NUR-590 Benchmark – Evidence-Based Practice Project Proposal Final Paper

NUR-590 Benchmark – Evidence-Based Practice Project Proposal Final Paper

Benchmark – Evidence-Based Practice Project Proposal Final Paper

Assessment Description

For this assignment, you will synthesize the independent evidence-based practice project proposal assignments from NUR-550 and NUR-590 into a 4,500-5,000-word professional paper.

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Final Paper

The final paper should:

1. Incorporate all necessary revisions and corrections suggested by your instructors.
2. Synthesize the different elements of the overall project into one paper. The synthesis should reflect the main concepts for each section, connect ideas or overreaching concepts, and be rewritten to include the critical aspects (do not copy and paste the assignments).
3. Contain supporting research for the evidence-based practice project proposal. NUR-590 Benchmark – Evidence-Based Practice Project Proposal Final Paper

Main Body of the Paper

The main body of your paper should include the following sections:

1. Problem Statement
2. Organizational Culture and Readiness
3. Literature Review
4. Change Model, or Framework
5. Implementation Plan
6. Evaluation Plan

Appendices

The appendices at the end of your paper should include the following:

1. All final changes or revisions for the drafts that will be included in the appendices of your paper.
2. Complete the “APA Writing Checklist” to ensure that your paper adheres to APA style and formatting criteria and general guidelines for academic writing. Include the completed checklist as the final appendix at the end of your paper. In each preceding course you have been directed to the Student Success Center for assistance with APA style, and have submitted the APA Writing Checklist to help illustrate your adherence to APA style. This final paper should demonstrate a clear ability to communicate your project in a professional and accurately formatted paper using APA style.  NUR-590 Benchmark – Evidence-Based Practice Project Proposal Final Paper

General Requirements

You are required to cite 10-12 peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

Benchmark Information

This benchmark assignment assesses the following programmatic competencies:

MBA-MSN; MSN-Nursing Education; MSN Acute Care Nurse Practitioner-Adult-Gerontology; MSN Family Nurse Practitioner; MSN-Health Informatics; MSN-Health Care Quality and Patient Safety; MSN-Leadership in Health Care Systems; MSN-Public Health Nursing

1.1: Translate research and knowledge gained from practice, while adhering to ethical research standards, to improve patient outcomes and clinical practice.

5.1: Design ethically sound, evidence-based solutions to complex health care issues related to individuals, populations, and systems of care.

Week 8 Participation – NUR-590 Benchmark – Evidence-Based Practice Project Proposal Final Paper

Assessment Description

There is no description for this assessment.

Resources

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Evidence-Based Practice in Nursing and Healthcare: A Guide to Best Practice

Read “Making Connections: An EBP Exemplar” in Unit 6 in Evidence-Based Practice in Nursing and Healthcare: A Guide t

… Read More

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Translating Evidence Into Practice Through Knowledge Implementation

Read “Translating Evidence Into Practice Through Knowledge Implementation,” by Campione, Wampler-Kuhn, and Fisher, from Rehab

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https://lopes.idm.oclc.org/login?url=http://ovidsp.ovid.com.lopes.idm.oclc.org/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=01893697-202104000-00006&LSLINK=80&D=ovft

Translating Evidence Into Practice: How Advanced Practice RNs Can Guide Nurses in Challenging Established Practice to Arrive at Best Practice

Read “Translating Evidence Into Practice: How Advanced Practice RNs Can Guide Nurses in Challenging Established Practice to Arrive at

… Read More

https://lopes.idm.oclc.org/login?url=http://ovidsp.ovid.com.lopes.idm.oclc.org/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00000703-201711000-00004&LSLINK=80&D=ovft

Advanced Nursing Research: From Theory to Practice

Read Chapter 25 in Advanced Nursing Research: From Theory to Practice.

View Resource

Participation Requirements

Participating in classroom discussion is paramount to the learning experience. Participating in the weekly discussions allows students and instructors to share experiences, investigate complicated subject matter, share expertise, and examine the content from new perspectives. The qualitative participation requirements are:

• Follow-up responses to classmates’ initial answers or responses that integrate course theories with a practical application of the subject, offering a personal observation or experience, or referencing real-world examples, current events, or presenting current research on the topic. NUR-590 Benchmark – Evidence-Based Practice Project Proposal Final Paper
• Classroom interaction demonstrating deeper or broader thoughts beyond rephrasing what the textbook has presented on the topic.
• Responses encouraging further discussion and ongoing dialogue with other students and the instructor in the class.NUR-590 Benchmark – Evidence-Based Practice Project Proposal Final Paper
• Asking additional, relevant questions about the week’s topic.
• Communications that are presented in a professional and supportive manner, and with respectful tone.

The participation expectations in this class are:

• Number of Required Substantive Posts Each Day: 1
• Number of Required Days: 3

Course Grade Scale

Benchmark – Evidence-Based Practice Proposal Final Paper Example

Benchmark – Evidence-Based Practice Proposal Final Paper Section A: Organizational Culture and Readiness Assessment

Before implementing evidence-based practice, completing the Organizational Culture and Readiness Assessment is necessary (Yusif, Hafeez-Baig & Soar, 2017). The results obtained in the assessment would help advise the readiness and culture for evidence-based practice in any organization.

Organizational Readiness

The results from the assessment prove that many organizations have accommodated evidence-based practice. The evaluation involved eighteen questions, with many of the participants answering approximately eight. The organization shows the right progress towards the use of research for EBP. EBP guides its professional practice and vision hence training the staff to drive the practice through the physician’s support. There is also a department responsible for research with dedicated scientists and researchers having numerous published works. The staff is facilitated to learn and practice EBP. The existence of advanced practice nurses assists in translation and teaching. There are several libraries dedicated to EBP and research, making information reach all workers through computers.

Mentoring is an essential act with the mentoring program helping to drive the mentors and their learners. The inter-dependent teams have been crucial and act as the driving force. The team compromise of nurse champions, educators, administrators, and physicians. Metrics are an essential aspect due to the size of the organization. Sharing the results and practices has helped other facilities through peer groups who help in sharing metrics. The peer groups also share and discuss both the EBP and effects. It is one of the goals for the organization to attain magnet status. The organization values the use of EBP as it understands it is the primary way to success.

Section B: Proposal/Problem Statement and Literature Review

Dementia is among the main challenges affecting the aged. The condition affects the memory, thinking, and social abilities of the people. It also affects the daily routine of the individuals and is a combination of several diseases. One of the affected areas is the loss of memory, and lack of memory is not a base to conclude the presence of dementia. Alzheimer’s disease is the leading cause of dementia in older adults (Emre et al., 2014). Several issues lead to the condition and can be solved through alternative therapies or medications. The two methods are responsible for reducing agitation. The paper aims at determining the most appropriate method for treating dementia through an analysis of secondary data.

The research employed the use of current research articles to support the PICOT statement. Materials that are recently published would offer up-to-date data about the condition. The choice of these articles was founded on the capacity to relate different treatments for the disease. Therefore, the selected items would help determine the best type of treatment that would help in curing the condition. The articles will answer the PICOT question that assesses the best treatment method for dementia. Besides, other than treating the disease, the treatment method would deal with agitation. The aged patients are the main subjects that were involved in the research as they are the main ones who are at advanced risk of suffering from dementia. It was easy to obtain the necessary articles as the search provided many relevant materials that would offer a detailed analysis. NUR-590 Benchmark – Evidence-Based Practice Project Proposal Final Paper

Analysis of secondary data acted as the primary method for analysis. The research depended more on research done in the past. According to Johnston (2017), the method helps develop the PICOT statement due to the availability of ready data. The method is appropriate, especially to researchers who have limited time and resources. The results prove that both the use of medications and alternative therapies are effective methods in reducing agitation in patients who have dementia. The use of music therapy and massage are necessary measures to help the affected patients and those at advanced risk for dementia. Atypical drugs are also useful in the treatment of behavioral and psychological symptoms of dementia. The use of these medications has been associated with several side effects that continue to affect the lives of the victims.

In conclusion, the study proved that Nonpharmacological interventions could provide positive results in the reduction of dementia. The most appropriate population for the study is the aged adults as they are at an advanced risk for dementia. One of the main limitations of the research included a lack of financial funding for the resources necessary for the study. Besides, there are other limitations, like the use of some therapies that employ the use of sound scientific foundations to prove ineffective. The issue follows the presence of symptomatic Alzheimer’s disease. The third limitation lies with inappropriate methodological quality in music therapy toward the treatment of the condition. The issues necessitate additional research to uncover more information concerning music therapy and the treatment of dementia.

