1-Article Analysis

1-Article #1

Kakkos, S. K., Caprini, J. A., Geroulakos, G., Nicolaides, A. N., Stansby, G., Reddy, D. J., & Ntouvas, I. (2016). Combined intermittent pneumatic leg compression and pharmacological prophylaxis for prevention of venous thromboembolism. Cochrane Database of Systematic Reviews, (9). Retrieved from https://core.ac.uk/download/pdf/144577522.pdf

The paper discusses the essence of the deployment of pharmacological prophylaxis in the prevention of venous thromboembolism within the context of the medical care environment. A significant weakness in the paper is the lack of a consensus on combined modalities to make the analysis wholesome.

Article #2

Calder, J. D., Freeman, R., Domeij-Arverud, E., van Dijk, C. N., & Ackermann, P. W. (2016). Meta-analysis and suggested guidelines for the prevention of venous thromboembolism (VTE) in the foot and ankle surgery. Knee Surgery, Sports Traumatology, Arthroscopy, 24(4), 1409-1420. Retrieved from https://link.springer.com/article/10.1007/s00167-015-3976-y

The article discusses various methods that prove relevant to prevent venous thromboembolism. The weakness is that it uses a substantial sample to achieve its objective that may not be helpful in this study. It does not necessarily explain the impact of thromboprophylaxis infection undergoing major orthopedic surgery compared to the lack of thromboprophylaxis in venous thromboembolism.

Article #3

Liew, N. C., Alemany, G. V., Angchaisuksiri, P., Bang, S. M., Choi, G., DE, D. S., … & Suviraj, J. (2017). Asian venous thromboembolism guidelines: updated recommendations for the prevention of venous thromboembolism. International angiology: a journal of the International Union of Angiology, 36(1), 1-20. Retrieved from https://europepmc.org/abstract/med/27606807

The paper explains various methods that prove relevant to prevent venous thromboembolism. An issue is the lack of a discussion of the impact of thromboprophylaxis infection undergoing major orthopedic surgery compared to the lack of thromboprophylaxis in venous thromboembolism.

Article #4

Büller, H. R., Bethune, C., Bhanot, S., Gailani, D., Monia, B. P., Raskob, G. E., … & Weitz, J. I. (2015). Factor XI antisense oligonucleotide for prevention of venous thrombosis. New England Journal of Medicine, 372(3), 232-240. Retrieved from https://www.nejm.org/doi/pdf/10.1056/NEJMoa1405760

The article explains the use of factor XI antisense oligonucleotide that proves relevant to prevent venous thromboembolism and shows that reducing levels of factor XI reduces VTE. On the contrary, it does not explain the impact of thromboprophylaxis infection undergoing major orthopedic surgery compared to the lack of thromboprophylaxis in venous thromboembolism.

Article #5

Kim, J. Y., Khavanin, N., Rambachan, A., McCarthy, R. J., Mlodinow, A. S., De Oliveria, G. S., … & Mahvi, D. M. (2015). Surgical duration and risk of venous thromboembolism. JAMA surgery, 150(2), 110-117. Retrieved from https://jamanetwork.com/journals/jamasurgery/fullarticle/1984239

The document explains various methods that prove relevant to prevent venous thromboembolism. It shows that the correlation between VTE and surgical intervention implies an increase in one increases the other. On the contrary, it fails to give a succinct explanation to the impact of thromboprophylaxis infection undergoing major orthopedic surgery compared to the lack of thromboprophylaxis in venous thromboembolism.

Article #6

Barber, E. L., & Clarke-Pearson, D. L. (2017). Prevention of venous thromboembolism in gynecologic oncology surgery. Gynecologic oncology, 144(2), 420-427. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5503672/

The article explains various methods that prove relevant to prevent venous thromboembolism. The paper majorly focuses on gynecologic oncology surgery as a way of giving the necessary recommendations from the perspective of the study. On the contrary, it fails to provide a succinct explanation for the impact of thromboprophylaxis infection undergoing major orthopedic surgery compared to the lack of thromboprophylaxis in venous thromboembolism.

