Phillip March 26, 2024 No Comments

EB006 Disseminating Evidence-Based Practice Changes

EB006 Disseminating Evidence-Based Practice Changes Name  University NURS 6052 Essentials of Evidence-Based Practice Prof. Name Date Introduction Effective communication of evidence-based practice changes is vital within healthcare organizations to enhance patient outcomes and the quality of care. This presentation aims to evaluate different dissemination strategies, emphasizing both recommended approaches and those less favorable. The objective is to facilitate the successful adoption of evidence-based practices within our organization (Jensen & Gerber, 2020). Recommended Dissemination Strategies Strategy 1: Interactive Workshops Interactive workshops encourage active participation, collaboration, and skill development among staff. This approach is effective as it allows for immediate feedback, peer learning, and practical skill enhancement (Dang et al., 2021). Strategy 2: Webinars and E-Learning Webinars and e-learning platforms offer flexibility, enabling staff to access training materials at their convenience. This strategy accommodates busy schedules and supports self-paced learning (Cullen et al., 2022). Least Recommended Strategies Strategy 1: Mass Emails Mass emails can be easily disregarded, overlooked, or lost in a cluttered inbox. This strategy lacks interactivity and engagement, making it unsuitable for effective dissemination (Chapman et al., 2020). Strategy 2: Lengthy Paper Manuals Lengthy paper manuals can be overwhelming and may not be user-friendly. This strategy does not facilitate active learning and might discourage staff participation (Arul et al., 2021). Barriers to Recommended Strategies Barrier 1: Staff Resistance Barrier 2: Limited Technological Proficiency Overcoming Barriers Overcoming Barrier 1 (Staff Resistance) Addressing concerns and misconceptions through small group discussions and sharing success stories and data on improved patient outcomes can help overcome staff resistance (Dang et al., 2021). Overcoming Barrier 2 (Limited Technological Proficiency) Providing step-by-step tutorials and technical support for online training, along with offering in-person sessions for staff uncomfortable with technology, can mitigate limited technological proficiency (Jensen & Gerber, 2020). References Jensen, E. A., & Gerber, A. (2020). Evidence-based science communication. Frontiers in Communication, 4, 78. Dang, D., Dearholt, S. L., Bissett, K., Ascenzi, J., & Whalen, M. (2021). Johns Hopkins evidence-based practice for nurses and healthcare professionals: Model and guidelines. Sigma Theta Tau. Cullen, L., Hanrahan, K., Farrington, M., Tucker, S., & Edmonds, S. (2022). Evidence-based Practice in Action: Comprehensive Strategies, Tools, and Tips from University of Iowa Hospitals & Clinics. Sigma Theta Tau. NURS 6052 Assessment 6 EB006 Disseminating Evidence-Based Practice Changes Chapman, E., Haby, M. M., Toma, T. S., De Bortoli, M. C., Illanes, E., Oliveros, M. J., & Barreto, J. O. M. (2020). Knowledge translation strategies for dissemination with a focus on healthcare recipients: an overview of systematic reviews. Implementation Science, 15, 1-14. Arul, R., Al-Otaibi, Y. D., Alnumay, W. S., Tariq, U., Shoaib, U., & Piran, M. J. (2021). Multi-modal secure healthcare data dissemination framework using blockchain in IoMT. Personal and Ubiquitous Computing, 1-13. NURS 6052 Assessment 6 EB006 Disseminating Evidence-Based Practice Changes

