an evidence-based practice project proposal. The project begins in NUR-550 and culminates in NUR-590. The project will be completed in sections throughout both courses and culminate in NUR-590, during which the project elements are synthesized into a final written paper that details the evidence-based practice project proposal.

Refer to the “Evidence-Based practice project Proposal – Assignment Overview” document for an overview of the evidence-based practice project proposal assignments. This document serves only to provide context for the overall project and how the assignments interact. Refer to each assignment in the classroom.

RefWorks and EndNote: RefWorks and EndNote Login

Manage your citations with the RefWorks tool, located on the GCU Library website. RefWorks automates the creation of your reference lists in the format of your choice (APA, MLA, etc.).

NUR-590 Evidence-Based Practice Project Topic 1: Evidence-Based Practice

Aug 12, 2021 – Aug 18, 2021

Max Points:80

Objectives:

1. Present a PICOT for the evidence-based practice project proposal.
2. Examine the role of the advanced registered nursing in evidence-based practice.

Assessments

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Class Introductions

GO TO DISCUSSION

Start Date

• Aug 12, 2021 12:00 AM

Due Date

• Aug 14, 2021 11:59 PM

Points

• 0

Status

• Upcoming

Assessment Description

Take a moment to explore your new classroom and introduce yourself to your fellow classmates. What are you excited about learning? What do you think will be most challenging?

NUR-590 Evidence-Based Practice Project Topic 1 DQ 1

GO TO DISCUSSION

Start Date

• Aug 12, 2021 12:00 AM

Due Date

• Aug 14, 2021 11:59 PM

Points

• 5

Status

• Upcoming

Assessment Description

Based on the PICOT you developed for NUR-550, summarize the intervention you are proposing. How does this support the population of focus, your setting, and role? Justify how the problem you selected to investigate is amenable to a research-based intervention using the PICOT format. Include your PICOT statement with your response.

NUR-590 Evidence-Based Practice Project Topic 1 DQ 2

GO TO DISCUSSION

Start Date

• Aug 12, 2021 12:00 AM

Due Date

• Aug 16, 2021 11:59 PM

Points

• 5

Status

• Upcoming

Assessment Description

Explain the importance of a “spirit of inquiry” in an evidence-based culture and what you can do as an advanced registered nurse to encourage this within your practice or organization. In response to your peers, compare the role and implementation of EBP in your specialty area with another advanced registered nurse specialty.

NUR-590 Evidence-Based Practice Project Literature Review – Resubmission

SUBMIT ASSIGNMENT

Start Date

• Aug 12, 2021 12:00 AM

Due Date

• Aug 18, 2021 11:59 PM

Points

• 50

Rubric

• View Rubric

Status

• Upcoming

Assessment Description

Submit your literature review from NUR-550 for your NUR-590 instructor to review. If your NUR-550 instructor indicated areas for revision be sure to incorporate these improvements prior to submitting your paper for this assignment.

You will use the revised literature review for your final written paper in Topic, 8 detailing your evidence-based practice project proposal.

Prepare this assignment according to the guidelines in the APA Style Guide in the Student Success Center.

This assignment uses a rubric. Please review the rubric before beginning the assignment to familiarize yourself with the expectations for successful completion.

You are not required to submit this assignment to LopesWrite.

Assessment Description

There is no description for this assessment.

NUR-590 Evidence-Based Practice Project Resources

Advanced Nursing Research: From Theory to Practice

• Read Chapters 1 and 2 in Advanced Nursing Research: From Theory to Practice.

View Resource

Evidence-Based Medicine Toolkit

• Explore the “Evidence Based Medicine Toolkit,” by Buckingham, Fisher, and Saunders (2012), located on the University of Alberta w… Read More http://www.ebm.med.ualberta.ca/

Striving for Evidence-Based Practice Innovations Through a Hybrid Model Journal Club: A Pilot Study

• Read “Striving for Evidence-Based Practice Innovations Through a Hybrid Model Journal Club: A Pilot Study,” by Wilson, Ice, Nakas… Read More

http://www.sciencedirect.com.lopes.idm.oclc.org/science/article/pii/S0260691715000817

Evidence-Based Practice Tutorial

• Read the Evidence-Based Practice tutorial, located on the Duke University website.

http://guides.mclibrary.duke.edu/c.php?g=158201&p=1036002

Centre for Evidence Based Medicine: Resources

• Explore the Resources page of the Centre for Evidence Based Medicine (CEBM) website.

http://www.cebm.net/category/ebm-resources/

Evidence Based Medicine

Explore the Evidence Based Medicine page of the University of Illinois Library of the Health Sciences website. Use this website as a reso… Read More http://researchguides.uic.edu/ebm

Centre for Evidence Based Medicine: About Us

• Read “About Us” page of the Centre for Evidence Based Medicine (CEBM) website.

http://www.cebm.net/about

Evidence-Based Practice in Nursing and Healthcare : A Guide to Best Practice

• Read Chapters 1-3 in Evidence-Based Practice in Nursing and Healthcare: A Guide to Best Practice.

View Resource

Implementation Science and Nursing Leadership: Improving the Adoption and Sustainability of Evidence-Based Practice

• Read “Implementation Science and Nursing Leadership: Improving the Adoption and Sustainability of Evidence-Based Practice,” by Ne… Read More

https://lopes.idm.oclc.org/login?url=http://ovidsp.ovid.com.lopes.idm.oclc.org/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00005110-202105000-00003&LSLINK=80&D=ovft

A Leader’s Guide to Implementing Evidence-Based Practice: Lead the Way to Healthcare Quality and Safety

• Read “A Leader’s Guide to Implementing Evidence-Based Practice: Lead the Way to Healthcare Quality and Safety,” by Tucker and Mel… Read More

https://link.gale.com/apps/doc/A616904277/AONE?u=canyonuniv&sid=AONE&xid=f2d66c7c

Evaluation of a Nurse Practitioner-Led Project to Improve Communication and Collaboration in the Acute Care Setting

• Read “Evaluation of a Nurse Practitioner-Led Project to Improve Communication and Collaboration in the Acute Care Setting,” by Au… Read More

https://lopes.idm.oclc.org/login?url=http://ovidsp.ovid.com.lopes.idm.oclc.org/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=ovft&AN=01741002-900000000-99523&PDF=y

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NUR-590 Evidence-Based Practice Project Topic 2: Making the Case for Evidence-Based Practice

Max Points:130

Objectives:

1. Describe effective strategies to create an evidence-based practice culture within a health care setting.
2. Identify stakeholders needed for the evidence-based practice project.
3. Assess organizational readiness for the evidence-based practice project.

Assessments

NUR-590 Evidence-Based Practice Project Topic 2 DQ 1

Points

• 5

Status

• Upcoming

Assessment Description

• Compare two organizational readiness tools. Identify the tool you selected and explain why it is most appropriate for assessing your organization.

NUR-590 Evidence-Based Practice Project Topic 2 DQ 2

GO TO DISCUSSION

Start Date

• Aug 19, 2021 12:00 AM

Due Date

• Aug 23, 2021 11:59 PM

Points

• 5

Status

• Upcoming

Assessment Description

• Do you foresee any issues with the proposed implementation of your project? Identify a strategy to help create or sustain a higher level of readiness to change with your organization and discuss how current research or literature will be used to ensure that change is based on current evidence.

