Comment1

Relying on the use of technology to show evidence and convince others of the importance of a change happening is a very good strategy. In my opinion, the first thing I must do is a small analysis or questionnaire to identify the different learning styles of those involved. But according to the specialists it is advisable to use a mixed teaching strategy that includes all the styles to have a better success. Regardless of their learning style, individuals learn best when they partake in a variety of multisensory activities. It’s best to try and plan out activities that are suited for visual, auditory, and kinesthetic learners (Cox, 2018).

      The best way to mix all styles is to motivate all the senses of our audience. This can be achieved through the visualization or projection of a video, according to Encore, 2018, nothing captures attention more effectively than beautiful visuals. An event which greatly captures the attention of the audience via their sight makes the event memorable by enhancing the ability of the audience to recollect specific moments. This collection of the most memorable moments, is what interests us that our audience captures. In the video should be emphasized, or should be highlighted at a specific time, the importance or impact, which will have the change in those involved.

Comment2

According to the World Health Organization (WHO), a health technology is the application of organized knowledge and skills in the form of devices, medicines, vaccines, procedures and systems developed to solve a health problem and improve quality of lives(“health technology,” n.d.).  My EBP is the education of nursing/security staff on assessment skills to recognize  decompensation of mental health patients, to implement my project I think I will use power point, and a plastic card system to attach to all staff IDs.  The computer system at my facility is very archaic, there is no way of flagging a patient or tasking a nurse.  Also when the nurse is in front of the patient, this is the time for the quick assessment, and no computer is available.  The card system will bullet point key objectives to recognize decompensation during encounter.

 

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Comment1

During the analysis conducted with my mentor, we believe that from the clinical point of view the results obtained from the patients will be positively impacted through the implementation of the EBP, and the application of the knowledge acquired from the planned educational proposal. The professionals who participate in the educational project will be able to learn the importance of the application of EBP in the daily routine and this will result in better health care provided to patients. This increase in positive results is synonymous with quality, therefore the organization will benefit from providing their patients with a high-quality service which will make the standards of the same, stay above what is required. All the aforementioned, makes the financial cost of implementing the educational project is not noticed. In any case, the expenses are expected to be minimal, but the benefits that the plan will bring will make disappear the possible economic barrier that could represent the implementation of the proposal for the administration of the organization. Healthcare expenditures must be correlated with high quality and efficiency in the delivery of services to improve health outcomes. In a very good study carried out by Hussey, Wertheimer, and Mehrotra, 2013, they point out that “One possibility is that improvements in quality will require increases in cost (or conversely, cost reductions could reduce quality). In reality, the association between cost and quality probably falls between these 2 extremes, that some types of health care costs are associated with high quality and others with poor quality. The effect depends on where the money is spent”.

Comment2

Evidence-based practice is associated with higher quality care and better patient outcomes than care that is steeped in tradition. However, the integration of evidence-based practice implementation into daily clinical practice remains inconsistent, and the chasm between research and bedside practice remains substantial. Practice changes most of the time requires an upfront investment of time and resources. These investments are designed to create an improvement in outcomes, whether clinical (e.g., reduced infections), organizational (e.g., shorter length of stay), or fiscal (e.g., reduced unplanned readmissions, which helps the organization avoid Medicare penalties). Any of these may have cost implications. Some EBP improvements may not create cost savings but may achieve an equally valuable outcome (e.g., patient satisfaction) that helps fulfill the organizational mission. 

 

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Comment1

Evaluating the outcome of an evidence-based practice project is the final step of the process.  I would probably choose one or two different methods of evaluation-starting with a survey for staff and patients.  Surveys are easy and usually have a good number of responses.  I would compare the answers to the survey done prior to the implementation of the EBP project.  Another method would be to collect data involving safety issues prior to and since the project improvements.  

A survey for nurses regarding bullying would include questions to see if they are more comfortable at work with the new policy changes in place and if they would make a report if they had a bullying experience.  The main objective in reducing bullying in the nursing workforce is to attempt to reduce the number of nurses leaving and increase nurse retention.  Therefore, it would be important to make sure the message has been understood and policies enforced.  Posting results to employees communicates transparency in the process.

