Re: Topic 5 DQ 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?

ANSWER BY ANNE
 

Technology Support/Integration That Can Improve EBP Project

In the Nelson presentation (2015), one of the research questions put forth was, “Can a centralized, telephone-based model of early childhood developmental screening and care coordination improve quality of care for young children and their families” (Nelson, 2015). There are 211 Call centers that cover over 90% of the US population. In a LA based 211 developmental screening, over 11,000 early childhood screenings and coordinated care have been coordinated with appropriate services. The 211 potential advantages include time availability, standardized and validated online screening tools, extensive resource directory that includes care coordination, data collection and dissemination, continuity of care, and coordination with clinical settings. Of the children screened over 90% received some kind of referral. As the presenter reported, the American Academy of Pediatrics recommends universal screening and surveillance at every well visit, screening at 9, 18, and 24-30 months, autism-specific screening tool at 18 and 24-30 months, and prompt referral to evaluation and intervention services. The impact of early screening and intervention has evidence pointing to the improvement in developmental, social, educational, and health outcomes. Society benefits with a pronounced ROI in every dollar invested (Nelson, 2015).

Plans for Use and Barriers to Implement

The idea of starting a similar resource would be fantastic. It is an idea that could potentially be integrated into the school district and county for which I work. The same barriers I see from making it happen are the same barriers that the article mentioned, and that is the 211 has limited documentation. The same concerns that plague us now are the same for 211 regarding lag time between referral and service implantation. Eligibility and participation in services are always the big hinderances to making this work, and of course the age-old question of who will pay for this service (Nelson, 2015).

Nelson, B. (2015). Clinical-community partnerships and 2-1-1 technology to improve early childhood

developmental screening and care. [PowerPoint slides]. Retrieved from 

http://www.publichealthsystems.org/sites/default/files/PHS4/PresBioProjInfo_Nov%2019_Nelson%20UC

LA.pdf

 

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Lewin’s Change Theory has three concepts that includes “driving forces,” “restraining forces,” and “equilibrium.” As the driving force implies, there are forces that push or cause things to change, shifting the equilibrium. Restraining forces fight against the driving forces which also causes shifts in equilibrium. Equilibrium can be described when no changes occur due to equal amount of force applied. There are three stages in his theory and that is “unfreezing,” “change,” and “refreezing.” Unfreezing is getting out of the rut of behaviors that are not healthy or productive. This requires fortitude to break out of the individual mindset and group conformity. This can be accomplished by either increasing the driving forces that direct behaviors away from the current norm or by decreasing the restraining forces that negatively affect movement away from equilibrium. A third alternative would be a combination of both. The change stage is producing growth and moving to a new level. It is evidenced by new thought, feeling and/or behavior changes. The refreezing stage is making the new patterns set as the new normal. Once they are “frozen,” it helps to prevent falling back into old unhealthy patterns (Change Theory, 2011).

Imogene King: Goal Attainment Theory has an emphasis on interaction theory vs systems theory. The concepts are based on an open system framework that honors nursing as a major system within the health care system, and places high emphasis on interpersonal processes. In the conceptual framework are three systems; the Personal (individual), Interpersonal (individuals interacting with each other) and the Social where groups of people in a community or society share common goals, interests, and values and is studied as a whole vs isolated parts. The practice of nursing is differentiated from other healthcare professions in that interpersonal systems are in place and this is reflected in the nurse-client relationship. The individual is viewed as a spiritual being, rational thinker, and records own history through own language, and expresses individual needs, wants, and goals. Humans have three fundamental needs: access to health information, illness prevention, care in times of illness. Health is dependent on continuous adjustment to stressors in the internal and external environments with use of ones resources to achieve maximum potential (Gragera, 2013).

Theory for EBP Project

The Goal Attainment Theory seems to be the best fit for the Capstone project. Results of screening and referrals develop into IHPs and IEPs that are tailored to the individual’s needs. This would seem to fit best with engaging the entire intraprofessional team in working with the student and the family in implementing interventions.

Theory Used by Mentor 

“I suppose I engage some level of nursing theory with each response in the work setting, protocol development, policy revision, and the like. When looking at the two theories you shared, I would probably most closely align myself with Imogene King’s Goal Attainment Theory. Nursing is a major system within the health care system, with vast and significant impact on individuals, families/groups, and communities (local, regional, national, and world)” (P. Anderson, personal communication, August 19, 2019).

