Approximately 150-180 words APA format with references and in-text citations.
Where in the World is Evidence-Based Practice?
This paper addresses the main discussion post regarding evidence-based practice (EBP). EBP provides problem-solving to clinical practice that focuses on the best research, clinical expertise, and patient preferences or values (Melnyk & Fineout-Overholt, 2019, p. 8). It is imperative to implement EBP into clinical practice as it leads to high-quality nursing care and better patient outcomes. The purpose of this discussion post is to explore a healthcare organization website and determine if they are grounded in EBP.
Description of Healthcare Organization
The healthcare organization website that I reviewed was the Centers for Medicare & Medicaid Services (CMS). EBP appears in the quality initiatives section of the CMS website. This section informs patients that CMS seeks information on how to transform clinician practices by changing practice behavior through evidence-based care to improve patient care and lower healthcare costs (CMS, 2018). CMS has quality improvement organizations dedicated to improving health quality. The mission of CMS quality improvement organizations is to improve the effectiveness, efficiency, and quality of services for Medicare patients (CMS, 2018). CMS has developed Core Measures, which provides EBP information on health care quality that allows physicians, clinicians, and patients to make informed decisions (CMS, 2017).
Healthcare Organization Grounded in EBP
Throughout the CMS quality initiatives website, there are indications that they are grounded in EBP to improve their patient’s care and outcomes. In our required reading, it was noted that the most critical reason for implementing EBP is to provide the highest level of care and the best patient outcomes (Melnyk & Fineout-Overholt, 2019, p. 12). CMS has also focused their aim on providing better care and better health at lower costs (CMS, 2018). In our required reading, it was also noted that research shows that EBP leads to a reduction in healthcare costs (Melnyk, Fineout-Overholt, Stillwell, &Williamson, 2010, p. 51).
Changed Perception of the Healthcare Organization
The information that I discovered on the CMS website has changed my perception of the organization by assuring me that they are using EBP to ensure that their patients receive the best possible care which improves patient care and outcomes (CMS, 2018). For example, both of my parents have Medicare coverage; it is comforting to know that they are receiving care based on evidence that has been shown to improve their care and outcomes. The aim at CMS is to provide better care at lower costs, which has also changed my perception (CMS, 2018). For example, both of my parents live on fixed incomes, so it is essential for them to receive quality healthcare coverage as well as prescription drug coverage at a lower cost.
References
Centers for Medicare & Medicaid Services. (2017, July 28). Core measures. Retrieved May 26, 2019, from https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/QualityMeasures/Core-Measures.html
Centers for Medicare & Medicaid Services. (2018, April 19). Quality initiatives – general information. Retrieved May 26, 2019, from https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/QualityInitiativesGenInfo/index.html
Centers for Medicare & Medicaid Services. (2018, September 18). Quality improvement organizations. Retrieved May 26, 2019, from https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/QualityImprovementOrgs/index.html
Melnyk, B. M., Fineout-Overholt, E., Stillwell, S. B., & Williamson, K. M. (2010). Evidence-based practice: Step by step. The seven steps of evidence-based practice. American Journal of Nursing, 110(1), 51-53. Retrieved from https://ovidsp-tx-ovid-com.ezp.waldenulibrary.org/sp-3.33.0b/ovidweb.cgi?WebLinkFrameset=1&S=CGFCFPFNMMDDDBNJNCDKKDLBDJEIAA00&returnUrl=ovidweb.cgi%3f%26Full%2bText%3dL%257cS.sh.22.23%257c0%257c00000446-201001000-00030%26S%3dCGFCFPFNMMDDDBNJNCDKKDLBDJEIAA00&directlink=https%3a%2f%2fovidsp.tx.ovid.com%2fovftpdfs%2fFPDDNCLBKDNJMM00%2ffs046%2fovft%2flive%2fgv023%2f00000446%2f00000446-201001000-00030.pdf&filename=Evidence-Based+Practice%3a+Step+by+Step%3a+The+Seven+Steps+of+Evidence-Based+Practice.&pdf_key=FPDDNCLBKDNJMM00&pdf_index=/fs046/ovft/live/gv023/00000446/00000446-201001000-00030
Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing and healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.
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Discussion Response To Article Below
/in Uncategorized /by developerApproximately 150-180 words APA format with references and in-text citations.
Where in the World is Evidence-Based Practice?
This paper addresses the main discussion post regarding evidence-based practice (EBP). EBP provides problem-solving to clinical practice that focuses on the best research, clinical expertise, and patient preferences or values (Melnyk & Fineout-Overholt, 2019, p. 8). It is imperative to implement EBP into clinical practice as it leads to high-quality nursing care and better patient outcomes. The purpose of this discussion post is to explore a healthcare organization website and determine if they are grounded in EBP.
