NR 451 Week 8 Discussion: Your Nursing Destiny

Name

Chamberlain University

NR-451: RN Capstone Course

Prof. Name

Date

Week 8 Discussion: Your Nursing Destiny

Every profession is marked by a unique professional culture that cultivates the ethos and values shared among its members. Professional organizations play a crucial role in nurturing and sustaining this culture through various actions and initiatives. Such organizations exist in every industry to advocate for their members while embodying the core values of the profession. The nursing field is no exception, with professional nursing organizations serving not only as advocates but also as platforms for nurses to connect with peers, participate in continuing education conventions, stay informed about the latest changes in healthcare, and obtain specialized professional certifications (Matthews, 2012).

The American Society of Superintendents of Training Schools for Nurses, founded in 1893 and now known as the National League for Nursing, was the first professional organization in nursing. Currently, several significant nursing professional organizations are active, including the American Nurses Association (ANA), the American Red Cross, the Hospice and Palliative Nurses Association, various State Nursing Associations, and the National Student Nurses Association (NSNA). My current involvement is with the NSNA, which has been an invaluable resource for student nurses since its inception in 1969 (Matthews, 2012). This organization offers career resources, educational journals, and support for students enrolled in all nursing degree programs.

NR 451 Week 8 Discussion: Your Nursing Destiny

Looking ahead, I am considering joining the American Nurses Association (ANA), which is the largest professional organization for nurses in the United States. Its extensive state-level connections make it accessible and beneficial for nurses across the country (Matthews, 2012). Membership in the ANA would enhance my resume, especially as I seek better employment opportunities. Additionally, as an ANA member, I would have complimentary access to leading nursing journals and magazines, along with networking opportunities with other nursing professionals.

In terms of certification, I am contemplating two nursing credentials: Certified Registered Nurse Anesthetist (CRNA) and Certified Clinical Research Professional (CCRP). The CRNA certification would enable me to administer anesthesia during surgical procedures. Each U.S. state has distinct requirements for CRNA certification, but all are overseen by the National Board of Certification and Recertification for Nurse Anesthetists (Matthews, 2012). The CCRP certification encompasses roles such as medical and clinical laboratory technicians, medical scientists, and laboratory technologists. My goal to further my education and pursue a graduate degree aligns with my aspirations to meet the necessary qualifications for these certifications. For example, to qualify for the CCRP, one must hold a degree in nursing, medical technology, statistics, clinical laboratory science, or business administration. Without one of these degrees, pursuing the certification would be challenging and could limit job prospects. Therefore, continuing my education to obtain a graduate degree would position me to achieve these certifications, ultimately enhancing my employment opportunities.

References

Matthews, J. (2012). Role of Professional Organizations in Advocating for the Nursing Profession. OJIN: The Online Journal of Issues in Nursing, 17(1), Manuscript 3.

NR 451 Week 8 Discussion: Your Nursing Destiny

Table of Content

NR 451 Week 7 Discussion

Name

Chamberlain University

NR-451: RN Capstone Course

Prof. Name

Date

Utilization of CDC Wonder Resources in Nursing Practice

The Centers for Disease Control and Prevention (CDC) offers a variety of resources through its Division of Informatics and Surveillance website that nurses can creatively integrate into their care delivery. One particularly valuable resource is the CDC Wonder site, accessible at https://wonder.cdc.gov/ (Links to an external site). This platform provides data and tools that can enhance nursing practice, particularly in the areas of patient education and disease management.

Application of CDC Wonder Resources by Nurses

Among the resources available on the CDC Wonder site, the information on diabetes prevention and management stands out. The CDC reports that approximately 34.2 million individuals in the United States have diabetes, representing about 10.5% of the population. Among these, 26.9 million are diagnosed, while an alarming 7.3 million remain undiagnosed (CDC, 2020). Nurses play a critical role in educating patients about diabetes prevention and management. For instance, a nurse can provide guidance on dietary changes, exercise routines, and medication adherence to patients with diabetes. Additionally, for pre-diabetic patients, nurses can offer insights into lifestyle modifications to avert the onset of diabetes and advise on warning signs to monitor.