 

 
 

2-Article 1

Jilani, S. M., Frey, M. T., Pepin, D., Jewell, T., Jordan, M., Miller, A. M., … Reefhuis, J. (2019). Evaluation of state-mandated reporting of Neonatal Abstinence Syndrome – six states, 2013-2017. MMWR: Morbidity & Mortality Weekly Report, 68(1), 6–10. https://doi-org.lopes.idm.oclc.org/10.15585/mmwr.mm6801a2

This article is a great resource of information for my project. It offers the information on severity of the problem new generation is facing as well as it offers insight on importance of trained staff. The weak part is, that only 6 states were chosen for the survey and does not provide the reason why those states were chosen and possibly creating a bias.

Article 2 

Suarez, M. A., Horton-Bierema, W., & Bodine, C. E. (2018). Challenges and resources available for mothers in opiate recovery: A qualitative study. Open Journal of Occupational Therapy (OJOT), 6(4), 1–8. https://doi-org.lopes.idm.oclc.org/10.15453/2168-6408.1483

This article offers insight on challenges mothers with newborn face and what their children go through. While the article is mostly about mothers and their feelings it supports the idea of improving community education about the importance of starting the treatment during pregnancy.

Article 3

Mahdavi Khaki, Z., AbbasZadeh, A., Rassoli, M., & Zayeri, F. (2015). Evaluation of nursing care associated with infants born to mothers with drugs abuse and its comparison with the standards in selected hospitals in Kerman 2013-2014. Journal of Medicine & Life, 8, 295. Retrieved from https://search-ebscohost-com.lopes.idm.oclc.org/login.aspx?direct=true&db=edb&AN=129161724&site=eds-live&scope=site

The strength of the article is in supporting evidence of quality nursing care of newborns and the importance of nursing proficiency leading to improved outcome. Another positive factor is that it shows the drug abuse is not prevalent only in the US but also in other countries of the world. The shortcoming was in specifying what tools the nurses used to evaluate the infants signs and symptoms of drug abuse.

Article 4

MacMullen, N. J., Dulski, L. A., & Blobaum, P. (2014). Evidence-based interventions for Neonatal Abstinence Syndrome. Pediatric Nursing, 40(4), 165–203. Retrieved from https://search-ebscohost-com.lopes.idm.oclc.org/login.aspx?direct=true&db=ccm&AN=103762898&site=eds-live&scope=site

This research article is somewhat weak support for my work, but supportive evidence of proper assessment and nursing intervention leads to improved outcome. It shows what kind of assessment and grading tool was used and how effective it was in the assessment of the abstinence syndrome.

Article 5

Cook, C. L., Dahms, S. K., & Meiers, S. J. (2017). Enhancing care for infants with neonatal abstinence syndrome: An evidence-based practice approach in a rural midwestern region. Worldviews on Evidence-Based Nursing, 14(5), 422–423. https://doi-org.lopes.idm.oclc.org/10.1111/wvn.12217

This article provides excellent support to prove that quality of education and introduction of the evidence-based practice will improve the recognition of the NAS, reporting and provide education to families. The authors offer ways to educate the staff and provide adequate resources for the staff to use as needed.

Article 6

Lucas, K., & Knobel, R. (2012). Implementing practice guidelines and education to improve the care of infants with Neonatal Abstinence Syndrome. Retrieved from http://ovidsp.dc2.ovid.com.lopes.idm.oclc.org/sp-3.33.0b/ovidweb.cgi?&S=CPIKFPHLBGEBAABJJPDKPHBHCKDLAA00&Link+Set=S.sh.22%7c7%7csl_10&Counter5=SS_view_found_article%7c00149525-201202000-00011%7cyrovft%7covftdb%7cyrovftm&Counter5Data=00149525-201202000-00011%7cyrovft%7covftdb%7cyrovftm

Approval of standardized assessment tool by nursing staff has proven to be effective for identifying and diagnosing the infants with NAS. It also shows how subjective assessment can lead to poor outcomes. The possible weakness of the article is in using only one assessment tool (Finnegan’s) not showing which tool is better.

 

3-Hi a, you have an interesting topic, but what I do not see the relevance of the articles and nursing related interventions. Since I do not know your picot, and I do not work in your field, I am wondering how that information will improve nursing care. I had to change my topic for the final project due to the same issue- it was more medical related than nursing. Can you elaborate more on how the above information is related to nursing? Lenka

 

 

 

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1-The Clinical Nurse Leader is a nurse with her masters and is prepared to practice across the continnum of care within any healthcare setting. The CNL was created by the American Association of College of Nursing (AACN) with the collaboration of health care leaders and educators to address the need to improve the quality of patient outcomes (AACN, 2018). The CNL can do a number of things including are coordination, outcome measurements, transitions of care, interprofessional communication and team leadership, risk assessment, implementation of best practices based on evidence, quality improvement.