Description of Healthcare Organization
The healthcare organization website that I reviewed was the Centers for Medicare & Medicaid Services (CMS). EBP appears in the quality initiatives section of the CMS website. This section informs patients that CMS seeks information on how to transform clinician practices by changing practice behavior through evidence-based care to improve patient care and lower healthcare costs (CMS, 2018). CMS has quality improvement organizations dedicated to improving health quality. The mission of CMS quality improvement organizations is to improve the effectiveness, efficiency, and quality of services for Medicare patients (CMS, 2018). CMS has developed Core Measures, which provides EBP information on health care quality that allows physicians, clinicians, and patients to make informed decisions (CMS, 2017).
Healthcare Organization Grounded in EBP
Throughout the CMS quality initiatives website, there are indications that they are grounded in EBP to improve their patient’s care and outcomes. In our required reading, it was noted that the most critical reason for implementing EBP is to provide the highest level of care and the best patient outcomes (Melnyk & Fineout-Overholt, 2019, p. 12). CMS has also focused their aim on providing better care and better health at lower costs (CMS, 2018). In our required reading, it was also noted that research shows that EBP leads to a reduction in healthcare costs (Melnyk, Fineout-Overholt, Stillwell, &Williamson, 2010, p. 51).
Changed Perception of the Healthcare Organization
The information that I discovered on the CMS website has changed my perception of the organization by assuring me that they are using EBP to ensure that their patients receive the best possible care which improves patient care and outcomes (CMS, 2018). For example, both of my parents have Medicare coverage; it is comforting to know that they are receiving care based on evidence that has been shown to improve their care and outcomes. The aim at CMS is to provide better care at lower costs, which has also changed my perception (CMS, 2018). For example, both of my parents live on fixed incomes, so it is essential for them to receive quality healthcare coverage as well as prescription drug coverage at a lower cost.
References
Centers for Medicare & Medicaid Services. (2017, July 28). Core measures. Retrieved May 26, 2019, from https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/QualityMeasures/Core-Measures.html
Centers for Medicare & Medicaid Services. (2018, April 19). Quality initiatives – general information. Retrieved May 26, 2019, from https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/QualityInitiativesGenInfo/index.html
Centers for Medicare & Medicaid Services. (2018, September 18). Quality improvement organizations. Retrieved May 26, 2019, from https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/QualityImprovementOrgs/index.html
Melnyk, B. M., Fineout-Overholt, E., Stillwell, S. B., & Williamson, K. M. (2010). Evidence-based practice: Step by step. The seven steps of evidence-based practice. American Journal of Nursing, 110(1), 51-53. Retrieved from https://ovidsp-tx-ovid-com.ezp.waldenulibrary.org/sp-3.33.0b/ovidweb.cgi?WebLinkFrameset=1&S=CGFCFPFNMMDDDBNJNCDKKDLBDJEIAA00&returnUrl=ovidweb.cgi%3f%26Full%2bText%3dL%257cS.sh.22.23%257c0%257c00000446-201001000-00030%26S%3dCGFCFPFNMMDDDBNJNCDKKDLBDJEIAA00&directlink=https%3a%2f%2fovidsp.tx.ovid.com%2fovftpdfs%2fFPDDNCLBKDNJMM00%2ffs046%2fovft%2flive%2fgv023%2f00000446%2f00000446-201001000-00030.pdf&filename=Evidence-Based+Practice%3a+Step+by+Step%3a+The+Seven+Steps+of+Evidence-Based+Practice.&pdf_key=FPDDNCLBKDNJMM00&pdf_index=/fs046/ovft/live/gv023/00000446/00000446-201001000-00030
Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing and healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.
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Discussion Response To Evidenced Based Practice
/in Uncategorized /by developerApprox 150-180 words APA format with references and in-text citations response to the discussion below.
The term “Evidence-Based Practice” (EBP) was fairly new when I was entering nursing school in 1999.
Although it made sense that nursing practice was based on academic research and findings, many nurses have passed down traditions simply based on the notion that “it has always been done this way”. I can remember this new term, and the exciting thought that nursing would be more valued and respected with a greater emphasis on practice based in facts and best outcomes. I became an RN in 2004, and I have worked in the psychiatric field for the majority of my career. The American Psychiatric Nurses Association (APNA) was my chosen healthcare organization website. This can be found at https://www.apna.org/i4a/pages/index.cfm?pageid=1 . Although I was already somewhat familiar with what the website had to offer, I gained a greater understanding and admiration for this site as I dug a little deeper.