Innovations in Nursing and Telehealth

The CDC Wonder site is not only informative but also essential for promoting optimal health. Nurses can leverage telehealth technologies to deliver education and support to patients remotely, especially during the COVID-19 pandemic. Patients with diabetes fall into a high-risk category for COVID-19 complications, making telehealth an invaluable tool for ensuring their safety while still receiving care. Through telehealth, nurses can address patients’ inquiries and provide education regarding their health concerns without necessitating in-person visits. As noted by Paterson et al. (2020), “Telehealth reduces the travel burden on patients for consultation, affords a timely solution to discuss distressing side effects, initiate interventions, and enable possible treatment additions and/or changes.” Moreover, as emphasized in this week’s lesson, “Innovation is viewed by many disciplines and businesses as a necessary factor for reaching goals” (Chamberlain College of Nursing, 2021). Therefore, it is imperative for nurses to embrace innovative practices to deliver up-to-date and optimal care.

Conclusion and Nursing Innovations

The innovation inherent in the CDC Wonder site lies in its provision of readily accessible, current health information. Anyone can visit the site to find relevant health facts and data, underscoring the concept that knowledge is power. One innovative idea I have considered in my nursing practice is the implementation of an electronic translator for communication with non-English speaking patients. Effective communication is fundamental to providing optimal care, and utilizing advanced technology, such as an iPad for real-time translation, can significantly enhance nurse-patient interactions. This technological integration is not only innovative but also critical for establishing a strong rapport and relationship between nurses and their patients.

Table of Information

References

Centers for Disease Control and Prevention. (2020). CDC WONDER. Retrieved February 16, 2021, from https://wonder.cdc.gov/WelcomeT.html

Chamberlain College of Nursing. (2020). NR451 RN capstone: Week 7 lesson. Downers Grove, IL: Online Publication.

NR 451 Week 7 Discussion

Paterson, C., Bacon, R., Dwyer, R., Morrison, K. S., Toohey, K., O’Dea, A., Slade, J., Mortazavi, R., Roberts, C., Pranavan, G., Cooney, C., Nahon, I., & Hayes, S. C. (2020). The role of telehealth during the COVID-19 pandemic across the interdisciplinary cancer team: Implications for practice. Seminars in Oncology Nursing, 36(6). https://doi.org/10.1016/j.soncn.2020.151090

NR 451 Week 6 Assignment: EBP Change Process form

Name

Chamberlain University

NR-451: RN Capstone Course

Prof. Name

Date

Week 6 Assignment: EBP Change Process Form using the ACE Star Model of Knowledge Transformation

Star Point 1: Discovery (Identify Topic and Practice Issue)

The topic identified for this assignment is the reduction of errors made by nurses in healthcare institutions, with a focus on promoting a culture of safety. Errors are prevalent in hospital settings, often resulting in severe consequences that jeopardize patient health and, in some cases, lead to fatalities. These errors can stem from various factors, including recklessness, fatigue, and inattentiveness. Given their critical role in patient care, nurses are uniquely positioned to implement strategies that can significantly reduce or eliminate these errors.

The rationale for selecting this topic stems from the alarming frequency of errors reported in hospitals, which have contributed to the deaths of millions globally. The scope of the issue is broad, affecting not only individual patients but also overall healthcare quality and institutional credibility.

Star Point 2: Summary (Evidence to Support Need for a Change)

The primary practice problem revolves around the increasing incidence of errors in healthcare settings, which encompasses missed care, patient hand-offs, infections, falls, and medication errors. Despite the serious implications of these errors, efforts to foster a safety culture within healthcare environments remain insufficient. Consequently, there is a pressing need for research and interventions aimed at improving patient outcomes.

To formulate a guiding question, the PICOT framework is utilized. The relevant systematic review selected from the Cochrane Database of Systematic Reviews is:

• Ammouri, A. A., Tailakh, A. K., Muliira, J. K., Geethakrishnan, R., & Al Kindi, S. N. (2015). Patient safety culture among nurses. International Nursing Review, 62(1), 102-110.

Other scholarly sources consulted include:

1. Flynn, F., Evanish, J. Q., Fernald, J. M., Hutchinson, D. E., & Lefaiver, C. (2016). Progressive care nurses improving patient safety by limiting interruptions during medication administration. Critical Care Nurse, 36(4), 19-35.
2. Cloete, L. (2015). Reducing medication errors in nursing practice. Cancer Nursing Practice, 14(1).
3. Bush, P. A., Hueckel, R. M., Robinson, D., Seelinger, T. A., & Molloy, M. A. (2015). Cultivating a culture of medication safety in prelicensure nursing students. Nurse Educator, 40(4), 169-173.

