The discussion should have two references within the past 5 years in APA 6th. edition format. Students may use the textbook as a reference source with a minimum of 250 word.

There is a minimum of two references required for each post. 

Reflect on the role that the electoral process and government plays in one’s daily work and family life. As nurses, health policy can influence both arenas of our lives. What policy issues might drive nurses to lobby Congress and/or get involved in campaign politics? What strategies might nurses use to have their voices heard? 

The American Nurse: http://www.theamericannurse.org/2014/10/22/time-for-nurses-to-get-out-the-vote/ 

This week’s assigned reading includes chapters 44, 45, 46, 49. 

The objectives for this week are as follows:

1. Cite the relationship and functioning among the federal, state, and local levels of government and how nursing can have an influence.

2. Describe the electoral process and the importance of voting.

The initial post MUST include the main concepts in the rubric. 

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All work submitted by students must contain no more than 10% similarity index; any percentage greater than 10% is unacceptable and considered as plagiarism. Papers submitted with greater than 10% similarity index may receive a grade of zero.

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What is the main issue for your organization in addressing a solution to evidence-based nursing practice? Discuss what might be the first step in addressing and resolving this issue.

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COMMENT 1 TEACHER’S QUESTION

Welcome to week 2 DQ.  As you’re answering this DQ, reflect on the medical advances for cancer treatments and outcomes.  Is cancer terminal?  Why or why not?

COMMENT 2 

I really like your ideas about incorporating diet and exercise interventions. As you have stated that it is a very cost effective and easy way to improve your health. Many people are unaware of the immediately positive effects of diet and exercise on their body. Also, educating our patients on the the importance of these components is crucial as preventives measures against other co-morbidities. Obesity has become an epidemic in America and has been causing many problems in American’s bodies (Hruby and Hu, 2015). Through education and support we can help our communities learn the importance of living an active and healthy lifestyle. 

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Comment 1

One weakness that I have with regards to professional presentations is pressured speech and tendency to skip information because of pressure and timing. All the “professional presentations” (nursing school) that I have been in, there is always a time limit. I then feel that I need to talk faster to be able to present all the information. If I feel the audience knows some of the information, then I will skip some bullet points and move on to another. I have come to realize this takes away from other individual’s learning experience. One personal strength that I have with regards to professional presentations is enthusiasm. No matter what the topic, I always put 100% into all my work. This information could change someone life. I also like to personalize the presentation in some way or another. Your personal experience could help someone in the future, or spark inspiration in someone to achieve one of their dreams.

One method of improvement for my weakness would include patience and non-assumption. I need to understand that the information being presented is important and to take time to present the material. I need not to assume that everyone’s knowledge base is the same, and need to present all the information that is one the PowerPoint. Working on these methods will make me as an individual seem more professional and that I have knowledge about the topic. Why would someone take information and use it in their practice if the presenter is unsure of themselves? One method of improvement for my strength would be limiting my personal experiences and know that not everything you say will change a situation forever. Too much personal experience takes away from the validity and importance of the presentation. Not every presentation will change a life, but it could expand their knowledge and understanding.

Comment 2

Professional presentations are not my favorite topic, I do not like being center of attention by any means. I tend to get nervous and anxious when I have to get in front of a group of people or present to an audience. One of my weaknesses giving professional presentations is my speech, I talk very fast when I get nervous, sometimes forgetting what just came out of my mouth and repeating myself. One way to improve this would be to create an outline of my presentation, write down notes on note cards, numbering each note card, turning them over after each point is covered, to make sure I do not repeat myself. Practicing the presentation in front of other people would also help reduce my anxiety. However, one of my strengths is using power point presentations and other visual aids. I enjoy being creative, using designs, graphs, and clip art to communicate important points. I have also found, that when I use power points in my presentations, it takes away some of the anxiety and fear that I am feeling. I am no longer the center of attention in my professional presentation, the power point I created becomes the focus.

It is important that I work on my speech and presentation, if I want to present my findings in a more formal setting, so other professionals will visualize me as being strong confident in my knowledge. Part of professional presentations, is understanding your audience, and determining what they want and expect to get from your presentation (Mind Tools, 2019). I know from experience, when presenters come across as nervous and anxious, the audience becomes bored and loses interest. A professional presentation, should engage an audience and make them feel important, providing information in a well-structured format, identifying key points, and using examples to support findings. Reading from note cards and a lecture, can also detour audiences from being engaged, losing their interest.  According to Mind Tools (2019) “you owe it to yourself, and your organization, to develop the skills you need to present your ideas clearly, purposefully, engagingly, and confidently” (p. 1). It would me in my best interest to take a class on public speaking, to help decrease my anxiety and give me the confidence and skills to become a better speaker and presenter.

Commant 3 DQ 2

Two potential barriers that may prevent my EBP change proposal from continuing past the 6 months to one-year interval would be time devoted to implementation and preparation and knowledge of the EBP being implemented according to Ginex (2018).

Time should be devoted to preparation of the staff and unit and also  including knowledge of why this practice is being changed or improved. The benefits to the staff and patients regarding this EBP should be clear and focused. Time should be allocated to questions and education regarding the concept. Provide opportunity for stakeholders to offer input and observations regarding the implementation.

 According to Ginex (2018), behavior change is not easy. It takes persistence, determination, and a readiness to be open to new options along the way. Working together will promote positive outcomes for both patients and ourselves.

