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peer responses essay

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peer responses essay

 

1—- At my clinical site, one internal method for the dissemination of my EBP project would be a team of people elected by the corporation’s shareholders to represent the shareholders’ interests and ensure that the company’s management acts on their behalf. The head of the board of directors is the chairman or chairperson of the board. The external method for the dissemination of your EBP project who be “The American Nurses Association (ANA), they are a premier organization representing the interests of the nation’s four million registered nurses. ANA is at the forefront of improving the quality of health care for all. One that we, as nurses, practices every day.

It is important to report my results to both of these groups: a) Stakeholders can affect or be affected by the organization’s actions, objectives, and policies. b) On the other hand, ANA knows that recognizing the essential value of nurses is just the start. Nurses work in all health care settings and have a unique perspective given that we serve in so many diverse roles and specialties. As a result, nurses can offer insights and contributions on how to improve health care in this country.

One’s lines of communication need to be robust, monitored, and evaluated. This also relates to organizational influence and responsibilities of an individual, and one also needs to recognize their role and appreciate the roles of others, to change each group.

2——– At the Indian Health Council, it is important to share project results with the staff who are participating in the project and those who are affected by the changes. Change agents often use graphs or statistics to show that the project is making a positive impact on patient care. “Reporting of project results is essential to garner continued support and recognition for the program” (Cullen, Dawson, Hanrahan, & Dole, 2014, p. 285). When staff realize that they played an important role in the project, there is more support for the new project, and staff feel recognized for their hard work. This would be an internal method for sharing the EBP (evidence-based practice) project. Staff can see what is working and may have input to continually improve the project.

When looking at the results for a project on screening, brief intervention, and referral to treatment (SBIRT), staff may take ownership of the project when they see an increase in the number of patients with positive screens getting brief interventions or referrals to treatment. In addition, the project results can be shared with other directors in the clinic, which promotes more support for the project. According to Cherry (2017), an “…effective change agent will understand that a change in one area almost always will affect another group or department…” (p. 311).

An external method for sharing this nurse’s EBP project results might be sharing the results with tribal leaders, other Indian Health Clinics, or sharing the results in a community newsletter. This shows that the clinic is striving to use the best-evidence based practices to improve patient care and safety. Patients, family members, and community leaders can see the positive impact that the project is making on their community. This not only keeps the clinic in business, but it demonstrates that the clinic is providing quality care for its patients. When presenting the project to the community, the must use language that is understandable and culturally sensitive, which demonstrates that the staff at Indian Health Council cares about their patients. Confidentiality and the stigma of going to a behavioral health department can be barriers, so addressing these concerns can change the way the community thinks about counseling or seeking treatment.

When sharing a new project, both the community and staff need information so that everyone understands what the new project is about, but it may need to be disseminated differently. For example, staff may need a written policy and a PowerPoint presentation while the community may get a flier or newsletter explaining the new project. The change agent needs to communicate with leadership and tribal leaders, so that the project is supported. If the project results in positive changes, it may help the change agent obtain more resources to improve the project. For example, if SBIRT is more effective with a behavioral health counselor working out of the medical department, leadership may decide to fund or write a grant for a full-time person in the medical department to help perform counseling and interventions. Who disseminates changes in your practice?

3—–Communication is key to any new or changing initiative and can make or break the success of the project. With this realization, it’s important to outline a plan to communicate our capstone project; in turn, planning for the success of our project. The best way to promote communication of a project is to engage your audience and ensure there is a solid foundation of understanding regarding the project (Krizner, 2019). We can all appreciate that with the ever mounting list of tasks nurses have on their plate, resistance is often a factor when we are tasked with a new project without appreciating why it is needed. Communication can help curb some of this resistance by outlining the goal of the project and how it will help patient outcomes. The way I have and continue to plan for communication is the following.

Internal communication has been a relatively easy task for my project. I feel this is largely due to the strong argument that I made for my project early on; demonstrating it’s validity in research studies and outlining a solid plan for implementation in our department. During my research thus far, I have been able to communicate my project internally by means of email communications, presentations at meetings, and corroboration with other team members. This has allowed for better team collaboration and seemingly allowed for better acceptance by my peers and providers.

External communication has been more informal as my current capstone project is still in its infancies and doesn’t yet have a large “reach” into the community. An external member that I have worked with is meals on wheels, which is a community-based service that provides nutritional services to patient’s homes. For one of my patients, I was able to work with this organization to organize a low sodium diet to a patient suffering from heart failure. In this instance, I was able to work with the manager of our community service and explain the goal of the project and how this dietary need would help facilitate better outcomes for the patient. Through this contact, I was able to establish a line of communication with the manager and have since reached out to her multiple more times with similar patient care needs.

Communication is a constant state and continues to evolve, beyond this, nurses often need to mediate health care-related situations and effective communication skills are essential (as cited in Cherry, 2017). From the examples above, you can see that it has been easier to communicate when an established team has been identified; as is apparent with my immediate department. External communication has been more of a challenge as I’m still learning about new resources that may be beneficial to include with this project. Nonetheless, it is important to continue to leverage strong communication techniques as the project grows and changes. My plan is to summarize the conclusion findings of my study and send them to those stakeholders who have been involved in the project upon its completion.

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4————When disseminating evidence based research there are three questions that need to be answered to be sure that the evidence found is effective to use. The ability to determine if evidence is trustworthy, valuable, and of high-quality is called critical appraisal. The three questions are:

  1. Is the evidence of good quality?
  2. Would the findings apply in the proposed setting? Are the subjects in the study similar to the patients under the nurse’s care, for example?
  3. What are the consequences of the evidence for patients or clients? In other words, what would implementation of practice techniques in the evidence mean for patients or clients? What would be the pros and cons?

