Nursing Theory and Nursing models

Nursing Theory and Nursing models
Nursing theory and Nursing models
Analysis of underpinning care planning knowledge including the nursing process
CRITICAL DISCUSSION of underpinning NURSING KNOWLEDGE related to care planning including:
DEFINITION OF NURSING ( critic the definition)
METAPARADIGM : Person, environment, health and nursing
Common nursing care planning knowledge/ models ( advantages and disadvantages of each model, comparing the models and critically discuss them.)
Nursing Model 1 : Roper, Logan &Tierney
Nursing Model 2: Callister Roy’s model
Nursing Model 3: Hildegarde Peplau
Nursing Model 3: Hildegarde Peplau
And
Nursing theory Carper
Culminating chosen model the Roper Logan&Tierney, critical discussion of nursing process, explanation, types of advantages and disadvantages, chosen type .
Nursing Process, ( APIE) Assessment, Plan, Implementing, Evaluation

Registered Nurses

 Registered Nurses
In this discussion you will be able to identify an individual of a health care team and write about some significant areas of their occupation. This will include a description of duties, desirable personal characteristics, employment outlook and typical earnings for that health care worker.
Instructions:
Use the most current electronic source: United States Department of Labor’s Occupational Outlook Handbook. United States Department of Labor’s Occupational Outlook Handbook.

 

Modeling and Analysis of A Clinical Documentation Improvement System: Calculating Patient Outcome

Compare the different CDI softwares available now (5 of them). For example, MIDAS, 3M CDI software, EPIC. These should strictly be the software available for data entry and DRG calculation. Discuss all pros and cons of each. Find the loophole needed to justify research and design of a new software that allows indepth entry of a patient’s hospital visit exhaustively. Then discuss about the benefits the new software will have – complete data entry to withstand scrutiny of any kind, ease of access to patient’s record, ease of calculation of length of stay, re-admissions based on same MS DRG, case mix index, reimbursement, revenue impact, availability of record at any time with complete information and no need to access the patient’s physical record again (the CDI entry will tell the whole story on the screen), ease of data analysis and calculation. Do an exhaustive comparison of the existing CDI software models in use. Talk about their evolution over time. PLEASE USE TABLES, GRAPHS, PLOTS, etc to illustrate things and data. Need very high quality writing and VERY scholarly.

Theory Application and Evaluation Assignment

Theory Application and Evaluation Assignment
How would you, as the nurse, apply the “Art of Nursing” to the following situations? Write a paragraph for each scenario.
a. A mother who has delivered a stillborn child
b. A patient who has just been told he has cancer
c. A family who is unsure whether or not to place a loved one in an extended care facility
2. In class we have heard and discussed many nursing theories and their application to nursing practice. You are also now hearing about nursing diagnoses. After reading each diagnosis and provided nursing interventions, choose a theory that you think would work the best in addressing the problem. Explain why you think it is the best fit. No more than 1 page per diagnosis
a. NANDA nursing diagnosis: Sleep deprivation
Suggested Outcome: Rest and sleep
Nursing interventions:
Keep environment quiet for sleeping
Consider the use of ear plugs
Encourage the client to use soothing music to facilitate sleep
Which theory do you think would work best for a client with this diagnosis, outcomes, and these interventions? Type you answer below. Explain why you think it is the best fit.
b. NANDA nursing diagnosis: Caregiver Role Strain
Suggested outcomes: Caregiver emotional health
Nursing interventions:
Assess for care giver role strain
Screen at frequent intervals
Help caregiver find personal time
Which theory do you think would work best for a client with this diagnosis, outcomes, and these interventions? Type you answer below. Explain why you think it is the best fit.

