Dq71 Response 19444151

Hello Eugenia & Class,As you know, it is very important for researchers to post his or her work in highly respected journals. Please name a few Nursing Journals that are good for nursing researchers. Please explain their relevance, scope, and target audience. Thanks,

 
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Dq71 Response

Anne Kolsky    7 posts   

Re: Topic 7 DQ 1  Internal Project Team Identified  The internal project team for the change project are identified as the nurse, administration, social workers, teachers, case managers, counselors, and support staff (Spruce, 2015).  External Project Team Identified  The external team includes the parent or guardian, the health care provider, mental health providers, external social workers, school board and community members (Spruce, 2015).  Identification of Scope of Project  The EBP internal and external teams or representatives would ideally meet together, but at the very least will be presented the information needed for collaboration to bring consensus to the methods of monitoring students who have been identified with needs through screenings and have been presented with referrals for services (Spruce, 2015).  Identifying the Evidence  The nurses involved in screening will need to present to both groups evidence for the need to screen, identify, give referrals, and monitor to ensure that needed services are in place and implemented. The nurses will also make practice recommendations to both groups as they are stakeholders in not only making things happen, but funding for screening and monitoring. Health care and mental health care will need to support with identification of funding sources, monitoring and surveillance and services (Spruce, 2015).  Importance of Reporting Results to Both Groups  Providing feedback to team members is extremely important. Everyone wants to know if the time, effort, and funding is making a difference. Feedback is important from the stakeholders to make sure needed changes are working in the most streamlined manner. It is recommended to review the process every two years or as often as needed when evidence changes or practice needs change. Teaching the groups the importance of the long-term benefits of early childhood screenings and the financial incentives to both community and family are a must (Spruce, 2015).  Communication Strategies   Internal communication would include teaching screening methods, referral processes, and monitoring from the school perspective. Technology can most definitely be used to integrate EBP for identification and follow-through (Spruce, 2015).  Spruce, L. (2015). Back to basics: Implementing evidence-based practice. AORN Journal, 101(1), 106–112. Doi:10.1016/j.aorn.2014.08.009

Please reference must include doi or retrieval URL 

 
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Dq72 Response 19447377

    Re: Topic 7 DQ 2
 

The most effective and important piece of change is through the evaluation of the patient. After education of the staff and implementation of the education and procedures that are to begin taking place for the surgical patient, surveys will be conducted. As it currently stands, each and every post-operative patient is contacted the next business day and a brief survey is done verbally, a few weeks later, a written survey is sent out. Patients that undergo procedures with expected pain and post-operative medications, will receive slightly different surveys than those surveys that exist today. New questions for those patients who received pain medication will include their satisfaction level with pain in the Post Anesthesia Care Unit on a scale of one to ten, their current level of pain at home, and their satisfaction with their level of pain at home with their current medication. Additionally, the patients will be asked if they know when they are to take two pills in a prescription that states “one to two pill, every four to six-hour”, as well as what to do with any leftover medications they may have after surgery, the current amount of medications left on hand, and where the patient is currently storing their pain medications in the house. The answer to these questions will be compiled each day to create a record of the patient’s understanding of the teachings they were given, and their satisfaction with their care and level of pain after surgery. These surveys will continue to be complied to create monthly satisfaction surveys.

 
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Dq72 Response 19447379

One significant change I have noticed is a reduction in past due medication error after implementing the updated bedside shift report (BSR). Staff now open the electronic health records during BSR. According to the Agency for Healthcare Research and Quality (AHRQ), the significant elements of a BSR after introducing the nurses to the patient are open the electronic health record at the bedside.

      A nurse performs electronic health record assessment to review the medication administration record and check all medications that have been supplied and documented correctly, vital signs, intake and outputs, etc. During this time, the patient can clarify questions about the medication, its use, and side effects and set short and long term aims with the nurse. Understanding that the nursing staff is receiving the information required to promote care reduces patient and family anxiety and enhances patient satisfaction. This sort of shift report improves staff interaction while assuring nurse responsibility (Lippincott Solutions, 2017).While bedside shift reports, the nurses have the opportunity to clarify relevant information and watch the patient physically, including drains, tubes, intravenous medications, and wounds, which work as an essential evaluation to enhance patient safety. Better interaction also helps the oncoming nurse prioritize duties according to requirements. Nurses are constantly on the same side during the report because they’re both looking at the same information at the same time (Lippincott Solutions, 2017).