“I’ve consistently landed on the historical (and I think still relevant) dimensions of health: physical, social, emotional, intellectual, spiritual. The individual, embracing, reflecting, and continuously balancing these five dimensions, can engage in self-responsibility and decision-making relative to the three fundamental needs identified in King’ theory:  health information, illness prevention, and care in times of illness ~ expressing needs, wants, and goals” (P. Anderson, personal communication, August 19, 2019).

Change Theory. (2011). Retrieved from http://currentnursing.com/nursing_theory/change_theory.html

Gragera, Jen. Imogene King: Goal Attainment Theory. (2013). Retrieved from https://www.slideshare.net/jen316/imogene-king-23548267

 

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Stakeholders help ensure the success of a change project. They can be an individual or group that is interested in or affected by the change. When stakeholders are involved in the change, they raise awareness in the community, and provide valuable insight (ORourke, Higuchi, and Hogg, 2016). Working with stakeholders from the beginning of the project allows for their input and expertise on what the goals should be. When stakeholders are engaged, change is easier, and the plan is often better developed (Ginex, 2018).

     The proposed change project will require several stakeholders. Internal stakeholders for postpartum hemorrhage bundle will include: administration, department manager, doctors, nurses, midwives, lab, surgery, house supervisor, and anesthesia. The external stakeholders will include administration at the corporate level of SCL-Health, the quality department, and possibly the legal team.

     For us to successfully overhaul how we provide care to postpartum patients, we will need the support from all the stakeholders. OR and anesthesia are important stakeholders, because they can identify possible problems with staffing, and OR space during hemorrhage management. Providers, both MD and midwives, are important because they will need to agree on the best first-line medications and cutoffs for implementing the protocol. They must be prepared to be called back to the bedside more often if there is a concern about blood loss and change their practice from estimated blood loss, to quantified blood loss. The lab is also an important stakeholder; we are a small hospital, so they can help assess what blood products are available at any given time and how long it takes to prepare each blood product. The house supervisor is also important because they coordinate the departments and serve as an extra set of hands. We will need the support of external stakeholders, such as the administration team from SCL-Health to ensure we have both the financial and physical resources needed to implement the change. We also must ensure that we are meeting the requirements for quality and patient safety.

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We plan to provide data to the various stakeholders, so they are aware of the importance of this project. We will provide national statistics, but even more importantly, we will provide them with internal statistics on postpartum hemorrhage cases. Additionally, we will provide education opportunities to help providers gain sills and knowledge necessary to provide better care to our delivering moms.

References

Ginex, P. K. (2018). Overcome barriers to applying an evidence-based process for practice 

change. ONS Voice, 33(5), 62. Retrieved from https://search-ebscohost-

com.lopes.idm.oclc.org/login.aspx?direct=true&db=ccm&AN=131514683&site=eds-

live&scope=site

O’Rourke, T., Higuchi, K. S., & Hogg, W. (2016). Stakeholder participation in system 

change: A new conceptual model. Worldviews on Evidence-Based Nursing, 13(4), 261–

269. doi:10.1111/wvn.12165

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• Discussion Question
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//appNavObj.setWindowTitle(“???<tiles:getAsString name=’title’></tiles:getAsString>???”); appNavObj.setWindowTitle((“Thread View”)+” | LCS Learning Platform”);  

Last Accessed

You are being taken to what you last accessed in your Path

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Don’t show this message again      jQuery(document).ready(function(){ appNavObj.appendSubmenu(“courseLCSSubmenu”); jQuery(“#lastAccesed”).click(function(){ jQuery(“#lastAccesedPopup”).hide(); }); });  