Evidence-Based Practice Proposal – Section C: Solution Description Proposed Solution

Dementia is unraveled by using behavior change initiatives (Bessey & Walaszek, 2019). Patients are supposed to involve themselves in alternative therapies which fit in music and art. It is, therefore, necessary to motivate the aged people to change their beliefs and behaviors. The patients should take part in physical activities like music and dance and exercise to deal with the condition. Physical activities divert the attention of aged people from the use of drugs to treat dementia. The aging will, therefore, consider exercising as an essential solution for their condition. Besides, it is necessary to have a directorial principle that safeguard both verbal and on paper information is delivered to the patients.

There is also support for data by different procedures that ensure that important information is available. The main role of the nurses is monitoring the long-lasting results connected to the clients. Another issue include making sure that the collected data is detailed. These issues add in simple infrastructures employed in the collection of data associated with the patients, and pathology of data (Shah et al., 2016). The issue makes sure that the condition is managed both at the population and individual levels. Besides, physical activities are also a cheaper method as it involves fewer resources to control the condition.

Organization Culture

The endorsed solution is reliable with the values of the community. People of different cultures are affected or infected differently. Besides, the main reason for the consistency is its ability to provide emotional care and team care to the management. NUR-590 Benchmark – Evidence-Based Practice Project Proposal Final Paper

Expected Outcomes

One of the expected outcome is reduction of agitation. The outcome results when dementia is managed through alternative therapies. It is one of the easiest methods to use with the patients. Participating in the physical activities results in the reduction of the number of deaths among the patients affected by dementia. The use of the method is essential as it help in improving the mobility issue among aged patients. The case leads to the improvement of the health status (Groot et al., 2016).

Method to Achieve Outcomes

The process of realizing the outcomes depends on several methods. Some of the used techniques include the use of proper communication as well as the psychological support of the patients. Besides, it is also necessary to make regular follow-ups to ensure that the patients improve.

Outcome Impact

It is necessary to detect the occurrence of the disease early. The issue help in the delivery of quality. The issue help in controlling dementia before it can affect the patients fully. Early detection help in maintaining the quality of care in connection to the life of the patient. The issue of effective communication among health care professionals helps to relay the correct information (Thyrian et al., 2016). It helps to improve the quality of care since it reduces any chances of errors. Physicians can enhance the outcome of the patients through reducing the depression and anxiety among the patients. The efficiency of care provided is dependent on the kind of staff that are employed. The use of skilled, experienced and competent nurses will improve the efficiency of care provided to the patients.

Evidence-Based Practice Proposal – Section D: Change Model

More than a few theoretical models help to turn the outcomes of research into medical practice. The models help organizations to implement EBP in their practice. Leaders in many organizations mainly decide evidence-based practices. These models help break the complicated process into small units and bringing a systematic approach. Their use assists in improving success rates, results in the efficient allocation of resources, completing the implementation, and providing a mechanism that helps implement the outcomes. Dementia is a problem that can be dealt with through the Iowa Model of Evidence-Based Practice.

One of the areas of concern for the Iowa Model is in care promotion. The model is essential in easing the implementation of EBP. Many organizations contain a documented performance of the model in terms of success rate and value. Besides, the model uses an algorithm possessing decision points and feedback loops. There is also a feedback mechanism within the algorithm which helps in questioning the practice. The issue helps in determining the availability of evidence that assists in improving the methods. The model focuses on practical challenges and new knowledge only (White & Spruce, 2015).

The model is selected to reduce agitation in dementia patients as it can work with changes in an organization (White & Spruce, 2015). Secondly, it concentrates on an interdisciplinary approach through input from teams in implementing EBP. Besides, the model is intuitive, friendly to the users, and understandable, hence attractive. It also gives space for trials associated with the change before implementation (White & Spruce, 2015).

The Iowa model contains different stages. The initial stage entails assessing the practice.

Besides, the stage drives the formation of questions in clinical settings. These questions are obtained in clinical judgment, research, and the patient’s preferences (Iowa Model Collaborative et al., 2017). The following stage is decision-making. The main decision is founded on the priority of choice as per the National Patient Safety goals. The matching of the patient’s goals and the questions raises the chances for it being a priority. Another stage is planning, followed by implementation and, finally, evaluating the change (Stavor, Zedreck-Gonzalez & Hoffmann, 2017). The implementation of the change involves diverse pilot units. Also, the evaluation stage involves evaluating the success of the change.

It is necessary to assess the practice concerning dementia to reduce agitation. It is necessary to determine the primary concern and outcome of the research. It is at this step that comparing if alternative therapies are effective in reducing agitation in the patients. Regarding the second stage, it is vital to decide on resource availability and what had worked in the past. The main concern will be how changing the practice will occur. The third stage will entail planning based on relevant and applicable data towards facilitating the change in care delivery. At this step, it will be essential to collect data.

In conclusion, after data is collected, the intervention stage brings in the process of revising the caregiving protocol (Giauque, 2015). Finally, there will be an evaluation to determine the plan’s success in reducing agitation in dementia patients. The stage will involve training the staff, communicators, and reviewers as well as employ educators. It will also be necessary to consider giving feedback and monitoring the change in practice. NUR-590 Benchmark – Evidence-Based Practice Project Proposal Final Paper

Evidence-Based Practice Proposal – Section E: Implementation Plan Implementation Plan

The implementation of a change within an organization incorporates many issues. The process will need the hand of different phases, individuals, drivers, and obstacles or barriers (Bernhardsson et al., 2017). The paper will highlight the significant ways used in implementing any suggested solution. The hypothesis statement highlighted the solution that needs to be implemented to solve the problem. The process of reducing agitation is faced with different limitations as an intervention among dementia patients. One of the major solutions is behavior change among patients. The healing process will therefore require notable inclusion of the alternative interventions. The primary method used in reducing agitation is the use of alternative therapies, including music and art. Involvement in physical activities among older adults who have dementia is a robust method of reducing agitation.

The Potential Subjects

The implementation of the solution will be practiced in several care centers. Members who want to join the process will do so voluntarily. The recruitment will involve an advertisement that will run for two weeks to reach many dementia patients. Since the study will incorporate human beings’ analysis, there is a need to ensure that a consent form is prepared (Barber, 2018). The participants will, therefore, sign the consent forms before the start of the study. The signing of the forms will indicate that old adults are willing to take part in the survey. The participants will also be educated on the requirements during the course, including the risks. The issue will also confirm that the participants have been educated on the different aspects of the study.

Time

With the implementation of physical activities for dementia patients, there is a need for planning on the time required. Exercises play an essential role in the reduction of agitation among old adults. The implementation of the projected is projected to take a total of two months.

Resources

Resources make work easier in implementing the interventions. The issue implies that a budget must be set aside to cater for the required resources. These are the costs of all the expenditures the old adults will need during the physical activities within the eight weeks that the project will run. The stage takes the highest bunch of resources and marks the area; many projects fail to achieve the intended goal and objectives. The lack of these resources means that the project will fail. Some of the resources required to implement the intervention and reduce agitation among the patients include dieticians, physical facilities, physical trainers, and medical doctors. Much of the budget will therefore be used to pay for the services by these professionals and acquire equipment used for exercises.

Monitoring the Implementation

Questionnaires to the participants will be very useful in evaluation. It will be essential to administer the questionnaires every two weeks to assess the progress towards achieving the set goals. The choice for the use of questionnaires is an easy time in its analysis. Many healthcare organizations are also familiar with the help of questionnaires among its leadership and staff. The use of this method is also cheap and hence lowers the cost of conducting the entire study. The use of questionnaires only requires the expense of photocopying the questions (Brace, 2018). There is a high likelihood that most of these participants, due to their age and different experience, have heard or filled questionnaires before. The use of a simple questionnaire where participants respond by a yes or no or place a tick on the respective response makes the method easy to use. Questionnaires are filled by the respective participants and represent the principled stand for the individual taking part in the study.

