Marcia Stapleton    4 posts   Re: Topic 7 DQ 1  The OB Committee at the hospital will be an internal method for the dissemination of my EBP project.This committee is comprised of 10 people which include OB providers, nursing administration, medical administration, anesthesia, clinic staff and nursing staff. Their monthly meetings are focused on OB issues, policies, education and process changes.The project has already been presented to them and the providers are in the process of reviewing the order set with the other OB providers and adding their recommendations for changes.Before implementation, the order set must be approved by this committee.Communication with this committee happens by getting on the agenda for the meeting and presenting the process change.Results will be communicated as the process is implemented with feedback requested from the providers and nursing that are involved in the implementation.This group of OB hospital leaders are key for the implementation and dissemination of the EBP project.The successful implementation and maintenance of EBP in an organization is complex and multifaceted.Communication with these leaders needs to be over time and at multiple levels (Stetler, Ritchie, Rycroft-Malone, & Charns, 2014).  An external method for the dissemination of my EBP project is Allina’s Excellian electronic healthrecord, which is a branch of Epic.The final version of the order set needs to be submitted for change to Excellian.This is important because we as a hospital cannot change our own order sets, it must be change through our EMR.Communication with this group will all be done electronically.Once the final revision is made, there is an electronic process to go through to revise the order set.This electronic process is important as each order is dependent on the patient presentation, so there needs to be much detailed work in lining up the orders with the presentation, so when you click on the patient presentation, the orders needed for that presentation are also selected.Results need to be communicated with Excellian for any adjustments needing to be made as the process is implemented.  Reference  Stetler, C. B., Ritchie, J. A., Rycroft-Malone, J., & Charns, M. P. (2014). Leadership for evidence-based practice:  Strategic and functional behaviors for institutionalizing EBP. Worldviews on Evidence-Based Nursing, 11(4),  219–226. https://doi-org.lopes.idm.oclc.org/10.1111/wvn.12044

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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

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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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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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