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While there is a debate regarding the criminalization that is being done to people just because they consume drugs, as of now the whole global community is against the offenders and addicts and wants them reformed or locked away. The reason is that there is a demonstrated relationship between drug abuse and crime, and the use of drugs and the peddling of the drugs have been shown to be the root cause of many violent crimes and domestic violence. Thus the importance given to rehabilitating drug users with intervention programs is not a misconceived notion, and nor is the involvement of the criminal justice system in the costly programs unwarranted. That being so it can be pointed out that for the youth, the intervention is crucial before they set out to become hardened criminals. (Peterson, 2009)
Thus for juvenile offenders it is important that the community based intervention…… [Read More]
Evidence-Based Models for Substance Abuse Treatment in the Criminal Justice System
The United States currently incarcerates a higher percentage of its citizens than any other industrialized nation in the world. A majority of Americans who are incarcerated were taking drugs or drinking alcohol, or both, during the commission of their crimes, or were actively engaged in substance-abusing behaviors that resulted in their involvement with the criminal justice system. The costs that are associated with incarcerating these millions of convicts each year are staggering, making the need for cost-effective interventions that can help divert substance-abusing nonviolent offenders from the penal system into other, less expensive community-based alternatives. Likewise, from a strictly pragmatic perspective, treating existing substance abuse among prison populations using methods with proven efficacy just makes good business sense. To this end, this paper compares and contrasts two evidence-based substance abuse treatment models that have demonstrated efficacy in the criminal…… [Read More]
Evidence-based practice model
EBP project issue: Obesity
"The prevalence of obesity (BMI > 30) has been increasing; currently; at least 27% of the adult population is obese" (McTigue 2003: vii). Despite being one of the most pervasive health problems in modernity, there is relatively little information on obesity available in the annals of evidence-based medicine. This may be due to the fact that obesity is such a complex and multifactorial disease, without a clear etiology. Perfectly-controlled studies can be difficult to construct. Many different factors can impact a person's ability to maintain a health BMI, spanning from genetics to culture to lifestyle to social and economic factors.
A 2003 evidence-based review of existing studies of obesity in adults found in MEDLINE from January 1, 1994 to July 31, 2001 only found four meeting the relevant criteria of studying persons suffering from obesity. There were no CT (randomized controlled trials,…… [Read More]
Evidence-Based Group Work
How can I increase attendance of a support group for at-risk teenage Latino students in a school setting?
Search for Evidence
In order to search for evidence in increasing attendance of a support group for Latino students in a school setting, I went to PubMed as my initial search engine. I chose PubMed because I have found it to be a great starting place for health-care research. Not only does it provide details about relevant articles, but it provides abstracts for most of those articles, as well as the full-text of many articles. Initially my question was how to increase the attendance of a support group for minority students in a school setting, but the amount of available information was overwhelming, so I then narrowed my search to the Latino community. The search terms that I used were "support group," "group therapy," "school setting," "teenage," "Latino," "Spanish,"…… [Read More]
Evidenced-Based Practice - Environment
There are perhaps few environments and professions within which change is both as important and as difficult as it is within health care. While there are many barriers to the change process, there are at least an equal amount of drivers that indicate the necessity for change. In evidence-based practice, nursing practitioners, administration personnel, management personnel, and all involved in the health care profession need to form teams with patients and family members in order to ensure an optimal environment for change. This is not a process that will happen overnight, especially in the hospital and nursing home settings, where recognizing the need for change is often subordinate to more immediate and severe problems such as personnel and funding shortages.
The readiness for change in the hospital and nursing home environment is often subordinate to practical day-to-day challenges, including severe personnel and funding shortages. These create…… [Read More]
During the monitoring phase, it was found that the fatigue levels of cancer patients after treatment were significantly improved. The article suggests that therapies other than exercise, as well as alternative exercise therapies can benefit from further research and refinement. Reaching the stage of Evidence-based practice in the Grove model will therefore be a process of increasingly refined and focused research.
The Virginia Henderson theory of nursing focuses upon the patient and working together with him or her in order to achieve optimal health, or at least to die peacefully. The article is informed by this theory, as it focuses upon helping the patient accomplish a goal, rather than simply providing medications towards the goal.
In providing an exercise regime, the patient is empowered to control his or her energy levels by means of a personal and individual choice. As such, nursing is to help the patient to achieve 14…… [Read More]
The evidence base suggests that approaches such as exercise, screening for treatable risk factors, energy conservation and activity management, progressive muscle relaxation, and education and anticipatory guidance are likely to be effective in reducing fatigue. Anticipating which interventions are likely to be effective can assist clinicians in the design of a multi-component fatigue treatment approaches. Clinicians also can use these results to examine their own practices, identifying intervention strategies such as complementary therapies that may be recommended only infrequently for fatigue but still hold the potential to be effective (Mitchell, Beck, Edwards Hood, Moore, and Tanner, 2006).
Evidence-based practice was adopted in a similar format to the Grove's model in the fact that it was developed by studying what works and what doesn't. In order to produce the best outcome for patients it is important to not waste time trying several treatment options unless these options have been studied and…… [Read More]
The abnormal activities observed can point out at many different issues such as anxiety or heart failure.
The interview of the patient is a very vital and essential assessment tool in the hands of the nurse. The nurse can conduct a thorough interview to have the complete and big picture of patient (the nurse can assess the patient both physically and mentally much more efficiently by just asking what is wrong and where are the problems).
