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Article that Best Supports the Topic

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Integrating Evidence-Based Practice

Write a 1000-1500 word essay addressing each of the following points/questions. Be sure to completely answer all the questions for each bullet point. There should be two main sections, one for each bullet below. Separate each section in your paper with a clear heading that allows your professor to know which bullet you are addressing in that section of your paper. Support your ideas with (2) sources (1 outside source and the textbook) using citations in your essay. Make sure to cite using the APA writing style for the essay. The cover page and reference page in correct APA do not count towards the minimum word amount. Review the rubric criteria for this assignment.

Part 1:

Describe the eight steps to integrating evidence-based practice into the clinical environment. What barriers might you face in implementing a new practice to address your research topic (as identified in Module 1)? Describe strategies that could be used to increase success including overcoming barriers.

Part 2:

Describe six sources of internal evidence that could be used in providing data to demonstrate improvement in outcomes.

Assignment Expectations:

Length: 1000 – 1500 words
Structure: Include a title page and reference page in APA format. These do not count towards the minimum word count for this assignment. Your essay must include an introduction and a conclusion.
References: Use appropriate APA style in-text citations and references for all resources utilized to answer the questions. A minimum of one (1) scholarly source and the textbook are required for this assignment.

Below is what was discussed in Module 1

Clinical Question

In terminally ill patients and their families (P), how does the provision of educational programs to demystify benefits of hospice care (I) as compared to informal community education (C) influence their ability to increased awareness of the best options and benefits of hospice care (O) within a period of hospital stay (T)?

Justification for the Clinical Problem

This paper describes a hospice educational program for terminally ill patients. The main focus of this study is the lack of accurate and inconsistent information on the benefits and options of hospice care. There is a large gap of eligibility, philosophies and knowledge concerning hospice care for patients facing end of life transition. Most studies that have been carried out on the topic have either been biased or provided less detailed information on the importance of creating awareness of the benefits of hospice care for terminally ill patients. Lack of knowledge about the importance of hospice care has led to increased number of people living their last days without receiving the benefits of this service (Garcia, 2018).

Most families learn about the benefits of hospice care care when it is too late for the patient. In addition, the families learn about the advantages of the service once the patient has already been admitted in the program. The main reason for enrolling their terminally ill patients to the program is not because they know its benefits but for the lack of another option. The significance of this study is to help patients and families to enroll in hospice care early enough in the course of a life limiting illness for them to receive comfort care and experience easier transition.

According to Tofthagen, Guastella, & Latchman, 2019), the need for palliative and hospice care program has increased as people are living with complex diseases with no cure and population ages. The study suggests more hospice care professionals will be needed in the near future to meet the increasing demand for the services (Tofthagen, Guastella, & Latchman, 2019). Lack of knowledge on the importance of these services has resulted in families keeping terminally ill patients at their homes. The authors of this study suggest that providing educational programs to communities could help reduce the number of terminally ill patients who are not receiving these services (Tofthagen, Guastella, & Latchman, 2019).

Another study conducted in 2020, found out that healthcare professionals in the hospice care setting can only provide effective services to patients if there is a conceptual framework to guide practice and education (Dyess et al., 2020). The study suggests that most people are unable to access hospice care because of lack of knowledge. “The framework builds on theoretical caring to convey elements of relational, holistic and compassion; articulates inter-professional tenets for guiding values; and aligns with constructs for palliative and hospice best practices” (Dyess et al., 2020). The study suggests that such a framework invites leaders as well as clinicians to develop educational programs to promote awareness about hospice services.

According to Allo et al., (2016), healthcare professionals do not have exposure to provide quality home based care. This is as a result of lack of enough education among healthcare practitioners to attend to home-based patients. The study suggests that participation in patient home visits is an effective way to provide education in communities about the benefits of hospice care (Allo et al., 2016). This approach does not cause any form of distress to both patients and their families. As a matter of fact, families who participated in this study were quick to enroll their patients to hospice care (Allo et al., 2016).