Recognising deteriorating patient critical analysis of the case study

Recognising deteriorating patient critical analysis of the case study
Please see below the writing style  wrote 1200 words and require to complete the work:
Critical analysis on recognising and responding to clinical deterioration: A case study
This assignment will illustrate a case study and focus to explore current nursing practice relating to the assessment and interventions required for recognising the patient who is at risk of deterioration in the clinical environment. The insight into the value of clinical reasoning and critical thinking for the nursing professional will be addressed. Critical reflection surrounding the identification and management of early warning signs, effective communication skills, clinical judgments and professional role of nurses providing timely and appropriate managed care will be discussed.
A review of current literature has been undertaken from 2004 to 2014 to find the best available data on the subject. The literature search is outline in appendix 1 were critically analysed to provide an objective and balanced consideration of the issues arising, and limitations of current practice in regards to the nursing role of recognition and management of patient deterioration. The search of the literature has been carried out using the electronic databases such as EBSCO host, Medline, CINAHL, Science Direct and library search through the ……. University search engines. The key words used were: deterioration, critically ill, nurse, recognising, management, evaluation, early warning systems, policies, recommendations, clinical judgments and nurse responsibilities. A total of ……articles were come up to be of use, few of this were published outside the UK. However, through critical evaluation of the data presented it was decided that evidence was relevant and they were considered appropriate to use. Subsequently, 125 article were identify using inclusion and exclusion criteria, year from 2004 and 2014, peer review journals. The search shown the topic had been fairly well researched. However, a further search was undertaken using the terms communication, SBAR and RSCP to bring more concurrent articles. In addition, Department of Health, the National Institute of Clinical Excellence, Patient Safety First, National Patient Safety Agency were useful references.
Case Study
A case study centred on events witnessed by an author while providing a direct postoperative care to the patient in post anaesthetic care unit (PACU) – Observation Area (OA). This reflective piece of work aim to provide a clear description of the situation with a critical analysis, where other options are considered as well as reflection upon experience to examine what the health care practitioner would do should the situation arise again. In order to maintain confidentiality of the patients, the patient will be referred to as Mrs. Jones (HCPC, 2008; NMC, 2008).
Mrs. Jones, a 32 years old mother, 42+ weeks pregnant was admitted to delivery suite for induction of labour. Due to prolonged labour and fetal bradycardia, Mrs Jones underwent an emergency lower segment caesarean section (LSCS) under combined spinal/epidural anaesthesia (CSE). During surgical procedure patient shown signs of tachycardia (121b/min), being hypertensive (158/75) and with a temperature of 37.6. C.
On admission to the OA, Mrs. Jones was enjoying her healthy baby boy. However, she has remained being hypertensive (155/84) and with elevated temperature of 37.8 C. In order to provide an optimal pain relief the CSE stayed insitu. A junior midwife took over care for Mrs Jones following by handover from anaesthetic and scrub nurse. Later on (1hr), phone call came from OA regarding Mrs Jones heath status and was referred to anaesthetic to review the patient as Mrs Jones became confused, with low oxygen level (92% on RA) and still hypertensive. Due to the emergency case in the theatre, anaesthetist made a request to his colleague from general theatre (10mins away) to review the patient, but meantime send a second anaesthetic nurse to carry out an assessment. Upon arrival of anaesthetic nurse, a systematic approach based on airway, breathing, circulation, disability and exposure (ABCDE) was performed immediately by anaesthetic practitioner to determine and treat (if required) Mrs. Jones.