The Institute of Medicine’s Roundtable on Evidence-Based Medicine put an emphasis on three major areas: a learning healthcare system, generating evidence to support effective healthcare strategies, and improving public awareness regarding the importance of EBP in healthcare (Melnyk, & Fineout-Overholt, 2018). The APNA website contributes to the IOM’s goal of improving public awareness related to EBP. This is evident in the numerous resources on the website from academic journals, continuing education (conferences and CEU’S), standards of practice updates, and also the ability to find information about academic programs and scholarships. The Journal of the American Psychiatric Nursing Association is a peer-reviewed journal which publishes original research, practice-focused articles, editorials, and interviews. One tab entitled “Reports & Surveys” shares the latest national reports and surveys covering topics related to the future of nursing and nurses’ health.
Although the website is not entirely based in EBP (some tabs are related to the organization and membership) it is clear that its goal is to promote the understanding of psychiatric nursing through the recent solid research. One item available for free via ebook to members (and for sale to non-members) is “Psychiatric-Mental Health Nursing: Scope and Standards of Practice”. This spells out important aspects of psychiatric-mental health nursing- the who, what, when, where, and how of practice- at various levels and in multiple settings. The latest edition was published with the input and expertise of psychiatric nurses from the APNA and the International Society of Psychiatric-Mental Health Nurses (ISPN). Goals established prior to the easy access of the internet are able to be met not only through scholarly articles, but with new styles of sharing information and with a culture of networking to filter out the most relevant, and timely information.
Crabtree, E., Brennan, E., Davis, A., & Coyle, A. (2016). Improving patient care through nursing engagement in evidence-based practice. Worldviews on Evidence-Based Nursing, 13(2), 172–175. doi:10.1111/wvn.12126
https://www.apna.org/i4a/pages/index.cfm?pageid=1
Laureate Education (Producer). (2018). Introduction to Evidence-Based Practice and Research [Video file]. Baltimore, MD: Author.
Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.
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Discussion Response Week 1
/in Uncategorized /by developerComment using your own words but please provide at least one reference for each comment.
Do a half page for discussion #1 and another half page for discussion #2 for a total of one page.
Provide the comment for each discussion separate.
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Discussion Responses Approx 100 150 Words 18975609
/in Uncategorized /by developerTHIS IS A DISCUSSION RESPONSE APA 6TH ED. USING IN TEXT CITATIONS AND REFERENCES.
According to Chinn and Kramer (2014), personal knowing is a process of Self-knowing that is conscious; it is developed deliberately to know fully who you are and to understand your actions and relationships. Personal knowing allows you to take past experiences and reflect on that to develop yourself into a better person to more adequately care for patients. Personal knowing is not just internal reflection of also how people perceive you through your actions. In order to develop personal knowing you can ask the questions “Do I do what I know?” and Do I know what I do?” This allows the person to recognize and hold themselves accountable for providing the best, unbiased care.
A professional strength that I possess would be that I have a great attention to detail when it comes to patient care and my job. When it come to patient assessment, I can quickly notice a change in condition or behavior. I pay attention to a patient’s appearance such as grooming, edema to extremities, or gait. My co-workers always say, “Jen doesn’t miss anything!” My second professional strength is that I strive to be the best at what I am doing. I want to go the extra mile to do what is right for the patient and the people I work with. I do not want to be told twice or reminded on how to do something. When I work in the recovery room, I know what the doctor’s preferences are in caring for the patient.
My first weakness and biggest downfall is that I am critical. I put a lot of pressure on myself and other people to do things correctly. This is something that I continuously must check myself on. Just because it isn’t my way doesn’t mean that it isn’t being done correctly. I have found that through my work and personal experience that if you are constantly picking at someone, they may just give up! My second weakness is that I am not very confident. When I feel insecure and unsure about myself or my skills, I try to talk myself out of it. I clam up in uncomfortable situations.
Benner’s model of skill acquisition theory helps to improve my confidence and attention to detail. My base knowledge and experience help to provide me with the confidence boost that I need. According to McEwen and Wills (2014), expertise develops when the clinician tests and refines propositions, hypotheses, and principle-based expectations in actual practice situations. I know that in my current position, I am an expert. This makes me feel comfortable that I am making the right decisions for my patients. This can also apply to my weakness of criticism. A novice nurse may not seek advice from me if I am constantly critical of them and their work.