Reference

Clinical Nurse Leader (CNL). (n.d.). Retrieved from https://www.aacnnursing.org/CNL

 

 

 
 

2-The American Association of Colleges of Nursing proposed the clinical nurse leader (CNL) role in 2007 as their response on how to manage the needs of an aging population and improve the nursing profession. When the CNL position was first proposed and implemented in 2008, candidates to be a CNL had to have a baccheluers degree with a minimum of two years nursing experience and be well respected by peers and physicians. They were expected to oversee units with 12-18 patients, perform daily rounds, serve as a resource for nurses, review patient outcomes, and teach change management and evidence based practice to nurses (Sotomayor, 2017).

In units where a CNL was present, there was shown to be a significant reduction in patient falls, CAUTIs, central line-associated infections, and hospital-acquired pressure ulcers (Sotomayor, 2017).

A CNL influences direct patient care by assessing how nursing care is currently being delivered and how it can be improved. They are responsible for educating nurses on their unit regarding how improvements can be made and also tracking how effective these changes are.

This role is not only reserved for inpatient units but can also be used for nursing positions out in the community to improve access to care and care coordination.

Reference:

Sotomayor, G. (2017). CNE SERIES. Clinical Nurse Leaders: Fulfilling the Promise of the Role. MEDSURG Nursing, 26(1), 21–32. Retrieved from https://search-ebscohost-com.lopes.idm.oclc.org/login.aspx?direct=true&db=ccm&AN=121353509&site=ehost-live&scope=site

 

 

3-Thank you for sharing your findings with the rest of the class. It was a great post. I actually have clinical nurse leaders at my facility and I find them to be extremely helpful, bot only to the nurses but the patients as well. They are familiar with policies and procedures and serve as a great resource when needed. As I new nurse I am always looking for a clinical nurse leader. My charge nurse is a great resource. She has made every mistake into a teachable moment and it has made transitioning into the nursing practice much smoother had she not been there. Thank you again for your post.

 

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1-Since prevention of post-operative infection on the operating room unit was my topic for my Capstone, it would be appropriate to present my findings to the Med-Surg nursing journal. Since a medical surgical unit was used for research, helping other surgical units prevent post-operative infection would be beneficial for patient safety. This is an environment where it is important to take every opportunity to interrupt the chain of infection.

A health care conference that would benefit from the research conducted by me through the Capstone project would be a medical-surgical nursing conference, a patient safety conference, or a nurse education conference. These would relate to the unit, relate to the specific topic and prevention, and lastly it would educate nurses on the importance of having the patient free from getting infections after any surgical procedure.

Reference

Lippincott® NursingCenter ®. (n.d.). Retrieved from https://www.nursingcenter.com/journalaccess?msclkid=

(n.d.). Retrieved from https://www.draeger.com/en_aunz/Hospital/Acute-Care-Insights/Infection-Prevention-Control/Operating-Room

 

 

2-The journal that I have chosen is a Journal of Gynecology and Neonatal Nursing. This Journal is a great opportunity for nurses to present their research in regards to nursing care in relation to women and their babies. This journal is a result of the Association of Women’s Health, Obstetric and Neonatal Nurses that work on the standardization of care for women and neonates. 

When it comes to conferences it is a little bit harder to choose the right one. Searching for the conference I have searched for the conferences this year and an I found one that is focusing on the Future of Health which involves technology. Technology is the new way to do education not only in schools but also in healthcare because it can reach more people at the same time. My project involves technology and improvement of training. 

https://www.awhonn.org/page/AWHONNJournals

https://events.cbinsights.com/future-of-health/paukwoth?utm_term=2019%20healthcare%20conference&utm_campaign=AdWords+Events&utm_source=adwords&utm_medium=ppc&hsa_tgt=kwd-774149708363&hsa_grp=72376815796&hsa_src=g&hsa_net=adwords&hsa_mt=e&hsa_ver=3&hsa_ad=358224184778&hsa_acc=5728918340&hsa_kw=2019%20healthcare%20conference&hsa_cam=1050181172&gclid=CjwKCAjw-ITqBRB7EiwAZ1c5U8zfC8HfdcFCmYhEgSIDN8WUy8ABYM77o6vDrdOo3auzu9XpYjlpQRoCc70QAvD_BwE

 

 

3-Hello professor and classmates, 

this has been a great experience and seeing myself to succeed at my age I have realized I can do a lot more from now on. The work can be more than just a paycheck and a day at work. The school gave me the confidence and motivation to do more and learn as well. After all, continuous education is a part of the nurse’s life.