Upon assessment, it has been noted that Mrs Jones has also developed haematoma around insertion of epidural catheter and continue to bleed (approximately 250ml of blood loss) from insertion point, while junior midwife was unaware of this problem. By following the assessment, the cold compress and pressure was applied to stop the bleeding and concerns were relayed to the second anaesthetist who arrived shortly after. Mrs Jones being promptly examined and medical intervention were given where appropriate and she continuously stayed under a close observation for the next 48hrs.
According to the Health Social Care Information Centre (HSCIC) on the 5th of November 2013, NHS hospitals across England are dealing with 15.1 million admissions a year and rising up to 13% in five years. On average 1.500 patients admitted every day. Patients placed their trust in the healthcare professionals caring for them, believing that appropriate care and prompt actions will be undertaken by medical team if any deterioration in their condition arise.
Unfortunately, this is not always the case. National Institute for Health and Clinical Excellence (NICE) (2007) emphasized that many patients, who are became or acutely ill in the hospital setting may be given suboptimal care due to number of reasons, such as: inability of the medical staff to recognized the signs of deteriorations, late respond, poor communication and documentation, lack and provision of critical care expertise as well as heavy workload. Therefore, NICE and National Safety Patient Agency endeavour of introducing systems to be able assist healthcare professionals to recognise deteriorating patient early and act upon appropriately (NICE, 2007; NPSA, 2007a; 2007b).
An Early Warning Systems (EWS) is known to be critical tool to assist healthcare professionals in recognising patients at risk of deterioration and deliver appropriate managed care. The Department of Health has also emphasized on using EWS system throughout the UK supporting the rationale behind it (DH, 2000). However, Cuthbertson and Smith (2007) argues the effectiveness of EWS, highlighting that further assessments of the use of EWS must be undertaken, ensuring a structured and evidence based approach to their development and evaluation.
The identification and management of early warning signs are critical and perhaps a junior midwife was well aware of that. However, reflecting on the case study it is also important to highlight the importance of a full clinical assessment, and of tailoring the written monitoring and management plans to the individual patient’s clinical circumstances, as well as clear communication strategies, which in this case were unexploited. The ABCDE approach was not been embark on by midwife correctly and concerns were not communicated accurately. Therefore, the clinical management of the patient could be delayed and clinical intervention focused in different clinical area.
Discussion
Implication
Recommendation for Practice
Conclusion
In this paper the reflective analysis on a case study was given to enhanced knowledge and skills of nurses on assessment and evaluation in the care of patients at risk of deterioration.
Nowadays a lot of attention still on emphasising the importance of nursing actions, interventions and ability to timely manage and respond to the early warning signs, use of clinical judgments and communication skills while caring for patient who are at risk of deteriorating. Careful observation and appropriate action must be utilised by nurses and be a fundamental practice rather than a basic task.
References
Cuthbertson, B and Smith, G (2007) A warning on early-warning scores! British Journal of Anaesthesia. 98 (6), 704-706.
Health Social Care Information Centre (2013) Hospital Episode Statistics, Admitted Patient Care, England – 2012-2013 (NS). Available at: http://www.hscic.gov.uk/article/3674/41500-patients-admitted-to-hospital-every-day-in-England—up-nearly-13-per-cent-in-five-years (assessed on 07/11/14)
National Patient Safety Agency (2007) Recognising and responding appropriately to early signs of deterioration in hospitalised patient. Available at: http://www.npsa.nhs.uk/corporate/news/deterioration-in-hospitalised-patients/?locale=en (assessed on 07/10/14).
National Institute for Health and Care Excellence (2007) Acutely ill patients in hospital: Recognition of and response to acute illness in adults in hospital. Available at: http://www.nice.org.uk/guidance/CG50 (assessed on 07/10/14).
Patient Safety First (2008) The ‘How to Guide’ for reducing harm from deterioration. Available at: http://www.patientsafetyfirst.nhs.uk/ashx/Asset.ashx?path=/How-to-guides-2008-09-19/Deterioration%201.1_17Sept08.pdf (assessed on 07/10/14)