Benchmark – Evidence-Based Practice Project Proposal: Organizational Culture and Readiness

Benchmark

SUBMIT ASSIGNMENT

Requires LopesWrite

Start Date

• Aug 19, 2021 12:00 AM

Due Date

• Aug 25, 2021 11:59 PM

Points

• 100

Rubric

• View Rubric

Status

• Upcoming

Assessment Description

In order to successfully implement a change within an organization, the change agent must assess the organization’s culture and readiness for change. In 750-1,000 words, analyze the culture and level of readiness of the organization for which your evidence-based practice project is proposed.

You will use the assessment of the organization’s culture and readiness in the Topic 8 assignment, during which you will synthesize the various aspects of your project into a final paper detailing your evidence-based practice project proposal.

Include the following:

1. Describe the organization’s culture and explain to what degree the culture supports change. Consider organizational and leadership structure, mission and values, interprofessional collaboration/team engagement, communication, perception of the organization by employees, etc.
2. Select an organizational readiness tool and assess the level or readiness for change within your organization. Identify the readiness tool and summarize the survey results. Discuss the degree to which the culture will support and sustain an evidence-based practice change. Consider strengths and weaknesses, potential barriers, stakeholder support, timing of the proposal, and resources. Provide rationale.
3. Discuss what health care process and systems you would recommend for improving quality, safety, and cost-effectiveness for the organization.
4. Propose strategies to better facilitate the readiness of the organization.
5. Identify the stakeholders and team members for the project. Include what their duties will be in the evidence-based practice project proposal.
6. Explain what information and communication technologies are needed for the implementation and how they will be integrated in the setting by the internal stakeholders. Explain how these will help improve nursing practice and care delivery for individuals and populations for your intervention.

Refer to the “Evidence-Based Practice Project Proposal – Assignment Overview” document for an overview of the evidence-based practice project proposal assignments.

You are required to cite a minimum four peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Complete the “APA Writing Checklist” to ensure that your paper adheres to APA style and formatting criteria and general guidelines for academic writing. Include the completed checklist as an appendix at the end of your paper.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.

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 LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

Benchmark Information

This benchmark assignment assesses the following programmatic competencies:

• MBA-MSN; MSN-Nursing Education; MSN Acute Care Nurse Practitioner-Adult-Gerontology; MSN Family Nurse Practitioner; MSN-Health Informatics; MSN-Health Care Quality and Patient Safety; MSN-Leadership in Health Care Systems; MSN-Public Health Nursing
• 3.1:  Assess health care processes and systems to recommend measures for improving quality, safety, and cost-effectiveness across an organization.
• 3.3:  Integrate appropriate information and communication technologies to improve nursing practice and care delivery for individuals and populations.

Status

• Upcoming

Assessment Description

• There is no description for this assessment.

NUR-590 Evidence-Based Practice Project Resources

Supporting the Uptake of Nursing Guidelines: What You Really Need to Know to Move Nursing Guidelines Into Practice

• Read “Supporting the Uptake of Nursing Guidelines: What You Really Need to Know to Move Nursing Guidelines Into Practice,” by Mat… Read More

https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104283177&site=ehost-live&scope=site&custid=s8333196&groupid=main&profile=ehost

Evidence-Based Practice in Nursing and Healthcare : A Guide to Best Practice

• Read Chapters 15 and 18 in Evidence-Based Practice in Nursing and Healthcare: A Guide to Best Practice.

View Resource

Agency for Healthcare Research and Quality

• Explore the Agency for Healthcare Research and Quality (AHRQ) website.

http://www.ahrq.gov/

Aligning Organizational Culture and Infrastructure to Support Evidence-Based Practice

• Read “Aligning Organizational Culture and Infrastructure to Support Evidence-Based Practice,” by Ost, Blalock, Fagan, Sweeney, an… Read More

https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=143440827&site=ehost-live&scope=site&custid=s8333196&groupid=main&profile=ehost

JBI EBP Resources

• Use the JBI EBP Resources to search for EBP resources related to your project.

https://jbi.global/ebp

Organizational Readiness Tools for Global Health Intervention: A Review

Read “Organizational Readiness Tools for Global Health Intervention: A Review,” by Dearing, from Frontiers in Public Health</… Read More

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5840160/

The Checklist: Recognize Limits, but Harness Its Power

• Read “The Checklist: Recognize Limits, but Harness Its Power,” by Grif Alspach, from Critical Care Nurse (2017).

https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=125112053&site=ehost-live&scope=site

Cochrane Library

• Explore the Cochrane Library website.

http://www.thecochranelibrary.com/view/0/index.html

A Multisite Health System Survey to Assess Organizational Context to Support Evidence-Based Nursing

• Read “A Multisite Health System Survey to Assess Organizational Context to Support Evidence-Based Nursing,” by Pitmann et al., fr… Read More

https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=137966882&site=ehost-live&scope=site&custid=s8333196&groupid=main&profile=ehost

Advanced Practice Nursing: Essential Knowledge for the Profession

• Read Chapters 23 and 24 in Advanced Practice Nursing: Essential Knowledge for the Profession.

View Resource

Readiness Assessment

• Read “Readiness Assessment” (2015), located on the Agency for Healthcare Research and Quality (AHRQ) website.

https://www.ahrq.gov/teamstepps/readiness/index.html

Cultivate a Culture of Excellence at the Point of Care

• Read “Cultivate a Culture of Excellence at the Point of Care,” by Medeiros, from Nursing Management (2020).

https://lopes.idm.oclc.org/login?url=http://ovidsp.ovid.com.lopes.idm.oclc.org/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00006247-202005000-00002&LSLINK=80&D=ovft

The Cochrane Collaboration

• Explore the Cochrane Collaboration website. http://www.cochrane.org/

6 Steps for Transforming Organizational EBP Culture

• Read “6 Steps for Transforming Organizational EBP Culture,” by Ogiehor-Enoma, Taqueban, and Anosike, from Nursing Management… Read More

https://lopes.idm.oclc.org/login?url=http://gateway.ovid.com.lopes.idm.oclc.org/ovidweb.cgi?T=JS&NEWS=N&PAGE=fulltext&AN=00006247-201005000-00004&LSLINK=80&D=ovft

NUR-590 Evidence-Based Practice Project Topic 3: Theoretical Framework and Models for Change

Aug 26, 2021 – Sep 01, 2021

Max Points:130

Objectives:

1. Apply a change model or framework to the evidence-based practice project proposal.
2. Describe the relationship between bias and a framework or model.

Assessments

NUR-590 Evidence-Based Practice Project Topic 3 DQ 1

GO TO DISCUSSION

Start Date

• Aug 26, 2021 12:00 AM

Due Date

• Aug 28, 2021 11:59 PM

Points

• 5

Status

• Upcoming

Assessment Description

• Discuss the significance of frameworks or models in guiding research or evidence-based practice projects. How can choosing an incorrect framework or model create bias in research?