 

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1-According to ahrq.gov website resource, the communication techniques play the most crucial part in disseminating message across the communication channels, and that active strategies are the most effective. Active strategies include posting information on the developer’s website, publishing in scientific publications, and searchable databases.

In my case, the results of my research will be available for all interested in our unit’s wall. My mentor is already interested in using it for her work to prepare educational materials for future in-service. I could also use the hospital website, or email, or could develop a presentation for the management.

To reach people externally, email would be the best method to reach educators in the community. Talking to pediatricians visiting the children with NAS, for example as well. I think the networking style is the best to reach the people interested in change and improvement.

Background and objectives for the systematic review. (2012) Retrieved from

https://effectivehealthcare.ahrq.gov/topics/medical-evidence-communication/research-protocol

 

 
 

2-The updated SBAR/ audit form that has been constructed has had good feedback thus far from rural hospitals as well as within my own organizations trauma program manger, director, risk management, forms committee, etc. There are many steps that have to be taken to implement such a tool especially since we will be handing it out to the community/ rural hospitals to utilize as well. If they follow our SBAR/audit tool and there is a poor outcome that could fall back on the organization so we must get approval by our trauma surgeons internally first. Externally it would be valuable to share with the Trauma Nursing Society and the American College of Surgeons which is who verifies our trauma center to review as well as they may have already implemented and seen such a form developed. I have already gotten some push back within my own organization but important to persevere and keep the ultimate goal on grounding EBP and utilizing it appropriately to improve communication and patient outcomes. Attached is a rough draft that is currently being edited by the trauma team and external resources. I am working closely with the trauma clinical nurse leader to make appropriate changes and ensure EBP guidelines for each of the rows.

 

Attached FilesUpdated SBAR.docx

 

 
 

3-I agree that communication is vital in the implementation process. Email is effective for the first initial contact; however I find implementation efforts to be more productive when face to face or skype meetings are initiated to have open discussions. Building trust and a foundational relationship is important. Electronic communications can save time, so can face-to-face meetings, particularly when trust needs to be established. It is difficult to communicate genuineness and a sense of being heard with digital communications, especially those that don’t occur visually and in real time. “But even video conferences limit the remarkable capacity we humans have to sense and feel and discern the other when we are fully present to each other,” says  Kevin Armstrong, Chief of Staff and Executive Vice President of Mission and Values at Indiana University Health.    

Health Management. (2018). Face to Face Communications. Retrieved from: https://healthmanagement.org/c/hospital/news/does-face-to-face-communication-always-work-best

 
 

 

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Develop a 3-4-page preliminary care coordination plan for an individual in your community with whom you choose to work. Identify and list available community resources for a safe and effective continuum of care.

NOTE: You are required to complete this assessment before Assessment 4.

The first step in any effective project or clinical patient encounter is planning. This assessment provides an opportunity for you to strengthen your understanding of how to plan and negotiate the coordination of care for an individual in your community as you consider the patient’s unique needs; the ethical, cultural, and physiological factors that affect care; and the critical resources available in your community that are the foundation of a safe plan for the continuum of care.

As you begin to prepare this assessment, you are encouraged to complete the Care Coordination Planning activity. Completion of this will provide useful practice, particularly for those of you who do not have care coordination experience in community settings. The information gained from completing this activity will help you succeed with the assessment. Completing formatives is also a way to demonstrate engagement.

Demonstration of Proficiency

By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

• Competency 1: Adapt care based on patient-centered and person-focused factors. 
  • Analyze a health concern and the associated best practices for health improvement.
• Competency 2: Collaborate with patients and family to achieve desired outcomes. 
  • Establish mutually agreed-upon health goals for a care coordination plan, in collaboration with the patient.
• Competency 3: Create a satisfying patient experience. 
  • Identify available community resources for a safe and effective continuum of care.
• Competency 6: Apply professional, scholarly communication strategies to lead patient-centered care. 
  • Write clearly and concisely in a logically coherent and appropriate form and style.

