Fluent Essays

To Prepare: · Reflect on the four peer-reviewed articles you critically appraised in Module 4, related to your clinical topic of interest and PICOT. · Reflect on your current healthcare organization and think about potential opportunities for evidence-based change, using your topic of interest and PICOT as the basis for your reflection. · Consider the best method of disseminating the results of your presentation to an audience.  The Assignment: (Evidence-Based Project) Part 4: Recommending an Evidence-Based Practice Change Create an 8- to 9-slide PowerPoint presentation in which you do the following: · Briefly describe your healthcare organization, including its culture and readiness for change. (You may opt to keep various elements of this anonymous, such as your company name.) · Describe the current problem or opportunity for change. Include in this description the circumstances surrounding the need for change, the scope of the issue, the stakeholders involved, and the risks associated with change implementation in general. · Propose an evidence-based idea for a change in practice using an EBP approach to decision making. Note that you may find further research needs to be conducted if sufficient evidence is not discovered. · Describe your plan for knowledge transfer of this change, including knowledge creation, dissemination, and organizational adoption and implementation. · Explain how you would disseminate the results of your project to an audience. Provide a rationale for why you selected this dissemination strategy. · Describe the measurable outcomes you hope to achieve with the implementation of this evidence-based change. · Be sure to provide APA citations of the supporting evidence-based peer reviewed articles you selected to support your thinking. · Add a lessons learned section that includes the following: · A summary of the critical appraisal of the peer-reviewed articles you previously submitted · An explanation about what you learned from completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template (1-3 slides) Part 4: Disseminating Results Create a 5-minute, 5- to 6-slide narrated PowerPoint presentation of your Evidence-Based Project: · Be sure to incorporate any feedback or changes from your presentation submission in Module 5. · Explain how you would disseminate the results of your project to an audience. Provide a rationale for why you selected this dissemination strategy. 81 (81\%) - 90 (90\%) The narrated presentation accurately and completely summarizes the evidence-based project. The narrated presentation is professional in nature and thoroughly addresses all components of the evidence-based project. The narrated presentation accurately and clearly explains in detail how to disseminate the results of the project to an audience, citing specific and relevant examples. The narrated presentation accurately and clearly provides a justification that details the selection of this disseminaEvidence-Based Project Shola Owoyemi Dr. Doris Hill NURS 6052 December 31, 2020 Clinical Issue The clinical issue selected is about stroke care. One of the guidelines that is provide is a complete bedside dysphagia screen by the nursing staff. One of the methods of care is oral care every two hours. The issue is on whether there are long term outcomes related to good oral care for the patients who suffer from stroke. PICOT Question “In acute stroke patients with dysphagia, how does an oral care regimen help reduce aspiration pneumonia rather than no oral care regimen?” (P) Stroke patients with dysphagia (I) Frequent oral care regimen (C) No oral care regimen (O) Reduce aspiration pneumonia (T) Three weeks post-implementation I developed the PICOT question based on the experience that I have working in a stroke unit. The question is developed because there is a strict protocol when it comes to taking care of stroke patients. I looked at how the oral care regimen that is recommended every two hours can help in the overall health outcomes of the patients. Research Databases I began by searching the Walden University Library using the key words “oral care”. I then used the Boolean operators as per the Library of Congress guidelines. The next database I used is Cochrane Database of Systematic Reviews.  The final database I used is MEDLINE with full text using “oral care (stroke OR dysphagia).”  