Comment 19021199

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Comment1

Clinical nurse leader role (CNL) is  a new specialty developed in nursing to prepare highly skilled nurses    to focus on the improvement of quality and safety outcomes for patients. According to IOM report on 1999 large number of death occurred as result of avoidable medical errors. In response to this   American Association of Colleges of Nursing(AACN) launched the role of clinical nurse leader ,to educate and strengthen nurses to improve safety, quality and better outcomes of care delivered. The CNLs provide education to all and corporate with evidence based practice (“Clarifying the clinical nurse leader role: guardian of care – American Nurse Today”, 2018).

 The clinical nurse leader (CNL) is an advanced clinician with master’s level education. Education is necessary to bring clinical competence and knowledge to serve as a resource to entire nursing team. CNLs  who works with multi-disciplinary team of physicians, pharmacists, social workers clinical nurse specialists’.CNL collect and evaluate treatment results .CNLoften manages other nursing staff and even serve as a resource to the entire team.CNL s require strong problem  solving and critical thinking skills to evaluate the quality of patient  care (2018) .

Comment2

Clinical nurse leaders (CNL) are nurses that can be described as advanced generalists. They serve general populations within medical care. CNLs will deal with oncology patients, bariatric patients, cardiology patients, etc. These patients will have a variety of diagnoses and treatment plans that the CNL will have to be familiar with. As such this places CNLs as prime educators within the medical system that educate the groups with whom they work on the most current evidence based practice. As a result this improves the delivery of patient care. For example, CNLs will work with clinical nurse educators (CNE) to address areas of educational gaps for the staff. They will then assess the feedback given by the staff to note areas of improvement and/or success (Monaghan, 2011).

In order to become a qualified CNL, one must have a nursing degree and  complete a master’s degree in order to ensure clinical competency and mastery. After which, a program designed to teach the role of CNL to the students (Stanley, 2018).

The success of CNLs has been quantified many times over particularly in the Veterans Health Administration (VHA). With the implementation of CNL roles, the VHA has documented an increase in nursing hours per patient day, reduction of sitter hours for patients with dementia, decrease in preoperative and gastrointestinal patient cancellations, and increase in the compliance of providing discharge teaching by the nursing staff, reduction in ventilator-associated pneumonia, reduction in falls, nosocomial infections, and pressure ulcers” (Monaghan, 2011).

 
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Comment 19028129

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Comment1

My personal preference for scholarly databases, of those listed by GCU, is the CINAHL Complete. It is described as “the definitive research tool for nursing and allied health professionals with access to the top nursing and allied health journals” (Grand Canyon University, n.d., para 1). I have found that using the CINAHL database has provided me with the most comprehensive articles and information throughout the duration of my career as a nurse. I also tend to utilize the Joanna Briggs Institute EBP alongside the CINAHL database. The Briggs database “is a recognized global leader in evidence-based healthcare resources…[including] evidence summaries, evidence based recommended practices, best practice information sheets, etc…” (Grand Canyon University, n.d., para 3).

These databases, and those listed in the GCU Library are far superior to using Google Scholar or a general internet search. The databases listed above are first and foremost, medical specific. The information obtained in a search on either database will reveal only articles and information related in a medical aspect. Secondly, the use of traditional search engines, like Google Scholar, does not allow for the user to apply as detailed specificity to the search as could be in a database search. This in turn results in a “grab bag” of results that make it difficult to determine what is accurate information and what is not (LibGuides, 2018, para 5). Lastly, the use of databases remains consistent; meaning that standard web searches and results found on those websites can change without notice. This leaves room for error and for a loss of content to occur; you may not see the same information twice with a Google Scholar search (LibGuides, 2018, para 6)

comment2

The first one that I found helpful in aiding my research is the CINAHL database.  There are more than 4 dozen nursing specialties that are covered in the journals on their engine.  It provided you with the most current practices, continuing education and evidence base best practices (Grand Canyon University, n.d).  Secondly, the Joanna Briggs Institute will also help me in finding scholar information to support my EBP proposal.  It offers the best evidence base practices and systematic reviews.  These two databases are better than google scholar articles because it has been researched by specialist and proven before publication.  Articles that are found on google scholar or internet may not reliable because they can be written from opinions.  Since being a student at GCU, I have also found the databases to be valid, the peer review articles have reliable sources and have been thoroughly researched.  By also filtering it to what you are looking for, you can also find the most current practices.