Strategies for overcoming these barriers are according to Wyant (2017) include development of EBP models that address the clinical problem and an approach to ongoing practice change. Wyant (2017) refers to the Iowa Model of Evidence-Based Practice to Promote Quality Care, the Advanced Research and Clinical Practice Through Close Collaboration Model, the Johns Hopkins Nursing Evidence-Based Practice Model, and the Promotion Action on Research Implementation in Health Services (PARIHS) Framework as examples of tools to help implement and EBP change. Each of the models address the sustainability of EBP through cultural change, stakeholder engagement, comprehensive literature review, barrier identification, and outcomes distribution.

Comment 4 DQ 2

Supporting a change can be interesting as well as difficult since many things can affect the process of changing. The two most critical potential barriers that may impact the evidence-based project is the patient’s attitude. A patient of urinary tract infection must involve himself/ herself in physical activity, but if the doctor is not allowing to perform any physical work, so the patient must stop doing it as it will be harmful to their health. The second most significant barriers that may impact the evidence-based project is the practice environment that is provided to the doctors.

I believe one of the most critical issues to support a change is to do self, require it from others and to maintain consistency. It seems very often, as judged from the practice at work, that supervisors are complacent and reluctant to require something from staff. I believe in the personal example, if needed to do it by self in the allocated time, then I can require it from others. For example, if management asked to do a procedure, the management must be ready to follow the procedure themselves and to remind staff to use the procedure over and over.

Sometimes doctors are not being facilitated by all the equipment to do the research and cannot find the solution of the new diseases. If doctors do not have enough knowledge of the disease, so it becomes difficult to suggest any solution to their diabetic patients. It is not easy to deal with such kind of barriers, but it is not impossible. One should try to communicate with patients more sensitively and try to convince them on our opinion and try earning their trust so that they can share every problem (Lyon, 2011). If a firm is unable to provide the equipment such as computers and machinery, then the doctors can launch awareness programs and should discuss more ideas with their trainees to have more possible solutions.

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Comment 1

Independent variables is a variable that is manipulated or varied by the researcher, and the dependent variable is the measurement of the response to the independent variable (Rutgers University Library, 2018). The independent variables of my project would be the age, sex, training, and degree of the nurses and other health care staff. The dependent variables would be formulating questions to further research-based knowledge, use the databases to find out relevant knowledge, and participate in the implementation of research-based knowledge in practice Boström, Rudman, Ehrenberg, Gustavsson, & Wallin, 2013).

I need to collect both the independent and dependent variables because I need to see the relationship between the nurses and health care staff, and their knowledge and abilities to carry out the EBP project. In order to determine the effectiveness of the EBP project, a study must be done. The independent variables would be manipulated by giving them the knowledge and resources to provide better quality care. Better quality care would improve and decrease incidences of pressure ulcers. The dependent variable would determine if the project was successful or not.

Comment 2

My EBP project is focusing on staff retention of newly hired nurses on the nights shift. The dependent variable that I will be measuring is the reduction of nurse turnover after use of mentor/mentee program in first three months of employment. The independent variable is the three-month time frame and the use of nurses in research.

An article from Sarikas, (2018) describes the independent and dependent variable relationship like this. The independent variable is what I want to change (i.e. use of mentor/mentee program). The dependent variable is what changes (i.e. rate of new nurse turnover).

Collection of the dependent variables will show the success or lack of success in implementing the use of a mentorship program that will reduce the rate of newly hired nurse turnover. This information will show an improvement in nurse confidence and job satisfaction which will affect patient satisfaction. If the nurses are happy the patients will benefit through more confident and patient centered care. The independent variable would be the implementation of the mentorship program that will promote nurse satisfaction over a three-month period.

Comment 3 DQ 2

Statistical significance and clinical significance are vital is determining how effective different studies are. Studies have shown that clinical significance is difficult to define and has different meanings. According to Polit (2017), one definition is “the degree of improvement experiences by patients (e.g., the amount of pain reduction among patients with cancer)” (p. 18). Another definition is “the absence of change (e.g., the absence of deterioration in spirometry test values among patients with idiopathic pulmonary fibrosis” or there is change, “the amount of change that would be clinically significant might depend on what the “baseline” value is” (p. 18). Statistical significance is defined as the way “to indicate that the result of a statistical analysis probably are not attributable to chance or serendipity, at a specified level of probability” (Polit, 2017, p. 18). A major difference between clinical significance and statistical significance, statistical significance is affected by sample size; whereas, clinical significance relies on patient-reported outcomes, such as quality of life and pain to determine the effectiveness of interventions.

I can use clinical significance to support positive outcomes in my project by ensuring that staff and management are aware of the guidelines of the project. I would also try to motivate the staff to implement the change in patient care by informing them how engaging in the interventions would improve patient outcomes. It would also improve staff outcomes because the patients would have less instances of pressure ulcer development, and the nurses and other staff can focus on other parts of patient care. Other types of care would include medication administration and ADLs. The company would also save money on the supplies needed to heal and treat pressure wounds. The company could use the money they save on other supplies, improve the facility, or give back to the employees.

Comment 4

Clinical significance is defined as a subjective explanation of a research result as practical or useful for the patient and likely to affect provider behavior and statistical significance deals with the probability that a research result is accurate according to Thompson (2017).

Clinical significance (CS) can also be know as clinical importance or practical importance. CS relates to the research results effect on patient outcomes relating to pain, treatment effects, or comfort. CS is a subjective decision that tells us how effective the research may be to patients,

Statistical significance (SS) tells us the chance that research is a chance finding, according to Thompson (2017). SS is based on the sample size and depending on how large the sample is, most can be statistically significant.

Clinical significance can be used to support outcomes in my EBP by showing the value in retaining staff and investing in supporting and maintaining newly hired nurses through mentorship programs. Breaking down the financial savings associated with hiring and training nurses only to have them leave the job or transfer to other departments or shifts is expensive and developing or maintaining a mentorship program will show the value involved in nurse retention.

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