Lincoln, Ch. 5 & 6Ch. 5.Disparities in healthDid the statistics surprise you? Who are the people in your patient/client population? Do they reflect the statistics? What questions do you need to ask

Lincoln, Ch. 5 & 6

Ch. 5.

Disparities in health

1. Did the statistics surprise you?
2. Who are the people in your patient/client population?
3. Do they reflect the statistics?
4. What questions do you need to ask during an assessment?

Trust & Mistrust

1. Have you ever been in a situation with a HCP where trust was an issue?
2. Think of your patients and their histories, are there issues of trust?
3. In what way could you initiate a dialogue about trust and treatment?

Thoughts on previous experience

1. Think about a positive encounter with someone different from yourself- what aspects made it that way?
2. A negative encounter, what do you think made it that way?
3. What would you do differently?

From the patient’s perspective

1. How easy is it for your patients to “navigate” through your facility?
2. Are you familiar with the cultural beliefs and healthcare practices of your patients?
3. Are there flexible clinic appointments at your facility?
4. Is transportation readily available to your patients?
5. What would you change at your facility to improve access to resources?

Education

1. Have you had the opportunity to discuss influences of history, past and current, on healthcare decisions?
2. Does your institution provide educational seminars on the cultural characteristics of ethnic and cultural groups?
3. Are there discussions that help you understand the ways in which language and culture may influence healthcare behaviors and practices?
4. If so, what are you and your institution doing to narrow and eventually eliminate those disparities?

Research

1. Think about your patient population, where do you see healthcare disperities?
2. If given the opportunity to discover way to eliminate disparities where would your research be focused?
3. How would you disseminate your finding?
4. How would you design your program?
5. How would you orient it to educate both patients and HCPs?

Ch. 6.

Thinking outside of the box

1. In what ways can we increase access to care?
2. Are our hours of operation meeting the needs of our patient/patient population?
3. Have our interpreters received medical and cultural training?
4. Do we involve the community in our decision-making process?
5. Does our educational material meet the learning needs of our patients?
6. Does our staff reflect the diversity of our patient population?

Health insurance

1. Have you ever gone without health insurance?
2. What was your greatest concern or fear during that time?
3. Think about your patient population, what percent are uninsured?
4. What resources are in place within your organization to meet these needs?

Language

1. Have you ever been traveling in a foreign country, gotten sick and sought medical care?
2. How did you get your message across to the HCP in that situation?
3. What is the predominate language of your patients spoken at your site?
4. Do you speak another language? If not, which one would you like to learn?
5. Is there a translator class offered by your organization?
6. What percentage of HCPs is bilingual and bicultural?

Education and Literacy

1. What is the literacy level of our patient population?
2. Does our education material match the literacy level of our patients?
3. How do you encode and take in information?

Summary: The purpose of the weekly reflective journal exercises is to allow for analysis, synthesis and evaluation of nursing theory using guided questions. Reflection has been referred to as a process that happens internally, privately or in isolation (Hill & Watson, 2011).  Also a useful definition of reflection has been referred to as the examination of an issue of concern, as a consequence of experience, creating clarity and meaning in terms of self, and which results in a change of perspective ( Boyd & Fales, 1983).

Focus on the successful exceptions (i.e., positive deviants), not the failing norm.—Pascale, Sternin, & Sternin, 2010Positive deviants—those who are able to innovate and create affirmative results

Focus on the successful exceptions (i.e., positive deviants), not the failing norm.

—Pascale, Sternin, & Sternin, 2010

Positive deviants—those who are able to innovate and create affirmative results—do so within the same constraints that others face. These outliers reveal how the desired outcomes can be achieved by expanding beyond the boundaries of the status quo, while maintaining a focus on what is professionally, legally, and morally appropriate.

Consider the following example:

In 1990, Save the Children (SC), a nongovernmental organization in the United States, was asked by the government of Vietnam to create a program to enable poor villages to solve the overwhelming problem of childhood malnutrition. Given just six months to create a sustainable solution, those involved realized that they needed to look at the positive results that some had been able to achieve relative to the lack of success others had encountered under similar circumstances. They posed the question: “If some individuals in a community were better able to solve problems than others with access to exactly the same resources, could we use that provocative discrepancy?” Taking this tack, they were able to identify approaches that differed from the norm and apply this knowledge to produce positive results that led to a dramatic improvement in child health (Dura, Singhal, and Sternin, 2009).

In this Discussion, you examine a health care problem or issue and consider how you could apply the concept of positive deviance to produce systems-level change that leads to improved quality.

To prepare:

• Review the information in this week’s Learning Resources, including the first chapter in Pascale, Sternin, and Sternin book and the Bradley, Curry, Ramanadhan, Rowe, Nembhard, and Krumholz article.
• Reflect on health care quality problems or issues that warrant systems-level change. Consider the significance of each problem/issue. Identify one, in particular, that you would like to focus on for this Discussion. Note: You may use the quality improvement issue that you selected for your Course Project, if appropriate.
• With this problem or issue in mind:
  • How would you apply the principles of positive deviance to address this problem/issue? What specific steps would you take to move from identification of the problem/issue through evaluation of outliers to implementation of a larger scale change to improve quality?
  • What examples of positive deviance, if any, are you aware of related to this problem/issue? Conduct research as necessary to see if you can locate one or more instances of positive deviance.