NUR-590 Evidence-Based Practice Project Topic 3 DQ 2

GO TO DISCUSSION

Start Date

• Aug 26, 2021 12:00 AM

Due Date

• Aug 30, 2021 11:59 PM

Points

• 5

Status

• Upcoming

Assessment Description

• Review the different models and frameworks that can be used to facilitate change. Compare two and explain which is best for your evidence-based practice proposal and why. Provide rationale.

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NUR-590 Evidence-Based Practice Project Benchmark – Evidence-Based Practice Proposal Project: Framework or Model for Change

Benchmark

SUBMIT ASSIGNMENT

Requires LopesWrite

Start Date

• Aug 26, 2021 12:00 AM

Due Date

• Sep 01, 2021 11:59 PM

Points

• 100

Rubric

• View Rubric

Status

• Upcoming

Assessment Description

Applying a model or framework for change ensures that a process is in place to guide the efforts for change. In 500-750 words, discuss the model or framework you will use to implement your evidence-based practice proposal project. You will use the model or framework you select in the Topic 8 assignment, during which you will synthesize the various aspects of your project into a final paper detailing your evidence-based practice project proposal.

Include the following:

1. Identify the selected model or framework for change and discuss its relevance to your project.
2. Discuss each of the stages in the change model/framework.
3. Describe how you would apply each stage of the model or theoretical framework in your proposed implementation.
4. Create a concept map for the conceptual model or framework you selected to illustrate how it will be applied to your project. Attach this as an appendix at the end of your paper.

Refer to the “Evidence-Based Practice Project Proposal – Assignment Overview” document for an overview of the evidence-based practice project proposal assignments.

You are required to cite minimum of four peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Complete the “APA Writing Checklist” to ensure that your paper adheres to APA style and formatting criteria and general guidelines for academic writing. Include the completed checklist as an appendix at the end of your paper.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.

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 LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

Benchmark Information

This benchmark assignment assesses the following programmatic competencies:

MBA-MSN; MSN-Nursing Education; MSN Acute Care Nurse Practitioner-Adult-Gerontology; MSN Family Nurse Practitioner; MSN-Health Informatics; MSN-Health Care Quality and Patient Safety; MSN-Leadership in Health Care Systems; MSN-Public Health Nursing

1.2 Apply theoretical frameworks from nursing and other disciplines to make decisions regarding practice and health-related problems at the individual and population level.

Week 3 Participation

GO TO DISCUSSION

Start Date

• Aug 26, 2021 12:00 AM

Due Date

• Sep 01, 2021 11:59 PM

Points

• 20

Status

• Upcoming

Assessment Description

• There is no description for this assessment.

Resources

Advanced Practice Nursing: Essential Knowledge for the Profession

• Read Chapter 6 in Advanced Practice Nursing: Essential Knowledge for the Profession.

View Resource

Evidence Based Medicine: Levels of Evidence

• Read “Evidence Based Medicine: Levels of Evidence,” by the University of Illinois/Chicago’s Library of the Health Sciences at Peo… Read More

http://researchguides.uic.edu/content.php?pid=232200&sid=1921074

A Test of the ARCC Model Improves Implementation of Evidence-Based Practice, Healthcare Culture, and Patient Outcomes

• Read “A Test of the ARCC Model Improves Implementation of Evidence-Based Practice, Healthcare Culture, and Patient Outcomes,” by… Read More

https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=121082056&site=ehost-live&scope=site&custid=s8333196&groupid=main&profile=ehost

Iowa Model of Evidence-Based Practice: Revisions and Validation

• Read “Iowa Model of Evidence-Based Practice: Revisions and Validation,”

NUR-590 Fall Precautions Implementation Plan Paper

Expected Outcomes

The proposed project seeks to address the issue of hospital falls among elderly patients of 65 years and above in an hospital setting. This is in line with the American and British Geriatrics Societies practice guidelines that require health practitioners to develop innovative strategies for addressing the issue (The American Geriatrics Society, 2011).

The project seeks to establish an individualised fall prevention plan for older patients that can be quickly and efficiently implemented within the nominated hospital to increase quality and safety of care. This will be achieved by enhancing the clinician’s knowledge about fall prevention, especially on fall risk assessment, risk communication availability of fall prevention resources.

The second intended outcome of the STEADI project will be reduced fall cases by enhancing fall prevention screening among adults of age 65 and older. This will be a chieved through an initial screening program using the Timed Up and Go (TUG) screening tool. Lastly, STEADI project expects reduced fall rates because of a comprehensive fall medical assessment that relies on the Timed Up and Go (TUG) screening tool to develop an individualised comprehensive fall prevention plan for each patient.

Data Collection Tools

Assessing the STEADI project will require data collection tools that engage the various stakeholders to identify the project’s impact. Furthermore, the project will require data collection tools that can effectively utilise the limited resources to yield comprehensive feedback (de Oca et al., 2021).  In this regard, Shaw et al. (2021) proposed questionnaires as an appropriate data collection tool that allows for a continual data collection through stakeholder engagement.

The questionnaires will be appropriate for evaluating all the three intended interventions namely training, screening and medical assessment. For training, questionnaires will yield data on the clinical staffs and supervisors’ knowledge of patient fall as a clinical issue, both before and after the training to gauge the progress. For screening and medical assessment, questionnaires will be useful in gauging the clinicians’ and patients’ use of the Timed Up and Go (TUG) screening tool, and the effectiveness of the various fall prevention plans such as occupational therapy and vitamin D supplements and physical therapy. Lastly, the questionnaire swill be useful in gauging the overall effectiveness the program as seen by the change team, especially by gathering their opinion on the overall effectiveness of the adopted change implementation strategy.

Statistical Tests

Descriptive statistics will be the most appropriate statistical tools for evaluating the proposed project. Thomas et al. (2019) defined descriptive statistics as a statistical summary of quantitative data that describes the features of a set of collected data to develop quantifiable conclusions about the phenomenon under investigation.

Because the project will rely on questionnaires as the main tool of data collection, descriptive statistics such as mean median and mode will be helpful to gage different aspects of the project. for example, the project team would use descriptive statistics to understand the average number of falls before and after STEADI implementation. Similarly, mean scores would be used to quantify the clinicians’ and supervisors’ knowledge of patient fall risk assessment before and after the training.

More importantly, mean will be used as the best measure of central tendency to gauge the project’s effectiveness through Likert-type questionnaire items. Through descriptive statistics, similar questionnaire questions will be combined into a single composite variable or score and analysed as interval data (Lohman et al., 2017). The scale might also be described through standard deviations.

Strategies that will be taken if outcomes do not provide positive or expected results

During the implementation process, the change team might experience certain challenges with various aspects of the project such as the TUG screening tool that may prevent the achievement of positive results. For instance, Nguyen et al. (2021) observed that the TUG may not be acceptable to all users, or it might not fit well with the hospital’s clinical workflow due to space and time constraints. In this case, the project will select other fall risk screening tools such as the 30-second chair stand test. Also, some screening strategies such as routine checks for orthostatic blood pressure may cause unacceptable delays within the clinical system and therefore, they will be limited to patients who report certain symptoms such as balance difficulties, dizziness, or undetermined causes of gait.