The observation is also a very important tool, nurses can make avail of the interactions they made with patients by observing their responses to different kinds of stimuli. This practice assists the nurses in recognizing the overall pain, any sort of emotional disturbances and the patient's reaction towards the treatment applied.
This observation factor is very important especially for those patients who have any sort of difficulty in communicating with the nurses or medical…… [Read More]
Qualitative, meetings and seminars, then questions to ascertain efficacy.
Smallish, 65 in one hospital.
Survey and qualitative observation.
Clear and effective communication goals were met using positive educational interventions.
Longitudinal and sample size.
Good basic, lacks lengthy literature review. Data may be extrapolated, but further work needs to be done using larger, more diverse sample.
Melnyk, B., et.al.
Evidence-based Practice: Step-by-Step Igniting a Spirit of Inquiry.
What is the effectiveness of an evidence-based practice format on collaborative inquiry.
Meta-Analysis and presentation of package.
None other than previous research.
Literature review and meta-analysis.
This is a presentation of a model approach suggested by an experienced nursing professor.
None for type of study.
Strong. Shows nurses how to use knowledge and skills to implement EBP consistently as part of the best practices of contemporary nursing care.
Nadzan, D. And Westergaard, F.
Pediatric Safety in the Emergency Department
What are the…… [Read More]
Evidence-Based Practice (EBP) is the assimilation of the best research evidence with clinical proficiency and patient values. This takes into account placing equal emphasis on the situation of the patient, his or her goals, objectives, values and aspirations, the best accessible research evidence and the clinical proficiency and expertise of the practitioner. Evidence-based practice in psychology can be defined as the incorporation and assimilation of the best accessible research with clinical knowledge and expertise in the context of patient features, culture, and preferences. In psychology, the main purpose of evidence-based practice encompasses the promotion of efficacious psychological practice, improvement of public health by making use of empirically supported principles of psychological evaluation, case formulation, therapeutic association, and intervention (Drisko, 2012).
Therefore, taking this into consideration, evidence-based practice can be delineated as a wider notion that account for not only knowledge and understanding but also action in three fundamental components of…… [Read More]
Still, the concept of guided imagery tends to stray far from traditional methods of pain management. Pharmaceuticals have long been a major method of treatment for pain, but have resulted in major backlashes in regards to patients becoming addicted, especially in long-term and chronic cases of pain. If guided imagery could be a successful method, it may reduce pain or increase pain tolerance, without the threat of chemical dependence.
There are a number of benefits which are seen in the ongoing discourse today. As such, the expected improvements include things like drops in blood high blood pressure, lower heart rates, and reduction of chronic pain symptoms, lessoning of headache pain, and increasing overall pain tolerance (Cornelius, 2010). In situations were patients going into a major surgery were coached with guided imagery, it was "shown to decrease stress and anxiety before and after surgery," thus helping reduce additional pain issues during…… [Read More]
Evidence-Based Practices When Working With Clients
Evidence-based practice is a concept that emerged in the field of medicine to help lessen mistakes or errors during treatment. This concept seeks to do so through ensuring clinical decisions are grounded on the best available research evidence. Since its emergence, the concept of evidence-based practice has become common in the medical field and is constantly used to help improve patient outcomes. The tremendous success of this concept in medicine is attributable to its integration of the best available research evidence, clinical judgment and expertise, and patient preferences and values.
Given its success in the field of medicine, evidence-based practice is being imported into the field of psychology (Lilienfeld, 2014). This trend emerges from the need for clinicians to utilize the most suitable and effective mechanisms to improve their clients' outcomes. Current evidence postulates that utilizing interventions that have been shown to work with…… [Read More]
NEW MODELS FO EVIDENCE-BASED PACTICE a professional goal DNP-prepared nurses produce evidence-based models care develop evidence-based guidelines. As continue develop DNP Project Premise engage EBP Project, aim mind.
As a nurse practitioner who works in a diverse range of settings spanning from hospitals to nursing homes to clinics, evidence-based practice is part of my daily routine. Virtually all of the facilities at which I work prioritize evidence-based practice given that the facilities' scarce resources means that time, energy, and money cannot be wasted on untested treatments or treatments based merely upon 'hunches.' Evidence-based practice is based upon demonstrated benefits from particular approaches to patient care in recent literature. I strive to remain current in my own knowledge of EBP, frequently reviewing nursing journals and articles online as well as the websites of professional associations so I am aware of new treatments, approaches, and evidence of what works…… [Read More]
evidence-based practice use in nursing for making decisions using evidences to provide care to patients. This assignment has highlighted five main principles of EBP. These principles should be considered while implementing EBP. Moreover, there are certain challenges and barriers in implementing EBP. This assignment focused on strategies for implementing EBP.
Introduction of evidence-based practice to the workplace:
Changing the accepted confirmation of an NG (nasogastric) tube
Currently, I am employed at a medical and geriatric unit in a rehabilitation hospital. The unit is such that the majority of the nurses (60%) have over ten years' experience of practice. Thus the nurses on the unit are highly-trained professions who are extremely competent at their jobs. However, nurses of this level of experience are also often extremely change-resistant. Due to the level of the morale on the unit, nurses are often reluctant to alter the standard operating procedures with which they have…… [Read More]
Evidence-Based Solution to educing Incidence
The goal of this assignment is to increase my ability to appraise and synthesize evidence to provide experience a logical argument in support of a proposal for practice change, and to provide experience in designing a detailed implementation and evaluation plan for my project. I need to discuss my project plan with you.
