Nu 309 Week 1 Evidence Based Practice

Complete the following table for each of the diseases assigned to you in NFS 715. The purpose of this assignment is to teach you how current research and evidence summaries are used to influence patient care.

Evidence-Based Practice Proposal Final Paper Usha Kizhakkedan Grand Canyon Final Paper of Evidence Based Proposal NUR-699 Dr. Debbie Long June 1, 2016 Table of Contents Part 1: Organizational Culture and Readiness Assessment 4 • Introduction to Evidence-Based Practice 4 • Barriers to Evidence-Based Practice 4 • Facilitators of Evidence-Based Practice 5 • Integration of Clinical Enquiry 5 • The Survey 6 Part 2: Problem Description 7 • Description 7 • Identification of change agents in the Health care system 8 • PICOT question 8 • Purpose and Objectives 9 • Rationale 10 • Literature support 10 • Research Method 10 Part 3: Literature Support 11 • Research Questions 11 • Search Method 12 • Organization of Literature 12 • Framework 12 • Nursing Rounds- Patient and Family Satisfaction: 13 • Communication: 15 • Management of Pain, Use of Call Lights and Cases of Patient falls 15 • Data Collection 16 Part 4: Solution Description 16 • Objectives 17 • Change Methodology 17 • Implementation Plan 18 • Evaluation 19 Part 5: Change Model 19 • Change Model 20 • Implementing Change 21 • Rationale 22 Part 6: Implementation Plan 22 • Staff Education 23 • Client feedback 23 • Timeframe 23 • Hiring Process 24 • Implementation 24 • Data collection and Evaluation 24 • Progression 24 • Resource Management 24 • Budget Plan 25 • Outcomes and its impact 25 • Summary 26 Part 7: Evaluation of Process 26 • Objectives 26 • Methodology 27 • Procedure 27 • Collection and Analysis of data

Magnet asks healthcare organizations to define their philosophy because it is the leading resource for establishing effective and efficient nursing practices. (Magnet Monday, n.d.). This magnet is a landmark behind the success of certain hospitals with low turnover rates, better quality of care, decreased length of stay, and improved outcomes. (Magnet Monday, n.d.). American Nurses Credentialing Center for Magnet status is a prestigious award that not all hospitals attain. Those who are Magnet status have higher nurse retention and satisfaction, improved quality of care, less nurse burnout, and lower mortality rates

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195). As stated by Birk (2007) American Nurses Credentialing Center (ANCC) standards for magnet classification speaks of applied theoretical framework and articulated philosophy in day to day operations. Landmark and Hickey (2007) states that the components of a magnet environment that will likely contribute to high consensus within the organization are the magnet programs attention on sequences between nursing mission, vision, values, philosophy and strategic priorities and those organizations.

Measures used to evaluate the outcome of the evidence-based practice (EBP) change will be reviewing quarterly dashboard data. To ensure inter-rater reliability, the infection control nurse, and only the infection control nurse, will monitor ongoing efforts of data collection of CAUTI, and be an integral part of the feedback loop responsible of giving on-sight feedback to clinicians and team members. Also, the infection control nurse along with other team members will revisit the literature to see if any new knowledge focused triggers will be considered. The quarterly dashboard will inform of outcome indicators which may, or may not, affect the process indicators. Process and outcome indicators will be used for improvement purposes within the unit. The quarterly dashboard report also allows questions to be asked by team members and stakeholders, which stimulates more discussion and advanced thought toward quality improvement of the EBP change. The dashboard will assist in

Considering potential damage to the spine of a trauma victim within the overall treatment of a patient is vital when preventing any secondary injury. As stated in the ARC Guideliness,1 symptoms and signs of a spinal injury can include pain in the injured region, paralysis, nausea, headaches, dizziness, absent skin sensation, an abnormal head or neck position, an associated head injury, an altered conscious state, difficulties breathing or loss of function in limbs. Falls in the elderly population or a significant blow to the head are also commonly recognised as causing spinal damage.1 As an elderly woman with a substantial blow to the head and an altered state of consciousness, the patient should be treated as having a suspected