The systematic review highlights that patient safety is crucial in enhancing healthcare quality. Key predictors of patient safety include effective communication about errors, continuous feedback, hospital management support, clear management expectations, and teamwork in addressing potential errors.

To address the identified issues, evidence-based solutions will be proposed. Hospital management should prioritize developing systems and practices that nurture a culture of patient safety while enhancing leadership capabilities to facilitate open communication, foster continuous organizational learning, and create a blame-free environment.

Star Point 3: Translation (Action Plan)

To support intervention planning, it is essential to identify existing care standards, practice guidelines, or protocols. A comprehensive, learner-centered training module can significantly enhance nurses’ skills, attitudes, and knowledge, while also raising awareness about various error-reduction strategies.

Key stakeholders involved in the change process include:

Nurses play a vital role in the change process by reporting errors or near misses to the appropriate authorities, allowing for analysis and subsequent preventive measures. They must also report unsafe conditions, such as faulty equipment, and utilize activity checklists to ensure comprehensive care.

Star Point 4: Implementation

To initiate the trial, the nurse leaders will formally seek permission from hospital management by submitting a detailed letter that outlines the problem, its implications, and the proposed intervention measures, including anticipated benefits. Educating staff about the change process is critical for its success; training sessions will emphasize the importance of reducing errors and enhancing patient safety.

The proposed implementation timeline is as follows:

Measurable outcomes based on the PICOT framework include:

• P (Population): Number of medication errors.
• I (Intervention): Promotion of patient safety.
• C (Comparison): Application of checklists during interventions.
• O (Outcome): Mortality rate.
• T (Time): Six months.

To record data during the pilot process, individual error types will be documented against the nurses involved. Available resources include checklists, posters, and flashcards to aid staff throughout the trial. Weekly meetings will be scheduled for stakeholders to evaluate the intervention’s effectiveness and make necessary adjustments.

Star Point 5: Evaluation

Outcomes of the trial will be reported using frequency tables to illustrate changes in error rates pre- and post-intervention. The findings will serve as a foundation for determining the effectiveness of the implemented changes and will offer insights for further improvement efforts aimed at reducing medication errors in the facility.

References

Ammouri, A. A., Tailakh, A. K., Muliira, J. K., Geethakrishnan, R., & Al Kindi, S. N. (2015). Patient safety culture among nurses. International Nursing Review, 62(1), 102-110.

Bush, P. A., Hueckel, R. M., Robinson, D., Seelinger, T. A., & Molloy, M. A. (2015). Cultivating a culture of medication safety in prelicensure nursing students. Nurse Educator, 40(4), 169-173.

Cloete, L. (2015). Reducing medication errors in nursing practice. Cancer Nursing Practice, 14(1).

NR 451 Week 6 Assignment: EBP Change Process form

Flynn, F., Evanish, J. Q., Fernald, J. M., Hutchinson, D. E., & Lefaiver, C. (2016). Progressive care nurses improving patient safety by limiting interruptions during medication administration. Critical Care Nurse, 36(4), 19-35.

NR 451 Week 5 Assignment iCARE Paper

Name

Chamberlain University

NR-451: RN Capstone Course

Prof. Name

Date

Introduction

The interprofessional collaboration within the nursing department significantly contributes to achieving positive outcomes in healthcare. Effective teamwork among healthcare professionals ensures that responsibilities are shared, allowing them to work cohesively. Such collaboration not only enhances efficiency but also serves as a motivational factor, enabling healthcare workers to remain aligned with their tasks. This research draws data from three key healthcare settings: the code team, acute care, and rehabilitation. Teams in these areas are specifically trained to handle their daily responsibilities effectively (DiazGranados et al., 2017).

The dynamics of the acute care environment necessitate that teams work efficiently under pressure. In acute care settings, where ambulatory cases frequently arise, the nursing team, particularly in the intensive care unit (ICU), must demonstrate high levels of efficiency. Here, the ICU team must balance mutual dependence and independence, enabling them to save time and reduce the effort required from each healthcare professional involved (Reeves et al., 2010).

Compassion

Compassion is a fundamental element in the acute care department, guiding the prioritization of tasks. The nursing teams in these settings support each other’s morale and provide direction where needed. In the ICU, nurses often encounter unexpected situations, particularly involving critical patients, which can challenge their confidence. However, interprofessional collaboration frequently helps healthcare providers overcome these obstacles (Reeves et al., 2013). A strong sense of compassion among professionals in a team-oriented environment is essential. In my experience, the intense workload in the acute care unit can strain relationships among team members, as they all face significant emotional challenges simultaneously.