Delivery of the Intervention

The method used in delivering the proposed intervention is an integrated approach (Reid & Sanders, 2019). The primary interventions considered for implementation are nutritional education, physical activities, and behavior change. The main area of education will be eating healthy foods to provide energy for the exercises. Another area of concern is the type of activities that will help the old adults recover from the conditions and avoid straining. Besides, all the participants will be involved in the implementation of the interventions. It will be essential to initiate simple tasks initially and then progress to other advanced studies later. The issue will help the old adults to strengthen the muscles as well as gain the lost energy. Education and training should feature the main areas to focus on and what not to do before initiating the physical activities.

Data Collection

During the two months of the study, questionnaires will help in collecting data. The intervention will be subjected to the old adults and data collected out of their experience. The participants will then fill the questionnaires each week concerning their experience after the exercises. The reduction of agitation will be evident after the use of the interventions in a few hours. Excel spreadsheets will hold the collected data, which will then be analyzed. NUR-590 Benchmark – Evidence-Based Practice Project Proposal Final Paper

Dealing with Challenges

Some of the main challenges in conducting the study are lack of equipment for exercise and training costs. The majority of older adults lack the funds for buying healthy food, which is required during the activities. It is advisable to partner with organizations focusing on organic food to offer such products at affordable costs or even for free. Partnering with other advanced organizations will provide the much-required equipment for training. These organizations have a well-established sports department.

Feasibility of the Implementation Plan

The implementation phase incurs the highest cost. The trainer will take much of the expenses. Since the study runs for eight weeks, hiring a trainer is a useful option. Another consideration is the subsidy on the food taken during the physical exercises. Subsidized and healthy food will be sufficient for the health and the pocket of the participants (Allcott, Diamond & Dubé, 2017). A data storage device will assist in storing data collected in the entire period of the study. There will be a need to have a data storage device that will store the data collected over the eight

Plan for the Proposed Solution

The collected data will determine the action to discontinue, extend, revise, or even maintain the intervention. The decision is made founded on the results from the questionnaires. The preliminary finding, therefore, is dependent on the success of the questionnaire in collecting data.

Evidence-Based Practice Proposal – Section F: Evaluation of Process

The process of evaluation of the development plans gives essential data on the appropriate methods for improvement. It is necessary to assess the collected data to determine the success rate (Wettinger et al., 2014). In the process, the primary objective is meeting the goals and future areas of research. There are different ways of assessing the success of a project. The success of these methods lies in their ability to analyze the collected information. The evaluation process is necessary for drawing the conclusions and recommendations needed for future research and development on a topic.

Rationale for the methods

There are different methods employed in collecting data. These methods target proof of how practical physical activities are reducing agitation in patients who have dementia. One of the primary ways of use is questionnaires. Questionnaires were selected due to previous knowledge in filling such documents by the participants in the past. Another benefit is linked to its cost compared to other methods. The use of questionnaires only requires photocopying papers used by the participants to fill their details. The technique also incorporates the issue of privacy, and hence the participants can feel freely. The case provides accurate delivery of information as they are assured of their privacy and confidentiality (Keränen et al., 2017).

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Outcome measures

The study will be successful when it shows positive results on the patients. Therefore, the success will mark a reduction in the rate of agitation among the patients within a short period.

One of the primary objectives is providing an alternative method for reducing agitation as opposed to using medications. The project measurements were accomplished by comparing results obtained after the participants took part in an exercise. The data after the exercise is further compared with the previous one before involving in the physical activity.

Statistical methods are used in analyzing the evidence presented in the collected data. The methods will highlight the main advantages associated with reliability, validity, and applicability of data. The main techniques employed in the analysis include statistical and mathematical models. The different models are based on practical and achievable outcomes making the results reliable, applicable, and valid (Cook et al., 2015). Making the project suitable to all the patients is necessary for making the results accurate. NUR-590 Benchmark – Evidence-Based Practice Project Proposal Final Paper

Measurement and evaluation of outcomes

Obtaining negative results in the project will require establishing alternative methods.

These methods will ensure that the results are improved. Therefore, it is necessary to analyze the negative results by giving recommendations that will help improve the results. These recommendations are primarily based on the methods that will enhance the outcome. In such a case that there are no chances to improve the project, the strategy and action to take is termination. The process of analyzing the data is necessary since it determines whether the project will be achieved. The process is, therefore, essential when conducted as the last strategy.

Besides, the primary implication associated with the results indicates the usefulness of physical activities in reducing agitation. When there are positive results, the project demonstrates that physical activities are an effective means of lowering agitation in dementia cases.

Furthermore, the project’s failure indicates the opposite, with physical activities being an ineffective method used in reducing agitation. Therefore, it is critical to consider further research that will focus on alternative methods used in the reduction of agitation among such patients.

In conclusion, the process of evaluation is an integral part of a proposed project. It helps in making sure that the objectives of the project are met. Besides, the evaluation process help in the making of critical decisions regarding the practicability of the scheme. The issue helps in deciding on whether to continue or terminate the project. The use of physical activities in the reduction of dementia proved successful and effective. Therefore, it is critical to employ the use of these exercises as opposed to the use of medications while attempting to reduce agitation among dementia patients.

References – NUR-590 Benchmark – Evidence-Based Practice Project Proposal Final Paper

Allcott, H., Diamond, R., & Dubé, J. P. (2017). The geography of poverty and nutrition: Food deserts and food choices across the United States. National Bureau of Economic Research.

Barber, B. (2018). Research on human subjects: Problems of social control in medical experimentation. Routledge

Bernhardsson, S., Lynch, E., Dizon, J. M., Fernandes, J., Gonzalez-Suarez, C., Lizarondo, L., … & Grimmer, K. (2017). Advancing evidence-based practice in physical therapy settings: multinational perspectives on implementation strategies and interventions. Physical therapy, 97(1), 51-60.

Bessey, L. J., & Walaszek, A. (2019). Management of behavioral and psychological symptoms of dementia. Current psychiatry reports, 21(8), 66

Brace, I. (2018). Questionnaire design: How to plan, structure, and write survey material for significant market research. Kogan Page Publishers.

Cook, D. A., Brydges, R., Ginsburg, S., & Hatala, R. (2015). A contemporary approach to validity arguments: a practical guide to K ane’s framework. Medical education, 49(6), 560-575

Emre, M., Ford, P. J., Bilgiç, B., & Uç, E. Y. (2014). Cognitive impairment and dementia in Parkinson’s disease: practical issues and management. Movement Disorders, 29(5), 663- 672

Giauque, D. (2015). Attitudes toward organizational change among public middle managers. Public Personnel Management, 44(1), 70-98

Groot, C., Hooghiemstra, A. M., Raijmakers, P. G. H. M., Van Berckel, B. N. M., Scheltens, P., Scherder, E. J. A., … & Ossenkoppele, R. (2016). The effect of physical activity on cognitive function in patients with dementia: a meta-analysis of randomized control trials. Aging research reviews, 25, 13-23

Iowa Model Collaborative, Buckwalter, K. C., Cullen, L., Hanrahan, K., Kleiber, C., McCarthy, M., & Authored on behalf of the Iowa Model Collaborative. (2017). Iowa model of evidence‐based practice: Revisions and validation. Worldviews on Evidence‐Based Nursing, 14(3), 175-182

Johnston, M. P. (2017). Secondary data analysis: A method of which the time has come. Qualitative and quantitative methods in libraries, 3(3), 619-626

Keränen, N. S., Kangas, M., Immonen, M., Similä, H., Enwald, H., Korpelainen, R., & Jämsä, T. (2017). Use of information and communication technologies among older people with and without frailty: a population-based survey. Journal of medical Internet research, 19(2), e29

Reid, R. D., & Sanders, N. R. (2019). Operations management: an integrated approach. John Wiley & Sons

Shah, H., Albanese, E., Duggan, C., Rudan, I., Langa, K. M., Carrillo, M. C., & Saxena, S. (2016). Research priorities to reduce the global burden of dementia by 2025. The Lancet Neurology, 15(12), 1285-1294

Stavor, D. C., Zedreck-Gonzalez, J., & Hoffmann, R. L. (2017). Improving the use of evidence- based practice and research utilization by identifying barriers to implementation in a critical access hospital. JONA: The Journal of Nursing Administration, 47(1), 56-61. NUR-590 Benchmark – Evidence-Based Practice Project Proposal Final Paper

Syrian, J. R., Eichler, T., Pooch, A., Albuerne, K., Dreier, A., Michalowski, B., & Hoffmann, W. (2016). Systematic, early identification of dementia and dementia care management is highly appreciated by general physicians in primary care–results within a cluster- randomized-controlled trial (DelpHi). Journal of multidisciplinary healthcare, 9, 183

Wettinger, J., Andrikopoulos, V., Strauch, S., & Leymann, F. (2014, March). Characterizing and evaluating different deployment approaches for cloud applications. In 2014 IEEE International Conference on Cloud Engineering (pp. 205-214). IEEE.