 
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Comment 19065641

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comment1

Every organization has its stakeholders, irrespective of its size, nature, structure and purpose. The stakeholders can be any person or entity, who influence and can be influenced by the organization’s activities. Stakeholders can be categorized as internal and external stakeholders. Those who works with in the organization are known as internal stakeholder. Physicians, nurses and hospital management in my case are internal stakeholders. External stakeholders are those not employed by hospital but they have a say in hospital operations such as Licensing or Accreditation agencies like (Joint Commission), patients,policy makers, labor unions and care givers. Change is often difficult to implement because of inertia and so many competing interests. Certain elements must be in place in an organization for change to take hold: an agreed-on direction for the practice, a functional and effective leadership structure, and a culture that promotes and rewards change.

Comment2

Stakeholder buy-in is the glue that binds all elements of a project together and ensures that the change will actually happen”.( May, 2016). It is important to have the backing of the decision makers/stakeholders both within and outside of an organization to successfully push a change project through because:

  1. They will provide expertise from their wealth of knowledge about current process, historical information and way forward, thereby, bringing value to the project.
  2. They will help reduce or uncover risks involved in change project process in terms of project needs, constraints and plans to mitigate those problems as they arise to increase the chances of project success.
  3. They help to increase the success of the project by speeding up the process, providing resources and creating the support needed to move change forward.
  4. Finally, they have the power and authority to grant the project acceptance. (Schoenhard, 2017).

 
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Comment 19066943

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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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Comment 19072707

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comment1

The clinical aspect is patient medication education.  Nurse patient education is a core and fundamental aspect of nursing practice. “Today nurses assume more and more responsibility for education of patients and helping them to become responsible for their own health status… and work to stabilize and  prevent or minimize complications from any chronic illness”. (Tips to Improve Patient Education, 2018). Providing structured medication education and monitoring of therapy especially, with patients on long-term therapy taking medication that require strict adherence to complex processes for treatment effectiveness is an important clinical practice.

Financial aspect: there is no heavy financial burden on organization in the implementation of this practice proposal. The only financial obligation will be in developing educational training materials such as video programs for training nurses or the human resources and time required to provide training and evaluation of change outcomes. Financial benefits will include decreases in healthcare cost from treatment of osteoporotic complications due to non-compliant to treatment regimen, also, decreased hospitalization and financial burden on patients and community in general.

Comment2

The quality aspect of my EBP involves taking an active approach on safety, monitoring and re-evaluation of new safety practices.  Creating an atmosphere of healing benefits everyone.  Quality of care, best possible outcomes, and effective problem solving can only take place when there is teamwork and communication.  We have learned from research literature that workplace violence in healthcare settings can be reduced with the implementation of enhanced safety measures, and the safety our facilities is importance to staff, patients, and visitors.  Workplace bullying is a top reason for high nurse turn-over rates and low retention-especially with new nurses.  With this knowledge, we can make the changes within our teams necessary for success.

 
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Comment 19089880

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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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Comment 19102395

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Comment1

The ENA Connection is a publication that is shared monthly by the Emergency Nurses Association.  This would be an excellent place to share my evidence-based project idea on reducing violence and enhancing safety in healthcare facilities and addressing the issue of bullying within the nursing profession.  The publication covers many issues in emergency nursing including, education on grant funding, medical issues, shared governence, quality control, effective management, current trends in nursing, and using evidence-based solutions in our practice.

The Emergency Nurses Association holds conferences both regionally and nationally.  I recently attended an ENA regional confernce in Milwaukee, Wisconsin.  I think that a regional conference would be the perfect place to present my EBP project ideas.  As emergency workers, I feel they understand the need for increased security measures in our healthcare facilities, as well as the need to address the issue of lateral violence in the form of burse to nurse bullying.  It is truely a problem in our profession that is drastically affecting the ability of healthcare organizations to recruit and most importantly-retain good nurses.

Commenr2

If I were to choose a professional journal to present my EBP project, I would choose the Journal of Autism and Developmental Disorders.  This journal is published monthly and focuses on all aspects of autism spectrum disorders and developmental disabilities that are related to autism.  I feel that presenting the information that I have gathered about the importance of improving communication among adults with ASD would be beneficial to those who would read this journal.  I feel that my topic would fall under the category of a review article that they state are solicited in target areas of interest (Journal of autism and developmental disorders, 2019). 