The plans to maintain, extend, revise, and discontinue a proposed solution after implementation

Sustaining the STEADI project will require a continuous performance monitoring of each clinician and practice site. Furthermore, the project will benefit from sharing the performance results among the supervisors and clinicians in various departments because this will ensure a sustained interest from all the stakeholders. In case there are incidences of staff turnover or decreasing screening levels, the project team will need to implement refresher training sessions.

References

• Lohman, M. C., Crow, R. S., DiMilia, P. R., Nicklett, E. J., Bruce, M. L., & Batsis, J. A. (2017). Operationalisation and validation of the Stopping Elderly Accidents, Deaths, and Injuries (STEADI) fall risk algorithm in a nationally representative sample. Journal of Epidemiology and Community Health, 71(12), 1191-1197. http://dx.doi.org/10.1136/jech-2017-209769
• de Oca, M. K. M., Reid, H., Spinosa, D., Watson, C., & McNally, L. (2021). Perioperative risk stratification using the timed up and go test. Gynecologic Oncology, 162, S234. https://doi.org/10.1016/S0090-8258(21)01096-9
• Shaw, L., Kiegaldie, D., & Morris, M. (2021). Educating health professionals to implement evidence-based fall screening in hospitals. Nurse Education Today, 101, 104874. https://doi.org/10.1016/j.nedt.2021.104874
• Thomas, E., Battaglia, G., Patti, A., Brusa, J., Leonardi, V., Palma, A., & Bellafiore, M. (2019). Physical activity programs for balance and fall prevention in elderly. Medicine, 98(27), e16218. https://doi.org/10.1097/md.0000000000016218
• The American Geriatrics Society. (2011). AGS/BGS Clinical Practice Guideline: prevention of    falls in older persons. Accessed 14th November from http://www.alabmed.com/uploadfile/2014/0504/20140504033204923.pdf. www.americangeriatrics.org/education/prevention_of_falls.shtml

NUR 590 Topic 2: Making the Case for Evidence-Based Practice Papers

Objectives:

1. Describe effective strategies to create an evidence-based practice culture within a health care setting.
2. Identify stakeholders needed for the evidence-based practice project.
3. Assess organizational readiness for the evidence-based practice project.

Assessments

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Topic 2 DQ 1

GO TO DISCUSSION

Start Date

Aug 19, 2021 12:00 AM

Due Date

Aug 21, 2021 11:59 PM

Points

5

Status

Upcoming

Assessment Description

Compare two organizational readiness tools. Identify the tool you selected and explain why it is most appropriate for assessing your organization.

Topic 2 DQ 2

GO TO DISCUSSION

Start Date

Aug 19, 2021 12:00 AM

Due Date

Aug 23, 2021 11:59 PM

Points

5

Status

Upcoming

Assessment Description

Do you foresee any issues with the proposed implementation of your project? Identify a strategy to help create or sustain a higher level of readiness to change with your organization and discuss how current research or literature will be used to ensure that change is based on current evidence.

Benchmark – Evidence-Based Practice Project Proposal: Organizational Culture and Readiness

Benchmark

SUBMIT ASSIGNMENT

Requires LopesWrite

Start Date

Aug 19, 12:00 AM

Due Date

Aug 25, 11:59 PM

Points

100

Rubric

View Rubric

Status

Upcoming

Assessment Description

In order to successfully implement a change within an organization, the change agent must assess the organization’s culture and readiness for change. In 750-1,000 words, analyze the culture and level of readiness of the organization for which your evidence-based practice project is proposed. You will use the assessment of the organization’s culture and readiness in the Topic 8 assignment, during which you will synthesize the various aspects of your project into a final paper detailing your evidence-based practice project proposal.

Include the following:

1. Describe the organization’s culture and explain to what degree the culture supports change. Consider organizational and leadership structure, mission and values, interprofessional collaboration/team engagement, communication, perception of the organization by employees, etc.
2. Select an organizational readiness tool and assess the level or readiness for change within your organization. Identify the readiness tool and summarize the survey results. Discuss the degree to which the culture will support and sustain an evidence-based practice change. Consider strengths and weaknesses, potential barriers, stakeholder support, timing of the proposal, and resources. Provide rationale.
3. Discuss what health care process and systems you would recommend for improving quality, safety, and cost-effectiveness for the organization.
4. Propose strategies to better facilitate the readiness of the organization.
5. Identify the stakeholders and team members for the project. Include what their duties will be in the evidence-based practice project proposal.
6. Explain what information and communication technologies are needed for the implementation and how they will be integrated in the setting by the internal stakeholders. Explain how these will help improve nursing practice and care delivery for individuals and populations for your intervention.

Refer to the “evidence-based practice project proposal – Assignment Overview” document for an overview of the evidence-based practice project proposal assignments.

You are required to cite a minimum four peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Complete the “APA Writing Checklist” to ensure that your paper adheres to APA style and formatting criteria and general guidelines for academic writing. Include the completed checklist as an appendix at the end of your paper.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.

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 LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

Benchmark Information

This benchmark assignment assesses the following programmatic competencies:

MBA-MSN; MSN-Nursing Education; MSN Acute Care Nurse Practitioner-Adult-Gerontology; MSN Family Nurse Practitioner; MSN-Health Informatics; MSN-Health Care Quality and Patient Safety; MSN-Leadership in Health Care Systems; MSN-Public Health Nursing

3.1:  Assess health care processes and systems to recommend measures for improving quality, safety, and cost-effectiveness across an organization.

3.3:  Integrate appropriate information and communication technologies to improve nursing practice and care delivery for individuals and populations.

Upcoming

Assessment Description

There is no description for this assessment.

Resources

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Supporting the Uptake of Nursing Guidelines: What You Really Need to Know to Move Nursing Guidelines Into Practice

Read “Supporting the Uptake of Nursing Guidelines: What You Really Need to Know to Move Nursing Guidelines Into Practice,” by Mat

… Read More

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Evidence-Based Practice in Nursing and Healthcare : A Guide to Best Practice

Read Chapters 15 and 18 in Evidence-Based Practice in Nursing and Healthcare: A Guide to Best Practice.

View Resource

Agency for Healthcare Research and Quality

Explore the Agency for Healthcare Research and Quality (AHRQ) website.

http://www.ahrq.gov/

Aligning Organizational Culture and Infrastructure to Support Evidence-Based Practice

Read “Aligning Organizational Culture and Infrastructure to Support Evidence-Based Practice,” by Ost, Blalock, Fagan, Sweeney, an

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JBI EBP Resources

Use the JBI EBP Resources to search for EBP resources related to your project.

https://jbi.global/ebp

Organizational Readiness Tools for Global Health Intervention: A Review

Read “Organizational Readiness Tools for Global Health Intervention: A Review,” by Dearing, from Frontiers in Public Health</

… Read More

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5840160/

The Checklist: Recognize Limits, but Harness Its Power

Read “The Checklist: Recognize Limits, but Harness Its Power,” by Grif Alspach, from Critical Care Nurse (2017).

https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=125112053&site=ehost-live&scope=site

Cochrane Library

Explore the Cochrane Library website.

http://www.thecochranelibrary.com/view/0/index.html

A Multisite Health System Survey to Assess Organizational Context to Support Evidence-Based Nursing

Read “A Multisite Health System Survey to Assess Organizational Context to Support Evidence-Based Nursing,” by Pitmann et al., fr

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Advanced Practice Nursing: Essential Knowledge for the Profession

Read Chapters 23 and 24 in Advanced Practice Nursing: Essential Knowledge for the Profession.