• Path
• Content
• Objectives

//appNavObj.setWindowTitle(“???<tiles:getAsString name=’title’></tiles:getAsString>???”); appNavObj.setWindowTitle((“Course Outline IU View”)+” | LCS Learning Platform”);  Back To TopBack To Top #myLinkBoxDiv{bottom: 34px;}  var currentTime = new Date(2019,08,27,20,48,45);    // width and height of the online chat popup   function updateClock ( ) {   //alert(‘currentTime in function  = ‘+currentTime);   var currentHours = currentTime.getHours ( );   var currentMinutes = currentTime.getMinutes ( );   var currentSeconds = currentTime.getSeconds ( );    // Pad the minutes and seconds with leading zeros, if required   currentMinutes = ( currentMinutes < 10 ? “0” : “” ) + currentMinutes;   currentSeconds = ( currentSeconds < 10 ? “0” : “” ) + currentSeconds;    // Choose either “AM” or “PM” as appropriate   var timeOfDay = ( currentHours < 12 ) ? “AM” : “PM”;    // Convert the hours component to 12-hour format if needed   currentHours = ( currentHours > 12 ) ? currentHours – 12 : currentHours;    // Convert an hours component of “0” to “12”   currentHours = ( currentHours == 0 ) ? 12 : currentHours;    // Compose the string for display   var currentTimeString = currentHours + “:” + currentMinutes + “:” + currentSeconds + ” ” + timeOfDay;      var timeZone=’Mountain Standard Time’;   // Update the time display   if(document.getElementById(“clock”) != null){   document.getElementById(“clock”).firstChild.nodeValue = currentTimeString;   document.getElementById(“clock”).firstChild.nodeValue =document.getElementById(“clock”).firstChild.nodeValue+” “+timeZone;   //currentTime.setFullYear((currentTime.getYear()+1900),currentTime.getMonth(),currentTime.getDate(),currentTime.getHours(),currentTime.getMinutes(),(currentTime.getSeconds()+1));+   currentTime = new Date (currentTime.getTime()+1000);   }      }  // –>    var techSupportOn=false; var privacyPolicyOn=false;   var isOverIFrame = false;  function processMouseOut()  { isOverIFrame = false; }  function processMouseOver()  { isOverIFrame = true; top.focus(); }  function processIFrameClick()  { if(isOverIFrame)  { if(techSupportOn) {   jQuery(“#techBoxDiv”).slideUp(); jQuery(“#techBoxDiv”).css({“visibility”:”hidden”}); techSupportOn=false; } if(privacyPolicyOn) {    jQuery(“#popup3”).hide();  jQuery(“#popup3”).css({“visibility”:”hidden”}); jQuery(“#popupBg3”).css({“display”:”none”}); privacyPolicyOn=false; } jQuery(“.dropdown dd ul”).hide(); } }  function init()  { var element = jQuery(“iframe”); for (var i=0; i<element.length; i++)  { jQuery(element[i]).hover(function(e){ processMouseOver(); }, function(e){ processMouseOut(); }); } jQuery(top).blur(function(){ processIFrameClick(); });  }  //Get unread email count from Office 365 or GMail  function updateUnreadMailCount(){ var unreadMailCountURL=’https://login.microsoftonline.com/’; if(unreadMailCountURL!=””){ jQuery(“#emailLink”).val(‘https://login.microsoftonline.com/’); } }  function openEmailLink(){ window.open(jQuery(“#emailLink”).val(), ‘_blank’); } jQuery(document).ready(function(e)  { jQuery(‘.lc_techSupportInfoWrap a’).hover( function() { jQuery(this).closest(‘.lc_techSupportInfoWrap’).find(‘.lc_techSupportInfo’).show(); }, function() { jQuery(this).closest(‘.lc_techSupportInfoWrap’).find(‘.lc_techSupportInfo’).hide(); } ) jQuery(“#footerEmailBx”).click(function(){ openEmailLink(); }); if(navigator.platform == ‘iPad’ || navigator.platform == ‘iPhone’ || navigator.platform == ‘iPod’){ //jQuery(“.footer”).css(“position”, “static”); };   jQuery(‘#popup3’).bind(“click”, function(e)  {  e.stopPropagation();   }); jQuery(‘#popupBg3’).bind(“click”, function(e)  {  e.stopPropagation();   }); jQuery(‘#techBoxDiv’).bind(“click”, function(e)   {  e.stopPropagation();   });   