White, S., & Spruce, L. (2015). Perioperative nursing leaders implement clinical practice guidelines using the Iowa Model of Evidence-Based Practice. Association of Operating Room Nurses.AORN Journal, 102(1), 50-59 doi:http://dx.doi.org/10.1016/j.aorn.2015.04.00.

Yusif, S., Hafeez-Baig, A., & Soar, J. (2017). E-health readiness assessment factors and measuring tools: a systematic review. International journal of medical informatics, 107, 56-64. NUR-590 Benchmark – Evidence-Based Practice Project Proposal Final Paper

CLC – Health Promotion and Community Resource Teaching Project Paper

CLC – Health Promotion and Community Resource Teaching Project Paper

MY GROUP PICKED A TOPIC DIABETES. EVERY ONE IS WORKING ON THIS PROJECT SINCE THIS IS GRUOP PROJECT I HAVE TO COMPLETE PART 2 .SO JUST NEED PART 2 DONE.

LET ME KNOW IF YOU HAVE ANY QUESTIONS…..This is a Collaborative Learning Community (CLC) assignment.

An important role of nursing is to provide health promotion and disease prevention. Review the 2020 Topics and Objectives on the Healthy People website. Choose a topic of interest that you would like to address, in conjunction with a population at-risk for the associated topic. Submit the topic and associated group to your instructor for approval.

Create a 15-20-slide PowerPoint presentation for your topic and focus group. Include speaker notes and citations for each slide, and create a slide at the end for References. CLC – Health Promotion and Community Resource Teaching Project Paper

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Address the following:

1. Describe the approved topic and associated population your group has selected. Discuss how this topic adversely affects the population. How does health disparity affect this population?
2. Explain evidence-based approaches that can optimize health for this population. How do these approaches minimize health disparity among affected populations?
3. Outline a proposal for health education that can be used in a family-centered health promotion to address the issue for the target population. Ensure your proposal is based on evidence-based practice.
4. Present a general profile of at least one health-related organization for the selected focus topic. Present two resources, national or local, for the proposed education plan that can be utilized by the provider or the patient.
5. Identify interdisciplinary health professionals important to include in the health promotion. What is their role? Why is their involvement significant?

Cite at least three peer-reviewed or scholarly sources to complete this assignment. Sources should be published within the last 5 years and appropriate for the assignment criteria and public health content.

Refer to the resource, “Creating Effective PowerPoint Presentations,” located in the Student Success Center, for additional guidance on completing this assignment in the appropriate style.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center. CLC – Health Promotion and Community Resource Teaching Project Paper

NRNP 6635 Week 4: Anxiety Disorders, PTSD, and OCD

NUR-590 Benchmark – Evidence-Based Practice Proposal Project: Framework or Model for Change

NUR-590 Benchmark – Evidence-Based Practice Proposal Project: Framework or Model for Change

Benchmark – Evidence-Based Practice Proposal Project: Framework or Model for Change

Benchmark

Upcoming

Assessment Description

Applying a model or framework for change ensures that a process is in place to guide the efforts for change. In 500-750 words, discuss the model or framework you will use to implement your evidence-based practice proposal project. You will use the model or framework you select in the Topic 8 assignment, during which you will synthesize the various aspects of your project into a final paper detailing your evidence-based practice project proposal. NUR-590 Benchmark – Evidence-Based Practice Proposal Project: Framework or Model for Change

Include the following:

1. Identify the selected model or framework for change and discuss its relevance to your project.
2. Discuss each of the stages in the change model/framework.
3. Describe how you would apply each stage of the model or theoretical framework in your proposed implementation.
4. Create a concept map for the conceptual model or framework you selected to illustrate how it will be applied to your project. Attach this as an appendix at the end of your paper.

Refer to the “Evidence-Based Practice Project Proposal – Assignment Overview” document for an overview of the evidence-based practice project proposal assignments.

You are required to cite minimum of four peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Complete the “APA Writing Checklist” to ensure that your paper adheres to APA style and formatting criteria and general guidelines for academic writing. Include the completed checklist as an appendix at the end of your paper.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance. NUR-590 Benchmark – Evidence-Based Practice Proposal Project: Framework or Model for Change

Benchmark Information

This benchmark assignment assesses the following programmatic competencies:

MBA-MSN; MSN-Nursing Education; MSN Acute Care Nurse Practitioner-Adult-Gerontology; MSN Family Nurse Practitioner; MSN-Health Informatics; MSN-Health Care Quality and Patient Safety; MSN-Leadership in Health Care Systems; MSN-Public Health Nursing

1.2 Apply theoretical frameworks from nursing and other disciplines to make decisions regarding practice and health-related problems at the individual and population level.

Week 3 Participation

GO TO DISCUSSION

Start Date

Aug 26, 2021 12:00 AM

Due Date

Sep 01, 2021 11:59 PM

Points

20

Status

Upcoming

Assessment Description

There is no description for this assessment.

Resources

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Advanced Practice Nursing: Essential Knowledge for the Profession

Read Chapter 6 in Advanced Practice Nursing: Essential Knowledge for the Profession.

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Evidence Based Medicine: Levels of Evidence

Read “Evidence Based Medicine: Levels of Evidence,” by the University of Illinois/Chicago’s Library of the Health Sciences at Peo

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http://researchguides.uic.edu/content.php?pid=232200&sid=1921074

A Test of the ARCC Model Improves Implementation of Evidence-Based Practice, Healthcare Culture, and Patient Outcomes

Read “A Test of the ARCC Model Improves Implementation of Evidence-Based Practice, Healthcare Culture, and Patient Outcomes,” by

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https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=121082056&site=ehost-live&scope=site&custid=s8333196&groupid=main&profile=ehost

Iowa Model of Evidence-Based Practice: Revisions and Validation

Read “Iowa Model of Evidence-Based Practice: Revisions and Validation,” by Buckwalter et al., from Worldviews on Evidence-Bas

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https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=123692132&site=ehost-live&scope=site&custid=s8333196&groupid=main&profile=ehost

Use of Evidence-Based Practice Models and Research Findings in Magnet-Designed Hospitals Across the United States: National Survey Results

Read “Use of Evidence-Based Practice Models and Research Findings in Magnet-Designed Hospitals Across the United States: National Sur. NUR-590 Benchmark – Evidence-Based Practice Proposal Project: Framework or Model for Change

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Evidence-Based Practice in Nursing and Healthcare : A Guide to Best Practice

Read Chapter 14 and review Chapter15 in Evidence-Based Practice in Nursing and Healthcare: A Guide to Best Practice.

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Critical Appraisal Tools

Read “Critical Appraisal Tools,” located on the Centre for Evidence Based Medicine (CEBM) website.

https://www.cebm.ox.ac.uk/resources/ebm-tools/critical-appraisal-tools

Study Designs

Review “Study Designs,” located on the Centre for Evidence Based Medicine (CEBM) website.

https://www.cebm.ox.ac.uk/resources/ebm-tools/study-designs

Worksheet for Using Practice Guidelines

Study “Worksheet for Using Practice Guidelines,” from the “Evidence Based Medicine Toolkit,” by Buckingham, Fisher, and S

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http://www.ebm.med.ualberta.ca/CPGWorksheet.html

Guidelines and Measures

Study “Guidelines and Measures,” located on the Agency for Healthcare Research and Quality website.

https://www.ahrq.gov/gam/index.html NUR-590 Benchmark – Evidence-Based Practice Proposal Project: Framework or Model for Change

Star Model

Explore the Star Model resources, located on the UT Health San Antonio School of Nursing website.

https://www.uthscsa.edu/academics/nursing/star-model

Nursing Best Practice Guidelines

Investigate the Nursing Best Practice Guidelines page of the Registered Nurses Association of Ontario (RNAO) website.

http://www.rnao.org/Page.asp?PageID=861&SiteNodeID=133

Updating the Stetler Model of Research Utilization to Facilitate Evidence-Based Practice

Read “Updating the Stetler Model of Research Utilization to Facilitate Evidence-Based Practice,” by Stetler, by Nursing Outlo

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https://www-sciencedirect-com.lopes.idm.oclc.org/science/article/pii/S0029655401478390. Benchmark – Evidence-Based Practice Proposal Project: Framework or Model for Change

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Benchmark – Evidence-Based Practice Proposal Final Paper

Grand Canyon University NUR-590

Abstract

In this proposal you will see how the determination was made regarding the organizational culture and readiness assessment. You will learn about problem statement regarding the needed for Medication Assisted Therapy (MAT) with Cognitive Behavioral Intervention (CBI) within the correctional institutions due to the high number of Substance Use Disorder (SUD) complications such as deaths related to overdoes and emergency send outs related to overdoses. There will be a description of a proposed solutions and the changed model that can be used with an implementation plan and how it can be evaluated.