ALL PEER RESPONSES SHOULD BE MINIMUM OF 60 WORDS WITH PROPER CITATION AND REFERENCES.

peer responses essay

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peer responses essay

1———– The professional journal topic “Preventing and managing catheter-associated urinary tract infections.” Since the Foley catheters were introduced in the 1930s, it has become one of the primary sources of hospital-acquired infections, and long term urinary catheters used in community-based patients account for some 4% of community nurses’ time. This burden is likely to increase given the projected rise in life expectancy and the size of the aging population. This article considers the current literature around indwelling urinary catheterization and its management with a focus on long term catheterization in the community. My choice is the best option for disseminating new knowledge because “the authors discuss contemporary strategies to manage or prevent CAUTI that based on best practice guidelines.” However, it is clear from the dearth of empirical evidence that there is an urgent need to establish constructed research studies to investigate the prevalence of long term urinary catheterization in the community and the prevention and management of CAUTI.

The next topic nursing health conference journal topic is “Reducing catheter-associated urinary tract infections” As this piece states “Catheter-associated urinary tract infections (CAUTIs) are the most frequent type of healthcare-acquired infection, accounting for up to 80% of hospital-acquired infections. CAUTIs can lengthen hospital stays, increase morbidity and mortality, and raise healthcare costs. The Centers for Medicare & Medicaid Services no longer reimburses hospitals for additional costs generated by CAUTIs. My choice is the best option for disseminating new knowledge because this article reports on a pilot study of an evidence-based intervention to reduce CAUTIs.

2————- In order to disseminate evidence-based practice and research on SBIRT (screening, brief intervention, and referral to treatment), this nurse would like to inform other nurses by writing an article for a nursing journal, for example, the American Journal of Nursing (AJN). Sharing evidence-based research can help others improve SBIRT in their practice by sharing workflows and best practices. Nursing journals are read by many nurses online and many receive subscriptions to journals like AJN. In order to disseminate research, the nurse wants to share it with as many nurses as possible, and nurses from different disciplines read nursing journals. The American Journal of Nursing is well-known, peer-reviewed, and discusses the latest information on nursing practice. Sharing information helps improve nursing practice and patient care. SBIRT can be used in any practice and substance abuse impacts many patients, so this topic can benefit any nurse.

According to Christenbery & Latham (2013), “… an abstract, poster, and podium presentation can be used to support the translation of nursing evidence into effective nursing practice” (p. 22). For example, this nurse could share her project at an Indian Health Service (IHS) conference that is dedicated to educating other Native American clinics on best practices for GPRA (Government Performance Results Act). Key leaders of IHS would need to be contacted in order to present at the next IHS conference. Sometimes best practices are shared in a webinar, which can be more cost effective for some clinics because staff do not have to travel. Facilities, who have done well meeting GPRA indicators, can share workflows and best practices with other Indian Health clinics in this way. “Instead of independently exploring evidence, nurse leaders can utilize evidence-based recommendations from clinical practice guidelines and tailor them to the organization, population, or setting” (Cullen, Dawson, Hanrahan, & Dole, 2014, p. 288). Using evidence-based practices that work will save a facility time and money because staff members do not have to do the research, they just need to make a few changes so that the new practice fits into their workflow.

3—-In dissemination of my change project, I will focus on the journal that will reach and target a bigger audience. Pressure of ulcers is easily preventable yet, the problem remains a major concern in healthcare facility. As a result, I opt to use the Nursing Research and Practice Journal. The journal is majorly in used in the publication of the nursing researches as well as practices. Also, this is an open access journal which has a great probability of making the journal available to a large audience addressed in the change project (Nursing Research and Practice, 2019).

Furthermore, publishing my research using this journal is important since the whole columns of the publications in this journal are read by a great percentage of the population. The publications in this journal are not comprehensive in terms of the number of pages which makes them suitable to be read by even those people who are in a hurry. Pressure of ulcers is as result of insufficient information to address the problem, capitalizing on dissemination of information to the general public will increase the likelihood of addressing the patients or patient’s family hence, preventing escalating levels of pressure of ulcers (Cai, Rahman, & Intrator, 2014).

My opted healthcare conference is the World Nursing and Health Care Conference the conference is offered in an international venue and is universally identified as one among the most inventive and knowledge-intensive areas in universe and a top provider of products and solutions in vital segments like ICT, Cleantech, and Life Science (The conference, 2017).

4———–Evidence-based practice (EBP) is the conscientious and judicious use of current best evidence in conjunction with clinical expertise and patient values to guide health care decisions. According to the authors of the book Evidence-based practice in nursing & healthcare, the movement of healthcare organizations to involve nurses in decision-making has prompted employers to seek a larger percentage of employees who have furthered their education and earned a Bachelor of Science in Nursing (BSN) degree. Also, “as healthcare evolves to meet changing market dynamics, evidence-based practice in nursing, which is taught in baccalaureate programs, has become a key component in improving patient care and outcomes” (Melnyk, & Fineout-Overholt, (Eds.), 2014).

Therefore, EBP is an essential component of the practice of a BSN-prepared RN for many reasons among them being a decrease in the cost of healthcare and reduction of medical errors experienced across diverse healthcare facility around the country.

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Barriers

Although EBP is associated with significant clinical practice, there are barriers which hinders its implementation in the healthcare facility. One barrier I have personally noted in the implementation of EBP is the time taken to implement and cause change within the facility. In this case, EBP is time consuming and what is more, there might be less evidence to support the change. This can be a challenge as most of the management might not support the EBP (Hanberg, & Brown, 2016). Lack of management support is a great impediment that can demotivate the nurses to complete EBP. However, involving the management in the EBP implementation process can greatly help in involving them in the change proposal.

 

Tags: nursing