jQuery(‘#okButtonFooter’).bind(“click”, function() { jQuery(“#popup3”).hide(); jQuery(“#popupBg4”).css({“display”:”none”}); });  jQuery(“#popupClose3”).click(function() { jQuery(“#popup3”).hide(); jQuery(“#popupBg4”).css({“display”:”none”}); privacyPolicyOn=false; jQuery(“#privacyLink”).focus(); }); jQuery(‘#closeBtn1Lnk3’).bind(“click”, function(){ jQuery(“#techBoxDiv”).slideUp(); jQuery(“#techBoxDiv”).css({“visibility”:”hidden”}); techSupportOn=false; });  jQuery(‘#helpLink’).bind(“click”, function()  { window.open(‘http://support.loudcloudsystems.com’); });  updateClock(); setInterval(‘updateClock()’, 1000 ); appNavObj.updateEmailNotification(‘1’); jQuery(“#popupClose4, #okButtn2”).click(function() { jQuery(“#popup4”).hide(); jQuery(“#popupBg4”).hide(); }); jQuery(“#popupClose2”).click(function() { jQuery(“#popup2”).hide(); jQuery(“#popupBg2”).hide(); jQuery(“#techLink”).focus(); });  jQuery(“#clearCookie”).click(function(){ jQuery.cookie(“JSESSIONID”, null,{ path: ‘/learningPlatform’}); jQuery.cookie(“JSESSIONID”, null,{ path: ‘/lcsAnalytics’}); jQuery.cookie(“moduleName”, null,{ path: ‘/’}); jQuery.cookie(“loudbooksHelpShown”, null,{ path: ‘/learningPlatform’}); alert(“All cookies have been cleared from this browser.”); });  jQuery(“#closeTechSupportPopup”).click(function(){ if( jQuery(‘.techPopupdv’).is(‘:visible’) ) { jQuery(‘.sysTnfoDv’).click(); } jQuery(“#popup2”).hide(); jQuery(“#popupBg2”).hide(); jQuery(“#techLink”).focus(); });  jQuery(‘.techPopupdv’).hide(); jQuery(‘.sysTnfoDv’).click(function(){ jQuery(‘.techPopupdv’).toggle(); jQuery(this).toggleClass(‘sysTnfoDv2nd’) }); jQuery(‘.sysTnfoDv’).toggle( function() { jQuery(this).html(‘<a href=”javascript:void(0);” style=”color:inherit;text-decoration:none;”>Hide System Information</a><span class=”techUpArow”></span>’); }, function() { jQuery(this).html(‘<a href=”javascript:void(0);” style=”color:inherit;text-decoration:none;”>Show System Information</a><span class=”techDownArow”></span>’); });     var browserInfo = jQuery.client.profile(); jQuery(“#os”).find(“dd:last”).html(browserInfo.platform); jQuery(“#browserVersion”).find(“dd:last”).html(browserInfo.name+” “+browserInfo.version); jQuery.cookie(“checkCookieEnabled”, “true”,{ path: ‘/learningPlatform’}); if (jQuery.cookie(“checkCookieEnabled”)) { jQuery(“#cookiesEnabled”).html(“Yes”); } else { jQuery(“#cookiesEnabled”).html(“No”); }   jQuery.cookie(“checkCookieEnabled”, null,{ path: ‘/learningPlatform’}); jQuery(“#serverInstance”).find(“dd:last”).html(“plmuwbvs2303”); var techSupportEmail = “mailto:[email protected]?subject=Contact GCU Technical Support&body=Hi,%0A%0AWe have collected your system information in the body of this e-mail so that we can provide a better and fast solution to your issue. It would also be helpful for our support team if you include your Name, College Name, Instructor name and assigned class name if possible. %0A%0AEnvironment%20Details:%20%0A%0AOperating%20System:%20″+browserInfo.platform+”%0A%0ABrowser:%20″+browserInfo.name

 

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See attached DQ to be answered. Attached are previous weeks discussed.

Due 16 Feb

250 word min.

 

"Looking for a Similar Assignment? Get Expert Help at an Amazing Discount!"

Answer both of the following discussion questions for your discussion response. 

1. Discuss the epidemiology of thalassemia and share evidence-based practice guidelines necessary for chronic management.
2. Sickle-cell anemia has treatment parameters in the chronic state and acute exacerbation. The acute phase requires aggressive hydration and pain medication. What is the physiologic pattern for this problem?

at least 250 words. with reference no older than 5 years and intext citation.

 

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