Evidence-based practice is essential to providing safe, quality care to a diverse population in the acute care setting as well as in the community. Understanding the health care system at the local level is essential to consider when planning the implementation of evidence-based practice (EBP) because it helps those implementing changes understand and execute the move in an area of greatest need. Franklin and Hopson (2007) write that implementing evidence-based practice change in the community setting is challenging. Interventions that work in research or acute care setting are often very challenging to implement locally in the community setting due to the struggle with “building partnerships between clinical practitioners and researchers” (Franklin & Hopson, 2007, p. 379). Maintaining the effectiveness and reliability of interventions once moved to the community setting is difficult thus careful attention to the specific needs of the local community health care system is imperative (Franklin & Hopson, 2007).

Information from my course mentor that I will consider for my project is to ensure that I am following the hospital’s shared governance model to allow other nurses on the unit to have a voice in the project change (T. Brock, personal communication, August 20, 2019). The hospital where I am implementing my project change is a Magnet culture and uses a shared governance model when considering implementation of evidence-based practice change. My practice change does not only affect me, so it is imperative to share accountability and partnership with my unit manager, peers, and unit-based council members when implementing a project change on the unit for effective outcomes (T. Brock, personal communication, August 20, 2019).

Reference

Franklin, C., & Hopson, L. M. (2007). Facilitating the use of evidence-based practice in 

community organizations. Journal of Social Work Education, (3), 377-404. Retrieved 

from https://search-ebscohost-com.lopes.idm.oclc.org/login.aspx?

direct=true&db=edsgao&AN=edsgcl.170506618&site=eds-live&scope=site

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How has nursing practice evolved over time? Discuss the key leaders and historical events that have influenced the advancement of nursing, nursing education, and nursing roles that are now part of the contemporary nursing profession Discussion question responses required two references & one must be a peer reviewed article. Also responses need to be 150-200 words.

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Central line associated blood stream infection (CLABSI) is a major contributor to in-hospital morbidity and mortality and is linked with increased expenditure and length of intensive care unit (ICU) stay. The incidence of CLABSI is more in the ICUs due to emergency catheter placement, longer duration and repeated manipulation for sampling, administration of drugs and fluids, the additional confounding factors being chronic illness, old age, sepsis and immunosuppression (Atilla et al., 2016). My proposed solution of addressing this problem is nursing and patient education. Among the health care workers, nurses have the most direct and continuous role in handling CVCs, being involved with both insertion assistance and maintenance of central lines. Thus, they have a unique opportunity to contribute towards preventing these infections.Bedside nurses have the responsibility to implement the right interventions to prevent them. Appropriate training and education in central line management can go a long way in preventing this problem. Nurses are in a unique position to prevent CLABSIs across the health care spectrum. It would not be an overstretch to say that CLABSI prevention is completely a nursing responsibility. Let us consider the current health care scenario: the nursing scope of practice has increased vastly over the past decade and our profession continues to gain significance (Atilla et al., 2016).Educating the patients and families on the best practices of central line care and infection prevention is the responsibility of nursing staff. Making patients and caregivers partners in therapy by creating educational materials in simple language will help motivate adult learners to assimilate the knowledge (Patel et al., 2019). An interactive nurse-led demonstration accompanied by an illustrated guide to best practices of central line management ensure compliance to strict infection prevention practices. Again, this responsibility of educating patients falls on nurses, and patient education is a powerful tool to prevent CLABSIs (Patel et al., 2019). My current perspective was attributed by the fact that education empowers the patient and gives them ownership of their own care and condition.ReferencesAtilla, A., Doğanay, Z., Çelik, H. K., Tomak, L., Günal, Ö., & Kılıç, S. S. (2016). Central line-associated bloodstream infections in the intensive care unit: importance of the care bundle. Korean journal of anesthesiology, 69(6), 599.Patel, P. K., Olmsted, R. N., Hung, L., Popovich, K. J., Meddings, J., Jones, K., … & Chopra, V. (2019). A Tiered Approach for Preventing Central Line–Associated Bloodstream Infection. Annals of Internal Medicine, 171(7_Supplement), 