Phillip March 26, 2024 No Comments

EB005 Evidence-Based Decision Making

EB005 Evidence-Based Decision Making Name  University NURS 6052 Essentials of Evidence-Based Practice Prof. Name Date Evidence-Based Decision Making in Health Care Settings In contemporary healthcare management, evidence-based decision making plays a pivotal role in ensuring quality care delivery while optimizing resource allocation. This approach relies on the integration of rigorous scientific evidence with practitioner expertise and patient preferences to inform managerial strategies and policies (Savage, 2011). NURS 6052 Assessment 5 EB005 Evidence-Based Decision Making Key Concepts Evidence-based management in healthcare encompasses the systematic identification, appraisal, and application of the best available evidence to address managerial challenges and improve organizational performance (Pfeffer & Sutton, 2006). It involves translating research findings into actionable insights that guide decision making across various domains, such as clinical practice, administrative processes, and resource allocation (Shortell, Rundall, & Hsu, 2007). Challenges and Opportunities Despite its potential benefits, evidence-based decision making faces several challenges, including the complexity of healthcare environments, the diverse needs of stakeholders, and the limitations of available evidence (Rousseau, 2006). However, ongoing efforts to enhance research dissemination, promote knowledge translation, and foster interdisciplinary collaborations offer opportunities to overcome these barriers and advance evidence-based management practices (Mitton et al., 2007). Implications for Practice Healthcare managers must adopt a systematic approach to evidence-based decision making, involving the formulation of clear research questions, the critical appraisal of evidence, and the implementation of findings into practice (Kitson, Harvey, & McCormack, 1998). By fostering a culture of continuous learning and improvement, organizations can optimize patient outcomes, enhance operational efficiency, and achieve sustainable healthcare delivery (Walshe & Rundall, 2001). Conclusion In conclusion, evidence-based decision making is essential for driving innovation, improving quality, and maximizing the value of healthcare services. By integrating scientific evidence with managerial expertise, healthcare leaders can navigate complex challenges, optimize resource allocation, and ultimately, enhance patient care delivery. References Alexander, J. A., Hearld, L. R., Jiang, H. J., & Fraser, I. (2007). Increasing the relevance of research to health care managers: Hospital CEO imperatives for improving quality and lowering costs. Health Care Management Review, 32(2), 150–159. Amara, N., Ouimet, M., & Landry, R. (2004). New evidence on instrumental, conceptual, and symbolic utilization of university research in government agencies. Science Communication, 26(1), 75–106. Aram, J. D., & Salipante, P. F. (2003). Bridging scholarship in management: Epistemological reflections. British Management Journal, 14(3), 189–205. Axelsson, R. (1998). Towards an evidence-based health care management. International Journal of Health Planning and Management, 13, 307–317. Barnsley, J., Berta, W., Cockerill, R., MacPhail, J., & Vayda, E. (2005). Identifying performance indicators for primary care practices: A consensus process. Canadian Family Physician, 51(5), 700–701. Beyer, J. M., & Trice, H. M. (1982). The utilization process: A conceptual framework and synthesis of empirical findings. Administrative Science Quarterly, 27, 591–622. D’Agostino, R. B., & Kwan, H. (1995). Measuring effectiveness: What to expect without a randomized control group. Medical Care, 33(4), AS95–AS105. Davis, D., Evans, M., Jadad, A., Perrier, L., Rath, D., Ryan, D., & Zwarenstein, M. (2003). The case for knowledge translation: Shortening the journey from evidence to effect. BMJ, 327, 33–35. NURS 6052 Assessment 5 EB005 Evidence-Based Decision Making