Chin, P. & Kramer, M. (2014) Integrated Theory and Knowledge Development in Nursing: Theory and Process. (9th Ed.); Elsevier.
McEwen, M. & Wills, E. (2014). Theoretical Basis for Nursing (4th Ed.); Lipincott Williams and Wilkins ISBN 9781451190311
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Discussion Responses Approx 100 150 Words 18975629
/in Uncategorized /by developerTHIS IS A DISCUSSION RESPONSE APA 6TH ED WITH IN TEXT CITATIONS AND REFERENCES.
Personal knowing is hard to measure and define precisely in my opinion. I believe it is one’s know-how, ethics, compassion all mixed in one. It is because of one’s personal knowing that one wouldl pursue professional development and advancement in our profession. It takes someone with a good personal knowledge to understand the positive effect of investing in one’s self not only professionally but also personally. Clinical and theoretical experience is an example of personal knowing, they complement each other.
In my practice I have two qualities that comes to mind and stand out, I, as well as some colleagues, have noticed: I tend to remain calm in stressful and urgent situations, and I am good at starting IVs. My qualities reflect some of my personal knowledge because I attribute being calm in stressful situations and being able to start IVs as a result of my experience and professional knowledge. I was lucky to be thought mostly in a safe, non-threatening environment, which caused a positive effect in my learning (Little, 2006, p. 135).
In addition, I also consider myself an expert in some nursing tasks, which causes me to have more confidence and in turn creates a quality interpersonal contact favorable for patient flourishment (Little, 2006, p. 135; Polifroni & Welsh, 1999, p.18).
On the other hand my two weakness are my accent and not being able to cut someone off without coming off as rude. Because English is my second language, I talk with an accent and that becomes a weakness when I have to time manage my patients and speak fast. The words mash together, and the accent sometimes makes it hard for someone to understand me. The same goes when a patient starts telling me his or her life story and I have other more urgent tasks to take care of. I always feel bad cutting them of because if it were another day I would love to hear their stories.
Well, coming to think of it, my weaknesses float around the time management area. I should take my time and be in the moment with each patient while at the same time allocating a fair amount of time to all of them. Maybe nursing theory can help me by applying certain tasks to my routine that would benefit the patient as well as myself as a practitioner.
References
Little, M. (2006). Educational innovation. Preparing nursing students to be health educators: personal knowing through performance and feedback workshops. Journal Of Nursing Education, 45(3), 131-135.
Polifroni, E. C. & Welsh, M. (1999). Perspectives on Philosophy of Science in Nursing: An Historical and Contemporary Anthology. Philadelphia, PA: Lippincott Williams & Wilkins
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Discussion Responses Approx 100 150 Words
/in Uncategorized /by developerWe are all individual person living in the world, or the earth, our environment. We all somehow in our life get sick sometimes, which means we require nursing care. These four metaparadigm are cooperate with each other and they are connected together. However, the one of the most important metaparadigms is environment in my nursing practice.
The first week of my orientation on the floor is to learn the safety check in each room at the beginning of the shift. I was taught to check whether there are oxygen tubing, suction and bed alarm for high fall risk patients are set up and I have to make sure that there should be a clear pathway to walk around the patient’s rooms and there should not be any cords on the floor that possibly trip people. Keeping with the current healthcare focus of patient care quality and safety in acute and intensive care environments is very important. There is one time we have a patient that is in airway emergency and we need to suction him. However, the room was not ready with all the suction tubing and set up. The patient ended up with brain death because of delay intubation.
A lot of long-term hospitalization patients would like to decorate their room with their own stuffs, putting up all their own pictures with family, friends and have their ADLs, like toothbrush and pajama. They feel more relax and comfort when they have the quiet and warm environment provide then with safety and security.
According to Nightingale’s environment theory, it entails fresh air, pure water, effective drainage, cleanliness and light are the key elements in functioning of life’s processes and health status. It is involving the nurses’ initiative to configuring environmental settings appropriate for the gradual restoration of the patients’ health, and the external factors associated with the patient’s surroundings affect life or biologic and physiologic processes, and his development (Selanders, 1998).
Virginia Henderson’s “Need Theory” on one hand has the same goal as Nightingale’s environment theory. They both addressing the needs of patients is crucial in providing quality care. “Need theory” not only included providing the safe/secure environment to patients, it also considered close to realism and it is aiming to enable nurses to improve standard of caring by assessing patient needs including physiological, psychological, spiritual and moral (Ahtisham & Jacoline, 2015). Comparing these two theories, nurses have a unique ability to apply their observational skills to understand the role of the designed environment to enable healing in their patients. As a bedside nurse, by comparing the similarities and differences between these two theories, it put me up to in a better position to provide the holistic care to my patients.