View Resource

Readiness Assessment

Read “Readiness Assessment” (2015), located on the Agency for Healthcare Research and Quality (AHRQ) website.

https://www.ahrq.gov/teamstepps/readiness/index.html

Cultivate a Culture of Excellence at the Point of Care

Read “Cultivate a Culture of Excellence at the Point of Care,” by Medeiros, from Nursing Management (2020).

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The Cochrane Collaboration

Explore the Cochrane Collaboration website.

http://www.cochrane.org/

6 Steps for Transforming Organizational EBP Culture

Read “6 Steps for Transforming Organizational EBP Culture,” by Ogiehor-Enoma, Taqueban, and Anosike, from Nursing Management<

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NUR-590 Topic 4: Data Collection and Data Analysis

Objectives:

1. Select a research design for the evidence-based project proposal.
2. Select a statistical test for the evidence-based project proposal.

CAT: What is the difference between a qualitative and a quantitative research design?

Research designs are the strategies that help integrate study components to logically and coherently address a research problem. Strijker et al. (2020) note that research dictates data collection, measurement, analysis, and dissemination. The research design is influenced by the study’s research questions and objectives. Qualitative and quantitative research studies vary based on these parameters. Qualitative research designs are subjective inductive processes, while quantitative research designs are deductive objective research studies. Due to their nature of testing, quantitative studies have statistical data and thus utilize data analysis tools and statistical tests. Qualitative research designs utilize thematic and content analysis because they deal with textual data, while quantitative studies use numeric data (Mehrad et al., 2019). Qualitative research designs are explorative, while quantitative ones are often conclusive. These are the significant differences between qualitative and quantitive research designs

Reference

Mehrad, A., & Zangeneh, M. H. T. (2019). Comparison between qualitative and quantitative research approaches. Social Sciences. International Journal For Research In Educational Studies, Iran, 1-7.

Strijker, D., Bosworth, G., & Bouter, G. (2020). Research methods in rural studies: Qualitative, quantitative, and mixed methods. Journal of Rural Studies, 78, 262-270. https://doi.org/10.1016/j.jrurstud.2020.06.007

Assessments

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Topic 4 DQ 1

GO TO DISCUSSION

Start Date

Sep 02, 12:00 AM

Due Date

Sep 04, 11:59 PM

Points

5

Status

Upcoming

Assessment Description

Explain whether you would select a qualitative or quantitative design to collect data and evaluate the effectiveness of your evidence-based practice project proposal. Identify which data collection tool you would specifically use and explain why this design is best for your evidence-based practice project proposal.

Example Topic 4 DQ 1 Response

The nursing practice of interest is medication errors, and the evidence-based intervention selected is Barcode Medication errors. Prevalence and burden data are quantitative and are based on the number of medication errors. Any research study’s objectives and research questions influence the design because studies attempt to answer study questions and meet the research objectives.

The study’s objectives can only be studied using statistical means by evaluating data from the hospital database. The prevalence of medication administration errors compared to other medication errors and the changes in these errors will be vital in determining the effectiveness of BCMA (Williams et al., 2021). The data will thus require statistical evaluation, hence the need for a quantitative research design.

Bloomfield and Fisher (2019) state that a correlational quantitative research design is best suited to determine the relationship between variables and is thus best suited for this study. Data collected for this project will include medical records on medication errors in the facility and the collection of raw data (medication errors, including near misses and sentinel events) related to medication administration collected throughout the project. For this project, a quantitative design will be the most suitable to help collect data and evaluate the proposed project’s effectiveness. Data for this project will be quantitative hence the design’s selection.

Document review/secondary data collection methods and surveys utilizing quantitative research designs will collect and analyze data for the project. Document reviews utilizing healthcare records help professionals avoid time and resources wasted in data collection because the data is readily available (Melnyk & Fineout-Overholt, 2022). Data from the healthcare database on medication errors is the best to use in this quasi-experimental study and results in medication administration error differences pre-an post implementation of barcode medication administration technologies. Selecting the right research design will help with objective achievement through adequate planning.

References

Bloomfield, J., & Fisher, M. J. (2019). Quantitative research design. Journal of the Australasian Rehabilitation Nurses Association, 22(2), 27-30. http://dx.doi.org/10.3316/informit.738299924514584

Melnyk, B. M., & Fineout-Overholt, E. (2022). Evidence-based practice in nursing & healthcare: A guide to best practice. Lippincott Williams & Wilkins.

Williams, R., Aldakhil, R., Blandford, A., & Jani, Y. (2021). Interdisciplinary systematic review: does alignment between system and design shape adoption and use of barcode medication administration technology? BMJ Open, 11(7), e044419. http://dx.doi.org/10.1136/bmjopen-2020-044419

Topic 4 DQ 2

GO TO DISCUSSION

Start Date

Sep 02, 12:00 AM

Due Date

Sep 06, 11:59 PM

Points

5

Status

Upcoming

Assessment Description

Identify which statistical test you would use in conjunction with your selected research design from DQ 1 to evaluate the outcomes for your evidence-based project proposal and explain why you selected this test. What kind of information will this test provide about your outcomes?

Example Topic 4 DQ 2 Answer

The primary interest of the project is to determine changes in medication errors. Statistical tests in research are selected based on the objectives. Statistical. Data evaluating the relationship between variables (causal effects), data changes over time, and hypothesis testing require specific statistical tests. Tests such as ANOVA, t-test, and chi-squares help understand the variables’ changes and their relationships (Rebekah & Ravindran, 2018).

Zheng et al. (2021) note that the BCMA technology targets medication administration errors by confirming all medication administration rights at the dispensing point. The technology may affect other medication errors at dispense and prescription, but the primary interest is medication administration errors. The interest statistical test must be able to test changes in variables of time/ at different times.

The selected statistical test is the ANOVA test. The test helps evaluate the changes in variables concerning each other. They test the significance of results and thus help reject or accept the null or alternate hypothesis. The project aims to determine if barcode medication administration reduces medication administration errors. The statistical cost interest should help determine the relationship between BCMA administration and changes in medication errors. Data before and after BCMA should be compared to determine their similarities and differences.

The ANOVA test will be vital because data will be collected and analyzed at different times. The analysis will help determine the differences in medication (Rebekah & Ravindran, 2018). The ANOVA test is used when testing a hypothesis and evaluating the effectiveness of interventions. The ANOVA will help test the changes in the various variables over time. The changes in the variables, medication error rate, and their relationship to other medication errors will help evaluate the effectiveness of the interventions.

