Fluent Essays

evaluate a practice problem   Information used in Week 4 may be used as the basis for this. The goal is to develop a deeper understanding of the practice issue, using continuous quality improvement tools; specifically, a failure mode & effect analysis (FMEA) of the selected practice problem and an Ishikawa (fishbone) cause and effect diagram to analyze, improve, or mitigate related risks.    four components: first, identify a practice problem stated in PICOT format; second, conduct a failure mode & effect analysis of the practice problem; third, develop an Ishikawa (fishbone) cause and effect diagram to analyze, improve, or mitigate related risks and fourth, create a professional power point presentation with speaker notes for each slide to disseminate this information. Template: Failure Modes and Effects Analysis Step in Process Failure Mode Failure Cause Failure Effect Occurrence Likelihood Detection Likelihood Severity Risk Profile Number Actions to Mitigate Risk Occurrence Likelihood rate 1-10 (10 means most likely to occur) Detection Likelihood rate 1-10 (10 means least likely to be detected) Severity rate 1-10 (10 means most likely to cause severe harm) To calculate Risk Profile Number: Multiply Occurrence Likelihood times Detection Likelihood times Severity = Risk Profile Number Submit completed FMEA form to assignment link for grading, place on presentation slide, and summarize FMEA findings in your presentation slide. (see Practice Problem Analysis Guidelines and Rubric) 9/12/2019 Version Fishbone Diagram Template Name:             Cause Effect To complete click on grey box and type. People Environment                                                                                                                                                       Methods Equipment Materials How to develop your cause and effect diagram: 1. Identify practice problem you are trying to improve in the effect box. 2. In each category of causes, (a) people, (b) environment, (c) materials, (d) methods, and (e) equipment input causes for the effect. (See example and rubric). 8/19/2019 VERSION A Practice Problem Title Here Name and Credentials Here NR 706 Week 6 Practice Problem Analysis Assignment Instructor’s Name Here Revised 9/12/2019 Practice Problem Identification State the Practice Problem in PICOT format (1 slide) Identify all PICOT components 2 Background/Significance Evidence from research explaining background/significance of practice problem (no more than 1-2 slides – cited in APA) Include inclusion criteria for population of interest Include exclusion criteria for population of interest Failure Mode & Effect Analysis (FMEA) Place FMEA form here, answer questions below, and summarize analysis. (1-2 slides) Place diagram on slide and then answer: Which step is the most important to focus resources? The one with the highest risk profile number? How did this analysis benefit your understanding of your practice problem. Summarize analysis 4 Ishikawa (Fishbone) Diagram Place diagram here, answer questions below, and summarize analysis. (1-2 slides) Place diagram on slide and then answer: Of the five categories which are the most important to focus on for your practice problem and why? How did this analysis benefit your understanding of your practice problem. Summarize your analysis Conclusion Summarize the purpose and findings of the analysis Provide and justify the main conclusions Draw inferences from the quality improvement analysis 6 References Includes in-text citations throughout the PowerPoint Presentation Provides complete matching references in APA format Grammar and Mechanics throughout the PowerPoint Presentation are free of errors Note: This presentation should be submitted to the assignment link 7 TRANSLATION SCIENCE 13 Translation Science Project July 26, 2021 Comment by Shannon Hawkins: In the Resources tile (located on our course homepage) you will find the link to the Writing Center and a APA 7th edition template paper for you to download and use when writing future papers. There were significant APA formatting concerns with this paper. In 7th edition, the running head is no longer used. You also did not use an approved font style or 12font size. Your use of level headings was not correct as was not the reference page. I encourage you to print a copy of your paper and compare it to the APA template paper located in the Writing Center. Have you also attended the writing sessions? Dates and Times are located in the course Announcements. This is another valuable resource available to students. *This is a solid paper outlining a translation science project. My feedback is intended as guidance for your consideration. Attached is a copy of your paper with my feedback using track change comments. You are off to a nice start in your journey in evidence based practice through this translation science project. Although you did gain full points in many areas for addressing the question being asked, the content itself was missing key pieces that will be necessary to fully investigate substance abuse in youth as a practice problem. I noted several areas that require additional development. Good news is that the DNP Project is iterative. This is your starting point. Continue to immerse yourself in the research evidence. There is a plethora of research study evidence to support the development a compelling practice problem, and this evidence can be synthesized to strengthen your proposal, intervention, and evaluation. I strongly encourage you to review my comments and make adjustments as you will incorporate much of this information in to your Week 6 project. Significant APA errors noted throughout so please make use of the Writing Resources for DNP students and use the APA 7th edition paper template moving forward. The evidence summary table was also missing and