Peer Review Articles Daniel, K. M., & Smith, C. Y. (2018). Present and future needs for nurses. Journal of Applied Biobehavioral Research, 23(1),e12122. Haryanto, M. (2019). Nursing shortage: Myth or fact? Orthopaedic Nursing, 38(1), 1-2. Snavely, T. M. (2016). A brief economic analysis of the looming nursing shortage in the United States. Nursing Economics, 34(2), 98-101. Plank, L. (2018). Academic-practice partnerships to reduce the shortage of operating room nurses. Nurse educator, 43(6), 326-329. Levels of Evidence The first study has a level V of evidence because it is a literature review of several current study. The second study is also a level V level of evidence as it used review of studies on the issue. The last two studies are level VI with a single study being used. There are several strengths the first one being the methods used in selecting studies can help reduce bias and is more likely to have accurate and reliable conclusions. The systematic review is also better because it is easier for reading by the end user and enhances understanding.. Evaluation Table Evidence-Based Project, Part 4A: Critical Appraisal of Research Full APA formatted citation of selected article. Article #1 Article #2 Article #3 Article #4 Jarrar, M., Rahman, H. A., Minai, M. S., AbuMadini, M. S., & Larbi, M. (2018). The function of patient‐ centered care in mitigating the effect of nursing shortage on the outcomes of care. The International Journal of Health Planning and Management, 33(2), e464-e473. https://doi.org/10.1002/hp m.2491 Haryanto, M. (2019). Nursing shortage: Myth or fact? Orthopaedic Nursing, 38(1), 1-2. DOI: 10.1097/NOR.00000000000 00535 Wilson, D., Heaslip, V., & Jackson, D. (2018). Improving equity and cultural responsiveness with marginalised communities: Understanding competing worldviews. Journal of Clinical Nursing, 27(19-20), 3810-3819. https://doi.org/10.1111/jocn. 14646 Plank, L. (2018). Academic- practice partnerships to reduce the shortage of operating room nurses. DOI: 10.1097/NNE.000000000000049 6Nurse educator, 43(6), 326-329. Evidence Level * (I, II, or III) III V V V Conceptual Framework Patient-centeredness is helping in the mitigation of The nurse shortages remains to be a fact and not a myth Culture is influencing health, healthcare provisions, health Student experience, nursing course in the curriculum, and © 2018 Laureate Education Inc. 1 Critical Appraisal Tool Worksheet Template Doris Hill Article does not meet research Doris Hill Check APA formatting Doris Hill Doris Hill Add a title page, purpose statement, introduction and conclusion Theoretical basis for the study the adverse associations of nursing shortage on the healthcare outcome. due to the problems it presents when it comes to the delivery of healthcare services. inequity being experienced by some marginalized communities. addressing the nurse shortages issues Design/ Method The design and how the study was carried out The researchers used a descriptive, cross-sectional study in 12 private healthcare facilities. The data were gathered through self-administration questionnaire from 652 nurses with 61.8 percent response rate. A qualitative research work that involved a review of various studies that have addressed the problem of nursing shortage both in the United States and around the world. A positional paper that critically review of the experiences of the health inequity of the marginalized communities. This is a qualitative study that utilized literature review to find solution to the issue of nursing shortagesg Sample/Setting The stratified random sampling used to enable nurses to take part in the study The study was based on a systematic review, therefore, only articles related to the topic were reviewed The authors performed the critical review. There was no examination of the literature papers or experimental work. There is no specification on samples used since the researchers1 Evidence-Based Practice Change 1 1 Culture and Readiness The organization provides treatment to acute stroke patients with dysphagia. It specializes in the treatment of stroke using an oral care regimen to help reduce aspiration pneumonia. 2 The organization has established a culture of completing the tasks they started. They previously upgraded the Electronic Health records systems to accommodate interoperability. The management and the nurses appreciate there is a need for changes. Nurses are ready for a complete change to ensure the systems will be upgraded. 2 Current Issue 2 The current problem is relating to nurse shortages in taking care of increased patients. Nurses are not sufficient for patients who need care throughout the day. Acute stroke patients with dysphagia require various medical procedures such change in the consistency and quantity of food to enhance bolus movement, minimize rehabilitative exercises or the possibility of developing aspiration, changing posture to decrease the possibility of aspiration and manoeuvres to direct food away from the weak side (Daniel & Smith, 2018). 