IM/IT Analyis

IM/IT Analyis
Assignment 2: IM / IT Analysis
Criteria
Below 70% F
Fair
70-79% C
Proficient
80-89% B
Exemplary
90-100% A
1a. Determine, within the health care setting, the main features, capabilities, and operational benefits to a health care organization using the patient care applications. Provide a specific example.
Weight: 5%
Did not submit or incompletely determined, within the health care setting, the main features, capabilities, and operational benefits to a health care organization using the patient care applications. Did not submit or incompletely provided a specific example.
Partially determined, within the health care setting, the main features, capabilities, and operational benefits to a health care organization using the patient care applications. Partially provided a specific example.
Satisfactorily determined, within the health care setting, the main features, capabilities, and operational benefits to a health care organization using the patient care applications. Satisfactorily provided a specific example.
Thoroughly determined, within the health care setting, the main features, capabilities, and operational benefits to a health care organization using the patient care applications. Thoroughly provided a specific example.
1b. Determine, within the health care setting, the main features, capabilities, and operational benefits to a health care organization using the management and enterprise systems. Provide a specific example.
Weight: 5%
Did not submit or incompletely determined, within the health care setting, the main features, capabilities, and operational benefits to a health care organization using the management and enterprise systems. Did not submit or incompletely provided a specific example.
Partially determined, within the health care setting, the main features, capabilities, and operational benefits to a health care organization using the management and enterprise systems. Partially provided a specific example.
Satisfactorily determined, within the health care setting, the main features, capabilities, and operational benefits to a health care organization using the management and enterprise systems. Satisfactorily provided a specific example.
Thoroughlydetermined, within the health care setting, the main features, capabilities, and operational benefits to a health care organization using the management and enterprise systems. Thoroughlyprovided a specific example.
1c. Determine, within the health care setting, the main features, capabilities, and operational benefits to a health care organization using the e-Health applications. Provide a specific example.
Weight: 5%
Did not submit or incompletelydetermined, within the health care setting, the main features, capabilities, and operational benefits to a health care organization using the e-Health applications. Did not submit or incompletelyprovided a specific example.
Partiallydetermined, within the health care setting, the main features, capabilities, and operational benefits to a health care organization using the e-Health applications. Partiallyprovided a specific example.
Satisfactorilydetermined, within the health care setting, the main features, capabilities, and operational benefits to a health care organization using the e-Health applications. Satisfactorily provided a specific example.
Thoroughlydetermined, within the health care setting, the main features, capabilities, and operational benefits to a health care organization using the e-Health applications. Thoroughlyprovided a specific example.
1d. Determine, within the health care setting, the main features, capabilities, and operational benefits to a health care organization using the strategic decision-support applications. Provide a specific example.
Weight: 5%
Did not submit or incompletelydetermined, within the health care setting, the main features, capabilities, and operational benefits to a health care organization using the strategic decision-support applications. Did not submit or incompletelyprovided a specific example.
Partiallydetermined, within the health care setting, the main features, capabilities, and operational benefits to a health care organization using the strategic decision-support applications. Partiallyprovided a specific example.
Satisfactorilydetermined, within the health care setting, the main features, capabilities, and operational benefits to a health care organization using the strategic decision-support applications. Satisfactorilyprovided a specific example.
Thoroughlydetermined, within the health care setting, the main features, capabilities, and operational benefits to a health care organization using the strategic decision-support applications. Thoroughlyprovided a specific example.
2. Assume that you are a senior health service administrator responsible for the health information systems within your organization, and create an argument to be presented to the leaders with the organization that a strategic plan is essential for the IM / IT. Indicate the most significant elements that the administrator should address in the plan. Provide support for the rationale.
Weight: 20%
Did not submit or incompletely assumed that you are a senior health service administrator responsible for the health information systems within your organization. Did not submit or incompletely created an argument to be presented to the leaders with the organization that a strategic plan is essential for the IM / IT. Did not submit or incompletely indicated the most significant elements that the administrator should address in the plan. Did not submit or incompletely provided support for the rationale.
Partially assumed that you are a senior health service administrator responsible for the health information systems within your organization. Partially created an argument to be presented to the leaders with the organization that a strategic plan is essential for the IM / IT. Partially indicated the most significant elements that the administrator should address in the plan. Partially provided support for the rationale.
Satisfactorily assumed that you are a senior health service administrator responsible for the health information systems within your organization. Satisfactorily created an argument to be presented to the leaders with the organization that a strategic plan is essential for the IM / IT. Satisfactorily indicated the most significant elements that the administrator should address in the plan. Satisfactorily provided support for the rationale.
Thoroughly assumed that you are a senior health service administrator responsible for the health information systems within your organization. Thoroughly created an argument to be presented to the leaders with the organization that a strategic plan is essential for the IM / IT. Thoroughly indicated the most significant elements that the administrator should address in the plan. Thoroughly provided support for the rationale.