Reference
Ahtisham, Y., & Jacoline, S., (2015) Integrating Nursing Theory and Process Into Practice; Viginia’s Henderson need Theory. International Journal of Caring Sciences. May-August 2015 Vol. 8 Issue 2 pp 443-450
Selanders, L., (June, 1998). The Power of Environmental Adaptation. Florence Nightingale’s Original Theory for Nursing Practice. Journal of Holistic Nursing
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Discussion Review Of Current Healthcare Issues 19328179
/in Uncategorized /by developerIf you were to ask 10 people what they believe to be the most significant issue facing healthcare today, you might get 10 different answers. Escalating costs? Regulation? Technology disruption?
These and many other topics are worthy of discussion. Not surprisingly, much has been said in the research, within the profession, and in the news about these topics. Whether they are issues of finance, quality, workload, or outcomes, there is no shortage of changes to be addressed.
In this Discussion, you examine a national healthcare issue and consider how that issue may impact your work setting. You also analyze how your organization has responded to this issue.
To Prepare:
Post a description of the national healthcare issue/stressor you selected for analysis, and explain how the healthcare issue/stressor may impact your work setting. Then, describe how your health system work setting has responded to the healthcare issue/stressor, including a description of what changes may have been implemented. Be specific and provide examples.
references
Marshall, E., & Broome, M. (2017). Transformational leadership in nursing: From expert clinician to influential leader (2nd ed.). New York, NY: Springer.
45 (45%) – 50 (50%) Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.
Supported by at least three current, credible sources.
Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.
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Discussion Review Of Current Healthcare Issues 19437417
/in Uncategorized /by developerIf you were to ask 10 people what they believe to be the most significant issue facing healthcare today, you might get 10 different answers. Escalating costs? Regulation? Technology disruption?
These and many other topics are worthy of discussion. Not surprisingly, much has been said in the research, within the profession, and in the news about these topics. Whether they are issues of finance, quality, workload, or outcomes, there is no shortage of changes to be addressed.
In this Discussion, you examine a national healthcare issue and consider how that issue may impact your work setting. You also analyze how your organization has responded to this issue.
To Prepare:
By Day 3 of Week 1
Post a description of the national healthcare issue/stressor you selected for analysis, and explain how the healthcare issue/stressor may impact your work setting. Then, describe how your health system work setting has responded to the healthcare issue/stressor, including a description of what changes may have been implemented. Be specific and provide examples.
requires citations of at least three current references.
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Discussion Review Of Current Healthcare Issues 19437845
/in Uncategorized /by developerIf you were to ask 10 people what they believe to be the most significant issue facing healthcare today, you might get 10 different answers. Escalating costs? Regulation? Technology disruption?
These and many other topics are worthy of discussion. Not surprisingly, much has been said in the research, within the profession, and in the news about these topics. Whether they are issues of finance, quality, workload, or outcomes, there is no shortage of changes to be addressed.
In this Discussion, you examine a national healthcare issue and consider how that issue may impact your work setting. You also analyze how your organization has responded to this issue.
Post a description of the national healthcare issue/stressor you selected for analysis, and explain how the healthcare issue/stressor may impact your work setting. Then, describe how your health system work setting has responded to the healthcare issue/stressor, including a description of what changes may have been implemented. Be specific and provide examples.
APA citation 3 to 4 references with 5 years
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Discussion Review Of Current Healthcare Issues
/in Uncategorized /by developerDiscussion: Review of Current Healthcare Issues
If you were to ask 10 people what they believe to be the most significant issue facing healthcare today, you might get 10 different answers. Escalating costs? Regulation? Technology disruption?
These and many other topics are worthy of discussion. Not surprisingly, much has been said in the research, within the profession, and in the news about these topics. Whether they are issues of finance, quality, workload, or outcomes, there is no shortage of changes to be addressed.
In this Discussion, you examine a national healthcare issue and consider how that issue may impact your work setting. You also analyze how your organization has responded to this issue.
To Prepare:
· Review the Resources and select one current national healthcare issue/stressor to focus on.
· Reflect on the current national healthcare issue/stressor you selected and think about how this issue/stressor may be addressed in your work setting.
ASSIGNMENT
Post a description of the national healthcare issue/stressor you selected for analysis, and explain how the healthcare issue/stressor may impact your work setting. Then, describe how your health system work setting has responded to the healthcare issue/stressor, including a description of what changes may have been implemented. Be specific and provide examples.
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