References

Rebekah, G., & Ravindran, V. (2018). Statistical analysis in nursing research. Indian Journal of Continuing Nursing Education, 19(1), 62. https://www.ijcne.org/text.asp?2018/19/1/62/286497

Zheng, W. Y., Lichtner, V., Van Dort, B. A., & Baysari, M. T. (2021). The impact of introducing automated dispensing cabinets, barcode medication administration, and closed-loop electronic medication management systems on work processes and safety of controlled medications in hospitals: A systematic review. Research in Social and Administrative Pharmacy, 17(5), 832-841. https://doi.org/10.1016/j.sapharm.2020.08.001

Week 4 Participation

GO TO DISCUSSION

NUR 630 Grand Canyon University Healthcare Quality Data Sources Organizer

NUR 630 Grand Canyon University Healthcare Quality Data Sources Organizer

The purpose of this assignment is to become familiar with various data sources used by health care organizations to obtain quality data NUR 630 Grand Canyon University Healthcare Quality Data Sources Organizer. The Agency for Healthcare Research and Quality (AHRQ) creates an annual report, the National Healthcare Quality and Disparities Report, which assesses the performance of the U.S. health care system.

This report identifies strengths and weaknesses of the health care system in addition to disparities for access to health care and quality of health care. The report is based on more than 250 measures of quality and disparities, and it covers a broad range of health care services and settings.

Access the “2017 National Healthcare Quality and Disparities Report Data Sources” through the AHRQ website, using the link provided in the topic materials. Select five data sources from this report and fill in the required components on the “Quality Data Sources Organizer.” NUR 630 Grand Canyon University Healthcare Quality Data Sources Organizer

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center. 

You are not required to submit this assignment to LopesWrite.

Quality Data Sources Organizer Example

Data Source

Primary Content

Population Targeted

Demographic Data

Schedule

Is This a Source of Primary or Secondary Data?

How / When / Where
the Information Might
Be Used

Behavior Risk Factor Surveillance System (BRFSS)

The BRFSS collects uniform and state-specific data. The primary focus is on chronic illnesses, diseases, injuries, and preventable infectious diseases in the adult population. The primary survey consists of uniform questions asked in all states on selected topics administered with the states’ allowance. The set of questions is rotating and is asked yearly in all states. In some states, some questions are added to address the specific problems affecting these states. The questions asked focus on behavioral risk factors such as smoking, preventive health measures such as health-seeking behavior, HIV/AIDS, health status, physical abilities and limitations, and healthcare access and utilization

The targeted population is US civilian noninstitutionalized population ages 18 and above and residing in households

Significant demographic data includes gender, age (above 18), education level, race/ethnicity, household income, employment, and marital status

The data from the surveys are collected monthly and distributed annually

Primary data collected from health surveys carried out in all states in the United States

The BRFSS collected data on the health of US citizens, their health-related behaviors, chronic health conditions, and US preventive services. The system collects data from more than 400000 individuals annually, making it the most robust and continuously conducted healthcare survey system globally. The system produces data used in various ways, including determining the population’s health risks. The data generated is also used to determine the behaviors to target in managing chronic illnesses and other health conditions of public interest. The survey is thus integral to gathering information on behavioral risk factors and acting on them to minimize their effects on population health 

Quality and Safety Review System (QSRS)

The system facilitates patient safety improvements by improving the understanding of the burden of specific patient safety issues associated with hospital care. The system also collects and examines the risk factors and data on outcomes such as in-hospital mortality and length of hospital stay

The system targets all Medicare patients

Patients of all ages, races/ethnicity, gender, and whose healthcare payment source is Medicare

Data is collected and submitted in real-time but reported quarterly and annually to the AHRQ

Secondary data. The information is collected from an analysis of clinical data the care providers have already collected. The data is collected during their interaction with the patients

The system uses reliable clinical information such as prescriptions and laboratory test results relevant to patient safety. The system provides data on trending adverse events, allowing health institutions to plan their prevention and management. The data also helps local care leaders to implement surveys and interventions at the local level to help manage these problems based on the outcomes of their specific healthcare facilities

American Hospital Association, Information Technology Supplement

The complete AHA survey focuses on statistics that include current and historical data on utilization, personnel, revenue, expenses, managed care contracts, community health indicators, and physician models. Other statistics include technology, electronic health records, admission volume and status, and urban and rural status. The supplement questions healthcare facilities to determine which electronic health records and health information systems they use and the scope of computer function, use, and utilization in the healthcare facility

The system targets all healthcare facilities/hospitals in the United States, including nursing homes, and private institutions

The demographic data is in addition to the core survey and includes hospital information, leadership and organizational structures, facilities, and services, utilization data, community orientation indicators, physician arrangements, managed care relationships, expenses, staffing HER utilization, electronic systems utilization for prescribing and data sharing

Data is collected and submitted annually

Primary data. The information is collected first-hand from all healthcare facilities across the nation

The AHA surveys are annual and from all hospitals in the United States. The data collected focuses on four primary areas, organization, facilities, community benefit, and utilization. They gather information on the extent to which hospitals have implemented health information systems, their characteristics and functionality, and utilization by the hospital. The information from this source can be used for a variety of reasons. It can help suggest useful technologies for a facility. It can also be used to determine the effectiveness of certain technologies from data collected nationally. The data can also spearhead interventions to improve technology utilization in healthcare services such as staff education and support.

National Cancer Data Base (NCDB)

The NCDB entails standardized data elements on patient demographics, insurance status, tumor characteristics (stage, morphology, and site), comorbidities, first treatment course, disease recurrence, and patient survival data. The database also contains information on residence, such as state and Zip Code which are then used to compute area-based sociodemographic data

The database collects information on cancer patients in the unites states

All data relevant to the patients, such as gender, age at diagnosis, race/ethnicity, and other information pertinent to the cancer diagnosis

The data is collected annually

Primary data. This database collects information and presents it as collected by healthcare providers. The database uses its developed standardized registries for data collection and captures data on about 70% of all newly diagnosed cancer patients

The database contains data vital to the management of cancer patients. Chronic illnesses such as cancer and diabetes are on the rise, prompting the development of corrective interventions. The database contains data that assists the US government and healthcare facilities in understanding the current cancer burden and the specific cancer diagnosis. The data helps direct national efforts toward preventing and managing cancer and uses issues such as risk factors and causes to develop interventions that reduce cancer prevalence. The data also helps responsible bodies redirect financial assistance to ensure quality healthcare delivery and population outcomes.

Medical Expenditure Panel Survey (MEPS)

MEPS has three constitute surveys: The HC, Medical provider, and Insurance components. The HC components focus on demographic data, health conditions, satisfaction rate, insurance coverage, employment, and income and are the primary source for the NHDQR and NHDR data. The sections that generate data include the SAQ questionnaire that collects data on a variety of adult health and healthcare quality measures, DCS (diabetes and diabetes care), Child Health and Preventive Care (children health affairs), Access to Care, and Preventive Care

The survey targets the US civilian noninstitutionalized population

The demographic characteristics of interest include age, gender, race, education, ethnicity, industry, occupation, employment status, family income, and household composition

Annually

Primary and secondary data sources

The AHRQ collects data from national probability surveys on financing and use of medical care. It helps the nation understand how its population uses medical care services and its financing for improvement in these specific areas. The data can be used to drive financial reforms and interventions to increase access and utilization of healthcare services. Data estimates in the NHDQR data tables based on MEPS data are modified to reflect the experiences of the target populations for inference purposes.