3. Assess the importance of a systems development life cycle as it pertains to both the development of a custom application, coupled with the selection of proprietary systems. Provide an example to support the response.
Weight: 15%
Did not submit or incompletely assessed the importance of a systems development life cycle as it pertains to both the development of a custom application, coupled with the selection of proprietary systems. Did not submit or incompletely provided an example to support the response.
Partially assessed the importance of a systems development life cycle as it pertains to both the development of a custom application, coupled with the selection of proprietary systems. Partially provided an example to support the response.
Satisfactorilyassessed the importance of a systems development life cycle as it pertains to both the development of a custom application, coupled with the selection of proprietary systems. Satisfactorilyprovided an example to support the response.
Thoroughlyassessed the importance of a systems development life cycle as it pertains to both the development of a custom application, coupled with the selection of proprietary systems. Thoroughlyprovided an example to support the response.
4. Recommend the key element necessary to ensure secure access to health care and patient information within a health care management electronic system. Provide support for the recommendation.
Weight: 15%
Did not submit or incompletely recommended the key element necessary to ensure secure access to health care and patient information within a health care management electronic system. Did not submit or incompletely provided support for the recommendation.
Partially recommended the key element necessary to ensure secure access to health care and patient information within a health care management electronic system. Partially provided support for the recommendation.
Satisfactorily recommended the key element necessary to ensure secure access to health care and patient information within a health care management electronic system. Satisfactorily provided support for the recommendation.
Thoroughlyrecommended the key element necessary to ensure secure access to health care and patient information within a health care management electronic system. Thoroughlyprovided support for the recommendation.
5. Make at least two (2) recommendations for improving the application of systems theory to health care IM / IT governance and planning. Provide specific examples to support the response.
Weight: 15%
Did not submit or incompletely made at least two (2) recommendations for improving the application of systems theory to health care IM / IT governance and planning. Did not submit or incompletely provided specific examples to support the response.
Partially made at least two (2) recommendations for improving the application of systems theory to health care IM / IT governance and planning. Partially provided specific examples to support the response.
Satisfactorily made at least two (2) recommendations for improving the application of systems theory to health care IM / IT governance and planning. Satisfactorily provided specific examples to support the response.
Thoroughly made at least two (2) recommendations for improving the application of systems theory to health care IM / IT governance and planning. Thoroughly provided specific examples to support the response.
6. 4 references
Weight: 5%
No references provided
Does not meet the required number of references; some or all references poor quality choices.
Meets number of required references; all references high quality choices.
Exceeds number of required references; all references high quality choices.
7. Clarity, writing mechanics, and formatting requirements
Weight: 10%
More than 6 errors present
3-4 errors present
0-2 errors present
Assignment 2: IM / IT Analysis
Due Week 7 and worth 280 points
Write a five to six (5-6) page paper in which you:
Determine, within the health care setting, the main features, capabilities, and operational benefits to a health care organization using the following:
patient care applications
management and enterprise systems
e-Health applications
strategic decision-support applications
Provide specific examples of each.
Assume that you are a senior health service administrator responsible for the health information systems within your organization, and create an argument to be presented to the leaders with the organization that a strategic plan is essential for the IM / IT. Indicate the most significant elements that the administrator should address in the plan. Provide support for the rationale.
Assess the importance of a systems development life cycle as it pertains to both the development of a custom application, coupled with the selection of proprietary systems. Provide an example to support the response.
Recommend the key element necessary to ensure secure access to health care and patient information within a health care management electronic system. Provide support for the recommendation.
Make at least two (2) recommendations for improving the application of systems theory to health care IM / IT governance and planning. Provide specific examples to support the response.
Use at least four (4) quality resources in this assignment. Note: Wikipedia and similar Websites do not qualify as quality resources.
Your assignment must follow these formatting requirements:
Be typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides; citations and references must follow APA or school-specific format. Check with your professor for any additional instructions.
Include a cover page containing the title of the assignment, the student’s name, the professor’s name, the course title, and the date. The cover page and the reference page are not included in the required assignment page length.
The specific course learning outcomes associated with this assignment are:
Determine the main features and capabilities of patient care applications, management and enterprise systems, e-Health applications, and strategic decision-support applications within the health care setting.
Analyze the process of developing a strategic information system plan and determine its basic components.
Demonstrate an understanding of the systems development life cycle as it pertains to both the development of a custom application and the selection of proprietary systems.
Assess the need for and determine the methods of accomplishing the security of information systems.
Use technology and information resources to research issues in health information systems.
Write clearly and concisely about health information systems using proper writing mechanics.
Grading for this assignment will be based on answer quality, logic / organization of the paper, and language and writing skills, using the following rubric.