either could have been added as an Appendix at the end of the paper or as a separate attachment, but neither were located. Detailed comments attached through the paper. Translation Science Project Introduction The paper seeks to identify the practice problem, synthesize available evidence, and appraise the evidence to determine its applicability in addressing substance abuse in health care settings. The practice problem is substance abuse challenging to address both at the state and national levels. Stakeholders have made efforts, and there has been a slight improvement over the past few years. However, youth are still vulnerable to substance abuse, damaging the quality of life in the community. Evidence is essential in addressing the practice problem because it offers the most effective care available, aiming to improve patient outcomes. When evidence is applied, patients expect to receive the most effective care based on available appraised evidence (Kelly & Mee-Lee, 2019). Stakeholders identify knowledge gaps, formulate questions, and conduct a literature search. Then, they determine the validity of the evidence found and apply them to improve patient outcomes. The DNP scholars aim to improve patient outcomes through enhanced healthcare delivery. DNP scholars focus on the scholarship of practice and translate evidence into practice using quality and effective methodologies. They also identify gaps that need to be addressed through literature to inform practice. DNP scholars are taking part in academic nursing, where they take part in studying the prescription of drugs and strategies that improve patient care. DNP scholars are also skilled in gravitating scholarship of discovery and create/refine knowledge to improve healthcare delivery. Comment by Shannon Hawkins: You nicely introduced the practice problem, your purpose statement is clear and concise, you stated an ;evidence-based solution’ but did not provide the pertinent background information regarding the evidence itself, and the role of the DNP practice scholar is described. Practice Problem and PICOT question There are significant trends of substance abuse in Florida. CDC reports that fatalities from alcohol poisoning are higher in Florida compared to any part of the US. The practice problem has impacts on individuals, families, and communities. Substance abuse has cumulative effects that contribute to physical, mental, and economic challenges on a long-term basis. Comment by Shannon Hawkins: Where is the source that this data came from? Remember to credit all outside sources with in-text citations and include them o your reference page. Millions of Florida residents are dependent on substance abuse. The media portrays huge masses of Floridians, especially college students indulging in substance abuse. Although it is uncommon for the underage, reports indicate that a small number of underage citizens are in substance abuse (Sharp et al., 2019). In Florida, many Citizens continue trapped into addiction. The economic ramifications of substance abuse cannot be ignored. If this problem is not treated on time, the problem places a burden on the healthcare system, workplace, and communities. Families spend many resources so that their loved ones can access health services. The corporate sector loses about $120 billion in productivity because of high labour costs. The government also channels much money in substance abuse treatment instead of using the funds in other construction projects. Comment by Shannon Hawkins: Where did this statistics come from? Credit the source. PICOT Question P-The main population affected by substance abuse in Florida is the youth population which records the highest level of substance abuse and related disorders. I-SBIRT C-Practice as usual O-The objective of the intervention is to reduce the rate of substance abuse in Florida. T-six months Comment by Shannon Hawkins: You nicely described the significance of the practice problem, you included pertinent background information regarding the evidence including the prevalence and the economic ramifications. The PICOT question was not provided in question format as expected but rather listed and therefore, points deducted. In addition, the PICOT format requires further development. Please see feedback below on each aspect. P = Population Youth in Florida. The population refers to the population of patients/subjects you plan to investigate as part of your DNP project. You certainly cannot implement a project that reaches all youth in the state of Florida. You must narrow the scope of your population as it relates to your project setting. Think about a specific age range, gender, admission diagnosis, outpatient vs. inpatients or other smaller demographic or region. This will help when it comes time to implement and collect data. I = Intervention SBIRT. This is too vague as written and because not in question format, nothing is explained as to what SBIRT is. Here, you need to fully elaborate exactly what your evidence-based practice intervention is. Your literature search should be guiding you towards what best practice is and what is most suitable for your chosen population and project setting. C- Comparison Practice as usual. What does “as usual” look like exactly? And how often? Here, you need to think about what is currently taking place in practice, and how it is contributing or causing the issue you are addressing. If there is currently nothing being used in the setting, then articulate that there is no comparison and why. O = Outcome Reduce the rate of substance abuse. This is where you need to think about the outcome you are expecting. What exactly will you measure, what validated tool will you use? and how will you determine if your intervention was a success? T = Timeframe Six months. The timeframe should be specific to how long you could