2 The hospital is lacking sufficient professional nurses to deal with the problem. The problem persists due to high-turnover of patients. 3 1 Evidence-Based Change In Practice 2 The idea is to provide a friendly working environment. The EBP will offer personal career programs to mentor nurses and allow them to develop their careers. 2 The hospital should also focus on maintaining professional nurse-patient ratio. Healthcare can focus on integrated healthcare systems to address the friendliness of the working environment. 4 1 Evidence-Based Practice Change Continued 2 The plan is to develop a knowledge transfer plan to ensure the knowledge is created, transferred and implemented. The creation process will include developing training manuals on enhancing nurse satisfaction. The summary will be presented to the management for action. The knowledge will be implemented to develop solutions for the evidence-based idea. 3 The projects dissemination will be carried out by poster presentations and presentations to different disciplines and departments within the hospital.  1 These platforms will promote the positivity of the new practice change by Educating and discussing issues and concerns (Haryanto, 2019). 5 Measurable Outcomes 2 The measurable outcome is to eliminate nurse shortages by increasing the number of nurses. To increase the satisfaction of nurses and patients. 4 To reduce nurses  2 turnover and increase the number of nurses interested in the treatment of acute stroke patients with dysphagia. To reduce the workload for a single nurse in handling cancer patients. 6 1 Critical Appraisal Summary 2 The critical appraisal process is important to assess the effectiveness of articles in addressing real problems. I learned that the critical appraisal process evaluates if research is efficient in developNURS 6052 Student Name 4th August, 2020 ANSWERING THE PICOT QUESTION OF: In penetrating trauma patients, does spinal immobilization increase the risk of morbidity or mortality? Conference presentation via podium/oral presentation with an engaging, informative powerpoint presentation in order to: Reach a large audience Gives the opportunity to disseminate research findings quickly Attended by leaders in trauma that are more likely to be early adopters of research into practice (Edwards, 2015). DISSEMINATION STRATEGY There is a study that assesses patterns of error leading to trauma mortality citing 16\% failure to secure an airway due to spinal immobilization (Velopulos, et al, 2018). spinal immobilization in adults with penetrating trauma is associated with an increase in mortality and not only no benefit but also apparent actual harm in terms of neurologic deficit or potentially reversible neurologic deficits. Spinal immobilization is not recommended for routine use in penetrating trauma patients (Long, Koyfman, & Gottlieb, 2019) Mortality was clearly associated with spinal immobilization due to the fact it impedes the ability of providers to care appropriately for the patient due to obscuring injuries, life saving procedures more difficult, and lastly delayed transportation (Velopulos, et al, 2018). spinal immobilization is a time consuming intervention when the best intervention is getting our patients to the hospital quickly. Spinal Immobilization, necessary or Not??? What does the research say? decrease the burdens on the emergency departments by evaluating the need of spinal immobilization in all penetrating trauma patients. There is a need for a universal protocol for pre hospital assessment of trauma patients by EMS to evaluate the need for full spinal immobilization due to there being less than 1\% of all trauma patients that suffer a spinal cord injury (Vaillancourt, et al, 2011). develop a firm protocol for all trauma centers on the use of cervical spine radiograpy. There is a large number of normal cervical spine radiographs performed that adds to the cost of healthcare as well as the burden of time on emergency department staff and emergency medical services, who are expected to immobilize all patients before transport (Vaillancourt, et al, 2011). What is my goal? Selective Spinal Immobilization Protocol End the use of spinal immobilization in penetrating trauma patients as studies have shown that the use of spinal immobilization in penetrating trauma patients increases risks of local pressure injury, increased intracranial pressure, covering of penetrating wounds therefore missed injuries, delaying lifesaving procedures including endotracheal intubation. The use of the C-Spine rule was used and evaluated in Ontario, Canada had exceptional results with decrease in morbidity & mortality in penetrating trauma patients(Vaillancourt et al., 2011). Proposal Decrease in pressure injur