NUR 630 Topic 7: Performance Improvement Tools And Reportable Metrics

Objectives:

1. Identify stakeholder reporting agencies.
2. Identify trends in health care data.
3. Create a presentation of data for stakeholders.

Topic 7 DQ 1 

Identify at least two stakeholder agency reporting sources. How do these external reporting groups contribute to or hinder CQI?

Topic 7 DQ1 Example

Internal and external stakeholders are indispensable for the successful delivery of healthcare and its ongoing quality enhancement. Internal and external stakeholders are reporting sources for stakeholder agencies in health care. Internal stakeholders are involved in coordinating, financing, resource allocating, and publishing the health care and well-being partnership’s strategies.

(Lübbeke et al., 2019) External stakeholders frequently contribute their perspectives and experiences when addressing significant issues that may impact the overall management of healthcare. External stakeholders include insurance companies, such as Medicaid, pharmaceutical companies, and suppliers. Internal stakeholders include hospital administration.

The healthcare system should be tailored to its stakeholders’ ideas, requirements, and perspectives. Because the organizational output will be denied if such a decision is made, it is unwise to go against them. For instance, failure to adhere to market trends provided by external stakeholders will result in losses because products and services will not meet market demands. Thus, the stakeholders are crucial from program design to evaluation. (Wu et al., 2019).

External stakeholders contribute to an organization’s ongoing quality enhancement. Their perspectives shape healthcare delivery in the correct direction. It assists policymakers in passing appropriate legislation. It also aids in revealing the errors and inappropriate decisions made by the organization, as evidenced by the negative opinions of its stakeholders, thereby facilitating appropriate decision-making as efforts are made to avoid them. (Segarra-Ona et al., 2020). For instance, the opposing views of community members regarding the hospital’s environmental contamination influence the hospital’s recycling, waste treatment, and waste disposal practices.

In addition, how stakeholders’ opinions are addressed influences their perception of the institution and utilization of the offered services. Therefore, internal and external stakeholders contribute to shaping the organization’s operations and ensuring the organization’s pursuit of continuous quality improvement. Their perspectives, ideas, and requirements contribute to decision-making from project conception to evaluation, resulting in efficient service delivery.

The institution should listen to the affected parties’ opinions and consider them when making decisions. It ensures that the provided goods and services satisfy market demand and adhere to government regulations. The organization is improved by resolving its issues based on the perspectives of its stakeholders (Lübbeke et al., 2019).

References

Lübbeke, A., Carr, A. J., & Hoffmeyer, P. (2019). Registry stakeholders. EFORT open reviews, 4(6), 330–336. https://doi.org/10.1302/2058-5241.4.180077

Wu, J., Wang, Y., Tao, L., & Peng, J. (2019). Stakeholders in the healthcare service ecosystem. Procedia CIRP, 83, 375-379. https://doi.org/10.1016/j.procir.2019.04.085

Segarra-Oña, M., Peiró-Signes, Á., & Verma, R. (2020). Fostering innovation through stakeholders engagement in the healthcare industry: tapping the right key. Health Policy. https://doi.org/10.1016/j.healthpol.2020.05.013

Topic 7 DQ 2 

You are going to present data that have been collected to your administrative group. The focus is on outcome measures and the data collected are unplanned readmission rates at two different hospitals. What format would you choose to display your data and why? What information would you include with the data?

Topic 7 DQ2 Example

I would want to present this data in a power point presentation with easy to see/understand graphs. First, I would explain the purpose of the project and data and relate the importance to any important CQI or hospital initiatives. I would also educate the administrative group on the data collection method(s) used to obtain the data. Data related to unnecessary readmissions and readmission rates differ based on the data collection methodology (Hechenbleikner, 2016). I would start with a control chart showing the total readmissions for both sites over the last year. I would then display the same data but broken into two charts, one for each location. This would assist in identifying/explaining any trends over time. 

I would also plan to include pie charts with the associated readmission diagnosis for each location and relate this back to any affiliated best practices or certifications each facility may possess. I would also include national averages and show how my organization compared at this level. Depending on this comparison I would suggest areas of improvement or maintenance strategies. I love to include case studies and if time permitted, I would highlight a successful readmission case and recognize the employees who did the outstanding work. I would then dive into the unplanned cases and highlight ones that may have been prevented if best practices were followed.

Reference:

Hechenbleikner EM, Makary MA, Samarov DV, Bennett JL, Gearhart SL, Efron JE, Wick EC. Hospital readmission by method of data collection. J Am Coll Surg. 2013 Jun; 216(6):1150-8. 

Benchmark – Hospital-Associated Infections Data 

The purpose of this assignment is to examine health care data on hospital-associated infections and determine the best methods for presenting the data to stakeholders. Use the scenario below and the “Hospital Associated Infections Data” Excel spreadsheet to complete the assignment.

Scenario

You have been tasked with displaying Centers for Medicare and Medicaid Services (CMS) hospital quality measures data for a 5-year period on four quality measures at your site. After examining the data, identify trends and determine the best way to present the actionable information to stakeholders.

Assignment

Create a 12-15-slide PowerPoint (not including title and reference slides) presenting the data to the stakeholders. Address the following in your PowerPoint:

1. What conclusions can be drawn for each quality measure over the 5-year period?
2. What trends do you see for each quality measure over the 5-year period?
3. When comparing each quality measure, is the quality measure better than, worse than, or no different from the national benchmark over time?
4. Based on your examination of the data, which of the quality measures should you prioritize and why?
5. Develop a quality improvement metric and related measures to improve care processes, outcomes, and the patient experience relating to the identified area of opportunity.
6. Explain how you would monitor the metric and use collected data for improvement.  

Include a title slide, references slide, and comprehensive speaker notes.

Refer to the resource, “Creating Effective PowerPoint Presentations,” located in the Student Success Center, for additional guidance on completing this assignment in the appropriate style.

Use a minimum of two peer-reviewed, scholarly sources as evidence.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

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

You are not required to submit this assignment to LopesWrite.

Benchmark Information

This benchmark assignment assesses the following programmatic competency:

MSN Leadership in Health Care Systems

6.6: Develop and monitor continuous quality improvement metrics and measures to improve care processes, outcomes, and the patient experience.

NUR 641E Topic 1: General Physiological And Pathophysiological Concepts

Objectives:

1. Describe principles of immunology in disease processes.
2. Evaluate the inflammatory response as a defense mechanism.
3. Evaluate the principles of cellular alterations in infection and the medications that treat infection.
4. Describe a pharmacological intervention using an evidence-based treatment guideline.

Topic 1 DQ 1

Start Date

Mar 3, 2022, 12:00 AM

Due Date

Mar 5, 2022, 11:59 PM

Points

5

Status

Published

Assessment Description

Part 1

What are the differences between primary and secondary line of defense? What factors interfere with these mechanisms? How are these levels of immunity affected in a child, an elderly person, or a person with a chronic disease? Include active, passive, innate, and acquired immunity.