I believe that rotating responsibilities among team members can foster compassion, leading to improved patient outcomes and enhanced performance among healthcare professionals.

Advocacy

Advocacy in nursing serves as a crucial action that bolsters interprofessional teamwork. When healthcare professionals work collaboratively, they develop mutual dependencies, allowing them to perform similar duties effectively (Retchin, 2008). The acute care unit’s structure is determined by management and is influenced by communication dynamics and patient conditions. When each team member is allowed to voice their opinions in decision-making, the overall efficiency of the team improves. This environment fosters advocacy, resilience, and flexibility.

Resilience

In the context of interprofessional collaboration, the acute care team exhibits resilience across various domains, including information exchange, decision-making, goal setting, coordination, and interpersonal relationships. Resilience acts as a driving force for maintaining workflow within organized teams. Additionally, flexibility plays a vital role in responding to the immediate needs of patients in both the ICU and acute care settings, as healthcare professionals often face urgent decisions regarding treatment initiation.

Evidence-based Practice

According to Hopia and Heikkilä (2019), evidence-based practice involves collecting new findings aimed at enhancing the quality of care. I contend that the acute care unit, as well as other healthcare settings, should implement evidence-based practices to pinpoint areas needing improvement. Given the rapid advancements in technology and medicine, ongoing research is essential for maintaining high-quality treatment standards. Healthcare organizations are expected to remain knowledgeable about current trends and practices. Evidence-based practice is crucial for providing timely responses to treatment approvals and for identifying challenges within the acute care unit.

Summary

As highlighted by Hopia and Heikkilä (2019), nursing departments in healthcare settings, whether acute care or rehabilitation, must maintain a sharp focus on detail to facilitate continuous learning. A solid research database is essential for understanding various aspects of daily operations. This approach aids teams in staying informed about ongoing innovations in the medical field. I believe that when teams operate cohesively and engage in discussions about their work, it not only reduces individual effort but also enhances patient recovery outcomes.

In the intense environment of the ICU, where each professional carries significant responsibilities, fatigue and loss of confidence can pose serious risks to patient care. However, fostering an interprofessional team environment can help maintain balance and support among healthcare providers.

References

DiazGranados, D., Dow, A. W., Appelbaum, N., Mazmanian, P. E., & Retchin, S. M. (2017). Interprofessional practice in different patient care settings: A qualitative exploration. Journal of Interprofessional Care, 32(2), 151–159. https://doi.org/10.1080/13561820.2017.1383886

Hopia, H., & Heikkilä, J. (2019). Nursing research priorities based on CINAHL database: A scoping review. Nursing Open, 7(2), 483–494. https://doi.org/10.1002/nop2.428

Reeves, S., Goldman, J., Gilbert, J., Tepper, J., Silver, I., Suter, E., & Zwarenstein, M. (2010). A scoping review to improve conceptual clarity of interprofessional interventions. Journal of Interprofessional Care, 25(3), 167–174. https://doi.org/10.3109/13561820.2010.529960

NR 451 Week 5 Assignment iCARE Paper

Reeves, S., Perrier, L., Goldman, J., Freeth, D., & Zwarenstein, M. (2013). Interprofessional education: Effects on professional practice and healthcare outcomes. Cochrane Database of Systematic Reviews. Published. https://doi.org/10.1002/14651858.cd002213.pub3

Retchin, S. M. (2008). A conceptual framework for interprofessional and co-managed care. Academic Medicine, 83(10), 929–933. https://doi.org/10.1097/acm.0b013e3181850b4b

NR 451 Week 4 Discussion: Advocacy and Cultural Competence

Name

Chamberlain University

NR-451: RN Capstone Course

Prof. Name

Date

Week 4 Discussion: Advocacy and Cultural Competence

Using the CLAS Standards in Nursing Practice

The National Culturally and Linguistically Appropriate Services Standards (CLAS) serve a critical role in advancing health equity, enhancing quality of care, and addressing healthcare disparities within organizations. According to the Think Cultural Health website, the primary goal of these standards is to eliminate inequities in healthcare by ensuring that healthcare professionals and organizations actively implement them in their practice. My colleagues and I utilize the CLAS standards in various ways to uphold these objectives.