By Day 3

Post a brief description of the health care quality problem or issue you selected and explain how it could be addressed using the principles of positive deviance. 250-300 words needed.

References optional

Bradley, E. H., Curry, L. A., Ramanadhan, S., Rowe, L., Nembhard, I. M., & Krumholz, H. M. (2009). Research in action: Using positive deviance to improve quality of health care. Implementation Science, 4(25), 1–11.

Dingfelder, H. E., & Mandell, D. S. (2011). Bridging the research-to-practice gap in autism intervention: An application of diffusion of innovation theory. Journal of Autism & Developmental Disorders, 41(5), 597–609.

Seidman, W., & McCauley, M. (2009). A scientific model for grassroots O.D. Organization Development Journal, 27(2), 27–37.

The Interrelationship Between Theory, Knowledge, and Research and Evidence-Based PracticeFawcett and Garity (2009) present an overview of the relationship between theory, knowledge, research, nursing

The Interrelationship Between Theory, Knowledge, and Research and Evidence-Based Practice

Fawcett and Garity (2009) present an overview of the relationship between theory, knowledge, research, nursing research, and evidence-based practice (see attached file). As you prepare for this Discussion, reflect on your own specialty area and consider how the authors’ definitions of evidence-based practice and of research align with your understanding of these concepts based on your professional experiences and your experiences as a doctoral student embarking on your EBP Project.

To prepare:

• Reflect on Fawcett and Garity’s definitions      of knowledge, theory, research and evidence-based      practice presented in the Learning Resources. How do these      definitions align with your understanding of the concepts?
• How does this interrelationship support or      guide your EBP Project?

By Wednesday 9/19/18 by 1:00 am please write a minimum of 550 words essay in APA format with at least 3 scholarly references from the list of required resources below. Include the level 1 headings as numbered below:

Post a cohesive scholarly response that addresses the following:

1) How do Fawcett and Garity’s (see attached file)definitions align with your understanding of knowledge, theory, research and evidence-based practice? Support your response with evidence from the literature (quote the literature below in the required readings).

2) Discuss the interrelationship between theory, knowledge, research and evidence-based practice.

3) How does this interrelationship support or guide your EBP Project?

Required Readings

Terry, A. J. (2018). Clinical research for the Doctor of Nursing practice (3rd ed.). Burlington, MA: Jones & Bartlett Learning.

With your EBP project in mind, select and read the chapter that best fits your proposed methodologies: (I can attach the following chapters, let me know if you don’t have them and need me to attach them)

• Chapter      6, “Designing a Clinically-Based Quantitative Capstone Research Project”
• Chapter      7, “Designing a Clinically-Based Qualitative Capstone Research Project”
• Chapter      8, “Designing a Clinically-Based Mixed Method Capstone Research Project”

Fawcett, J., & Garity, J. (2009). Chapter 1: Research and evidence-based nursing practice. In Evaluating Research for Evidence-Based Nursing, (pp. 3-20). Philadelphia, PA: F. A. Davis.

Adams, J.M., & Natarajan, S. (2016). Understanding influence within the context of nursing: Development of the Adams influence model using practice, research, and theory. Advances in Nursing Science, 39(3), E40-E56. 

Djulbergovic, B. (2014). A framework to bridge the gaps between evidence-based medicine, health outcomes, and improvement and implementation science. Journal of Oncology Practice, 10(3), 200-202. 

Hutchinson, A.M., Bioeth, M., Wilkinson, J.E., Kent, B., & Harrison, M.B. (2012). Using the promoting action on research implementation in health services framework to guide research use in the practice setting. Worldviews on Evidence-Based Nursing, First Quarter, 59-61.

Leung, K., Trevena, L., & Waters, D. (2014). Systematic review of instruments for measuring nurses’ knowledge, skills and attitudes for evidence-based practice. Journal of Advanced Nursing 70(10), 2181–2195.

Leung, K., Trevena, L., & Waters, D. (2016). Development of a competency framework for evidence-based practice in nursing. Nurse Education Today, 39, 189-196. 

PIICOT Question

In patients in extended intensive care within an urban acute care facility in Eastern United States, how does early mobilization as recommended by National Institute of Health and Care Excellence clinical guidelines on rehabilitation of patients after critical illness impact early transfers from intensive care as measured 6 months post-implementation when compared to the current standard of care including minimal mobilization of patients?

P: Adult patients 

I: in extended intensive care within an urban acute care facility

I: increased mobilization of the patients 

C: minimal mobilization of the patients

O: early transfers of the patients from intensive care

T: 6 months

Due tomorrow 09/19/18 by 1:00 am. Thanks!

reate a Staffing PlanYour staff is your most important asset and will make your grant intervention come to life. As such, your portrayal of how they will accomplish their work as part of your grant in

reate a Staffing Plan

Your staff is your most important asset and will make your grant intervention come to life. As such, your portrayal of how they will accomplish their work as part of your grant intervention is paramount to your success. Using the weekly readings, the South University online library resources, and the Internet, research how to write a staffing plan. Based on your research, address the following:

Create a staffing plan that shows the number of full- and part-time staff, including contractors and volunteers, who will implement your chosen public health intervention in response to your chosen FOA.

Deliver the staffing plan in an outline form, briefly describing each individual’s job title and responsibilities.

Include an organizational chart showing where these positions reside and to whom they will report.

Submission Details:

Develop a 3 – 5 page staffing plan.

Cite all sources on a separate page using APA standards.