If I were to present my EBP project at a conference, I believe that the Navigating Autism Today conference sponsored by Autism Alliance of Michigan would be a good place to do this.  This is a conference for families as well as professionals.  Families get to attend for free so I feel there would be a better turnout due to that.  Presenting to a mixture of family and professionals I feel would be important because if those with ASD are taught from an early age how to use augmented alternative forms of communication like the AAC board then when they reach adulthood it would already be a part of their normal communication.  If they were to enter into a group home or attend a medical appointment as an adult and had already been using these alternative forms of communication since childhood, that would make life much easier on them and those taking care of them to know what their wants and needs were to reduce stress, anxiety, and behaviors.

 
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Comment 19219031

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#1:

 

Stakeholder support is necessary for a successful change proposal project implementation. Consider your internal stakeholders, such as the facility, unit or health care setting where the change process is situated, and your external stakeholders, like an individual or group outside the health care setting. Why is their support necessary to the success of your project, and how you will go about securing that support?

#2:

 

Technology is integral to successful implementation in many projects, through either support or integration or both. Name at least one technology that could improve the implementation process and the outcomes of your EBP project. Do you plan to use this technology? If not, what are the barriers that prevent its use?

 
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Comment 19219033

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#1:

 

After discussion with your mentor, name one financial aspect, one quality aspect, and one clinical aspect that need to be taken into account for developing the evidence-based practice project. Explain how your proposal will directly and indirectly impact each of the aspects.

#2: 

Now that you have completed a series of assignments that have led you into the active project planning and development stage for your project, briefly describe your proposed solution to address the problem, issue, suggestion, initiative, or educational need and how it has changed since you first envisioned it. What led to your current perspective and direction?

 
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Comment 2 18596875

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To some people, the link     between nursing and politics might seem tenuous to some people, but     to those who have put aside their stethoscopes for an office in     their state capitals, the relationship is a natural one. Nurses are     in the unique position of representing the interests of their fellow     nurses and the health care needs of the general public (Larson, J.,     2016). 

        Black was elected to     the House of Representatives in 2010 and represents     Tennessee’s 6th district, comprised of 19 counties across     middle Tennessee. She has been a nurse for more than 40 years and her  real-world experiences as a nurse have uniquely       positioned her as a credible and effective leader on health care       policy in Congress. She is focused on fully repealing the       president’s disastrous health care law and advancing true       market-based, patient-centered reforms that will bring down the       rising cost of care by increasing private sector competition and       consumer choice . Black serves as Chairman of the powerful House Budget     Committee and a member of the Ways and Means Committee.     (Blackhouse.gov). She is an advocate of Telehealth and has this to     say about its usefulness. “Telehealth focuses on     harnessing innovative technology to increase convenience for     patients and caregivers, enhance the quality of care and save both     patients and the Medicare program money. In Tennessee’s rural     communities, the wider offering of telehealth services means more     access to care,”. “For patients in suburban and     urban communities throughout the state, telehealth offers the     benefit of reducing the number of in-person visits to healthcare     providers. As a nurse, I am proud to advance this bill so that     Medicare Advantage plans can offer vital telehealth services as a     basic benefit, rather than a supplemental service for our     seniors.” (Press Release, 2017).

It was stated that, under current law, traditional Medical plans     may only cover telehealth services in an extremely limited set of     circumstances, such as when the beneficiary resides in a qualified     rural area and is physically present in a hospital or     physician’s office. The Increasing Telehealth Access to     Medicare Act starts reform with Medicare Advantage, where plans have     an incentive to ensure cost savings.  Estimates have calculated     that a telehealth consultation can save the Medicare program $45     versus an in-person visit (Press Release, 2017).

        She authored the bill on     “Increasing Telehealth Access to Medicare Act (H.R. 3727),     which was unanimously passed in the U.S. House Ways and Means     Committee.  This bill will increase access to     telehealth services for Medicare Advantage enrollees and allows     plans to build as a core part of their care model. This congressman     must be very influential for this bill which she presented to have     passed the house. It is very interesting to know that those with     medicare can now have access to telehealth all because of the     influence of this powerful nurse. With this development, more nurses     should be encouraged to join politics as they are better advocate     for the people.  

I NEED YOU TO COMMENT FROM THIS POST, 150 WORDS NEEDED AND A REFERENCE PLEASE

 
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