 

Capstone Project Milestone #2:

Capstone Project Milestone #2:
Design for Change Proposal Guidelines
PURPOSE
You are to create a Design for Change proposal inclusive of your PICO and evidence appraisal information from your Capstone Project Milestone #1. Your plan is to convince your management team of a nursing problem you have uncovered and you feel is significant enough to change the way something is currently practiced. In the event you are not currently working as a nurse, please use a hypothetical clinical situation you experienced in nursing school, or nursing education issue you identified in your nursing program.
COURSE OUTCOMES
This assignment enables the student to meet the following course outcomes.
CO1: Applies the theories and principles of nursing and related disciplines to individuals, families, aggregates, and communities from entry to the healthcare system through long-term planning. (PO #1)
CO2: Proposes leadership and collaboration strategies for use with consumers and other healthcare providers in managing care and/or delegating responsibilities for health promotion, illness prevention, health restoration and maintenance, and rehabilitative activities. (PO #2)
DUE DATE
Milestone #2 consists of the proposal for your Design for Change Capstone Project. Submit this Milestone to the Dropbox by the end of Week 4.
POINTS
Milestone #2 is worth 225 points.
DIRECTIONS
1. Create a proposal for your Design for Change Capstone Project. Open the template in Doc Sharing. You will include the information from Milestone #1, your PICO question, and evidence appraisal, as you compose this proposal. Your plan is to convince your management team of a nursing problem you have uncovered and you feel is significant enough to change the way something is currently practiced.
2. The format for this proposal will be a paper following the Publication manual of APA 6th edition.
3. The paper is to be four- to six-pages excluding the Title page and Reference page.
4. As you organize your information and evidence, include the following topics.
a. Introduction: Write an introduction but do not use “Introduction” as a heading in accordance with the rules put forth in the Publication manual of the American Psychological Association (2010, p. 63). Introduce the reader to the plan with evidence-based problem identification and solution.
b. Change Plan: Write an overview using the John Hopkins Nursing EBP Model and Guidelines (2012)
i. Practice Question
ii. Evidence
iii. Translation
c. Summary
5. Citations and References must be included to support the information within each topic area. Refer to the APA manual, Chapter 7, for examples of proper reference format. In-text citations are to be noted for all information contained in your paper that is not your original idea or thought. Ask yourself, “How do I know this?” and then cite the source. Scholarly sources are expected, which means using peer-reviewed journals and credible websites.
6. Tables and Figures may be added as appropriate to the project. They should be embedded within the body of the paper (see your APA manual for how to format and cite). Creating tables and figures offers visual aids to the reader and enhances understanding of your literature review and design for change.
GRADING CRITERIA: DESIGN FOR CHANGE CAPSTONE PROJECT
Category Points % Description
Introduction 25 11% Introduction to the plan is nursing focused, with evidence-based problem identification and potential solutions clearly identified.
Change Plan; Practice Question (Steps 1–5) 50 22% Activities to achieve the first steps of change are fully described in detail and are based on the first five steps of the John Hopkins EBP Process; Practice Question.
Change Plan; Evidence (Steps 6–10) 50 22% Activities to achieve steps six through ten of the John Hopkins EBP Process are fully described in detail; Evidence.
Change Plan; Translation
(Steps 11–18) 50 22% Activities to achieve the final steps of change are fully described in detail and are based on steps 11 through 18 of the John Hopkins EBP Process; Practice Question.
Summary 25 11% Clear, solid summary summarizing the key points and steps of the change plan is included; ways to maintain the change plan are described.
APA Format 25 11% Minimal errors.
Total 225 points 100%
GRADING RUBRIC: CAPSTONE PROJECT MILESTONE #2
Dearholt, S. L., & Dang, D. (2012).Johns Hopkins Nursing Evidence Based Practice: Model and Guidelines (2nd ed.). Indianapolis, IN: Sigma Theta Tau International.
Title
Your Name
College of Nursing
NR451 RN Capstone Course
Term and Year
Your title here
This paragraph(s) is to introduce the paper. State the problem and potential solutions backed by evidence. Briefly, introduce the nursing focused plan. Remember this is a scholarly APA assignment so you cannot use first person.
Change Model Overview
In this first paragraph, provide an overview of the John Hopkins Nursing Evidence-Based Practice Process. Feel free to state why nurses should use this model as a guide to facilitate change. Under each of the second level headers listed below, you now link your identified topic to the John Hopkins EBP Process.
Practice Question
Step 1: Identify an EBP question
Restate your question. Include the PICOT elements but make sure you write them in paragraph form and not in list format.
Step 2: Scope of practice question
Why is this a problem? Give statistics and information to back the scope of the problem. How does this problem impact healthcare on a broader scale?
Steps 3, 4, and 5: Team
You will be the leader of the team since this is your project. Who will you also include in your team? Make sure you choose relevant stakeholders. You should have no more than eight members. Why are the members chosen important to your project?
Evidence
Steps 6 and 7: Internal and external search for evidence
What type of evidence did you find? EBP guidelines? Quality improvement data? Position statements? Qualitative research? Quantitative research? Briefly discuss the strength of this research.
Steps 8 and 9: Summarize the evidence
Synthesize the information that you obtained from your sources. You will need at least four sources. Of these four sources, three must be from peer-reviewed articles. The other source can be from a reputable source. See page 44 of your text for examples of sources you can use.
In this section, you need to synthesize the information from the articles. Feel free to cite multiple articles within one sentence. You should avoid one paragraph for each of the sources.
Step 10: Recommendations for change
What is your recommendation based on the research? Ideally, you will have found enough support in your evidence to proceed with implementing your pilot program.
Translation
Steps 11, 12, and 13: Action plan
You have not implemented your project yet, therefore, this section will be hypothetical. Develop your plan for implementation. What are the specific steps you will take to implement your pilot study? What is the timeline for your plan? Make sure you include a plan for evaluation of outcomes and method to report the results.
Steps 14 and 15: Evaluating outcomes
What are the desired outcomes? How will they be measured? How will you report the results to the key stakeholders?
Steps 16, 17, and 18: Implementation
How will you implement the plan on a larger scale? Will this be applicable to other units or the facility as a whole? What will you do to ensure that the implementation becomes permanent? How will you communicate your findings internally (within your organization) and externally (to others outside of your organization)?
Conclusion
Provide a clear and concise summary. Review the key aspects of the problem as well as the change model. Be sure to include important aspects of the three levels of change for the John Hopkins EBP process.
References