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In developing the evidenced based project to improve/increase formal workplace violence reporting utilizing the current “RL Solutions” software, there are several aspects of implementation that will affect the impact of the delivery and success of the plan. The first aspect to consider is the financial impact that the project will have on the organization. The plan entails a unit-based educational piece detailing: What constitutes workplace violence? and how to navigate RL solutions to document violent events, Education will also include the importance and impact of formal documentation, as well as what support processes to anticipate as follow-up to incident reporting. Educational material will be nominal, including a three-fold poster board and small fliers in strategic high nursing traffic areas. It will involve several in-services 10-15 minutes in length, provided by project leader to reach all staff. The larger impact to violence in the workplace is astounding. A 2017 report prepared for the American Hospital Association estimated that workplace violence costs U.S. hospital and health systems $2.7 billion in 2016, including $280 million related to preparedness and prevention, $852 million in unreimbursed medical care for victims, $1.1 billion in security and training costs and an additional $429 million in medical care, staffing, indemnity and other costs related to violence against hospital employees. (ashclinicalnews.org)Other costly aspects associated with WPV are lost wages, legal expenses, workman’s comp claims, diminished public image and employee turn-over expenses. The U.S.Department of Labor, estimates the cost to replace an employee due to workplace violence is approximately two-thirds to twice the annual salary of the employee being replaced.( www.osha.gov)Clinically, the impact of workplace violence leads healthcare workers to commit a greater number of medical errors which correlates with poorer patient outcomes. Also. Healthcare workers who must must take time off work to manage physical or psychological impact of violence put a strain on staffing availability. “Healthcare workers who were victims of violence experienced an average of 112.8 hours her year of sick, disability” (ashclinicalnew.org) which is a little more than twice that of those who did not experience workplace violence. Poor Staffing ratios due to lost staffing availability also stand to impact patient outcomes. The aspect of quality of care is also affected by episodes of workplace violence. A study published in 2001 by Judith Arnetz and Bengt Arnetz, “suggest that the violence experienced by healthcare staff is associated with lower patient ratings of the quality of care.”Additionally, workplace violent incidents contribute to decreased job interest, productivity and confidence, which directly impact the delivery of quality service to the patient. The RL solutions system is already in place, therefor there is no added cost required to design a program from the ground up. The project simply intends to increase the utilization of the current reporting system. Increased reporting will allow the organization to collect and analyze data that can assist the employer with developing prevention and intervention strategies to ultimately reduce workplace violence against workers and the physical and psychological impact victims suffer. It will also help to reduce the deleterious financial consequences associated workplace violence.  Arnetz, J.,& Arnetz, B., (Feb. 2001). Violence Toward Healthcare Staff and Possible effects on the Quality of Patient Care. Social Science and Medicare. Vol.52 Issue 3Beck, D., (Dec. 2018). Hazardous to Your Health: Violence in the Health-Care Workplace. ASH Clinical News. Retreived on Nov. 18, 2019, from https://www.ashclinicalnews.org/features/hazardous-health-violence-health-care-workplace/Hartley, D., Ridenour, M., Craine, J., & Morrill, A. (2015). Workplace violence prevention for nurses on-line course: Program development. Work (Reading, Mass.), 51(1), 79–89. doi:10.3233/WOR-141891Nowrouzi-Kia, B., (2017). The Impact of Workplace Violence on Health Care Workers’ Quality of Life. Developmental Medicine & amp; child Neurology. Vol. 59. Issue 7

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Transcultural Perspective in Childbearing

Read chapter 5 of the class textbook and review the attached PowerPoint presentation.  Once done answer the following questions;

1.  Analyzed how culture influences the beliefs and behaviors of the childbearing woman and her family during pregnancy.
2. During an outpatient contraception teaching session for a diaphragm, Sita, a Hindu woman states that she cannot use her left hand for handling the clean device.
3.  What are the health beliefs that underpin Sita’s hesitation and why?
4.   How can the nurse offer support to Sita’s based on Leininger’s theory?

As stated in the syllabus present your assignment in an APA format word document, Arial 12 font attached to the forum in the discussion tab of the blackboard titled “Week 5 discussion questions”. Also, the assignment must be posted in Turnitin and in the assignment tab of the blackboard titled “Week 5 APA”.  A minimum of 2 references (excluding the class textbook.  Two replies to any of your peers sustained with the proper references are required and the references must be quoted in the assignment and the replies.  A minimum of 700 words is required. Make sure you use spell-check or Grammarly before you post your assignment.  I’ve been seeing many spelling/grammars errors in the assignments.  

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