Keywords: Medication Assisted Therapy (MAT), Cognitive Behavioral Intervention (CBI), Substance Use Disorder (SUD)

Benchmark – Evidence-Based Practice Proposal Final Paper Section A: Organizational Culture and Readiness Assessment

Utilizing the Medication-Assisted Treatment for Opioid Use Disorder Self-Assessment Checklist, it is determined that the organization readiness level is high. There is so many of the processes in place such as, it has been decided which components of MAT will be provided internally and which patients will be referred to external providers. There are also engaged clinicians and staff that understand the benefits and importance of offering MAT services in our practice. There has also been a basic understanding of the elements of implementation and have an implementation plan to integrate MAT services into our practice. Some of the identified barrier are the cultural change and staff buy in. In the clinical setting in which we provide care include an interdisciplinary team that also include correctional officers. Their view on healthcare in general is different from that of the medical field so getting their buy in is essential to a successful program. It will take a lot of education to get the correctional officers to see the impact of drug use and the benefits of treatment not just during the patient incarceration but after incarceration once these patients are released and the effects it could have on recidivism. Getting someone in their leadership to buy in will help to get others to buy in. Areas that were low included the staffs understanding that addiction is a chronic disease with biological, psychological, and social aspects, which is a part of needing to change the culture in the correctional setting. We will have to develop a plan to support staff through continuing education, clinical supervision, and consulting resources that will educate on addiction. There was a high score in regard to operational systems and workflows. An example is the development of methods to identify opioid use disorder, including a protocol to incorporate standardized screening tools into the patient workflow. Overall, the readiness assessment shows that we are progressing in the right direction for the project. NUR-590 Benchmark – Evidence-Based Practice Proposal Project: Framework or Model for Change

Section B: Proposal/Problem Statement and Literature Review

The California Department of Corrections and Rehabilitation (CDCR) has experienced a 54% increase in Emergency Department transports and hospitalizations related to drug overdoses and a 160% increase in overdose between 2014 to 2017 (Kelso, 2018). Substance use disorders have now been recognized as a chronic health condition, like diabetes or hypertension, and require long term treatment as like any other chronic health condition. Patients that have a substance use disorder has often been viewed as drug seeking, manipulative, hopeless, selfish, and as people who lack the desire to change (“Substance use disorders,” 2019). There needs to be a cultural change within CDCR that deals with substance use disorders in correctional primary care settings, changing the stigma associated with substance use disorders, and recognizing that medicated assisted therapy along with cognitive behavioral therapy can be beneficial and successful for the treatment of substance use disorders.

There has been significant data that has shown there is a significant increase in opioid related death in the first two weeks after a patient in released from prison (SAMHSA, 2019). In the past the standard treatment for addiction was mental health counseling. This approach did not consider the way that opioids have altered the brain through continued use or that addiction is also a medical condition. Medicated assisted therapy along with cognitive behavioral therapy through evidence-based research, is beginning to become a more widely accepted treatment by providers. As the healthcare system continues to progress in this area of treatment and advances are made in the development of medications to treat addictions, we can help those make the necessary changes while incarcerated that will help these individuals after release and hopefully reduce recidivism in the process. NUR-590 Benchmark – Evidence-Based Practice Proposal Project: Framework or Model for Change

Section C: Solution Description

In January 2016, the Center for Disease Control (CDC) reported there was a significant increase in the drug overdose death rates, it doubled from the year 2000 to 2014, from 6.2 to 14.7 per 100,000 people. The California Correctional Health Care System (CCHCS), which is the health care provider for the California Department of Corrections and Rehabilitation (CDCR) has seen the same rise in the drug overdose rate over the last eleven years, the rates range from a 5.3 per 100,000 inmate in 2007 to 22.5 per 100,000 inmates in 2016 (Kelso, 2018). To help decrease the overdose death and treatment the substance use disorders as a chronic condition, the proposed solution is to treat those who want to be treated with Medicated- Assisted Therapy (MAT) in combination with Cognitive Behavioral Therapy (CBI). The evidence-based practice MAT is the use of FDA-approved medications, in combination with counseling and behavioral therapies (CBI), to provide whole-patient care approach to the treatment of substance use disorders (SAMHSA- Substance Abuse and Mental Health Services Administration, 2019).

There has been evidence that shows the MAT program is clinically effective with a significant reduction for the need of an inpatient detox service. The MAT program also includes a comprehensive, individualized program that include medication and behavioral therapy. There is also support services that can be offered to address patient’s needs. So, to expand on the solution the CDCR and CCHCS should implement a drug treatment program that will focuses on:

• reducing opioid overdose deaths within CDCR
• improving the continuity of treatment for inmates coming into and leaving CDCR
• developing a voluntary Substance Use Disorder Treatment (SUDT) program, that identifies SUD as a chronic disease and will manage it as a chronic condition with a complete care program, that will include MAT

The MAT program with CBI is lined up and consistent with what is currently being offered in the community. The Drug Medi-Cal (DMC) program offers SUD treatment services to Medi-Cal beneficiaries and this program is operated through contracts between the Department of Health Care Services and the counties (“DHCS,” 2020). The services being offered in the community include MAT with medications that would be included in the correctional setting, suboxone and methadone and they also are provided naloxone. Naloxone is a great medication that will provide emergency rescue for people at risk of overdose. MAT treatment has been proven to be the gold standard of SUD treatment. There is evidence that it is effective in decreasing the risk of overdose. MAT in communities is also provided with CBI. Other services being offered in the communities that can be helpful with linking correctional patient to upon release are counseling, care management, care coordination between SUD services and physical health, mental health, and social services (Hernandez-Delgado, 2019).

The expectation for starting SUD treatment in the correctional setting has many beneficial outcomes. SUD can be treated with long-term medical care with behavior modification treatments, the treatment has the same effectiveness that is similar to other chronic disease treatments. MAT has positive benefits such as increased retention in treatment programs, reduced illicit opiate-use, decreased craving, and improved social functioning (Kelso, 2018). By providing access to care for behavior and medication therapies for SUD during incarceration, and then linking them to community resources when it’s time to be released, has been shown to reduce recidivism and overdose risk and increase function such as maintaining employment (Kelso, 2018).