In another study conducted in 2019, the authors argue that most terminally ill patients do not have access to hospice services due to lack of knowledge in the communities (Livingstone, Welstand & Ryan, 2019). However, such patients would enroll to hospice care services if they were aware of its benefits. Livingstone, Welstand & Ryan, (2019), found out that the fears associated with end of life include not being able to stay at home, burden to the family and also fear of undignified death. Most terminally ill patients would therefore enroll to such programs to reduce these fears if they had enough knowledge.

Article that Best Supports the Topic

In a study conducted in 2018, the authors argue that hospice care is a service that has been widely misunderstood and underutilized (Garcia, 2018). Communities are not aware of hospice services. This results in increased suffering for patients having life limiting illnesses. Misconceptions by communities also lead to the lack of enrolling terminally ill patients to the service. Most people believe that the service is only provided for six months. People also don’t understand their illnesses as well as the treatment goals for hospice care. While there are many hospice care organization in communities, lack of clarity on who should handle this conversation exacerbates the situation (Garcia, 2018).

Limited knowledge, misconceptions and poor communication among patients and within the health care profession, have led to terminally ill patients not being referred on a timely manner (Garcia, 2018). Communities do not have enough knowledge to identify the identify patients who need hospice care. Late referrals have led to patients being denied access to hospice care at the end of their life. The underutilization of these services has resulted in poor communication and ineffective identification of those patients who deserve end of life care. The underutilization of hospice care leads to poor quality of life for terminally ill patients and also increased healthcare services (Garcia, 2018).

This article provides ways in which terminally ill patients and their families can access education programs to help them understand the benefits of hospice care services. The article also provides insights on the importance of providing educational programs to communities (Garcia, 2018). The other article focus more on the importance of providing hospice care rather than the importance of educational programs on hospice care services. Unlike the other selected articles, this article provides recommendation educational programs on the importance of hospice care can be administered in the community. By implementing this recommendation most people suffering from life limiting illnesses can access hospice car and end their life with dignity.

References

Allo, J. A., Cuello, D., Zhang, Y., Reddy, S. K., Azhar, A., & Bruera, E. (2016). Patient Home Visits: Measuring Outcomes of a Community Model for Palliative Care Education. Journal of palliative medicine, 19(3), 271-278. Retrieved from https://www.liebertpub.com/doi/abs/10.1089/jpm.2015.0275

Dyess, S. M., Prestia, A. S., Levene, R., & Gonzalez, F. (2020). An Interdisciplinary Framework for Palliative and Hospice Education and Practice. Journal of Holistic Nursing, 0898010119899496. Retrieved from

https://journals.sagepub.com/doi/abs/10.1177/0898010119899496

Garcia, M. J. (2018). Systematic Review of the Literature on Why There is Hospice Underutilization. Retrieved from https://scholarworks.waldenu.edu/cgi/viewcontent.cgi?article=6288&context=dissertations

Livingstone, T., Welstand, J., & Ryan, K. (2019). P-188 Improving access to hospice enabled care for heart failure patients–a service evaluation. Retrieved from https://spcare.bmj.com/content/9/Suppl_4/A79.3.abstract

Tofthagen, C., Guastella, A., & Latchman, J. (2019). Perspectives on Hospice and Palliative Care in the United States. In Hospice Palliative Home Care and Bereavement Support (pp. 105-119). Springer, Cham. Retrieved fromhttps://link.springer.com/chapter/10.1007/978-3-030-19535-9_7

 

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Policies and Practices to Support Healthcare Issues

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Discussion: Organizational Policies and Practices to Support Healthcare Issues

Quite often, nurse leaders are faced with ethical dilemmas, such as those associated with choices between competing needs and limited resources. Resources are finite, and competition for those resources occurs daily in all organizations.

For example, the use of 12-hour shifts has been a strategy to retain nurses. However, evidence suggests that as nurses work more hours in a shift, they commit more errors. How do effective leaders find a balance between the needs of the organization and the needs of ensuring quality, effective, and safe patient care?

In this Discussion, you will reflect on a national healthcare issue and examine how competing needs may impact the development of polices to address that issue.

  • Review the Resources and think about the national healthcare issue/stressor you previously selected for study in Module 1.
  • Reflect on the competing needs in healthcare delivery as they pertain to the national healthcare issue/stressor you previously examined.