Guided study

Guided study
Conceptual Framework and review of literature on this PICOT Question “Will decreasing nurse burnout in home health care improve patient satisfaction”

Discussion Question

Discussion Question
The case scenario provided will be used to answer the discussion questions that follow.
Case Scenario
Ms. G., a 23-year-old diabetic, is admitted to the hospital with a cellulitis of her left lower leg. She has been applying heating pads to the leg for the last 48 hours, but the leg has become more painful and she has developed chilling.
Subjective Data
Complains of pain and heaviness in her leg.
States she cannot bear weight on her leg and has been in bed for 3 days.
Lives alone and has not had anyone to help her with meals.
Objective Data
Round, yellow-red, 2 cm diameter, 1 cm deep, open wound above medial malleolus with moderate amount of thick yellow drainage
Left leg red from knee to ankle
Calf measurement on left 3 in > than right
Temperature: 38.9 degrees C
Height: 160 cm; Weight: 83.7 kg
Laboratory Results
WBC 18.3 x 10¹² / L; 80% neutrophils, 12% bands
Wound culture: Staphylococcus aureus
Critical Thinking Questions
What clinical manifestations are present in Ms. G and what recommendations would you make for continued treatment? Provide rationale for your recommendations.
Identify the muscle groups likely to be affected by Ms. G’s condition by referring to “ARC: Anatomy Resource Center.”
What is the significance of the subjective and objective data provided with regard to follow-up diagnostic/laboratory testing, education, and future preventative care? Provide rationale for your answer.
What factors are present in this situation that could delay wound healing, and what precautions are required to prevent delayed wound healing? Explain.