Phillip March 26, 2024 No Comments

EB004 Critical Appraisal, Evaluation/Summary, and Synthesis of Evidence

EB004 Critical Appraisal, Evaluation/Summary, and Synthesis of Evidence Name  University NURS 6052 Essentials of Evidence-Based Practice Prof. Name Date Critical Appraisal, Evaluation/Summary, and Synthesis of Evidence Author(s) Year Title Journal Volume(Issue) Pages DOI/URL Gieniusz, M., Nunes, R., Saha, V., Renson, A., Schubert, F. D., & Carey, J. 2018 Earlier goals of care discussions in hospitalized terminally ill patients, and the quality of end-of-life care: A retrospective study American Journal of Hospice and Palliative Medicine® 35(1) 21-27 https://doi:10.1177/1049909116682470 Mack, J. W., Cronin, A., Taback, N., Huskamp, H. A., Keating, N. L., Malin, J. L., Earle, C. C., & Weeks, J. C. 2012 End-of-life discussions among patients with advanced cancer: A cohort study Annals of internal medicine 156(3) 204 https://doi.org/10.1059/0003-4819-156-3-201202070-00008 Schneiter, M. K., Karlekar, M. B., Crispens, M. A., Prescott, L. S., & Brown, A. J. 2019 The earlier the better: The role of palliative care consultation on aggressive end-of-life care, Hospice Utilization, and advance care planning documentation among Gynecologic Oncology Patients Supportive Care In Cancer: Official Journal of The Multinational Association of Supportive Care in Cancer 27(5) 1927-1934 https://pubmed.ncbi.nlm.nih.gov/30209601/ Starr, L. T., Ulrich, C. M., Corey, K. L., & Meghani, S. H. 2019 Associations among end-of-life discussions, health-care utilization, and costs in persons with advanced cancer: A systematic review American Journal of Hospice and Palliative Medicine® 36(10) 913-926 https://doi.org/10.1177/1049909119848148 NURS 6052 Assessment 4 EB004 Critical Appraisal, Evaluation/Summary, and Synthesis of Evidence General Notes/Comments These levels are from the Johns Hopkins Nursing Evidence-Based Practice: Evidence Level and Quality Guide Level I: Experimental, randomized controlled trial (RCT), systematic review RTCs with or without meta-analysis Level II: Quasi-experimental studies, systematic review of a combination of RCTs and quasi-experimental studies, or quasi-experimental studies only, with or without meta-analysis Level III: Nonexperimental, a systematic review of RCTs, quasi-experimental with/without meta-analysis, a qualitative, qualitative systematic review with/without meta-synthesis Level IV: Respected authorities’ opinions, nationally recognized expert committee/consensus panel reports based on scientific evidence Level V: Literature reviews, quality improvement, program evaluation, financial evaluation, case reports, nationally recognized expert(s) opinion based on experiential evidence Note on Conceptual Framework Researchers create theoretical and conceptual frameworks that include a philosophical and methodological model to help design their work. A formal theory provides context for the outcome of the events conducted in the research. The data collection and analysis are also based on the theoretical and conceptual framework. Theoretical and conceptual frameworks provide evidence of academic standards and procedures. They also offer an explanation of why the study is pertinent and how the researcher expects to fill the gap in the literature. Literature does not always clearly delineate between a theoretical or conceptual framework. With that being said, there are slight differences between the two. References Dang, D., Dearholt, S., Bissett, K., Ascenzi, J., & Whalen, M. (2022). Johns Hopkins evidence-based practice for nurses and healthcare professionals: Model and guidelines. 4th ed. Sigma Theta Tau International. Gieniusz, M., Nunes, R., Saha, V., Renson, A., Schubert, F. D., & Carey, J. (2018). Earlier goals of care discussions in hospitalized terminally ill patients, and the quality of end-of-life care: A retrospective study. American Journal of Hospice and Palliative Medicine®, 35(1), 21-27. https://doi.org/10.1177/1049909116682470 Mack, J. W., Cronin, A., Taback, N., Huskamp, H. A., Keating, N. L., Malin, J. L., Earle, C. C., & Weeks, J. C. (2012). End-of-life discussions among patients with advanced cancer: A cohort study. Annals of internal medicine, 156(3), 204. https://doi.org/10.1059/0003-4819-156-3-201202070-00008 Schneiter, M. K., Karlekar, M. B., Crispens, M. A., Prescott, L. S., & Brown, A. J. (2019). The earlier the better: The role of palliative care consultation on aggressive end-of-life care, hospice utilization, and advance care planning documentation among gynecologic oncology patients. Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer, 27(5), 1927-1934. https://pubmed.ncbi.nlm.nih.gov/30209601/ Starr, L. T., Ulrich, C. M., Corey, K. L., & Meghani, S. H. (2019). Associations among end-of-life discussions, health-care utilization, and costs in persons with advanced cancer: A systematic review. American Journal of Hospice and Palliative Medicine®, 36(10), 913-926. https://doi.org/10.1177/1049909119848148 NURS 6052 Assessment 4 EB004 Critical Appraisal, Evaluation/Summary, and Synthesis of Evidence

Phillip March 26, 2024 No Comments

EB003 Clinical Inquiry, Problem-Intervention-ComparisonOutcome-Time (PICOT), and Searching Databases