First and foremost, we prioritize recognizing the cultural diversity of our patient population. We strive to respect and honor the cultural backgrounds of the individuals we serve. Our training emphasizes culturally sensitive approaches to patient care, which means we are mindful of specific practices that may not align with certain cultural beliefs. While we always aim to provide high-quality care, we ensure that our services are respectful and aligned with the cultural values of our patients. This practice reflects the core principle of the CLAS standards, which emphasizes the provision of effective, equitable, and understandable care that is responsive to diverse cultural health beliefs, preferred languages, and health literacy needs (Think Cultural Health, 2019).

The Nursing Action to Improve Cultural Competence

To enhance cultural competence in my practice, I will focus on advocating for the recruitment and support of a culturally diverse workforce. The third CLAS standard highlights the importance of having a healthcare workforce that is representative of the population served, emphasizing the need for cultural and linguistic diversity in governance and leadership (Think Cultural Health, 2019). By promoting this diversity, I will help ensure that the cultural needs of all patients are effectively met, thereby enhancing the quality of care provided (Barksdale et al., 2016).

References

Barksdale, C., Rodick, W., Hopson, R., Kenyon, J., Green, K., & Jacobs, C. (2016). Literature Review of the National CLAS Standards: Policy and Practical Implications in Reducing Health Disparities. Journal of Racial and Ethnic Health Disparities, 4(4), 632-647.

NR 451 Week 4 Discussion: Advocacy and Cultural Competence

Think Cultural Health. (2019). The National Culturally and Linguistically Appropriate Services Standards (CLAS). Think Cultural Health. https://thinkculturalhealth.hhs.gov/clas/standards

NR 451 Week 3 Healthcare Policy

Name

Chamberlain University

NR-451: RN Capstone Course

Prof. Name

Date

NR 451 Week 3 Healthcare Policy

Content

Healthcare Access – Telehealth Services & Technology

This presentation will discuss the selected healthcare policy bill and its summary. We will examine the potential impact of the bill on professional nursing practice standards if passed and the implications if it is not enacted. Further, we will analyze how the bill could influence my nursing practice, communication strategies to address concerns related to the bill, and support for the legislation under different scenarios. Ultimately, we will explore the impact of the bill on the broader community.

Health Care Policy Bill

Bill Name: ACCESS Act or Support for Seniors Act
Bill Number: H.R. 596 – 117th Congress – 1st Session
Titles:

• Title 1: Supplemental Appropriations
• Title 2: Increased Access to Telehealth Services and Other Technologies
• Title 3: Miscellaneous

The ACCESS Act (H.R. 596) aims to enhance the capacity of nursing facilities to access telehealth services and acquire technologies that enable virtual visits during the COVID-19 public health emergency. This legislation comprises three sections: Section 101 addresses supplemental appropriations, Section 201 offers definitions, and Section 301 establishes emergency designations.

Bill Summary

The ACCESS Act is designed to enhance connectivity during the COVID-19 emergency to improve healthcare access, particularly for seniors. It allocates funding as emergency spending to boost telehealth services and virtual visits in skilled nursing facilities. Specifically, the bill offers additional funding for the Telehealth Resource Center Program, aiming to eliminate barriers to telehealth for these facilities. This program is managed by the Office for the Advancement of Telehealth within the Federal Office of Rural Health Policy.

Furthermore, the legislation provides funding for grants to nursing facilities, enabling them to support virtual visits for residents during the COVID-19 emergency. The Department of Health and Human Services (HHS) is responsible for developing guidance for these grants and coordinating with the Federal Communications Commission to ensure access to telecommunications and broadband services.

Impact Of Bill On Professional Nursing Practice Standards – If Passed

If enacted, the ACCESS Act would lead to several significant changes in professional nursing practice standards, including:

• Increased emergency funding
• Improved healthcare access
• Implementation of advanced communication technologies
• Expanded telehealth and virtual visit services
• Grants for nursing facilities
• Enhanced staffing and collaboration opportunities

The bill empowers skilled nursing facilities to utilize telehealth services effectively, which could improve patient outcomes. Telehealth facilitates communication between patients and healthcare providers, reducing the risk of infection and allowing patients to remain at home while still receiving medical attention.

Impact Of Bill On Professional Nursing Practice Standards – If Passed

Further, the ACCESS Act would promote staff training to enhance skills, reduce healthcare costs by minimizing unnecessary hospital visits, and increase patient satisfaction. The adoption of telehealth can lead to early diagnosis, improved quality of care, and timely remote health services, ultimately reducing the risk of infections.