An evidence-based solution to reducing incidence of hospital acquired infections through indwelling medical devices
Hospital-acquired or nosocomial infections are the fourth leading cause of disease in developed countries. The increased insertion and implanting of prosthetic or indwelling medical devices is a leading cause of these infections since the introduction of a foreign body significantly reduces the body's immunity and decreases the number of bacteria needed to produce an infection. Prosthetic or indwelling medical devices such as urethral catheters, suprapublic catheter, nasogastric tubes, hemodialysis catheters, central venous catheters, and tracheostomy tubes are associated…… [Read More]
.. If one of the goals of the healthcare system is to promote health and prevent illness and injury, it may be logical to start with those who work in the system." (Yassi, Ostry, Spiegel, and Walsh, 2002, p.1)
Presently the healthcare environment is characterized by nurse shortages of 25% of the entire nursing force. It is held that the working conditions along with job stress negatively impact the nursing force and its turnover rate. Injuries are also reported by nursing staff. It is likely that the nursing shortage is the number one challenge in today's healthcare provision. The negative work environment negatively impacts the nursing professional and their decision to either leave or to potentially fail altogether to enter the profession.
Naturally when there is a shortage of any type of professional worker some area suffers their absence and when this concept is applied in the field of healthcare…… [Read More]
Facilitating Change to Evidence-Based Practice in Nursing: The Iowa and Stetler Models
The Iowa Model of Evidence-Based Practice
Developed by Marita Titler to promote quality healthcare, the Iowa Model is a source of guidance for nurses and clinicians when making decisions that have an impact on patient outcomes. It infuses research into practice by using a multidisciplinary team approach to address a number of topics that are clinically important (Melryk and Overholt, 2011). This model is represented as an algorithm that has well-defined feedback loops as well as decision points. The very first decision has got to do with whether a particular problem is a priority to an organization and the second decision considers how adequate the evidence is to change practice. After the conduction of a pilot of change, on the basis of the available evidence, subsequent decisions are made on whether to adopt it or not, which is…… [Read More]
SYSTEMS THEOY vs. DIFFUSION OF INNOVATION THEOY
Systems theory and diffusion of innovation theory
Systems theory and healthcare delivery in the U.S.
According to theorist Ludwig von Bertalanffy, it is essential to view organisms -- both living and man-made -- as functional systems in a holistic sense to understand their true nature. This principle is manifested in the human body and also the organizations which provide healthcare. "A complex adaptive system is a collection of individual agents with freedom to act in ways that are not always totally predictable, and whose actions are interconnected so that one agent's actions changes the context for other agents. Examples include the immune system, a colony of termites, the financial market, and just about any collection of humans (for example, a family, a committee, or a primary healthcare team)" (Plsek & Greenhalgh 2001: 625).
Complex systems, such as the healthcare delivery system,…… [Read More]
Statistics in Social Work
The steps of evidence-based practice include formulating an answerable question. How does knowing about statistics improve our ability to be an evidence-based practitioner at this step?
How understanding statistical principles can enable you to better understand if a question is answerable or not.
Are 'baselines' in descriptive function, or predictive function available for assessment.
In application of statistics to social phenomena, the frequency, duration and intensity of the subject tested will contribute to analysis where more than nominal (i.e. numbered) distributions are involved. Merely 'counting' a population is not a significant activity in statistical renderings as independent variables require dependent variables in order to acquire statistical meaning. Evidence-based practice references studies that 'replicate' existing tests, toward reinterpretation of former statistical outcomes in a new study of parallel significance, with variables of the same classification. Patterns in longitudinal tests over time offer insights into stasis or transformations…… [Read More]
Laura Polk's theory of resilience holds that an individual has the ability to rise above adversity. There are a number of factors that contribute to how this occurs -- dispositional, relational, situational and philosophical factors all play into this ability to be resilient (Jackson, 2015). This theory has significant implications for nursing practice, and can be evaluated through the lens of evidence-based practice.
Polk's Theory of esilience
Individuals rise above adversity
Dispositional, relational, situational, philosophical
Can be evaluated through evidence-based practice
Nurses can influence the different factors that contribute to resilience. The theory was developed on the basis of Polk's own real-life experience. She recognized that nurses can put themselves in the position of the patient, at least to some extent, and by doing this can empathize with the patient. This empathy allows the nurse to see the treatment through the eyes of the patient. Nurses can then…… [Read More]
Translation of esearch in Evidence-Based Practice
Nursing involves men and women who are willing to help the patients with their skills like health maintenance, recovery of ill or injured people and the treatment. They develop a care plan for the patient sometimes in collaboration with the physicists or therapists. This paper discusses the current nursing practice in which I am involved and needs to be changed.
Identification of a Current Nursing Practice equiring Change
Description of the Current Nursing Practice
Children of all age groups are facing a grave problem these days: obesity. It is considered as a chronic disease when the weight-gain reaches dangerously increased level, which becomes risky for the health. The raised body mass becomes dangerous for children and some schools are now looking into this matter with concern. They are sending notices to the parents to take care of their child's diet, and within…… [Read More]
Progressive Mobility Protocol
This paper is a project based on PICO. The clinical question that serves as the foundation for this data-based design is; for immobile critical care patients, does the use of a nurse driven progressive mobility protocol reduce ICU LOS compared to every hour of repositioning? In this paper, the adult patients admitted to an ICU represent the population (P) of interest. The nurse driven progressive mobility represents the intervention (I), the comparison (C) is the critical care patients repositioned every two hours, and the reduction in LOS represents the result.