The methods to be used to achieve this goal is by setting it up in stages of implementation. First, we must prepare for change by identifying a project champion, developing an implementation team, getting buy-in from leadership and staff at all levels, assessing the current procedures and policies, and developing the goals and action steps. Next we must plan and design the program by determining which medications to offer, which program model is best, decide who should be eligible for MAT, determine the program’s capacity, develop a diversion protocol, and also decide on what recommendations will be used for counseling. Then we need to develop the staff by providing staff training, developing the care teams, identify the appropriate staff-to-patient ratios and also provide ongoing staff supervision and support. We will also need to decide on the treatment model. We need to decide on the where and when MAT services will take place, determine which medications to offer and dosages, establish screening protocols to determine eligibility, develop guidelines for ongoing care, develop protocols related to drug testing, protocols for special populations, and protocols for program discharge and release. The care coordination and linking patient to services once released will also need to be done. This can be done by connecting patients to health insurance coverage, coordinating care with community providers, providing linkages to social services and recovery supports and also by providing education and resources to prevent opioid overdose. Audit will also have to be done to determine if the program is efficient and effective so we will need to identify who will conduct monitoring and evaluation activities, identify key metrics to monitor progress and evaluate impact, and also develop a plan for monitoring and evaluation. By implementing this program we will provide greater opportunities to ensure dependability, effectiveness and efficiency for SUD treatment which will save the state and communities financial burden from opiate related deaths and hospitalizations, and it will promotes positive outcomes such as safer work environments in correctional setting, reduction of recidivism, and safer communities and healthier patient population. NUR-590 Benchmark – Evidence-Based Practice Proposal Project: Framework or Model for Change

Section D: Change Model

The model selected that I would use as a framework for my project is the Iowa Model. The Iowa Model will help guide the process for my project with how to operate in an evidence- based manner, it teaches how to introduce the topic, then shows how to develop and evaluate evidence-based practice. The Iowa model focuses on organization and collaboration with the use of research, along with other types of evidence. It allows the focus to be on knowledge and problem-focused triggers, it leads staff to question current nursing practices and whether care can be improved through the use of current research findings (Doody & Doody, 2017). I believe this model is relevant to my project because the framework is geared at promoting quality care based on evidence-based practice. My project is geared at a quality care program that can be implemented in correctional institutions that will treat patient with Substance Use Disorders (SUD) as a chronic health conditions, the program will offer Medicated Assisted Therapy (MAT) and Cognitive Behavioral Intervention (CBI). Current practice and biases have been to look at SUD as a personal choice when research shows SUD are caused by a chemical brain dependency and it requires long term treatment, as someone with Diabetes or Hypertension.

The stages of the Iowa Model are to select a topic, then form a team, next you need to retrieve your evidence, after you gather your evidence you need to grade it, you will then need to develop the EBP standards, so that next you can implement the EBP, then the final step is to evaluate your project implementation. When you select your topic, you want to consider the priority of the problem and the impact, how it can contribute to improving care, the availability of data, and the commitment of staff. You need to be careful with the team selection as they are responsible for development, implementation, and evaluation. A team member from every discipline, along with management should be included with interested stakeholder. There also needs to be written policies, procedures and guidelines that are based on evidence. Then when getting your evidence together is should be pulled from electronic databases like Cinahl, Medline, Cochrane, other sources of evidence such as the National Institute of Health and Clinical Excellence (NICE) and Quality Improvement and Innovation Partnership (QIIP) (Doody & Doody, 2017). The next step is to grade the evidence, in this step the team addresses the quality of the research. The research question will have an influence on the research methodology, and this influences the way the data is collected and how it is analyzed. The development design of the EBP standards will be based on the studies and it will be tailored to what the benefits and risks to the patients were. This will set the practice standard guidelines, assessment, actions, and the treatment (Doody & Doody, 2017). Evidence-based practice should be a patient centered approach. Written policy, procedure, and guidelines that are evidence-based will be considered during the implementation phase. Direct care providers, the organization stakeholders, and leadership need to behind the changes for implementation to be successful.

There are many factors that can affect the implementation, so support and value need to be there for the integration of evidence into practice. Evaluation is the final process and it is essential to see if the study shows value and contributes to the evidence-based practice. An audit with feedback during the process of implementation is important, success cannot be achieved without support from the frontline leaders and the organization. The evaluation will show how the program had impacted the patient population and this can only be assessed with actual change occurring and if it had the desired effect. NUR-590 Benchmark – Evidence-Based Practice Proposal Project: Framework or Model for Change

The topic of my project was selected based in the impact SUD has had on my patient population in the correctional setting. There is a need to implement a quality-based program for treating this population. All the steps identified above will help guide me through the steps forming the team that will be best suited to gather and analyze the best-practices identified. It will help to develop the evidence-based practices to formulate our policies and procedures. With the stakeholder, management, leadership, and all other disciplines behind the project this program can be successfully implemented. NUR-590 Benchmark – Evidence-Based Practice Proposal Project: Framework or Model for Change

Section E: Implementation Plan

Many correctional institutions across the United States deals with the same issue the California Department of Corrections and Rehabilitation (CDCR) deals with and that is the issues of illegal drug use within the facilities. There has been an increase in the death rates related to drug overdoses over the past eleven years. The rates in the CDCR were 5.3 per 100,000 inmates in 2007, and now in 2016 is has risen to 22.5 per 100,000 in 2016 (Kelso, 2018). Between 2014 and 2017, there has been an increase of Emergency Department send outs and hospitalizations related to drug overdose of 54 percent and these inmate patient are two-and- a half times more likely to die from an overdose (Budget Change Proposal, 2017). There is also a significant increase for patients with a Substance Use Disorder (SUD) that they are 45 times more likely to die within the first two weeks of release from prison of an overdose. The patient population that this project will focus on is the inmate patients within the CDCR institutions.

Due to the increasing number deaths related to overdoses and the high number of hospital emergency send outs there is a need for implementation of a Medicated Assisted Therapy Program (MAT) in combination with Cognitive Behavioral Intervention (CBI). Due to the fact the patient population is in a prison there are special considerations that need to be looked at. This patient population is considered a vulnerable population, there are regulations federally governed due to their ability to make an informed and voluntary decision to participate in research is compromised (Research with Prisoners, 2020). Patients will be required to sign a consent for treatment as they would in the community prior to initiating treatment.

This project deals with many different entities within CDCR and there are also community partners that needs to be included in the care coordination. There are 35 institutions within CDCR that will require the program to be implemented. This project will need to be implemented in phases. Phase 1 will take approximately six months, this will include making sure the available staff is hired such as headquarter staff, supervisory staff, the addiction medicine providers, all institution supervisory registered nurses (RNs), Licensed Clinical Social Workers (LCSWs), and nurse consultants for the program. Phase 2 will take six months also.

This phase will also require hiring staff such as the headquarter administrative and analytical support staff, pharmacy staff, laboratory staff, RN institution staff for the program. After all the staff have been hired in phase 2 this phase will also include starting the screen and assessments for patients that will be releasing within 15-18 months, this allows time for the patient to be on the program for at least a year prior to releasing. The last phase is phase 3 which should take approximately twelve months. This will include statewide implementation at all 35 institutions with continued screening and assessment with the implementation of MAT program with CBI.

There are many resources that will be required to be implemented this project as it is a large-scale project. There are many entities within CDCR that will be a part of the collaboration to develop, implement, and operate this comprehensive program. In order for this to be implemented there will be additional resources needed for this to be successful. The hires needed for the different CDCR entities will include 99 positions for California Correctional Healthcare Services (CCHCS), CDCRs Medical Providers, another 201 positions for CCHCS Nursing Services, 5 positions for Division of Rehabilitative Programs (DRP), and 126 positions for the Division of Adult Institutions. This program will require changes in the processes that are being followed at this time. There will be new clinical tools being used but before any of these changes can be implemented there has to be training and education provided.

CCHCS uses a clinical risk classification system, registries, that will help identify if our patient population is receiving the most appropriate care to serve their needs. By developing a system that pulled information technology that could automate the clinical risk classification system it has proven to improve patient care results by 18 percent (Budget Change Proposal, 2017). Once this program has been implemented, we will be able to monitor the progress by use of the registries that can be built to track specific data that is pertinent to monitor the program.

It will be important to be transparent with all staff involved in the implementation of this program. Staff need to be on board. Education and training will have to be done before implantation to allow staff time to process the changes and also time to ask questions. It will also be important to provide the staff with the why, the why this program is important for this patient population. So, providing the time for a mandatory on the job training that will discuss SUD as a medical condition. There is a great video done by Dr. R. Corey Waller “Addiction Neuroscience 101” that explains the addiction and the effects (Waller, n.d.). This video would be a great way to engage staff, get them to see addiction as not a person personal choice but as a chronic condition that requires long term medical treatment. NUR-590 Benchmark – Evidence-Based Practice Proposal Project: Framework or Model for Change

The data collecti on will be monitored by the Quality Management (QM) team. The way CCHCS sets up there HQ staff is there is a specialty nurse consultant group over every healthcare discipline, such as mental health, pharmacy, medical, nursing, there will be a nurse consultant group created for this program also and it will include each discipline also. The QM team will develop what to include on the registry that will capture the data needed to monitor the processes such as identifying patients that will be releasing within twelve months and identify patient that have had recent over doses. Other things that will need to be captured is the once screened for a SUD they will move on to another screening that goes in to detail about which drug is being abused and whether or not they meet criteria for MAT with CBI or just CBI. We will have to track appointments and compliance dates, medication management, making sure appropriate labs are being tracked. This can all be done by utilizing the registries. There will also be a team at each institution that will consist of a supervising RN (SRN), resource RN, and an analyst to track the data locally and then there will be the nurse consultants at HQ tracking all the institutions as a whole.