reasonably implement your intervention at your project site and retrieve and analyse at least preliminary data. The typical DNP project lasts 6-10 weeks. Evidence synthesis Scope The synthesis focuses on the main points of each study before conducting a comparison between the four studies to determine the similarities and differences in findings. The synthesis will only focus on relevant aspects in answering the EBP question and addressing the practice problem. Main points from each source A-The study was a systematic comparison of randomized control trials in primary care stings. The researchers aimed to determine the efficacy of the SBIRT model in drug abuse management in primary care settings and revealed that SBIRT is effective. The research revealed that the model is effective but noted differences in outcomes based on age, gender, insurance, race, and the primary problem drug. B-Patel aimed to investigate the SBIRT model in primary care settings. He reviewed RCTs using Google Scholar, PubMed, and CINAHL. There were mixed results from the study, indicating that different factors shape the outcomes of SBIRT implementation. The researcher found that the use of computerized programs and motivational interviewing yields better results. C-The researchers conducted a systematic review of clinical intervention studies that revealed that patient cares cognitive behavioural and coordinated interventions enhance substance abuse management and treatment outcomes. However, Vogel et al. recommended more quality studies in the treatment of substance abuse disorders. D-The study involved the assignment of 181 patients with HCV and qualifying alcohol screener scores to SBIRT. The study revealed that SBIRT intervention is effective for patients with HCV. However, the researchers pose that the intervention is more effective when medical service providers offer emotional support to motivate the patients. The study also points out that referrals should be part of standard care. Comparison of main points across sources All the sources pose that the SBIRT model is effective in substance abuse management. If implemented correctly, it can help address the clinical problem in primary settings and the community. All the sources acknowledge deficiency in quality evidence and propose that further research is needed to solidify existing evidence. All sources agree that the environment and other factors such as motivation from healthcare workers to enhance outcomes. Sahker et al. reveal that the model is adequate. However, the researcher points out social factors such as sex, age, gender, ethnicity, and access to insurance as determining factors in the models effectiveness. On his part, Patel reveals that the model is effective, but the use of motivational interviewing and computerized programs yields additional results. Also, Vogel et al., believe that motivational interventions and coordination will lead to better outcomes. Lastly, Proschold-Bell et al. believe that emotional support from service providers enhances patient outcomes. Comment by Shannon Hawkins: You have displayed the main points of each source and compared the main points across sources. You did not consistently refer to the articles by their author or use in-text citation when referring to them, of which both are expected and mentioned in the Weekly Course Check-In sessions and recordings. Instead, you listed them as articles A.B. C, and D. The scope of evidence however refers to the databases searched, any exclusion criteria in the search and any key words used to locate the evidence which were not evident in this section of the paper. Again, formatting is significantly off. Level headings, font size and type, no indention in new paragraphs and missing in-text citations. Appraisal of Evidence Comment by Shannon Hawkins: The Evidence Summary table was not attached to the appendix as expected or as a separate submission as allowed. Also, the template) in the project guidelines was not applied and this table provided (or conceptual map if that is this case) is missing critical information such as the Sample, Sample Size & Setting Study findings that help answer the EBP question Limitations If the table presented here was to be the form of a conceptual map, it does meet criteria for displaying level and quality of evidence. Suitability is presented but no description on any of those aspects provided. Evidence Level of Evidence Quality rating of evidence Suitability Sahker, E., Sakata, M., Toyomoto, R., Hwang, C., Yoshida, K., Luo, Y. & Furukawa, T. A. (2020). Efficacy of brief intervention for drug misuse in primary care facilities: a systematic review and meta-analysis protocol. BMJ Open, 10(9), e036633. II Good Suitable Patel, R. (2019). Brief Intervention and Referral to Treatment (SBIRT) in Patients with Opioid Use Disorders in Primary Care: Evidence for Efficacy. I Very good Very suitable Vogel, E. A., Ly, K., Ramo, D. E., & Satterfield, J. (2020). Strategies to improve treatment utilization for substance use disorders: a systematic review of intervention studies. Drug and alcohol dependence, 212, 108065. I Very good Very suitable Proeschold‐Bell, R. J., Evon, D. M., Yao, J., Niedzwiecki, D., Makarushka, C., Keefe, K. A., ... & Muir, A. J. (2020). A randomized controlled trial of an integrated alcohol reduction intervention in patients with hepatitis C infection. Hepatology, 71(6), 1894-1909. III Average Suitable Translation path External factors for consideration Internal factors for consideration Steps of Evaluation Anticipated outcomes Strategies for sustainability Organizational support. Availability of resources. Time factors. Clinical usefulness of the evidence. Nurses’ skills. Existing knowledge in the use of evidence. Knowledge of research language. Belief in the value of EBP. Formulating clinical questions. Obtaining