Capstone Project Milestone #1: PICO and Evidence Appraisal Worksheets

Capstone Project Milestone #1: PICO and Evidence Appraisal Worksheets
Capstone Project Milestone #1:
PICO and Evidence Appraisal Worksheets
PICO WORKSHEET
Your Name:
Date:
Your Instructor’s Name:
Purpose: To identify a problem or concern that nursing can change and develop a PICO question to guide the change project.
Directions: Use the form below to complete the PICO assignment in Milestone #1. This includes filling in the table with information about your research question and your PICO elements.
Step 1: Identify the problem. What have you noticed in your work or school environment that isn’t achieving the desired patient or learning outcomes? What needs to change in nursing, what can you change with the support of evidence in the literature? Briefly describe the problem or practice issue that you want to research. What is your practice area; clinical, education, or administration?
Step 2: How was the practice issues identified? How did you come to know this was a problem in your clinical practice? Review the listed concerns and check all that apply.
Step 3: What is the scope of the problem? Does this problem affect an individual, population, or an entire institution?
Step 4: Select the key PICO terms for searching the evidence. Clearly define your PICO question. List each element P (problem, population, or problem), I (intervention), C (Comparison with other treatment/current practice), and O (Desired outcome). Is the potential solution something for which you (as nurse or student) can find a solution through evidence research? Look in your book for guidelines to developing your PICO question.
Step 5: What evidence must be gathered? Everyone should have a literature search. However, what other sources of reliable information will be helpful for your particular question?
Step 6: State the search question in narrow, manageable terms. What terms will you use in order to make sure that your search is wide enough to obtain required information but narrow enough to keep it focused? How will you narrow your search if needed?
PICO Worksheet
What is the practice issue/problem?
What is the practice area?
___ Clinical
___ Education
___ Administration
___ Other
How was the practice issue identified? (check all that apply)
___ Safety/risk management concerns
___ Unsatisfactory patient outcomes
___ Wide variations in practice
___ Significant financial concerns
___ Difference between hospital and community practice
___ Clinical practice issue is a concern
___ Procedure or process is a time waster
___ Clinical practice issue has no scientific base
___ Other
What is the scope of the problem?
___ Individual
___ Population
___ Institution/system
What is the PICO question?
___ P- (Patient, population, or problem):
___ I- (Intervention):
___ C- (Comparison with other treatment/current practice):
___ O- (Desired outcome):
What evidence must be gathered? (check all that apply)
___ Literature search
___ Guidelines
___ Expert Opinion
___ Patient Preferences ___ Clinical Expertise
___ Financial Analysis
___ Standards (Regulatory, professional, community)
___ Other
State the search question in narrow, manageable terms:
EVIDENCE APPRAISAL WORKSHEET
Your Name:
Date:
Your Instructor’s Name:
Purpose: To find evidence to support an intervention that will change the outcomes.
Directions: Type your search question below. Find AT LEAST FOUR sources to support the need for change and the potential intervention you have selected to solve the problem. At least three of your sources must be peer-reviewed articles. The forth source could be another peer-reviewed article or a reliable, credible source. Look in your text for ideas of other sources that can be used. Using the table below, insert and describe your four chosen resources.
Step 1: APA Reference for the article. You will need to list the reference for the source in APA format. Be careful when using built-in APA formats and library citations. They may not be in APA format. Refer to Chapter 7 of your APA manual.
Step 2: Type of Source. If your source is a research article, you will need to ensure that it is a peer review article. You need at least three peer-reviewed articles for your project. If your article is a non–research source, then you will need to list what type of source it is; systematic review, clinical practice guidelines, organizational experience, or individual expert opinion/case study/literature review. You may only use ONE non-research source.
Step 3: Strength of Research. Refer to page 238-240 for research evidence and page 242-244 for non-research evidence. While you do not need to assign a level for each study, you will assign a quality of evidence (high, good, or low/major flaw) and should discuss the study using some of the elements that are discussed in the appraisal forms. For example, Research evidence: was the sample size adequate? Was there a controlled group? Was it a randomized study? Were results clearly stated? Was the conclusion based on the results? Were study limitations discussed? Not all of these elements need to be discussed, but you should discuss this information to determine if the strength of the evidence is HIGH, GOOD, or LOW/MAJOR FLAW.
Step 4: Brief Description of the Research. In this section, you will summarize the source in your own words. How does this information apply to your project? What are the results of the source? What are their recommendations?
Evidence Appraisal Worksheet
PICO Question:
APA Reference for Article
Give the APA-formatted reference for the article. Type of Source
*Research: Peer-reviewed article
*Non-research systematic review, clinical practice guidelines, organizational experience, or expert opinion/case study/literature review Strength of Research
Discuss the strength of the sources.
Report if evidence is High, Good, or Low/Major Flaw. Use the tools on page 238-244 of your text and discuss the reasons why you have assigned a particular level of quality. Brief Description of Research
Address the questions.
*How does the information in the article apply to the project problem or proposed intervention?
*Summarize in your own words.
* Include results of the study and how these results are applicable to your project.
* What is the recommendation of the source for clinical practice?
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POINTS
Milestone #1 is worth 175 points (75 points for the PICO worksheet and 100 points for the evidence appraisal worksheet).
DIRECTIONS
1. Read this document including the grading rubrics below.
2. Download the PICO/Evidence Appraisal worksheets form from Doc Sharing. Consider what is the nursing problem or issue that you have uncovered. Make sure it is related to nursing, i.e., one that a nurse can solve independently. Do not select a medical problem that is dependent upon a medical professional to resolve. Completion of PICO worksheet will offer a tool for your literature search.
3. For the evidence appraisal worksheet, find AT LEAST FOUR sources to support the need for change and the potential intervention you have selected to solve the problem. Three of these sources must be peer-reviewed articles while one can be a reliable professional source.
4. Submit the completed PICO/Evidence Appraisal worksheet to the Week 2 Dropbox.