Most hospitals place critically ill patients on bed rest and reposition them every two hours in the intensive care unit. Some literature reviews provide evidence in favor of progressive mobility protocols. In addition, the paper also reviews the safety of mobilization of the critical patients and the negative effects bed rest may have on…… [Read More]
nurses deliver evidence-Based care?
Define main ideas within the title supported from the literature
Nurse instructors confront many hurdles in the present healthcare environment. Educational methods, philosophies, and the content of curricula is required to reviewed to cater to the requirements of the professional nurses who would practice in the coming millennium. (Kessenich; Guyatt; DiCenso, 25) Evidence-based practice or EBP has currently emerged to be a remarkable attribute in nursing literature along with a key impetus in restructuring nursing practice. (Elizabeth; Pyle, 64) Evidence-Based Nursing or EBN is the strategy by which the nurses formulate clinical conclusions applying the best available research evidence, their clinical skill and patient prioritization. (Evidence-Based Nursing: University of Minnesota) It could be narrated as the meticulous, unequivocal and judicious application of the current best evidences in formulating decisions about the care of individual patients. When clinicians formulate health care conclusions for a population or group…… [Read More]
Integration Evidence-Based Practice Professional Nursing Practice
The concept of evidence-based practice -- EBP is becoming growingly significant in the sphere of nursing. (Stiffler; Cullen, 2010) Evidence-based practice is not entirely a novel concept; it is the manner in which nurses cater to the norms of care and practice efficiently. (Nysna, 2006) According to Linda Burnes Bolton, DrPH, N, FAAN, vice president and chief nursing officer in the Cedars-Sinai Medical Center in Los Angeles, evidence-based practice -- EBP in reality it is only an alternative mode of viewing the conventional theme of the nurses maintaining their sanctified reliability with society. (Wessling, 2008) David Sackett, MD, a Canadian physician, is regarded the father of evidence-based practice. According to Sackett, "evidence-based practice is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients. . .[by] integrating individual clinical expertise with the best available external…… [Read More]
For example, although many nurses were taught to place infants in the prone sleeping position to prevent aspiration, there is now persuasive evidence that supine (back) sleeping position decreases the risk for sudden infant death syndrome." (p. 28)
This also implicates the practice dimensions of nursing. According to the primary text, evidence-based practice is particularly important as a way to dissuade against poorly informed or assumption-driven decision-making. here non-evidence-based practice is in place, the risk is higher that error or unwanted health consequences may result from treatment approaches. By contrast, the use of evidence-base practice provides the nurse with a set of empirically formed guidelines on how to approach each patient. Instinct such as that often relied upon so heavily in non-evidence-based practice, should be integrated with the understanding afforded by comprehensive research. Only then can the practicing nurse apply practical treatment decisions without falling into otherwise discredited customs or…… [Read More]
Working with Clients with Dual Diagnosis: The Case of Joe," (n.d.) shows how social policies can directly affect the lives of individuals, impacting their access to and awareness of care options and the availability of specific services. Moreover, social policies can influence mental health practitioners, reinforcing stereotypes and stigmas toward patients with substance abuse disorders in particular. A systematic review of the literature reveals "negative attitudes of health professionals towards patients with substance use disorders are common and contribute to suboptimal health care for these patients," (Boekel, Brouwers, van Weeghel & Garresten, 2013, p. 23). Social workers are at the forefront of substance abuse treatment, as social work professionals "regularly encounter individuals, families, and communities affected by substance use disorders," including co-occurring disorders as in Joe's case (NASW, 2013, p. 5). Therefore, in addition to their role in reducing stigma and ensuring evidence-based practice in mental health care, social workers…… [Read More]
Stage Two: Move/Action
Training/focus groups on cultural awareness among staff nurses
Ongoing ethics training classes in cultural diversity (benefits patients as well through nursing action)
CNL takes charge through implementing ethical standards of conduct:
Breaks up cliques through job rotations
Job performance evaluations include issues personal conduct toward other staff, including appropriate sanctions.
ewards (recognition, praise) for incentives to promote cultural diversity in the workplace by nurses.
elocate/terminate those nurses who continue to be forces of resistance to positive change.
Change action efficacy measured by ongoing anonymous nurse surveys on issues of nurse unity/disunity in the workplace, with suggestions for tweaking change.
On-going emphasis on professional standards of nursing creates unity among nurses.
Stage Three: e-Freeze
Identify those action steps that resulted in change; standardize those practices that have an evolutionary and maintaining effect (training, surveys, and job performance evaluations).
Change in the workplace can be a painful process…… [Read More]
This is one of the most common forms of research and, for some research questions is clearly a strong design (Ethics in Critical Care Nursing Research, 2005).