There are going to be many challenges as this program gets implemented. To try to mitigate some of those challenges we will need to make sure to choose the correct people for this program. There will be so many new positions for this program which will give the opportunity for those who believe in the project to apply. The management has the opportunity to pick those that are enthusiastic and who want to be a part of this program. This will help when the staff hired can go out and get others on board to understand the benefits of this program.

The implementation of this project has been proven to be successful in other states. Rhode Island was one of the first two states to develop a MAT program in their correctional institutions in 2016. They developed a process of screening their patient population with protocols to provide treatment medications such as methadone, buprenorphine, or naltrexone. Then they also partnered with community partners to ensure that patient was able to continue treatment after release, their program was fully operational by January 2017 (Greene et al., 2018). There will be a significant budget needed to implement a project of this magnitude but at the same time it will also save the state so much money on the death related to overdoses and the ED send outs related to SUDs. To get this project up and running it will take approximately $70 million for the general fund, then for 280 positions additional positions will require $160 million that will include salaries and benefits to continue hiring for all 35 institutions it will require addition staff to be hired in the next few years 2021-22, another 150 positions for a total of 430 positions which will require $164 million for the continuation of the MAT program.

For the program to be successful there will have to be continuous monitoring, meetings, and discussions regarding what is working and what does not. These meeting will have to include the multidisciplinary team members and all stakeholders. Three will need to weekly conference with the local level staff also to give a two-way communication to allow for changes to be discussed and also for questions to be asked. There needs to be a multidisciplinary approach when developing all the workflows, policies and procedures and local level staff need to be included since they are the ones doing the job and will have valuable insight. This project has so many benefits if it successful by our patient population releasing in in better health from being in treatment. It lessens the rates of communicable diseases, STIs, and can reduce recidivism rates.

Section F: Evaluation of Process

Monitoring the data and evaluating the program is an important part to ensure the programs outcomes and impact are understood. There are data monitoring tools and evaluation plans that can be utilized to track the activities of the Medicated Assisted Therapy (MAT) program. There are program metrics that should be tracked that can identify and help resolve issues faster, help there be a better understanding of the daily activities and also to identify the service impact over a period of time (Mace et al., 2020).

Outcome measures of the evidence-based project can evaluate if the objectives have been achieved. Evaluation of the outcome measures can start with information that is already being collected and easily pulled, such as medical data that is documented in the electronic health records. The goals of the metrics should be in collaboration with all stakeholders. Useful metrics are the ones that can help streamline feedback and accountability that will show the successes and ways to improve. For correctional MAT programs monitoring the data that tracks how well the program is being given and the outcome will show if the objectives are being achieved. If measures or metrics are chosen correctly it will help with strategic analysis and improvement. A main purpose for monitoring the data is to identify and resolve issues early (Mace et al., 2020). It is important to place attention on just a few key metrics that will be of value and can be addressed. In the correctional settings data across the continuum of care should be collected also. It should include data related to screening, treatment, and pre-release planning.

The outcomes that will be measured and evaluated are the identification of Substance Use Disorders and the treatment in the prisons. Then screenings of the inmate patients will be data that is collected with those who test positive identified for needing further assessment. The next measure to track is the those being offered the program and the initiation of treatment. Another measure to track is for those that complete the program and also tracking if coordination of care upon release was done. NUR-590 Benchmark – Evidence-Based Practice Proposal Project: Framework or Model for Change

If outcomes were not positive some strategies that can be taken to make improvement is to have multidisciplinary meetings with all stakeholders involved to review and address changes that need to be made. An important step to take is to evaluate the arear with negative results. If it was an issue with the methods used, it may require some adjustments. If there was nothing wrong with the method, then continue to monitor the data and share it with the stakeholders that can utilize the data so adjustments can be made when needed.

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The implications for this practice are needed because those with SUD in the correctional setting have a difficult time and it can be overwhelming when they transition back into the communities. Data has shown that within three months of release, 75 percent of people with an opioid use disorder experience a relapse (Berg, 2019). There is also data that newly released inmates are 10 and 40 times more likely to die of an overdose than the public with the first two weeks of release.

Appendix 1

Appendix 2

KEY COMPONENTS OF MAT PROGRAMS IN CORRECTIONAL SETTINGS

1. Preparing for Change

Identify a project champion. Develop an Implementation Team.

Obtain buy-in from leadership and staff at all levels. Assess current procedures and policies.

Develop goals and action steps. Monitor progress. NUR-590 Benchmark – Evidence-Based Practice Proposal Project: Framework or Model for Change

2.  Program Planning and Design

Determine which medications your facility will offer. Determine which program model is best for your facility. Determine who should be eligible for MAT.

Determine your program’s capacity. Develop a diversion protocol.

Determine your program’s recommendations for counseling.

3.  Workforce Development and Capacity

Provide staff training.

Develop a care team.

Identify appropriate staff-to-patient ratios. Provide ongoing staff supervision and support.

4.  Delivery of Treatment

Determine where and when MAT services will be delivered.

Determine which medication formulations to offer. Develop dosage guidelines.

Establish screening protocols to determine eligibility. Develop guidelines for ongoing care.

Develop protocols related to drug testing. Develop protocols for special populations.

Develop protocols for program discharge and release.

5.  Care Coordination and Linkages to Services Post-release

Connect patients to health insurance coverage. Coordinate care with community providers.

Provide linkages to social services and recovery supports. Provide education and resources to prevent opioid overdose.

6.  Data Monitoring and Evaluation

Identify who will conduct monitoring and evaluation activities. Identify key metrics to monitor progress and evaluate impact. Develop a plan for monitoring and evaluation.

7. Funding and Sustainability Assess existing resources. Determine program needs. Identify funding

Appendix 3

Budget Request Summary

Total Positions: 431.0

Total Salaries and Wages: $40,379 Total Personal Services: $60,886 Operating Expenses and Equipment General Expense: 705

Printing: 247

Communications: 460

Postage: 118

Insurance: 14

Travel: In-State 597

Training: 131

Facilities Operation: 2051

Utilities: 37

Consulting and Professional Services- External: 154 Consulting and Professional Services- Interdepartmental: 59009 Information Technology: 156

Non-Capital Asset Purchases- Equipment: 769 Other: 39483

Total Operating Expenses and Equipment: $103,931 Total Budget Request: $164,817

References – NUR-590 Benchmark – Evidence-Based Practice Proposal Project: Framework or Model for Change

DHCS: Behavioral health services: Medi-Cal behavioral health division. (2020). Retrieved from https://www.dhcs.ca.gov/services/Pages/MHSUDS.aspx

Hernandez-Delgado, H. (2019). Substance use disorders in Medi-Cal: An overview. Retrieved from https://healthlaw.org/resource/substance-use-disorders-in-medi-cal-an- overview/#_ftn4

SAMHSA- Substance Abuse and Mental Health Services Administration. (2019). http://www.samhsa.gov/find-help/disorders

Addressing some of the key factors when a patient is admitted with Substance Use Disorder. (2019). Retrieved from https://www.mghpcs.org/eed/SUD/Assets/documents/SUD/Nursing-Script-Language- Techniques-and-Safety.pdf

Doody, C. M., & Doody, O. (2017, June 11). Introducing evidence into nursing practice: Using the IOWA model. British Journal of Nursing, 20. Retrieved from https://www.researchgate.net/publication/51466031_Introducing_evidence_into_nursing_ practice_Using_the_IOWA_model

The Iowa model revised: Evidence-based practice to promote excellence in health care. (2017). Retrieved from https://uihc.org/iowa-model-revised-evidence-based-practice-promote- excellence-health-care

Budget change proposal: Integrated substance use disorder treatment program (DF-46(REV 08/17)) [Budget Proposal 2019/20]. (2017). https://esd.dof.ca.gov/Documents/bcp/1920/FY1920_ORG5225_BCP3149.pdf