Post an explanation of how competing needs, such as the needs of the workforce, resources, and patients, may impact the development of policy. Then, describe any specific competing needs that may impact the national healthcare issue/stressor you selected. What are the impacts, and how might policy address these competing needs? Be specific and provide examples.

 

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Family Nurse Practitioners advance patient

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Family Nurse Practitioners advance patient wellbeing by assessing complex family dynamics through the analysis of pathologies and the implementation of treatment plans that fits the needs of the patients (Norwick, 2016).  I chose the specialty of FNP because I would like to work with families and communities.  One organization that exemplifies the concept of family practice while implementing best-practices is the University of Miami Outpatient Family Care Center.

The University of Miami Outpatient Family Care Center is a subsidiary of the greater University of Miami Research Center and it is guided by three principles:  to promote wellness, to advance research about family practice, and to provide top quality comprehensive, customer friendly health care.  The mission of the organization is to provide personalized and comprehensive care to the community.  In this organization, FNPs provide preventative services in the form of routine analysis, well child checks, school and work physicals, teach patients about health promoting activities, conduct screenings and immunizations, and manage chronic conditions.

References

Scanlon, A., Cashin, A., Bryce, J., Kelly, J. G., & Buckely, T. (2016). The complexities of defining nurse practitioner scope of practice. Collegian, 23, 129–142. https://doi.org/10.1016/j.colegn.2014.09.009.

 

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Identify available community resources

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Develop a 3-4-page preliminary care coordination plan for an individual in your community with whom you choose to work. Identify and list available community resources for a safe and effective continuum of care.

NOTE: You are required to complete this assessment before Assessment 4.

The first step in any effective project or clinical patient encounter is planning. This assessment provides an opportunity for you to strengthen your understanding of how to plan and negotiate the coordination of care for an individual in your community as you consider the patient’s unique needs; the ethical, cultural, and physiological factors that affect care; and the critical resources available in your community that are the foundation of a safe plan for the continuum of care.

As you begin to prepare this assessment, you are encouraged to complete the Care Coordination Planning activity. Completion of this will provide useful practice, particularly for those of you who do not have care coordination experience in community settings. The information gained from completing this activity will help you succeed with the assessment. Completing formatives is also a way to demonstrate engagement.

Demonstration of Proficiency

By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

  • Competency 1: Adapt care based on patient-centered and person-focused factors.
    • Analyze a health concern and the associated best practices for health improvement.
  • Competency 2: Collaborate with patients and family to achieve desired outcomes.
    • Establish mutually agreed-upon health goals for a care coordination plan, in collaboration with the patient.
  • Competency 3: Create a satisfying patient experience.
    • Identify available community resources for a safe and effective continuum of care.
  • Competency 6: Apply professional, scholarly communication strategies to lead patient-centered care.
    • Write clearly and concisely in a logically coherent and appropriate form and style.

Preparation

Imagine that you are a staff nurse in a community care center. Your facility has always had a dedicated case management staff that coordinated the patient plan of care, but recently, there were budget cuts and the case management staff has been relocated to the inpatient setting. Care coordination is essential to the success of effectively managing patients in the community setting, so you have been asked by your nurse manager to take on the role of care coordination. You are a bit unsure of the process, but you know you will do a good job because, as a nurse, you are familiar with difficult tasks. As you take on this expanded role, you will need to plan effectively in addressing the specific health concerns of community residents.

As you assume your expanded care coordination role, you have been tasked with addressing the specific health concerns of a particular individual within the community. You decide to prepare a preliminary care coordination plan and proceed by identifying the patient’s three priorities for health and by investigating the resources available in your community for a safe and effective continuum of care.

To prepare for this assessment, you may wish to:

  • Review the assessment instructions and scoring guide to ensure that you understand the work you will be asked to complete.
  • Allow plenty of time to plan your patient clinical encounter.
  • Be sure that you have a patient in mind that you can work with throughout the course.

Note: Remember that you can submit all, or a portion of, your draft plan to Smarthinking Tutoring for feedback, before you submit the final version for this assessment. If you plan on using this free service, be mindful of the turnaround time of 24–48 hours for receiving feedback.