Telenursing, which uses technology to deliver nursing services via computers and mobile devices, has gained prominence as it allows patients to connect with nurses from any location. This trend enhances patient access to care and promotes timely monitoring of chronic conditions. Telehealth also offers cost savings, with studies indicating that telehealth visits are significantly less expensive than traditional office visits. The acceptance of telemedicine is on the rise, as patients find virtual health visits more convenient and comparable in quality to in-person appointments.

If Not Passed

If the ACCESS Act is not passed, it could have detrimental effects on healthcare access, particularly for seniors. The potential consequences include:

• Increased risk of infection
• Denial of services for healthcare providers unable to work remotely
• Poor emergency management
• Heightened burden on skilled nurses
• Limited telecommunication and patient monitoring services

Lockdowns and transportation issues could further restrict access to healthcare, particularly for individuals with chronic conditions. Without adequate monitoring systems, nurses may face challenges in providing necessary care, which could increase their workload.

Impact Of Bill On My Nursing Practice

The ACCESS Act would provide significant protections and opportunities for my nursing practice. It would:

• Reduce my risk of contracting infections
• Foster collaboration and teamwork
• Enhance real-time patient monitoring
• Facilitate telemedicine and prescription services
• Allow me to care for patients from home during emergencies

Telemedicine has emerged as a vital tool in reducing infection spread and ensuring timely access to care, particularly during public health crises. With advancements in technology, telehealth systems can improve patient engagement and enhance overall care quality by allowing healthcare providers to monitor patients remotely.

Communication Strategies for Legislators

To advocate effectively for the ACCESS Act, the following communication strategies can be employed:

• Establish clear agendas and goals
• Draft a policy proposal letter supported by evidence-based reports
• Schedule appointments with legislators to discuss the bill
• Utilize assertive communication to express concerns
• Employ persuasive communication to advocate for the bill
• Present both concerns and support for the legislation
• Follow up after meetings to reinforce messages

Effective communication is crucial in rallying support for the ACCESS Act, particularly using evidence-based strategies to underscore its importance.

Communication Strategies for Peers

For engaging peers regarding telehealth, consider these communication strategies:

• Evaluate the impact of telehealth on quality, equity, access, management, and satisfaction
• Discuss telehealth case studies to illustrate its effectiveness
• Encourage peer discussions around healthcare concerns
• Foster an environment that welcomes diverse viewpoints
• Promote open communication and knowledge-sharing

Engaging in dialogue with peers, particularly those with differing opinions, can enhance understanding and promote collaborative solutions to healthcare challenges.

Some Concerns

Several concerns related to telehealth must be addressed, including:

• Legal risks associated with licensing and compliance
• Policies and procedures for virtual care delivery
• Privacy and security risks, including cyber threats
• Potential for technical malfunctions that could lead to misdiagnoses
• High initial implementation costs

Legal and compliance issues can pose significant challenges for healthcare providers. Establishing clear policies and procedures is essential to navigate the complexities of telehealth effectively. Furthermore, addressing privacy and security risks is crucial to safeguard patient information.

Impact Of Bill On Community

The ACCESS Act would have a positive impact on community health by:

• Promoting culture-based care
• Increasing cultural humility and competency
• Building trust within communities
• Enhancing overall healthcare access in rural settings
• Facilitating home monitoring and telepharmacy services

Telehealth can significantly improve healthcare delivery, particularly in rural areas where access to care is often limited. By leveraging technology, healthcare systems can better serve diverse populations and bridge the gap between healthcare services and community needs.

References

AlDossary, S., Martin-Khan, M., Bradford, N., Armfield, N., & Smith, A. (2017). The development of a telemedicine planning framework based on needs assessment. Journal of Medical Systems, 41(5). https://doi.org/10.1007/s10916-017-0709-4

GovTrack.us. (2021). H.R. 596 — 117th Congress: ACCESS Act. Retrieved from https://www.govtrack.us/congress/bills/117/hr596

Harris, K., Sithole, A., & Kibirige, J. (2017). A needs assessment for the adoption of next generation science standards (NGSS) in K-12 education in the United States. Journal of Education and Training Studies, 5(9), 54. https://doi.org/10.11114/jets.v5i9.2576