Magnet recognition is a performance recognition that was started by the American Nurses Credentialing Center (Drenkard, 2010). The recognition is awarded to facilities who have applied and met the requirements (Magnet Recognition and Pathway to Excellence, 2018). The goals of the Magnet recognition are to improve positive patient outcomes while also providing an environment which promotes growth and safety for the nurses (Magnet Recognition and Pathway to Excellence, 2018). The opportunities for nurses that are provided by the Magnet recognition are continued education, promotion of growth by certifications and licenses, recognition of individual nurses, and staff satisfaction (Magnet Recognition and Pathway to Excellence,

The nursing profession is dealing with numerous issues that pertain to their role in the healthcare system. As the United States (US) healthcare system continues to expand, the nurses should acclimate to the changes it bring, including with the advancement in technology, the social issues we are facing, the knowledge from research and evidence-based project and innovation in the nursing education. With this in mind, the opportunity for nursing is unfolding and we are in the right position to capitalize on our strengths in knowledge, skills, and attitudes, being the frontline healthcare workers and the largest in numbers in taking care of our patients. The Magnet status and the Affordable Care Act (ACA) are the topics chosen for this discussion

Currently, 6% of hospitals in the United States hold Magnet status (Lowell General Hospital, n.d.). Being a Magnet hospital is an accreditation awarded by the American Nurses Credentialing Center (Lowell General Hospital, n.d.). Such recognition is given to hospitals that aim to focus on quality-patient care provided by nurses (Lowell General Hospital, n.d.). This status is earned and achieved after extensive review, and is good for four years before they are required to meet 35 different areas of focus again (Lowell General Hospital, n.d.). Trinkoff et al. (2010) review the working conditions of hospitals to determine whether Magnet status improves nursing working conditions. The authors of this article come from different areas of expertise as they hold nursing degrees, PhD degrees, ScD degrees, and many others with an educational background in statistics, epidemiology, and nursing. However, the authors fail to study the patient outcomes between Magnet and non-Magnet hospitals and to see if Magnet status has an impact on patient outcomes. They fail to look at the entire picture, as their primary focus is on the working conditions of nurses, and not the patients.

The literature review studies discuss the recurrent issue of higher and lower staffing ratios and how they affect patient outcomes. The studies show how several factors affect the nursing workload and the adverse results of the patients. The information is investigated under several methods that range from level one to a level five on the pyramid. The extensive research studies provide the support and the evidence on the issue needing change.

Research, quality improvement (QI), and evidence-based practice (EBP) all play an important role in the field of healthcare and are essential for the delivery of quality patient care. While each involves teamwork, critical thinking, and creativity there are distinct differences between them.

After looking through the different websites, and considering what qualities I am seeking in my future profession as a nurse, I found they all hold values I want to experience in my practice. However, the one that caught my attention foremost is the ANCC’s magnet status. According the ANCC’s website, “Magnet Recognition is an organizational credential awarded to exceptional health care organizations that meet ANCC standards for quality patient care, nursing excellence, and innovations in professional nursing practice” (Magnet Model, 2015). Receiving Magnet recognition is not an easy task seeing as only 82 hospitals are recognized. The “magnet model”, a guideline for achieving status as a magnet hospital, includes the components of transformational

Research has shown that children, who have a strong foundation, are ready to succeed in school. During the 1960’s, there was an increase of awareness of developmental psychology therefore, scientists were beginning to understand that early childhood education would increase cognitive development. The idea of a show like Sesame Street was introduced.

Evidence-Based Nursing is a form of Evidence-Based Practice, which is defined as the integration of best research evidence with clinical expertise and patient values(CITATION DELETED). There are five steps that evidence based practice consists of: assess the patient, ask a searchable clinical question, acquire the best evidence to answer the question, appraise the evidence, and apply it to the patient(CITATION DELETED). I have chosen to write about evidence based nursing practices that can help prevent ventilator- acquired pneumonia. Ventilator-acquired pneumonia is responsible for 90% of nosocomial infections (NI) in the mechanically ventilated population(Grap, Munro, Elswick, Sessler, & Ward, 2004, 83-91) [Click and drag to move] and occurs