EB003 Clinical Inquiry, Problem-Intervention-ComparisonOutcome-Time (PICOT), and Searching Databases Name  University NURS 6052 Essentials of Evidence-Based Practice Prof. Name Date Introduction The COVID-19 pandemic has caused significant disruptions to social norms and practices globally, raising concerns about its impact on children’s mental health and posing challenges for pediatricians in providing effective care (Fitzpatrick, Carson, & Weisz, 2021). Lockdown measures have exposed children to stressful conditions, increasing their vulnerability to long-term mental health issues (AJN, 2021). Clinical Issue This paper examines the consequences of the pandemic on pediatric mental health and its implications for healthcare delivery among caregivers. Pediatric hospitals in various regions have reported a substantial increase in emergency department (ED) visits, highlighting the severity of the problem (Bartek et al., 2021). How Pediatrics & Caregivers Are Affected The COVID-19 pandemic and its containment measures have disrupted numerous aspects of life, including education and healthcare services, affecting children’s mental health (Fitzpatrick et al., 2021). Preliminary data indicate that these disruptions exacerbate stressors, leading to adverse mental health outcomes in children, parents, and caregivers. Reports suggest a decline in emotional and social well-being among children and adolescents, resulting in internalizing and externalizing problems. Continuation Social isolation, school closures, and stay-at-home orders further contribute to stress among adolescents and children. Notably, approximately 35% of children who received mental health services through school programs are now deprived of such services due to closures (Fitzpatrick et al., 2021). Additionally, caregivers and parents experience deteriorating mental health due to increased childcare responsibilities, financial strain, unemployment, and loss of health insurance coverage. How To Improve Access to Mental Health During the Pandemic The strain on pediatric mental health resources during the pandemic underscores the necessity for enhanced accessibility and specialized care. While emergency departments have played a critical role in addressing pediatric mental health needs, advocating for funding to establish dedicated mental health care facilities and providing training to primary care pediatricians are crucial steps (Gupta et al., 2021). Additionally, governmental prioritization of community awareness and preventive measures is essential. NURS 6052 Assessment 3 EB003 Clinical Inquiry, Problem-Intervention-ComparisonOutcome-Time (PICOT), and Searching Databases PICOT Question In a general population, how has pediatric patients’ mental health, compared to other diseases, been affected since the onset of the COVID-19 pandemic? Formulating the PICOT Question A well-constructed PICOT question is essential for identifying and addressing issues in pediatric nursing practice through evidence-based approaches. The components of PICOT—population, intervention, comparison, outcome, and time frame—ensure clarity and guide research efforts. Continuation Population (P): Pediatric patients presenting in the ED during the COVID-19 pandemic. Intervention (I): Evidence-based interventions aimed at addressing mental health effects, including counseling and cognitive-behavioral therapy (CBT). Comparison (C): Alternative intervention of school-based primary care. Outcome (O): Impact of the new intervention on reducing ED visits, assessed over a six-month period. Research Databases Utilizing peer-reviewed articles and databases such as Education Source, MEDLINE, ProQuest, and OVID is crucial for ensuring the validity and reliability of data in nursing research. Combining these resources with the PICOT framework facilitates the development of evidence-based practices for practical implementation. Levels of Evidence and Strengths Level 1 research, involving systematic reviews and meta-analyses of randomized controlled trials, offers robust evidence for informing clinical practice. Randomized controlled trials help evaluate the effectiveness of interventions, while systematic reviews aid in identifying and evaluating relevant studies on specific clinical issues. References Fitzpatrick, O., Carson, A., & Weisz, J. R. (2021). Using mixed methods to identify the primary mental health problems and needs of children, adolescents, and their caregivers during the coronavirus (COVID-19) pandemic. Child Psychiatry & Human Development, 52(6), 1082-1093. AJN. (2021, September). The Psychological Toll of COVID-19 on Children: AJN The American Journal of Nursing. American Journal of Nursing. Bartek, N., Peck, J. L., Garzon, D., & VanCleve, S. (2021). Addressing the clinical impact of COVID-19 on pediatric mental health. Journal of Pediatric Health Care, 35(4), 377-386. Gupta, S., Schreiber, M., McGuire, T., & Newton, C. (2021). Addressing pediatric mental health during COVID-19 and other disasters: A national tabletop exercise. Disaster Medicine and Public Health Preparedness, 1-4. NURS 6052 Assessment 3 EB003 Clinical Inquiry, Problem-Intervention-ComparisonOutcome-Time (PICOT), and Searching Databases

