Week 11 quiz answers for advanced health assessment for Walden University.
Week 11 quiz answers for advanced health assessment for Walden University.
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Assignment: Application: Drawing Conclusions About Research Findings
Assignment: Application:
Drawing Conclusions About Research Findings and Their Implications for
Clinical Practice
As a current or future nursing researcher and professional, your ability to draw reasonable conclusions from research findings will determine the effectiveness of proposed solutions for clinical nursing practice. As you continue to develop your skill set to become a nursing leader, your exposure to a multitude of research designs, research findings, and evidence-based practice will likely inform how you will absorb this knowledge into meaningful clinical practice. Throughout this course and program, your exposure to different research questions, research study designs, and approaches to addressing serious issues in both nursing and health care confirms the ever-changing landscape in which you have elected to practice. While this is in its own right challenging, it also offers several opportunities to create new knowledge, improve upon current nursing practice, and exercise research skills for positive patient outcomes.
For this Assignment, review the research methods and findings of the Verweij study conducted in 2014. The primary purpose of this quantitative research study was to investigate the effectiveness of an intervention to decrease medication errors in a hospital. The citation and discussion/conclusion information is intentionally deleted so you can draw your own conclusions.
In a 2- to 3-page, double-spaced paper, describe three conclusions you have drawn from the findings in this study, taking into consideration the limitations of the study. Next describe three implications for clinical practice
Verweij, L., Smeulers, M., Maskant, J., & Vermeulen, H. (2014) Quiet please! Drug round tabards: Are they effective and accepted? A missed method study. Journal of Nursing Scholarship, 46(5), 340–48.
HEALTH CARE POLICY AND SYSTEMS1Key wordsPatient safety, quality improvement,evidence-based practice, medicationadministration errors, intervention research,focus group, drug round tabardAccepted: May 3, 2014doi: 10.1111/jnu.12092AbstractBackground:Theuseofdrugroundtabardsisawidespreadinterventionthatisimplementedtoreducethenumberofinterruptionsandmedicationadmin-istrationerrors(MAEs)bynurses;however,evidencefortheireffectivenessisscarce.Purpose:Evaluationoftheeffectofdrugroundtabardsonthefrequencyandtypeofinterruptions,MAEs,thelinearitybetweeninterruptionsandMAEs,aswellastoexplorenurses’experienceswiththetabards.StudyDesign:Amixedmethodsbefore-afterstudy,withthreeobservationperiodsonthreewardsofaDutchuniversityhospital,combinedwithpersonalinquiryandafocusgroupwithnurses.Methods:Inonepre-implementationperiodandtwopost-implementationperiodsat2weeksand4months,interruptionsandMAEswereobserveddur-ingdrugrounds.Descriptivestatisticsandunivariablelinearregressionwereusedtodeterminetheeffectsofthetabard,combinedwithpersonalinquiryandafocusgrouptofindoutexperienceswiththetabard.Findings:Atotalof313medicationadministrationswereobserved.Signifi-cantreductionsinbothinterruptionsandMAEswerefoundafterimplemen-tationofthetabards.Inthethirdperiod,adecreaseof75%ininterruptionsand66%inMAEswasfound.LinearregressionanalysisrevealedamodelR2of10.4%.Theimplementationtopicsthatemergedcanbeclassifiedintothreethemes:personalconsiderations,patientperceptions,andconsiderationsre-gardingtabardeffectiveness.The possible effect of medication errors (MEs) on pa-tient safety raises concerns for healthcare safety boardsworldwide. In reaction to this problem, boards incorpo-rate quality items and safety goals into their programs340C±
that require action by the hospitals (Institute for SafeMedication Practices, 2014; World Health OrganizationHigh 5, 2014).Literature indicates that the ME rate may vary from5% to 25% in all episodes of in-hospital drug admin-istration, but only 19% are reported (Antonow, Smith,& Silver, 2000; Krahenbuhl-Melcher et al., 2007; West-brook, Woods, Rob, Dunsmuir, & Day, 2010). This couldindicate that the actual incidence rates might be higher.Therefore, MEs endanger the safety of patients. MEsoccur in every stage of the medication process, with50% of them associated with medication administration(Krahenbuhl-Melcher et al., 2007). In hospitals, nursesare generally responsible for this stage in the medicationprocess.In general, interruptions or distractions are recognizedto reduce efficiency and contribute to errors (Brixey et al.,2007). In specific, interruptions appear to be a promi-nent causative factor for medication administration er-rors (MAEs; Biron, Loiselle, & Lavoie-Tremblay, 