Instructions

Note: You are required to complete this assessment before Assessment 4.

This assessment has two parts.

Part 1: Develop the Preliminary Care Coordination Plan

Complete the following:

  • Identify a health concern as the focus of your care coordination plan. Possible health concerns may include, but are not limited to:
    • Stroke.
    • Heart disease (high blood pressure, stroke, or heart failure).
    • Home safety.
    • Pulmonary disease (COPD or fibrotic lung disease).
    • Orthopedic concerns (hip replacement or knee replacement).
    • Cognitive impairment (Alzheimer’s disease or dementia).
    • Pain management.
    • Mental health.
    • Trauma.
  • Identify available community resources for a safe and effective continuum of care.
Part 2: Secure Individual Participation in the Activity

Complete the following:

  • Contact local individuals who may be open to an interview and a care coordination plan addressing their health concerns. The person you choose to work with may be a colleague, community member, friend, or family member.
  • Meet with the individual to describe the care coordination plan session that you intend to provide. Collaborate with the participant in setting goals for the session, evaluating session outcomes, and suggesting possible revisions to the plan.
  • Establish a tentative date and time for the care coordination plan session. Document the name of the individual and a single point of contact, either an e-mail address or a phone number.
Document Format and Length

For your care coordination plan, you may use the Care Coordination Plan Template [DOCX], choose a format used in your own organization, or choose a format you are familiar with that adequately serves your needs for this assessment.

  • Your preliminary plan should be 3–4 pages in length. In a separate section of the plan, identify the person you have chosen to work with, and be sure to include his or her contact information.
  • Document the community resources you have identified using the Community Resources Template [DOCX].
Supporting Evidence

Cite at least two credible sources from peer-reviewed journals or professional industry publications that support your preliminary plan.

Grading Requirements

The requirements, outlined below, correspond to the grading criteria in the Preliminary Care Coordination Plan Scoring Guide, so be sure to address each point. Read the performance-level descriptions for each criterion to see how your work will be assessed.

  • Analyze your selected health concern and the associated best practices for health improvement.
    • Cite supporting evidence for best practices.
    • Consider underlying assumptions and points of uncertainty in your analysis.
  • Establish mutually agreed-upon health goals for the care coordination plan, in collaboration with the selected individual.
  • Identify available community resources for a safe and effective continuum of care.
  • Write clearly and concisely in a logically coherent and appropriate form and style.
    • Write with a specific purpose with your patient in mind.
    • Adhere to scholarly and disciplinary writing standards and current APA formatting requirements.
Additional Requirements

Before submitting your assessment, proofread your preliminary care coordination plan and community resources list to minimize errors that could distract readers and make it more difficult for them to focus on the substance of your plan. Be sure to submit both documents.

CORE ELMS

Important note: The time you spend securing individual participation in this activity and the time you spend presenting your final care coordination plan to the patient in Assessment 4 must total at least three hours. Be sure to log your time in the CORE ELMS system. The CORE ELMS link is located in the courseroom navigation menu.

Grading Rubric

1.   Analyze a health concern and the associated best practices for health improvement.

Passing Grade:  Provides a perceptive analysis of a health concern and the associated best practices for health improvement. Provides credible evidence for best practices and articulates underlying assumptions and points of uncertainty in the analysis.

2.  Establish mutually agreed-upon health goals for a care coordination plan, in collaboration with the patient.

Passing Grade:   Establishes mutually agreed-upon health goals for a care coordination plan, in collaboration with the patient. Ensures the goals are realistic, measurable, and attainable.

3.  Identify available community resources for a safe and effective continuum of care.

Passing Grade:  Identifies significant and available community resources for a safe and effective continuum of care. Provides a comprehensive list of resources, with credible evidence of their contribution toward improving community health.

4.  Write clearly and concisely in a logically coherent and appropriate form and style.

Passing Grade:  Writes clearly and concisely in a logically coherent and appropriate form and style. Main points, ideas, arguments, or propositions are well-developed and engaging. Adheres to all applicable disciplinary and scholarly writing standards.

 

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