Phillip March 25, 2024 No Comments

EB002 Research Methodology

EB002 Research Methodology Name  University NURS 6052 Essentials of Evidence-Based Practice Prof. Name Date Research Methodology Article #1 Article #2 Article #3 Article #4 Full Citation Paulsen, T., Liland, H., Myklebust, T. Å., & Lindemann, K. (2022, February 1). Early referral to a palliative team improves end-of-life care among gynecological cancer patients: A retrospective, population-based study. International Journal of Gynecologic Cancer. Retrieved September 17, 2022, from link Price, D. M., Strodtman, L. K., Montagnini, M., Smith, H. M., & Ghosh, B. (2018, November 21). Health professionals perceived concerns and challenges in providing supportive care to cancer patients. SAGE journals. Retrieved September 17, 2022, from link Kao, Y.-H., & Chiang, J.- K. (2015, August 19). Effect of hospice care on quality indicators of end-of-life care among patients with liver cancer: A national longitudinal population-based study in Taiwan 2000–2011 – BMC Palliative Care. BioMed Central. Retrieved September 17, 2022, from link Schneiter, M. K., Karlekar, M. B., Crispens, M. A., Prescott, L. S., & Brown, A. J. (2019, May 1). The earlier the better: The role of palliative care consultation on aggressive end of life care, Hospice Utilization, and advance care planning documentation among Gynecologic Oncology Patients. Supportive care in cancer: official journal of the Multinational Association of Supportive Care in Cancer. Retrieved September 18, 2022, from link Why Chosen The study supported the benefits of early referral to palliative care for gynecological cancer patients. Addressed challenges preventing early referrals to palliative/end-of-life care. Showed the impact of hospice care on quality indicators of end-of-life care for liver cancer patients. Highlighted the role of palliative care consultations in reducing aggressive end-of-life care among gynecologic oncology patients. Brief Description of Aim To examine end-of-life care among gynecological cancer patients and the association with timing of palliative care referral. To assess health professionals’ concerns in providing supportive care to cancer patients. To evaluate the effect of hospice care on end-of-life care quality for liver cancer patients. To evaluate the role of palliative care consultations in reducing aggressive end-of-life care among gynecologic oncology patients. Research Methodology Population-based retrospective study in Oslo County, qualitative methodology using medical chart data. Qualitative study using thematic analysis of responses from healthcare providers. Quantitative study using data from Taiwan’s National Health Insurance program. Institutional Review Board approved retrospective chart review. Qualitative data extracted from medical records. Strengths of Methodology Population-based design with valid and complete data. Large sample size increases reliability. Large population sample enhances reliability. Well-established palliative care team with clear documentation. References Paulsen et al., 2022 Price et al., 2018 Kao & Chiang, 2015 Schneiter et al., 2019 NURS 6052 Assessment 2 EB002 Research Methodology References:Paulsen, T., Liland, H., Myklebust, T. Å., & Lindemann, K. (2022, February 1). Early referral to a palliative team improves end-of-life care among gynecological cancer patients: A retrospective, population-based study. International Journal of Gynecologic Cancer. Retrieved September 17, 2022, from https://ijgc.bmj.com/content/32/2/181 Price, D. M., Strodtman, L. K., Montagnini, M., Smith, H. M., & Ghosh, B. (2018, November 21). Health professionals perceived concerns and challenges in providing supportive care to cancer patients. SAGE journals. Retrieved September 17, 2022, from https://journals.sagepub.com/doi/10.1177/1049909118812193?icid=int.sj-full Kao, Y.-H., & Chiang, J.- K. (2015, August 19). Effect of hospice care on quality indicators of end-of-life care among patients with liver cancer: A national longitudinal population-based study in Taiwan 2000–2011 – BMC Palliative Care. BioMed Central. Retrieved September 17, 2022, from https://doi.org/10.1186/s12904-015-0036-9 Schneiter, M. K., Karlekar, M. B., Crispens, M. A., Prescott, L. S., & Brown, A. J. (2019, May 1). The earlier the better: The role of palliative care consultation on aggressive end of life care, Hospice Utilization, and advance care planning documentation among Gynecologic Oncology Patients. Supportive care in cancer: official journal of the Multinational Association of Supportive Care in Cancer. Retrieved September 18, 2022, from https://pubmed.ncbi.nlm.nih.gov/30209601/ NURS 6052 Assessment 2 EB002 Research Methodology