Hsieh, P. (2016). An empirical investigation of patients’ acceptance and resistance toward the health cloud: The dual factor perspective. Computers in Human Behavior, 63, 959-969. https://doi.org/10.1016/j.chb.2016.06.029

Keenan, J., Rahman, R., & Hudson, J. (2021). Exploring the acceptance of telehealth within palliative care: A self-determination theory perspective. Health and Technology. https://doi.org/10.1007/s12553-021-00535-9

NR 451 Week 3 Healthcare Policy

Mars, M. (2020). Medicolegal, ethical, and regulatory guidelines pertaining to telehealth. Fundamentals of Telemedicine and Telehealth, 297-303. https://doi.org/10.1016/b978-0-12-814309-4.00013-6

Mason, M. (2020). Updates on current federal telehealth legislation – National Health Council. National Health Council. Retrieved from https://nationalhealthcouncil.org/blog/updates-on-current-federal-telehealth-legislation/

Morrison, L. (2020). Assessing part-time nursing faculty needs: A needs assessment for a quality improvement project. Teaching and Learning in Nursing, 15(1), 42-44. https://doi.org/10.1016/j.teln.2019.08.011

Nigam, S. (2018). Telehealth and telemedicine: Clinical and regulatory issues. Telehealth and Medicine Today, 1(1). https://doi.org/10.30953/tmt.v1.69

Paradis, M., Atkinson, K., Hui, C., Ponka, D., Manuel, D., & Day, P. et al. (2018). Immunization and technology among newcomers: A needs assessment survey for a vaccine-tracking app. Human Vaccines & Immunotherapeutics, 14(7), 1660-1664. https://doi.org/10.1080/21645515.2018.1445449

NR 451 Week 2 Discussion

Name

Chamberlain University

NR-451: RN Capstone Course

Prof. Name

Date

Week 2: The Clinical Question

Your capstone change project commences this week with the identification of a practice issue that necessitates improvement. This practice issue must be related to a systematic review selected from a designated list of approved systematic reviews for the capstone project. You can find the link to this list in the guidelines for the Week 3 Capstone Project: Milestone 1 assignment page.

To start, select a systematic review from the approved list that aligns with your interests or practice context. From this review, formulate a significant clinical question that will serve as the foundation for your capstone change project. It is essential to articulate how you developed this question and describe its relevance to your clinical practice—whether in the past, present, or future. Additionally, you should explain what a research-practice gap entails.

There appears to be a misunderstanding regarding the nature of your clinical question, as it is perceived to be more medical than nursing-focused. Your intention to highlight nursing interventions, such as reminding physicians about the adherence to the SCIP protocol, is noteworthy. Some physicians have indicated that the responsibility for noticing that antibiotics were not ordered lies with nursing staff. However, it is crucial to ensure that your clinical question relates to the systematic review you selected from the approved list.

NR 451 Week 2 Discussion

You might consider the following clinical question: “Does the use of antimicrobial dressings and topical antibiotics compared to traditional sterile gauze dressings on surgical sites lead to a decrease in surgical site infections (SSIs)?”

• P (Patient, population, or problem): Adult patients undergoing surgery
• I (Intervention): Use of topical antibiotics, including antibiotic dressings
• C (Comparison with other treatment/current practice): Compared to traditional sterile gauze dressings
• O (Desired outcome): Reduction of surgical site infections
• T (Time Frame): 30 days postoperatively

Alternatively, you may choose to deviate from your selected systematic review and explore a different topic. You might encounter patients and their families who believe that rest is critical for healing after surgery. However, early ambulation could be challenging and may impede recovery.

NR 451 Week 2 Discussion

For this scenario, consider this clinical question: “In patients undergoing bowel surgery, how does early and frequent ambulation and nourishment compare to conventional recovery methods of rest and bowel rest, in terms of their impact on the return of bowel function and length of hospitalization within the first 72 hours postoperatively?”