Preparation

Imagine that you are a staff nurse in a community care center. Your facility has always had a dedicated case management staff that coordinated the patient plan of care, but recently, there were budget cuts and the case management staff has been relocated to the inpatient setting. Care coordination is essential to the success of effectively managing patients in the community setting, so you have been asked by your nurse manager to take on the role of care coordination. You are a bit unsure of the process, but you know you will do a good job because, as a nurse, you are familiar with difficult tasks. As you take on this expanded role, you will need to plan effectively in addressing the specific health concerns of community residents.

As you assume your expanded care coordination role, you have been tasked with addressing the specific health concerns of a particular individual within the community. You decide to prepare a preliminary care coordination plan and proceed by identifying the patient’s three priorities for health and by investigating the resources available in your community for a safe and effective continuum of care.

To prepare for this assessment, you may wish to:

• Review the assessment instructions and scoring guide to ensure that you understand the work you will be asked to complete.
• Allow plenty of time to plan your patient clinical encounter.
• Be sure that you have a patient in mind that you can work with throughout the course.

Note: Remember that you can submit all, or a portion of, your draft plan to Smarthinking Tutoring for feedback, before you submit the final version for this assessment. If you plan on using this free service, be mindful of the turnaround time of 24–48 hours for receiving feedback.

Instructions

Note: You are required to complete this assessment before Assessment 4.

This assessment has two parts.

Part 1: Develop the Preliminary Care Coordination Plan

Complete the following:

• Identify a health concern as the focus of your care coordination plan. Possible health concerns may include, but are not limited to: 
  • Stroke.
  • Heart disease (high blood pressure, stroke, or heart failure).
  • Home safety.
  • Pulmonary disease (COPD or fibrotic lung disease).
  • Orthopedic concerns (hip replacement or knee replacement).
  • Cognitive impairment (Alzheimer’s disease or dementia).
  • Pain management.
  • Mental health.
  • Trauma.
• Identify available community resources for a safe and effective continuum of care.

Part 2: Secure Individual Participation in the Activity

Complete the following:

• Contact local individuals who may be open to an interview and a care coordination plan addressing their health concerns. The person you choose to work with may be a colleague, community member, friend, or family member.
• Meet with the individual to describe the care coordination plan session that you intend to provide. Collaborate with the participant in setting goals for the session, evaluating session outcomes, and suggesting possible revisions to the plan.
• Establish a tentative date and time for the care coordination plan session. Document the name of the individual and a single point of contact, either an e-mail address or a phone number.

Document Format and Length

For your care coordination plan, you may use the Care Coordination Plan Template [DOCX], choose a format used in your own organization, or choose a format you are familiar with that adequately serves your needs for this assessment.

• Your preliminary plan should be 3–4 pages in length. In a separate section of the plan, identify the person you have chosen to work with, and be sure to include his or her contact information.
• Document the community resources you have identified using the Community Resources Template [DOCX].

Supporting Evidence

Cite at least two credible sources from peer-reviewed journals or professional industry publications that support your preliminary plan.

Grading Requirements

The requirements, outlined below, correspond to the grading criteria in the Preliminary Care Coordination Plan Scoring Guide, so be sure to address each point. Read the performance-level descriptions for each criterion to see how your work will be assessed.

• Analyze your selected health concern and the associated best practices for health improvement. 
  • Cite supporting evidence for best practices.
  • Consider underlying assumptions and points of uncertainty in your analysis.
• Establish mutually agreed-upon health goals for the care coordination plan, in collaboration with the selected individual.
• Identify available community resources for a safe and effective continuum of care.
• Write clearly and concisely in a logically coherent and appropriate form and style. 
  • Write with a specific purpose with your patient in mind.
  • Adhere to scholarly and disciplinary writing standards and current APA formatting requirements.

Additional Requirements

Before submitting your assessment, proofread your preliminary care coordination plan and community resources list to minimize errors that could distract readers and make it more difficult for them to focus on the substance of your plan. Be sure to submit both documents.

CORE ELMS

Important note: The time you spend securing individual participation in this activity and the time you spend presenting your final care coordination plan to the patient in Assessment 4 must total at least three hours. Be sure to log your time in the CORE ELMS system. The CORE ELMS link is located in the courseroom navigation menu.

 

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