The research that was done in this article would be considered a non-experimental type. There were two types of observation that were conducted. The first type was that of focus groups and the second being the file audit, both of which are observational in nature. In this case this was the most appropriate type of research design to use. Since they were simply trying to see what was actually going on in this area and how that was affecting patients the only real way to tot this was by observation. From this article a nursing care issue that can be raised is that of how palliative care nurses manage family involvement with end of life issues. Are there any standard procedures that are…… [Read More]
The Implementation of Evidence-Based Practice
Evidence-based practice is a cornerstone of effective patient care (Mateo & Kirchhoff, 2009). The robustness of any existing body of evidence is only as useful as the ability of advance practice nurses to access, retrieve, and implement that knowledge in the practice environment. Therefore, nurses need systematic and comprehensive strategies for making information available to colleagues. Nurses also need their administrators to invest in the latest tools and technologies that promote evidence-based practice including networks and information systems. Policies and procedures should not only uphold the tenets of evidence-based practice but also make it easier for nurses to find and share knowledge specific to developing practice behaviors in their care environments. Methods of finding knowledge specific to developing practice behaviors include utilizing proprietary databases, interviewing experts in the field, and utilizing online digital resources. Combining these three methods of knowledge acquisition can make research more…… [Read More]
Third, lack of attention to evidence-based practice can lead to inconsistent delivery of care services.
Evidence-based practice relates to almost every aspect of health care at every stage of a client's relationship with the institution. For example, evidence-based practice informs the types of questions asked during the diagnostic procedures and might even impact the diagnosis itself (Bennett & Bennett, 2000). Evidence-based practice impacts the methods by which infections are prevented (Cantrell, 2009). Evidence-based practices impact the extent to which nurses are empowered to make sound, safe, and effective decisions (Scott & Pollock 2008). Evidence-based practice has the potential to transform the structure of a health care organization like MMH. This is because evidence-based practice changes the hierarchical structure in the organization due to the increased responsibility of nurses for conducting their own research. Alternatively, evidence-based practice can be an extension of organizational change. Health care organizations reducing the hierarchical nature…… [Read More]
Refinement of a Nursing Concern into an Evidence-based Practice Proposal Using the Research Process
Research is mainly used to generate new knowledge or for the validation of existing knowledge based on a theory. Evidenced-based practice (EBP) is the translation of evidence and applying the evidence to clinical decision-making. Most of the evidence used in EBP stems from research. However, EBP will go beyond the use of research and it will include clinical expertise together with patient preference and values. EBP will make use of the evidence developed or knowledge discovered using research to determine the best evidence that can be used or implemented in clinical practice. Research and EBP go hand in hand in that while one will generate new knowledge, the other will make practical use of the knowledge and make use of the knowledge by implementing it into clinical practice. EBP is supported by research since any…… [Read More]
Improving Surgical Outcomes Using the Perioperative Dialogue Model
The estimated $8.5 to $17 billion lost to surgical errors in 1999 was not primarily due to individual incompetence, but to the failure of perioperative systems to operate seamlessly (reviewed by Plasters, Seagull, and Xiao, 2003). The successful management of an operating-room depends heavily on effective communications, but in the absence of a foolproof system for keeping abreast of changes in patient status or surgery schedules, miscommunication is not as rare as it should be.
An important component of the perioperative surgical team is the duties performed by the perioperative nurse (PN), who typically functions as a patient advocate before and during surgery (reviewed by Lee, Kerridge, Chui, Chiu, and Gin, 2011). In Sweden, surgical nursing care has begun to emphasize the importance of a perioperative dialogue between the patient and the PN (eviewed by Lindwall and von Post, 2008). Under the…… [Read More]
organization described in the Kuppler (n.d.) case study is General Motors (GM). General Motors is one of the largest automobile manufacturers in the world. Its other strengths include its operations in more than a hundred different countries. In spite of its more than a century of relative success, GM has experienced growing pains in recent years due to what Kuppler (n.d.) calls a "culture crisis." The organizational culture of General Motors is hierarchical, bureaucratic, and resistant to change.
The Kuppler (n.d.) case study reveals GM as having an organizational culture that is primarily custodial in nature, with some autocratic attributes. Both the autocratic and custodial elements discourage individual responsibility and prevent the sense of "urgency" that might have prevented the disastrous ignition switch debacle, which killed 13 people. One of the hallmarks of a custodial organizational model is that employees are acculturated to be dependent and loyal to…… [Read More]
Application Process Improvement Models Organizations Systems
A clinical practice improvement initiative
The strategy of treating patients with dementia must be dependent on a thorough neurological, psychiatric, and general therapeutic assessment of the nature and causes of the cognitive setbacks and related non-cognitive symptoms, in the setting of a strong collaboration with the patient and family. It is crucial to distinguish and treat general medical conditions, notably delirium, that may be answerable for or contribute to dementia symptoms (Ferrara, 2010).
Currently, the organization is embracing the Progressing evaluation strategy. This approach focuses on incorporating occasional monitoring of the advancement and development of cognitive and non-cognitive psychiatric and how they respond to intervention. With the end goal to provide prompt medication, improve patient safety, and provide convenient advice to the patient and family, it is ordinarily fundamental to see patients in routine follow-up at regular intervals. Frequent patient visits such as once…… [Read More]
Joanna Briggs Institute Model (JBIM) Advancing Research Clinical Practice Through Close Collaboration Model (ARCC). The JBIM a strong focus changing practice-based global scientific evidence, includes patient preferences, professional experience judgment.