2009;Freeman, McKee, Lee-Lehner, & Pesenecker, 2012; Tr-bovich, Prakash, Stewart, Trip, & Savage, 2010; West-brook et al., 2010).The literature describes several initiatives that in-fluence nursing medication practice to reduce MAEs(Hodgkinson, Koch, Nay, & Nichols, 2006; Raban &Westbrook, 2013). One of these interventions includestabards, or vests, with the inscription “do not disturb” orvisible signage.The use of drug round tabards is a widespread, in-expensive intervention that is thought to reduce thenumber of interruptions during drug rounds and MAEs.However, in practice the tabards are unpopular amongnurses; they doubt their effectiveness and do not feelcomfortable wearing them. Additionally, the evidenceon effectiveness of using tabards is limited (Raban &Westbrook, 2013; Scott, Williams, Ingram, & Mackenzie,2010). When evidence is lacking, the incentive to weara tabard will be especially weak and one can become re-luctant to implement interventions (Glasziou, Ogrinc, &Goodman, 2011; Smeulers, Onderwater, van Zwieten, &Vermeulen, 2014). If the effectiveness of these tabardscan be established and barriers and facilitators can beidentified, implementation in clinical practice will be fa-cilitated and endorsed. Therefore, the aim of our studyis to evaluate the effect of drug round tabards on (a)the frequency and type of interruptions, (b) the numberand type of MAEs, and (c) the magnitude of the relationbetween interruptions and MAEs during the process ofpreparation, distribution, and administration of medica-tion in hospital wards. In addition, we explored nurses’perspectives and experiences with drug round tabards toidentify barriers and facilitators for implementation.MethodsSettingThree wards in a Dutch 1,024-bed university hospi-tal contributed to this study: neurology, neurosurgery,and a combined ward with dermatology, ophthalmol-ogy, and ENT services. In total, these wards contain 60beds. Each ward has a closed medication storage andpreparation room where medication carts are stored foruse during drug rounds. These carts are equipped withdrawers and files containing computer-printed medica-tion prescriptions for each patient. All oral medicationsare distributed for 24 hr and are checked once by theward’s night shift. Fluids, intravenous medications, andother medications for injection are prepared and double-checked during each drug round directly before drug ad-ministration.PopulationThe participants were all registered nurses. Each hadan individual responsibility for distributing medicationsto their assigned patients.Study DesignWe performed a mixed method study, using a before-after design to collect the number of interruptions andMAEs during drug rounds before the implementation ofthe tabard in April 2012 (period 1), as well as 2 weeksand 4 months after tabard implementation (i.e., in Mayand September 2012, respectively periods 2 and 3). Aninterruption or a distraction was defined as an event ini-tiated by another professional(s) or something else, andwhen a nurse interrupted him- or herself. In this study,the term interruption was used for distractions as well asfor interruptions. MAEs are defined as a breach of one ofthe seven rights of medication administration: correct pa-tient, drug, dose, time, route, reason, and documentation(Pape, 2003).During period 2, nurses’ perspectives regarding thetabard were collected by documenting spontaneous re-marks and asking a single question at the end of the ob-servation: “What is your experience with the drug roundtabard?” In period 3, in-depth information on nurses’perspectives, experiences, and views was collected in afocus group setting to gain insight in barriers and facilita-tors for implementation of the drug round tabards.Ethical ApprovalEthical approval was not considered necessary by theInstitutional Review Board of the Academic Medical341C±l
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Describe how you will use evidence-based practice to improve patient quality
Describe how you will use evidence-based practice to improve patient quality and safety in your health care
setting. Be specific and provide examples. Then, explain how the knowledge gained about research in this course will support your role in practice as a nursing professional. Then, describe how you will use evidence-based practice to improve patient quality and safety.
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Describe how you will use evidence-based practice to improve patient quality
Describe how you will use evidence-based practice to improve patient quality and safety in your health care
setting. Be specific and provide examples. Then, describe how you will use evidence-based practice to improve patient quality and safety
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