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 19246141
/in Uncategorized /by developer150-180 words APA format with references and in-text citations.
Within the healthcare field we as nurses and future practitioners are faced daily with changes in our field. Whether it be current trends in healthcare, changes within our organizations or laws we embrace the changes to aid in the improvement of quality of care for the patients. Along with changes we are also faced with the many stressors that occur within our practice of work. Many stressors can occur such as issues with nurse patient ratios, healthcare breaches, and most importantly nursing shortages. The main stressor here I would like to focus on is nursing shortages with increased workloads. Retention is a key topic when addressing nursing shortage. According to Laureate Education, issues within healthcare will become more and more of a challenge for healthcare workers, therefore it is imperative to be able to adapt to the stressors (Laureate Education, 2015).
My organization is a non-profit healthcare facility. Located in Norfolk, VA we are a Level one trauma center as well as Magnet recognized organization. Working in such a facility in the heart of our community, we are faced with many challenging work shifts, difficulty workloads and most importantly a nursing shortage. I have seen in my organization units working understaffed, nursing managers and other members of leadership forced into staffing to take on patient assignments to not place the entire burden on bedside nurses. The assignments are heavier at times, the patients are a lot sicker and we seem to feel that we don’t have enough help in certain areas to properly treat our high acuity workloads. These types of issues place major stresses on staff members. Everyone becomes overwhelmed, displayed angers amongst staff, longer working hours, while feeling unappreciated at times. Over the years the nursing shortage has been a huge issue with some of the factors being lack of properly trained educators, an abundance of turnover rates as well as challenging workloads (Haddad & Tony-Butler, 2019).
Addressing Issues within Organizations
For such current issues within my organization, being in a leadership role I have seen the forefront of all that is being done to address our nursing shortage. For instance, we hold daily meetings that incorporate our staffing support services. This allows all members in our organization at the leadership level the insight on what extra staff help we have for the next few shifts. This allows everyone to critical think and plan ahead about areas where shortages may be occurring to plan for coverage of the gaps. Another area of tackling staffing issues within my organization has been incentive pay. Staffs are offered “call pay” which is extra pay for working extra shifts. Staff will be paid double pay for providing their time with covering staff shortages on certain units. This has allowed nurses to pick up extra hours to cover shortages decrease intense workloads, as well as offering a pay incentive. My organization has also extended contracts to travel nurses to work different assignments ranging 10-13 weeks. Having these nurses come in also works because those units critically short are offered help from a nurse assigned to them and only them for this period of time. Now although this is a temporary fix, we have had some of these nurses become our own staff nurses which increases our staffing. With nursing shortages in our organization, it has been more common for staff to adjust and work with what they have. The Affordable Care Act (ACA) has made various ways to implement measures within healthcare to support the many struggles faced in this field, therefore allowing organizations to change delivery systems for improvement of patient care (Pittman & Scully-Russ, 2016). Although we still may seem to not see much change happening, many organizations such as my own are working hard to support their team members.
References
Haddad LM, Toney-Butler TJ. Nursing Shortage. [Updated 2019 Jan 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK493175/
Laureate Education (Producer). (2015). Leading in Healthcare Organizations of the Future [Video file]. Baltimore, MD: Author.
Pittman, P., & Scully-Russ, E. (2016). Workforce planning and development in times of delivery system transformation. Human Resources for Health, 14, 1–15. https://doi-org.ezp.waldenulibrary.org/10.1186/s12960-016-0154-3
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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 To Pain 180 200 Words Apa
/in Uncategorized /by developerTHIS IS A DISCUSSION RESPONSE NO MORE THAN 200 WORDS IN-TEXT CITATIONS APA STYLE.
Pain is referred to as an emotional or sensory response of the body to both impending and real damage to its tissues. Pain has different manifestations associated with the injuries to tissues, for example, hyperalgesia, which is an overstated noxious stimulus-response. Once an injury occurs, nerve cell endings called nociceptors, respond to the unpleasant stimuli by conveying the rapid and urgent signal that something is wrong. This message triggers a nociception process, in which chemicals are released and in turns increases the pain signal (Huether & McCance, 2017). During, chronic pain spontaneous, Allodynia, or hyperalgesia occur from alterations in the central or peripheral nervous systems (Huether & McCance, 2017). Referred or visceral pain is pain perceived in an area other than that in which the noxious stimulation takes place that is often perceived in somatic nerve and spinal nerve root distribution (Huether & McCance, 2017).
Differences and Similarities between Acute, Referred, and Chronic Pain
Acute pain is immediate pain resulting from mishaps or physical trauma. Acute pain acts as an alert to indicate to the affected person that there is damage to the body somewhere. Chronic pain is long-term and enduring in nature. The pain, therefore, persists even after healing of the affected tissues. Therefore, unlike acute pain which warns of damage, the chronic pain does not pass any significant message. On the other hand, referred pain affects a tissue which is not its actual source (Alzheimer’s Association, 2016). Therefore, unlike the acute and chronic pain, one may not tell which tissues are being or already damaged. The similarities between these types of pain are the fact that they cause discomforts which can translate into physiological effects. These pains can be to some extent be alleviated with some form of pain relievers.
Behavior and Gender in Relation to Pain
Gender is one factor that plays a role in the treatment for acute, chronic and referred pain. Women report more frequent, severe and persistent pain levels when compared to men (Alzheimer’s Association, 2016). Women are more likely to experience pain during childbirth and mensuration. Therefore, this will have an impact on the diagnosis and treatment of pain since women are better at describing the sensation. On the other hand, behaviors like usage or drugs like heroin, tobacco, and even alcohol consumption may tamper with the pain sensors; hence a reduced awareness of pain, therefore, interferes with the diagnosis and even treatment (McPhee & Hammer, 2019).
The pain sensation is a usual bodily response to disease or even injuries which result from processes in the nociceptive system. Pain has a crucial protective function biologically, with complex phases, and can be affected by gender and behavior.
References
Alzheimer’s Association. (2016). Help end Alzheimer’s. Retrieved, from http://www.alz.org/
Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (Laureate custom ed.). St. Louis, MO: Mosby.
McPhee, S. J., & Hammer, G. D. (2019). Pathophysiology of disease: An introduction to clinical
medicine (Laureate Education, Inc., custom ed.). New York, NY: McGraw-Hill Medical
(n.d.). Acute Pain vs. Chronic Pain. Retrieved from https://my.clevelandclinic.org/health/articles/12051-acute-vs-chronic-pain
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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 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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Discussion Root Cause Analysis
/in Uncategorized /by developerReview the case scenario included in this week’s media resources, and examine the process flow chart, cause/effect diagram, and Pareto chart related to the case scenario.
In the scenario, the nurse manager and the director of pharmacy blame each other for the error. The facilitator (quality assurance person) asks everyone to avoid blaming and focus on applying the tools to analyze the data and get to the root cause of the error. While all of these tools contribute, for this Discussion, select one tool to analyze.
By Day 3
Post each of the following:
Support your response with references from the professional nursing literature. Your posts need to be written at the capstone level (see checklist)
Notes Initial Post: This should be a 3-paragraph (at least 350 words) response. Be sure to use evidence from the readings and include in-text citations. Utilize essay-level writing practice and skills, including the use of transitional material and organizational frames. Avoid quotes; paraphrase to incorporate evidence into your own writing. A reference list is required. Use the most current evidence (usually ≤ 5 years old). (Refer to AWE Checklist, Capstone)
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