Reflect on the following discussion questions
I think both the Joanna Briggs Institute Model (JBIM) and the Advancing Research and Clinical Practice Through Close Collaboration Model (ARCC) are interesting models to study in conjunction, given that both place a strong emphasis on the social aspects of change. Rather than focusing on individuals alone, they acknowledge that changes in healthcare behavior take place within a lived, social context. However, the ARCC model allows for the fact that even though changes may have their roots in social and organizational factors, the individuals behind the change must be willing to make lifestyle alterations. It is not enough to merely logically convince someone of change: change must be generated in a manner to make…… [Read More]
Accessed 08 Feb, 2012 from http://findarticles.com/p/articles/mi_m0U/is_12_27/ai_n17165803/pg_4/?tag=content;col1
Quality improvement research enables hospitals and doctors a means of maximize their services and ensuring that the patients receive the utmost care. A difficult area for doctors to find a solution was the area of compliance. Many patients fail to accept a physician's advice and their illness continues resulting in repeat hospitalizations and further injury to the patient.
In a study conducted in 1976, concerned physicians wanted to find a means of getting patients to better cooperate with their recommended treatment options. Prior to the study, less than half of the hospital's patients followed their doctor's advice and took their medication as prescribed. The one group that was most notorious for this was high blood pressure patients. So, this was the group that the study targeted and tried to improve the outcome of.
uring the study, doctors were trained on a new…… [Read More]
Mitigating isks from Dementia
Providing adequate care for an individual suffering from dementia presents many difficulties for nurses. Patients with dementia often have debilitating conditions such as Alzheimer's or similar neurologic diseases which are progressive, thereby making it challenging for them to remember, think lucidly, communicate effectively or complete activities of daily living. Furthermore, dementia can cause rapid variations in mood or even modify personality and behavior. With the tremendous number of elderly in society more and more nurses are required to care for patients with progressive dementias. It is imperative that a diagnosis be reached early in the course of the cognitive impairment and that the patient is closely monitored for coexisting morbidities. Nurses have a central role in assessment and management of individuals with progressive dementia. This essay provides some evidence-based practical strategies for managing the behavioral problems and communication difficulties often encountered in this population.…… [Read More]
This is discussed at length by Fusick and ordeau (2004) "...school-based counselors need to be aware of the disturbing inequities that exist in predominantly Afro-American urban school districts, where nearly 40% of Afro-American students attend school in the United States" (Fusick and ordeau, 2004) This again places emphasis on the need for mental health programs in these areas of concern. This is also related to findings from a study by McDavis et al. (1995) Counseling African-Americans, which refers to research that stresses the "...widening achievement gap between Afro-American and Euro-American students." (McDavis, et al. 1995)
An important study Laura a. Nabors, Evaluation of Outcomes for Adolescents Receiving School-ased Mental Health Services (2002) refers to the particular issue and problems experience at inner-city schools. The author states that, "School mental health (SMH) programs are an important setting for providing mental health services to adolescents, especially urban youth who typically face in-…… [Read More]
That is largely a function of the fact that the adult diabetes clinic emphasizes the patient counselling and patient education roles of nurses in clinical practice (Hamric, Spross, & Hanson, 2009).
Over the long-term, the outcomes of diabetes clinic practices depend substantially on the abilities of nurses to achieve high levels of patient compliance. This aspect of nursing practice is highly amenable to the osswurm-and-Larrabee concept because clinicians have the regular opportunity to evaluate and compare various methods of motivating patient compliance with protocols necessary to maximize the effectiveness of their clinical care. In that environment, clinicians can apply different approaches with different groups of patients, continually compare the relative degrees of compliance and to quantify the results of those differences in outcomes that lend themselves directly to objective empirical measurement. In principle, these elements are the principal conceptual components of the osswurm-and-Larrabee model for identifying necessary changes, designing appropriate…… [Read More]
A High Impact Negotiations Model: An Answer to the Limitations of the Fisher, Ury Model of Principled Negotiations
This study aims to discover the ways in which blocked negotiations can be overcome by testing the Fisher, Ury model of principled negotiation against one of the researcher's own devising, crafted after studying thousands of negotiation trainees from over 100 multinational corporations on 5 continents. It attempts to discern universal applications of tools, skills, and verbal and non-verbal communication techniques that may assist the negotiator in closing deals with what have been "traditionally" perceived as "difficult people." This study concludes that there are no such "difficult people," but rather only unprepared negotiators. The study takes a phenomenological approach to negotiations, with the researcher immersing himself in the world of negotiation training from 2012-14, for several major multinational corporations, intuiting the failings of the negotiators with whom he comes in contact,…… [Read More]
Value-based reimbursement models are becoming more common in healthcare. Value-based models structure reimbursements according to metrics like efficiency, cost, quality, and patient feedback (Pennic, 2014). Some of the most commonly used value-based reimbursement and payment models include Medicare Quality Incentive Programs, Pay for Performance, Accountable Care Organizations, Bundled Payments, Patient-Centered Medical Home, and Payment for Coordination (Pennic, 2014). More traditional reimbursement models include standard fee-for-service systems, which are woefully inefficient for patients with chronic conditions due to the large number and type of treatments needed (Sanghavi, George, Samuels, et al, 2014). While there is no one preferred approach to reimbursements, value-based models are clearly superior to fee-for-service models.
One of the most promising value-based reimbursement models is the Patient-Centered Medical Home model. This model tends to be more culturally-appropriate than others, taking into account individual and family needs, community diversity, and other contextual variables that might impact patient health outcomes…… [Read More]
Strategies for Dissemination
The key stakeholders in the implementation of the PICO project include patients, their families, health care team members including physicians, hospital administrators, insurers, suppliers, and investors ("Who are the Stakeholders in Health Care"). A broad and diverse group of stakeholders like this one requires a complex and multifaceted approach to project dissemination.