Phillip March 25, 2024 No Comments

EB001 Evidence-Based Practice and the Quadruple Aim

EB001 Evidence-Based Practice and the Quadruple Aim Name  University NURS 6052 Essentials of Evidence-Based Practice Prof. Name Date Evidence-Based Practice and the Quadruple Aim Evidence-based practice (EBP) involves utilizing current best evidence to inform clinical decision-making, serving as a lifelong problem-solving method (Melnyk & Fineout-Overholt, 2018). It is integral to achieving the Quadruple Aim of Healthcare, which aims to enhance healthcare quality, improve patient outcomes, reduce per capita healthcare costs, and empower clinicians to achieve a work-life balance (Melnyk & Fineout-Overholt, 2018). Initially, the Triple Aim, introduced by The Institute for Healthcare Improvement in 2007, focused on optimizing healthcare system performance through various metrics. However, in 2014, the Quadruple Aim expanded this framework to include either empowering clinicians to attain a work-life balance or securing health equity (Melnyk & Fineout-Overholt, 2018). Thus, EBP and the Quadruple Aim are inherently interconnected, with healthcare professionals relying on EBP to fulfill the goals of healthcare optimization. Patient Outcomes and EBP When healthcare professionals adopt an EBP approach, they utilize the best available evidence to inform clinical decisions, thereby ensuring the delivery of optimal and innovative patient care. Failure to integrate EBP can result in outdated practices that may compromise patient outcomes. Thus, the implementation of EBP is crucial for maintaining high standards of care and promoting positive patient outcomes. Healthcare Cost and EBP Numerous studies have demonstrated that the implementation of EBP leads to higher quality and more reliable care, improved population health outcomes, and reduced per capita healthcare costs. Despite the United States’ substantial healthcare spending, it lags behind in global health outcomes rankings. This disparity highlights the importance of transitioning from tradition-based practices to evidence-based approaches. By embracing the latest EBP recommendations, healthcare systems can optimize treatment costs while enhancing patient care quality and outcomes. NURS 6052 Assessment 1 EB001 Evidence-Based Practice and the Quadruple Aim Work-life of Healthcare Providers The healthcare industry exhibits higher rates of workforce burnout compared to other professions, impacting over 50% of healthcare providers and contributing to a significant number of unintended deaths annually in the United States (Melnyk et al., 2021). Recognizing this issue, Bodenheimer and Sinsky advocated for adding a fourth aim to the Triple Aim in 2014, focusing on improving clinician well-being. Research indicates that clinicians who engage in EBP experience greater empowerment and job satisfaction, potentially mitigating burnout and enhancing overall well-being (Melnyk et al., 2010). References Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Wolters Kluwer. Melnyk, B. M., & Raderstorf, T. (2021). Evidence-based leadership, innovation, and entrepreneurship in nursing and Healthcare: A practical guide to success. Springer Publishing Company. Melnyk, B. M., Fineout-Overholt, E., Giggleman, M., & Cruz, R. (2010, November 11). Correlates among cognitive beliefs, EBP implementation, organizational culture, cohesion and job satisfaction in evidence-based practice mentors from a community hospital system. Nursing Outlook. Retrieved September 11, 2022, from https://www.sciencedirect.com/science/article/pii/S0029655410002642 Stahmer, A. C., Dababnah, S., & Rieth, S. R. (2019). Considerations in implementing evidence-based early autism spectrum disorder interventions in community settings. Pediatric Medicine (Hong Kong, China), 2. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6764452/ NURS 6052 Assessment 1 EB001 Evidence-Based Practice and the Quadruple Aim

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