References

Lippincott Solutions (2017). Bedside Shift Reports Can Save Lives. Retrieved from http://lippincottsolutions.lww.com/blog.entry.html/2017/11/17/bedside_shift_report-dMev.html

 
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Dq72 Response

Carrie Smithson    2 posts   Re: Topic 7 DQ 2          In order to evaluate an evidence-based project, it is important to be able to determine the effectiveness of your change. In this discussion board, I will discuss one way that I will be able to evaluate whether my project made a difference in practice. The end goal of my project is to decrease admissions to the hospital by providing education on tobacco dependency. Tobacco use causes secondary illnesses such as heart attacks and strokes. Smoking is a major cause of coronary vascular disease and can raise triglycerides, lower HDL cholesterol, make blood sticky and more likely to clot, and cause thickening and narrowing of blood vessels (Centers for Disease Control and Prevention, 2019). Patients that are admitted with an acute diagnosis such as myocardial infarction and stroke, are often educated on risk factors. Some risk factors cannot be changed such as family history, age, and race. Other risk factors can be changed to promote health such as smoking, diet, and exercise. Once the education is provided, nurse managers can audit charts to determine if readmission of the same diagnosis is made. This is one way to evaluate if my project made a difference in practice. Another method to evaluate my project would be through follow up appointments. Every patient that leaves the hospital is made a follow up appointment with their primary care provider. During the follow up visit, the doctor can determine if the teaching performed in the hospital was effective. Success with a tobacco cessation program can decrease health risk tremendously, and that is the goal.  Resource  Centers for Disease Control and Prevention. (2019). Smoking and Heart Disease  and Stroke | Overviews of Diseases/Conditions | Tips From Former  Smokers | CDC. Retrieved from  https://www.cdc.gov/tobacco/campaign/tips/diseases/heart-disease-  stroke.html

Reference must include doi or retrieval URL

 
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Dq72

In order to evaluate an evidence-based practice project, it is important to be able to determine the effectiveness of your change.Discuss one way you will be able to evaluate whether your project made a difference in practice(My EBP is on hand washing) The reference must include doi or retrieval URL

 
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Dq7bbbb

Mrs. A, who is 81 years of age, weighs significantly more than her 47-year-old daughter, yet she is given a lower dosage of medication for insomnia of a similar degree. Why? Is this a dosage calculation error?

 
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Dq8 18895513

 

 
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Dq81 19349089

Based on how you will evaluate your EBP project, which independentand dependent variables do you need to collect? Why? EBP is on Hand washing 

 
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Dq81 Response 19351065

Carrie Smithson    1 posts   Re: Topic 8 DQ 1            Based on evaluation of my EBP project there are independent and dependent variables that need to be collected. A variable is something that varies or changes. “A variable in research simply refers to a person, place, thing, or phenomenon that you are trying to measure in some way” (University of California Libraries, 2019, para. 5). Independent variables are stable and unaffected by other variables you are attempting to measure. These are often manipulated by the researcher. Dependent variables are those that depend on other factors and change as a result of an experiment. This is the response that is measured. Dependent and independent variables are important because they drive the research process. A variable as opposed to a constant is simply anything that can vary and that many researchers consistently look at the relationship between the two variables. In order to evaluate my EBP project, I will have managers audit charts to determine if education provided to the patient was effective by not being readmitted with the same diagnosis. A few independent variable are patient’s willingness to learn, age, and time. These are important factors to consider when performing the audits. Some patients are not willing to make a change to their health and are set in their ways. The time spent with the patient is also important to consider. If the patient is being discharged and is ready to go, they aren’t going to fully be attentive to the teaching as they are eager to leave. Timing is key and having enough time to perform the teaching is important as well. Some dependent variables to consider are the patients who are admitted with stroke and chest pain who are tobacco users. The outcome depends on the effectiveness of the teaching performed by the nursing staff. The variables need to be collected because they will affect the evaluation. Surveys need to be performed on all different types of patient’s so that bias isn’t a factor.  Resource  University of California Libraries. (2019). Research Guides: Organizing Your Social  Sciences Research Paper: Independent and Dependent Variables. Retrieved  from https://libguides.usc.edu/writingguide/variables

 
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