Different dissemination strategies will be used for different stakeholders. For patients and their families, the dissemination strategy will consist of the distribution of educational materials and access to educational resources. The educational resources will help patients to be empowered, so that they can ask questions related to their catheterization. Knowing what questions to ask, and what the answers mean, will help patients and their loved ones make responsible health care choices. For example, the study will show patients that they do not have to keep the catheter in, just because the nurse has…… [Read More]
In fact it has been proposed that the positive impact observed of PBL on motivation may come from these academically talented individuals rather than the intervention itself (Hwang & Kim, 2006). GPAs and demographic characteristics were not found to be correlated to PBL (Ceconi et al., 2008).
White et al. (2004) found in a study regarding that PBL was not shown to be superior to other learning styles in assisting students to acquire or retain knowledge regarding asthma management. This finding is consistent with the majority of research that has not found greater knowledge acquisition or retention amongst PBL students vs. traditional teaching methods (Albanese, 2000; Beers, 2005; Rogal & Snider, 2008). However, it is not that PBL produces inferior results, most studies have found that there are no significant differences between PBL students and those from traditional curricula on standardized knowledge tests (Beachey, 2007). Beers (2005) points out that…… [Read More]
Indeed, quantitative research is synonymous with rigorous implementation; without rigor, then quantitative studies could be considered flawed or faulty, and in effect, not credible for use or application (Van Zomeren, 2008:507).
Another hallmark of quantitative research is that data and findings must be reliable -- that is, results can be repeated to a different group, population, or geographic area. While the results may not be the same, but the general findings must still hold true to another population or geographic area. This is an interesting and attractive feature of quantitative research: methods, analyses, frameworks and theories are constantly tested to different scenarios, populations, and areas that in the end, results and recommendations developed are truly relevant and responsive to the needs or issues confronted by the target population or area.
Similar to qualitative research, quantitative research's hallmarks include the ethical implementation of its studies. Like qualitative research, participants must not…… [Read More]
Community Mental Health "ecovery Model"
What is the recovery orientation/paradigm model of treatment?
A mental health ecovery Model is a treatment alternative in which the service delivery is such that clients have the primary and final decision-making ability over their own treatment. This is unlike the majority of most conventional forms of treatment, in which physicians have the primary control over decisions or clients are just consulted as a formality. The underlying principle of the ecovery Model is that if a client is empowered to have greater choice and control over their service delivery, then he or she will have a greater incentive and drive to take increased initiative and control of their lives (NASW Practice Snapshot: The Transformation of the Mental Health System, 2006).
b. What is the medical model and what are the differences between the medical model and the recovery model of treatment?
A mental health medical…… [Read More]
Shifting the Meanings and eliefs of Clients
Collaborative practice is variously and commonly referred to as conversational practice, social construction, postmodern, or dialogical, practice. It has evolved from assumptions in the wider postmodern movement in human and social sciences. It has also derived its elements from dialogue and social construction theories. Collaborative relations refer to the manner in which we orient ourselves; act, respond and be with another human so as to have them join in a therapeutic engagement that is shared and joint action (Shotter, 1984). This is also referred to as shared inquiry. In an earlier proposition, Shotter (1984) stated that all humans only exist in joint action; in meeting and interactive discourses with others in mutual fashion. He has lately opted to use ''relationally responsive'' notion (Shotter 2008). He implies that we are naturally relational beings with mutual influence on each other. Thus, the self cannot be…… [Read More]
setting, definition Sample/Setting
Level of Evidence
Implementing patient-focused healthcare within settings burdened by the combined challenges of scarce support systems, huge patient loads and constantly-growing patient care responsibilities, especially chronically ill patients
A healthcare organization with nursing staff on twelve-hour schedules
Characteristics: Number of patients individual nursing professionals have to cater to, which ranges between 3 and 5.
Catheter care, blood extractions, surgical schedules planned, antibiotic drugs' presence in the hospital inventory, patients' medicine/treatment plans
Necessity of bedside reporting, patient satisfaction and all-inclusive care framework
A case study technique implies researchers cannot undertake a broad-scale research using the sample. Outcomes might be case-specific and non-generalizable.
This article contributes to clarifying nursing role by employing numerous kinds of patient-focused care elements for improving care quality safely and manageably.