Part 2

Choose an inflammatory or infectious process and explain the pathophysiology changes that may occur. What patient education would need to be included related to this disorder? Make sure that you select a different medical condition than your peers. Include the name of the medical condition in the subject line so that the medical condition can be followed. Include your references in APA style.

Cristina Alimon

Posted Date

Mar 12, 2022, 8:21 PM

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Replies to Vanessa Brown

Proton Pump Inhibitor (Omeprazole)

Proton-pump inhibitors (PPIs) are a family of medications best recognized for their use in treating acid-related illnesses. When used as part of an all-natural treatment plan with other medicines, this effect can help heal a peptic ulcer, treat gastroesophageal reflux disease, treat Barrett’s esophagus, and even get rid of Helicobacter pylori (Ahmed & Clarke, 2021). With my experience in home health nursing before, most older patients take Omeprazole, especially if they have multiple drug maintenance. Some of the patients were prescribed maybe eight or more medications, and one of those is Omeprazole. Most of the time, they are discharged from hospital admission new medication will be added. It was always a struggle to coordinate with multiple physicians that the patient is seeing to verify the necessary medication they need to take as long term, and that is only short term. There was a patient that during the initial intake visit I asked him about why he is taking Omeprazole, he said because of GERD from all the medications that he is taking. Therefore, it is essential to be careful about our older patients’ medications. Because the more medications they are taking, the more susceptible they are to the adverse reactions from medications. Therefore, it is essential to educate the patient, give them an updated medication list, and instruct them or the family that they bring all the medication they are taking each time they see a physician to avoid duplication or unnecessary medication prescription.  

Pharmacokinetics of Proton Pump Inhibitor 

Absorption

The proximal small bowel absorbs these drugs, and when they reach the stomach’s parietal cells, they influence the cells (Ahmed & Clarke, 2021). The proton pump is an enzyme in the parietal cells that PPIs stop. This enzyme is the last step in releasing acid into the stomach, and it does this job very well.

Metabolism

Omeprazole is broken down by the hepatic cytochrome P450 enzyme system, mainly through CYP2C19 and CYP3A4 isozymes. It has a short half-life of a half-hour to an hour in healthy people and about three hours for people who have a problem with their liver (Shah, 2020).

Distribution

Within an hour of taking Omeprazole, the drug’s effects start to slow down. It takes two hours for the drug’s full effects to kick in. The effects of the drug last for about 72 hours after it is taken, and they usually wear off in 3 to 5 days. It will take four days for the effects to level off when taking medicine every day (Shah, 2020).

Excretion

Urinary excretion is the principal mechanism of omeprazole metabolite elimination (Shah, 2020).

Reference

Ahmed, A., & Clarke, J. O. (2021, August 1). Proton pump inhibitors (PPI) – StatPearls – NCBI bookshelf. National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov/books/NBK557385/

Shah, G. W. (2020, October 17). Omeprazole – StatPearls – NCBI bookshelf. National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov/books/NBK539786/

Topic 1 DQ 2

GO TO DISCUSSION

Start Date

Mar 3, 2022, 12:00 AM

Due Date

Mar 7, 2022, 11:59 PM

Points

5

Status

Published

Assessment Description

Select a medication used in evidence-based treatment guidelines for the condition chosen in the first discussion question. Share the mechanism of action of this medication and hints for monitoring, side effects, and drug interactions of which one should be aware. Make sure that you select a different medication than your peers. Include the name of the medication in the subject line so that the medications can be followed. Include your references in APA style.

Topic 1 DQ 2

Mar 3-7, 2022

Select a medication used in evidence-based treatment guidelines for the condition chosen in the first discussion question. Share the mechanism of action of this medication and hints for monitoring, side effects, and drug interactions of which one should be aware. Make sure that you select a different medication than your peers. Include the name of the medication in the subject line so that the medications can be followed. Include your references in APA style.

REPLY TO DISCUSSION

CA

Cristina Alimon

Posted Date

Mar 7, 2022, 11:39 PM

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Replies to Cristina Alimon

Cyclophosphamide

Cyclophosphamide, with the brand name of Cytoxan, is one of the medications given for Goodpasture disease to suppress the immune system in making anti-glomerular basement membrane (GBM) antibodies. Primarily this medication is for cancer like ovaries, breasts, blood, and others.

Mechanism of action

Cyclophosphamide is a cancer drug under a class of alkylating agents. The CYP450 system converts cyclophosphamide and ifosfamide to hydroxylated intermediates in the liver. The active chemicals phosphoramide mustard, and acrolein, are formed from the hydroxylated intermediates. The phosphoramide mustard reacts with DNA, causing cytotoxicity (LaPlant, & May 2019). Cyclophosphamide slows the development of cancer cells, which the body eventually destroys. Other side effects may develop because cyclophosphamide affects normal cell growth.

Hints for monitoring

Cyclophosphamide can temporarily reduce white blood cell counts, increasing the risk of infection and reducing the platelet count required for blood clotting (Mayo Clinic, 2022). Particular care must be taken to avoid infection or bleeding. Therefore, it is essential to instruct the patient to follow bleeding precautions. Avoiding contact sports and other circumstances that might cause bruising, cuts, and brushing or flossing teeth; monitor for signs of bleeding like bruises, blood in the urine or stools, or tiny red patches on the skin. Cyclophosphamide may reduce the body’s resistance, causing the vaccination to fail or the illness to occur; the patient should also avoid others who have received live virus vaccinations since they may spread the infection to the patient (Mayo Clinic, 2022).

Side effects

More common side effects are cough or hoarseness, fever or chills; lower back or side pain; missing menstrual periods; and painful or difficult urination (Mayo Clinic, 2022). The following side effects with high doses and long-term treatment are blood in the urine; dizziness, confusion, or agitation; fast heartbeat; joint pain; shortness of breath; swelling of the feet or lower legs; and unusual tiredness or weakness. Studies on nursing mothers show detrimental impacts on babies. It should be provided an alternative or discontinue nursing while using it.

Drug interaction

Cyclophosphamide has notable drug interactions with phenobarbital, phenytoin, digoxin, and anticoagulants (LaPlant, & May 2019). Chronic high dosages of phenobarbital enhance the metabolism and leukopenic action of cyclophosphamide. Therefore, warfarin’s impact is enhanced or decreased in individuals receiving warfarin plus cyclophosphamide (U.S. National Library of Medicine, 2021).

References:

LaPlant, K., & May, P. (2019). Anticancer Drugs. In K. Whalen (Ed.), Lippincott® illustrated reviews: Pharmacology (7th ed.). Wolters Kluwer.

Mayo Clinic. (2022, February 14). Cyclophosphamide (Oral route, intravenous route) description and brand names – Mayo Clinic. https://www.mayoclinic.org/drugs-supplements/cyclophosphamide-oral-route-intravenous-route/description/drg-20063307

U.S. National Library of Medicine. (2021, September 28). Cyclophosphamide injection, solution. DailyMed. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=a0e99679-f939-4fb3-9d38-dfdb824f89bc