• P (Patient, population, or problem): Adult patients who undergo colorectal surgery
• I (Intervention): Early and frequent ambulation with early nutrition
• C (Comparison with other treatment/current practice): Compared to less ambulation and bowel rest
• O (Desired outcome): Impact on return of bowel function and length of hospital stay
• T (Time Frame): 72 hours postoperatively

NR 451 Week 1 Discussion

Name

Chamberlain University

NR-451: RN Capstone Course

Prof. Name

Date

Week 1: Types of Nursing Models and Frameworks of Evidence-Based Practice (EBP)

Current Models and Frameworks of EBP

Nursing models and frameworks of evidence-based practice (EBP) have been developed significantly since the late 1950s and 1960s. This development was spearheaded by nursing researchers and theorists aiming to create structured approaches for enhancing nursing practice (American Nurses Association [ANA], 2015). Nursing models are crucial as they provide guidance and a foundation for implementing changes in practice, specifically tailored to nursing contexts and settings (Chamberlain College of Nursing, 2018). Stevens (2013) identifies 47 prominent EBP models in the literature, offering a wide array of options for practitioners. Among these, the ACE Star Model of Knowledge Transformation is notable; it represents an interdisciplinary method for translating research into practice and achieving quality improvement (Schaffer, Sandau, & Diedrick, 2013). This model illustrates five sequential steps that range from identifying a problem or new knowledge to evaluating the outcomes after implementation.

Another significant model is the Johns Hopkins Nursing Evidence-Based Practice Model, which emphasizes translating research into practice through a collaborative team approach. This model comprises three main steps: formulating a clinical question, collecting relevant evidence, and translating that evidence into practice (Dearholt & Dang, 2012). These models underscore the importance of structured frameworks in nursing to enhance clinical decision-making and improve patient outcomes.

Evidence Strength and Its Impact on Practice

The strength of evidence is paramount in translating research into practice, as robust evidence is essential for optimizing patient outcomes. Systematic reviews provide a comprehensive evaluation of existing evidence, allowing for the integration of reliable data into clinical practice. Research serves as the most trustworthy source of knowledge regarding effective strategies that can influence a patient’s health status positively (Stevens, 2013). The ANA (2015) states that while outcomes are crucial, the EBP process itself offers a structured framework for clinicians and researchers to formulate relevant, patient-centered, and testable questions. This approach ultimately yields vital practice guidelines that enhance patient care. It is essential that research is derived from credible sources, as patient safety hinges on the delivery of care based on the best available evidence. Nursing practices should evolve continually, adapting to new evidence, technological advancements, and the unique challenges presented by patients.

Integrating EBP with Patient and Family Preferences

Integrating evidence-based practice with patient and family preferences is critical in providing patient-centered care, a core competency of the baccalaureate nursing curriculum. Nurses must consider patient preferences alongside EBP when making clinical decisions. Systematic reviews empower nurses with evidence that supports effective interventions, yet implementing EBP can sometimes be challenging due to differing patient preferences. Factors such as religion, cultural beliefs, and personal experiences may create barriers to the adoption of evidence-based care. It is essential to acknowledge a patient’s spirituality, cultural background, decision-making processes, and health-related values when planning care that incorporates EBP.

Nurse’s Responsibilities in Discrepancies Between EBP and Patient Preferences

When there is a discrepancy between evidence-based practice and patient or family preferences, the nurse’s responsibility is to educate the family about the evidence supporting recommended interventions, enabling them to make informed decisions regarding care. Nurses should validate any concerns raised by patients and families and provide clear explanations of available options. It is also crucial to encourage patients to articulate their understanding of the information provided (Smirnoff, 2013). Engaging patients in discussions about the advantages and disadvantages of treatments and relating them to their values is an important part of shared decision-making. While EBP forms the foundation of safe care, the ultimate decisions in care plans should reflect patient preferences.

References

American Nurses Association. (2015). Nursing: Scope and standards of practice (3rd ed.). Silver Spring, MD.

Chamberlain College of Nursing. (2018). NR439 Capstone Course. Lesson week 1. Downers Grove, IL: DeVry Education Group.

Dearholt, S. L., & Dang, D. (2012). Johns Hopkins nursing evidence-based practice: Model and guidelines (2nd ed.). Indianapolis, IN: Sigma Theta Tau International.

Schaffer, M. A., Sandau, K. E., & Diedrick, L. (2013). Evidence-based practice models for organizational change: Overview and practical applications. Journal of Advanced Nursing, 69(5), 1197–1209.

NR 451 Week 1 Discussion

Smirnoff, L. (2013). Incorporating patient and family preferences into evidence-based medicine. BMC Medical Informatics and Decision Making, 13(Suppl 3), S6.

Stevens, K. R. (2013). The impact of evidence-based practice in nursing and the next big ideas. Online Journal of Issues in Nursing, 18(2), manuscript 4. https://doi.org/10.3912/OJIN.Vol18No02Man04