credible research. Appraise the evidence critically (Swank & Mullen, 2017). Integrate evidence with expertise. Determine outcomes. Standardized healthcare practices. Enhanced professionalism. Improved patient outcomes (Louie et al., 2018). Individual and collective leadership. Regular reflections. Maintain a yes, we can attitude. Performance evaluation. Comment by Shannon Hawkins: You have listed some internal and external factors impacting the translation of evidence. You also described anticipated outcomes, strategies for sustainability and plan to evaluate success of the project. As this section was displayed a conceptual map without any discussion or description, it made it difficult for the reader to identify how the evaluation plan, anticipated outcomes or strategies for sustainability were pertinent to the practice problem and the evidence supporting your intervention. No points deducted but this certainly requires further development to make these aspects specific to your project. How do the anticipated outcomes you listed pertain to reducing substance abuse in FL youth? Your evaluation steps should be those you are taking as part of your project to gauge the effectiveness of your intervention. A visual was provided and implied to be a Change Model but no mentioned or display of what that Model actually is called. therefore, points deducted for that reason. No references or supporting comments or title located anywhere that identifies the model being used…only the elements of an unkown model. Translation model Conclusion Substance abuse is a significant problem in Florida whose prevalence and economic ramifications are worrying. Despite many efforts done to address the matter, the current trends are still significant. The economic ramifications are significant at individual, family, and community levels. The state and federal governments also experience the financial burdens associated with the treatment of substance abuse. DNP scholars must be active in evidence translation to promote evidence-based practice that enhances patient outcomes. DNP scholars also identify knowledge gaps and refine existing knowledge for enhanced patient outcomes. Comment by Shannon Hawkins: Your conclusion provides a brief discussion on the impact of the practice problem. A summary of the appraisal of evidence and summary of the DNP Practice Scholar’s role in evidence translation was not addressed. References Comment by Shannon Hawkins: References should be bolded and aligned in the center of page. Hanging indents on each citation are not present. A doi is preferred over a url when available but no need to include both. Again, the font style and size is not correctly formatted. Also, the incorrect use of font size greater than 12 makes the paper longer than it actually is. When you edit to make it 12font as expected per guidelines and remove the Evidence Summary table which should have either been at the end of the paper or as a separate attachment, your paper length is only at 6pages at most. Kelly, J. F., & Mee-Lee, D. (2019). Quality, accountability, and effectiveness in addiction treatment: The Measurement-Based Practice Model. In The Assessment and Treatment of Addiction (pp. 207-217). Elsevier. URL: https://psycnet.apa.org/record/2018-18838-015 DOI: https://psycnet.apa.org/doi/10.1016/B978-0-323-54856-4.00015-8 Louie, E., Giannopoulos, V., Baillie, A., Uribe, G., Byrne, S., Deady, M., ... & Morley, K. C. (2018). Translating evidence-based practice for managing comorbid substance use and mental illness using a multimodal training package. Journal of dual diagnosis, 14(2), 111-119. URL: https://www.tandfonline.com/doi/abs/10.1080/15504263.2018.1437496 DOI: https://doi.org/10.1080/15504263.2018.1437496 Patel, R. (2019). Brief Intervention and Referral to Treatment (SBIRT) in Patients with Opioid Use Disorders in Primary Care: Evidence for Efficacy. URL: https://cdr.lib.unc.edu/concern/honors_theses/6682x861r DOI: https://doi.org/10.17615/x402-8175 Proeschold‐Bell, R. J., Evon, D. M., Yao, J., Niedzwiecki, D., Makarushka, C., Keefe, K. A., ... & Muir, A. J. (2020). A randomized controlled trial of an integrated alcohol reduction intervention in patients with hepatitis C infection. Hepatology, 71(6), 1894-1909. URL: https://aasldpubs.onlinelibrary.wiley.com/doi/abs/10.1002/hep.31058 DOI: https://doi.org/10.1002/hep.31058 Sahker, E., Sakata, M., Toyomoto, R., Hwang, C., Yoshida, K., Luo, Y. & Furukawa, T. A. (2020). Efficacy of brief intervention for drug misuse in primary care facilities: a systematic review and meta-analysis protocol. BMJ Open, 10(9), e036633. URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7470504/ DOI: https://dx.doi.org/10.1136\%2Fbmjopen-2019-036633 Sharp, A., Young, M. S., & Moore, K. A. (2019). Relationship between substance use, bullying, and other delinquent behaviors among high school students: a secondary analysis of the Florida Youth Substance Abuse Survey. The journal of behavioral health services & research, 46(4), 570-585. URL: https://www.semanticscholar.org/paper/Relationship-Between-Substance-Use\%2C-Bullying\%2C-and-a-Sharp-Young/8ad21a757b3e3ec2cfe1b65bdd3278862424ad3c DOI: https://doi.org/10.1007/s11414-019-09649-5 Swank, J. M., & Mullen, P. R. (2017). Evaluating evidence for conceptually related constructs using bivariate correlations. Measurement and Evaluation in Counseling and Development, 50(4), 270-274. URL: https://scholarworks.wm.edu/aspubs/261/ DOI: https://doi.org/10.1080/07481756.2017.1339562 Vogel, E. A., Ly, K., Ramo, D. E., & Satterfield, J. (2020). Strategies to improve treatment utilization for substance use disorders: a systematic review of intervention studies. Drug and alcohol dependence, 212, 108065. URL: https://escholarship.org/content/qt1c02k9p9/qt1c02k9p9.pdf?t=qfw0qp DOI: https://doi.org/10.1016/j.drugalcdep.2020.108065