Greene, T. C., Clarke, J., Brinkley-Rubinstein, L., Marshall, B. D., Alexander-Scott, N., Boss, R., & Rich, J. D. (2018). Post incarceration fatal overdoses after implementing medications for addiction treatment in a statewide correctional system. JAMA Psychiatry, 75(4), 405–Retrieved May 14, 2020, from https://doi.org/10.1001/jamapsychiatry.2017.4614

Improving processes and health outcomes at state correctional institutions case studies (Published on January 9, 2019) [Report]. (2019). HIMSS. https://www.himss.org/resources/improving-processes-health-outcomes-state-

correctional-institutions-case-studies

Kelso, J. C. (2018). Treatment to reduce the burden of disease and deaths from opioid use disorder [Report]. https://doi.org/https://cchcs.ca.gov/wp-content/uploads/sites/60/Reports/Drug-Treatment-Program.pdf

Research with prisoners. (2020). USC. Retrieved May 13, 2020, from https://oprs.usc.edu/irb-

review/research-with-prisoners/

Waller, R. C. (n.d.). YouTube. https://www.youtube.com/watch?v=bwZcPwlRRcc

Berg, J. (2019). Breaking the cycle: Medication assisted treatment (MAT) in the criminal justice system. Retrieved May 19, 2020, from https://blog.samhsa.gov/2019/03/15/breaking-the-

cycle-medication-assisted-treatment-mat-in-the-criminal-justice-system

Mace, S., Siegler, A., Wu, K., Latimore, A., & Flynn, H. (2020). Medication-assisted treatment for opioid use disorders in jails and prisons (National Council for Behavior Health). Vital Strategies. https://www.thenationalcouncil.org/wp-

content/uploads/2020/01/MAT_in_Jails_Prisons_Toolkit_Final_2020-01-30.pdf?

daf=375ateTbd56. NUR-590 Benchmark – Evidence-Based Practice Proposal Project: Framework or Model for Change

Assignment: Academic Success and Professional Development Plan Part 6: Finalizing the Plan

Assignment: Academic Success and Professional Development Plan Part 6: Finalizing the Plan

At some point in every construction project, efforts turn from design and the focus moves to actual construction. With the vision in place and the tools secured, the blueprint can be finalized and approved. Then it is time to put on hardhats and begin work.

Throughout the course you have developed aspects of your Academic and Professional Development Plan. You have put a great deal of thought into your vision and goals, your academic and professional network of support, research strategies and other tools you will need, the integrity of your work, and the value of consulting the work of others. With your portfolio in place, it is now time to finalize your blueprint for success.

Much as builders remain cognizant of the building standards as they plan and begin construction, nurses must remain mindful of the formal standards of practice that govern their specialty. A good understanding of these standards can help ensure that your success plan includes any steps necessary to excel within your chosen specialty.

In this Assignment you will continue developing your Academic Success and Professional Development Plan by developing the final component: a review of your specialty standards of practice. You will also submit your final version of the document, including Parts 1–5. Assignment: Academic Success and Professional Development Plan Part 6: Finalizing the Plan

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To Prepare:

Review the scope and standards of practice or competencies related to your chosen specialty.
Download the Nursing Specialty Comparison Matrix.
Examine professional organizations related to the specialization you have chosen and identify at least one to focus on for this assignment.
Reflect on the thoughts you shared in the Discussion forum regarding your choice of a specialty, any challenges you have encountered in making this choice, and any feedback you have received from colleagues in the Discussion.
The Assignment:
Complete the following items and incorporate them into the final version of your Academic Success and Professional Development Plan. Assignment: Academic Success and Professional Development Plan Part 6: Finalizing the Plan

Write a paragraph that provides a detailed comparison at least two nursing specialties, including your selected specialization and second-preferred specialization.
Write a clear and accurate 2- to 3-paragraph justification statement identifying your reasons for choosing your MSN specialization. Provide sufficient evidence of incorporating feedback you received from colleagues in this week’s Discussion Forum.
Clearly identify and accurately describe in detail the professional organization related to the specialization you have chosen to focus on for this assignment and explain how you can become an active member of this organization.
Note: Your final version of the Academic Success and Professional Development Plan should include all components as presented the Academic Success and Professional Development Plan template. Make all corrections to each part based on faculty feedback and submit a final and edited copy of the template (Part 1-Part 6) in correct APA format.

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Please note: Two specialty I Chose are Psychiatric-Mental Health Nurse Practitioner (First Choice), Family Nurse Practitioner (Second Choice). Thank you!

SAMPLE STUDENT APPROACH
Academic Success and Professional Development Plan Part 6: Finalizing the Plan
The current healthcare system is dynamic with changes aimed at improving the quality of care provided. As nurses, we play a significant role in helping revolutionize the provision of care services. Attaining my BSN was only a beginning to pave way for further advancement in my career life. Currently, I have decided to enroll in the masters of science in nursing (MSN) program at Walden University to gain the required knowledge and skills in specialized nursing practice. My main focus out of the available specialty option is to peruse a master’s degree in gerontology or psychiatry. Gerontology focuses on providing healthcare services to the elderly patients which have gained more market in the current healthcare system, whereas an MSN- PMHNP program mainly equips nurses with adequate knowledge and skills in delivering a full spectrum of care among patients suffering from psychiatric disorders including substance abuse issues and organic brain disorders (Endsley, 2017). Out of the two, I prefer enrolling in an MSN- PMHNP program, which aligns with my strength and prior knowledge in taking care of psychiatry patients.

The current healthcare system is overwhelmed with psychiatry patients as a result of increasing mental illness cases such as depression and anxiety. As such, there is an increased demand for psychiatry healthcare specialists across all disciplines including nurses. Assignment: Academic Success and Professional Development Plan Part 6: Finalizing the Plan

Consequently, nurses working in this field enjoy several benefits such as increased pay, with numerous job opportunities. Additionally, most of my colleagues have observed my good communication skills and a good relationship with my patients, which is crucial when taking care of patients with psychiatry disorders (Vargas et al., 2017). In the course of my BSN program, my preceptor, during my clinical rotation in the psychiatry department also observed my keen insight and good relationship with patients suffering from different mental disorders.

Consequently, in my report, she pointed out a good clinical outcome, among most of the patients who were under my care. As such, I find it very convenient and life-changing to focus on specializing in psychiatry, to help patients suffering from mental illness. However, it is very important to note that, the main challenge facing psychiatric nurses is forming a strong therapeutic relationship with patients suffering from mental illness together with their families.

In my professional line, I am looking forward to becoming a member of the American Psychiatric Nurses Association (APNA). This organization was founded in 1986 to provide leadership aimed at promoting psychiatric-mental health nurses, and improving the quality of mental health care services for patients from different cultural backgrounds, and shape the healthcare policies associated with improved mental health services (Delaney, Drew, & Rushton, 2019). APNA membership incorporates all PMH nurses (RN), including baccalaureate (BSN), associate degree (ADN), and advanced practice (APRN). Members of this organization come from different healthcare settings such as inpatient, academic, community, and research settings, in both private and public sectors, and healthcare institutions at both federal and state levels.

APNA has made it easier for nurses to advance their education hence improving the quality of services provided to patients with mental illness, as such, becoming a member of this organization will help in advancing my career, and advance my knowledge and skills in taking care of psychiatry patients.

References

Delaney, K. R., Drew, B. L., & Rushton, A. (March 01, 2019). Report on the APNA National Psychiatric Mental Health Advanced Practice Registered Nurse Survey. Journal of the American Psychiatric Nurses Association, 25, 2, 146-155. https://doi.org/10.1177/1078390318777873

Divane de Vargas, Janaina Soares, Talita Dutra Ponce, & Bruna Batista de Oliveira. (January 01, 2017). PSYCHIATRIC URGENCY AND EMERGENCY CARE NURSES: AN ANALYSIS OF THEIR PROFESSIONAL AND EDUCATIONAL PROFILE. Cogitare

Enfermagem, 22, 4.) https://pdfs.semanticscholar.org/b73d/25882372abdd7f69079cd553b590845f441f.pdf

Endsley, P. (January 01, 2017). School Nurse Workload: A Scoping Review of Acute Care, Community Health, and Mental Health Nursing Workload Literature. Journal of School Nursing, 33, 1, 43-52. https://doi.org/10.1177/1059840516681423. Assignment: Academic Success and Professional Development Plan Part 6: Finalizing the Plan