Comment2

Evaluation for my EBP could be done through data collection. Data collection done through monitoring of rate of adherence to treatment by these patient population. Monitoring means “regularly collecting information on your project that will help you answer basic questions about your work”. (Evaluating your Project, 2015). Data collection on persistence with therapy will be one major way of evaluating my project effectiveness. Varying types of data would need to be collected to prove persistence to treatment such as,  (1) data on refill rate or medication possession rate (MPR), because as patients take their medications, they should be refilling their prescriptions. (2) data collection on increasing or decreasing reports of adverse reactions to medications for treatment. If reports of adverse reactions resulting from improper intake of these medication are on the decrease that means patients are receiving the proper education and counselling and are adhering to them (3) Patient satisfaction with treatment and monitoring trends in treatment outcomes such as decreasing rate of fracture and increase bone mineral density in patients taking these oral medications for treatment of postmenopausal osteoporosis, since these medications are found to be effective in reversing bone loss, maintain bone density and prevent fracture. (Osteoporosis Treatment Medications can Help, 2017).

 

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Comment1

Since my EBP is proposing nursing intervention through provision of medication education to improve adherence to oral therapies used for treatment of postmenopausal osteoporosis, the independent variable that will be measured is frequency of patient medication education provided by nursing; quality/content and length of education; tools/means used in providing education and patient understanding of therapy management.

The dependent variable to be measured is patient satisfaction with treatment and ability to manage therapy independently.

It is important to know how patients feel about their care and treatment, because patients’ satisfaction with treatment and ability to manage therapy independently would be an indication that patient is happy with care being provided, understands treatment modalities / requirements and are likely to comply. Satisfaction with treatment, in this case, will also, mean decreased adverse reactions to treatment from improper use of medication, found to be a major reason for discontinuing treatment due to insufficient counselling and education on medication use. ( Alami, Hervouet, Poiraudeau, Briot, Roux, 2016)

comment2

My EBP project is designed around the idea that the level of safety of the nursing environment directly impacts the ability of a healthcare organization to recruit and retain good nurses.  The safety of the environment includes both safety from the aspect of potential violence committed against healthcare employees by patients and visitors, and the violence of nurse to nurse bullying.  It has long been known that nurses are often not friendly or helpful with new nurses, and my goal is to show that having a supportive environment that promotes a safe and secure environment along with a strong anti-bullying message is vital to the retention of nurses.

The independent variables are the education of nursing to the new anti-bullying stance of management, the involvement of management in the promotion of new policies related to bullying, and the immediate response of all staff and management when bullying occurs.  A zero tolerance policy must be in place.  Also enhancing the safety of the environmnt by improved lighting, signage, and the addition of cameras, locked entrances to patient areas, and increased visability of security personel.

 

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Comment1

My EBP project is on type 2 diabetes management through lifestyle changes. I have chosen my place of employment as a research facility being that huge percentage of the population is diabetic. Potential barriers that may prevent my EBP change proposal is the lack of knowledge and unpreparedness of the rest of the team. The company in which I work for has a total of 13 facilities. Each facility has at least one RN and various providers. In order for my EBP change proposal to be successful, the company will have to invest money in training the RNs. Budget is something that has to be meticulously analyzed before approving any type of training. However, the company believes in providing quality patient care and managing our patient’s diabetes will not only reflect in their blood glucose, but also their overall health. According to the article Budget Management Tips for New Managers, it is cost effective to invest time to learn right initially (McCarthy, 2018). At this time, the company is investing time and money to train all medical assistants into working universally throughout the 13 facilities. Being that diabetes is on the rise, and I have conducted evidence-based practice research, I have a good feeling that the company may want to invest time and money into training not only RNs in providing education to patients living with diabetes, but also mental health providers to support these patients.

comment2

Maintaining safe staffing is key.  Keeping staff engaged in the hourly rounding process and not accepting anything less as practice on our CLC is paramount to keeping the residents safe and continue to keep falls at a minimum.  Maintaining an alarm free environment, no matter what the staffing ratios are, will be important. If management is serious about the alarm free environment, then they will need to actively enforce the rounding and not allow it to slide. Lastly, to maintain staff compliance, on-going education needs to be reinforced regarding proper rounding and alarm/restraint statistics on alarm free environments.

 

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