Level 4.d -- Descriptive Observational Studies -- Case Study
(Fawaz, Williams, Myers, Jones, & Logsdon, 2015)
Assessing the efficacy…… [Read More]
Nursing theory: Nola Pender's Health Promotion Model (HPM)
In the United States and around the world, the consequences of the rise of chronic diseases like diabetes and heart disease are increasingly evident. Nola Pender's practice theory of the Health Promotion Model (HPM) was designed to offer a model of health promotion and wellness before the onset of chronic illnesses. Pender "became convinced that patients' quality of life could be improved by the prevention of problems before this occurred, and health care dollars could be saved by the promotion of healthy lifestyles" (Petiprin 2015). This practice-based theory is specifically designed to help patients help themselves and to change course in terms of their health and wellness behaviors. The model is particularly instructive to use today because of the need for more adequate self-care among patients. More and more diseases are lifestyle related thanks to the increase of calories and decrease of…… [Read More]
components of value-based purchasing (VBP) that are most pertinent to the U.S. Department of Veterans Affairs (VA) based on its vital mission to provide high-quality health care services to the nation's veterans while identifying opportunities to reduce costs and improve efficiencies in ways that promote improved clinical outcomes in measurable ways. The study also describes the three departments of a VA medical center that will be most important in implementing VBP, purchasing services, nursing services, and ambulatory care services and provide appropriate goals for this purpose. Because the three selected departments are at different stages of their VBP implementations, the preparation needed to achieve their VBP-related goals will vary, but staff will need to be educated and trained concerning the basics of VBP and how they apply to their unique departmental situations and all three departments must develop appropriate performance measures that can be used to determine the cost-effectiveness of…… [Read More]
With the passing of the Affordable Care Act, knowledge-based healthcare has become a federal mandate. Knowledge management processes vary depending on the nature of the healthcare organization, as well as local and state legislative contingencies. There is no formal auditing process for knowledge management systems analysis, but each healthcare institution is responsible for its own knowledge management and for the delivery of knowledge-based healthcare. The organizations that are primarily responsible for ensuring knowledge-based healthcare delivery are also specific to their areas of expertise. For example, the Centers for Disease Control and Prevention and the United States Public Health Service oversee knowledge-based healthcare service delivery related to infectious diseases and other public health concerns, whereas Medicare covers knowledge-based healthcare services for the senior population nationwide (Institute of Medicine Committee on Assuring the Health of the Public in the 21st Century, 2005). Professional organizations like the American Medical Association and the American…… [Read More]
The majority of communities in Alaska are separated by vast distances and the distance from many communities to the nearest medical facility is equivalent to the distance from New York to Chicago (Indian Health Service Alaska Area Services, 2011).
A study funded by AOA examined issues affecting access to home- and community-based long-term-care services among AI/ANS. Study results indicated that home healthcare was one of the most frequently needed services among AI/ANS. Further, 88% of the services sometimes, rarely, or never met the need, and 36% of services were rarely to never available (Jervis, Jackson & Manson, 2002). Only twelve tribally operated nursing homes exist in the U.S., and these rely predominantly on funding from Medicaid and tribal subsidies. Many tribes would like to have nursing homes but are blocked by state certificate-of-need requirements, Medicaid licensing requirements, and lack of commercial financing. The lack of alternate medical resources, whether private…… [Read More]
Discussion: Agent-Based Modeling and Simulation
Agent-based modeling and simulation allows for organizations to look at their individual parts and players (the agents) to see how they perform in a simulation. In today’s society, situations can develop rapidly as information spreads via social media, and policy makers have to be prepared to address situations as they arise virtually instantaneously. One problem that I can envision is where agent-based modeling and simulation may be useful in the public sector in response to a situation where public administrators have to respond to an accusation made towards a member of their administration regarding sexual misconduct. In such a situation, the spotlight of the public can be bright and intense and any misstep by the administration could result in a barrage of ill-will and condemnation from the public.
To adequately prepare an administration for such a situation, agent-based modeling and simulation may be very useful…… [Read More]
The always developing field of psychology and the tools used to develop this science, have provided many patients with much need relief. The constant evolution of the mind requires that clinical practices within mental health treatments also evolve and grow with the human race. The purpose of this essay is to discus Cognitive Behavior Therapy (CBT), as a useful method of treating mental and psychological issues.
First CBT will be discussed in general, and useful ideas presented about the approach will be introduced. A practical example of this therapy will also be highlighted to contextualize the information. Next, this essay will address CBT can be used specifically for the treatment for depression and the issues associated with that idea. Finally, this essay will address how computerized CBT software programs are assisting in treating these types of issues.
Cognitive Behavior Therapy (CBT) is simply a form of psychotherapy that…… [Read More]
Programs for Parents of Infants and Toddlers: ecent Evidence From andomized Trials
My initial thoughts and feelings were:
Infancy is a very important stage in children's development. It is at this stage that children are most receptive to both mental and physical change and they are at greater risk of potentially harmful influences than their older counterparts. Infants also get affected much more by parental disruptions than older kids. It has been shown that parent-child interactions during the early stages are great predictors of several late and early developmental outcomes. Lending parents support in coming up and implementing good parenting skills can lead to great child development (Pontoppidan, Klest & Sandov, 2016). Since the child is most malleable during infancy, experiences at this stage shape the child's behavior, wellbeing and brain development and so the effects can last for the entire life of the infant. Parenting interventions given to newborn…… [Read More]
Patricia Benner's Theory of Novice to Expert: Does It emain Valid?
What makes a nurse a good nurse? Patricia Benner's Theory of Novice to Expert examines the growth of a nurse's expertise and emotional development from her first years of practice to what Benner calls expertise, or higher-level competency. In Benner's view, expertise depends upon the development of the nurse's intuitive capacity. As noted by Lyneham, Parkinson, & Denholm (2008), this competency that Benner defined as "intuitive" is a little-understood term, given the basis of modern nursing in evidence-based practice (p.380). By intuition, Benner meant the internalization of experience as well as technical capabilities. To better understand Benner's ideas, the authors adopted a qualitative, phenomenological approach, interviewing 14 emergency room nurses who met Benner's standards of expert practice, to determine if Benner's framework was relevant. Specifically, the study attempted to respond to criticisms of Benner's model of expert practice.
Critics…… [Read More]
Advanced Nursing Practice
Nora Pender Model of Health Promotion:
Improving healthcare access to underserved diabetes patients in rural areas
The health promotion theory used to justify this project will by that of the Nora Pender Model of Health Promotion. The focus of this study will be upon expanding access of rural communities to healthcare. Pender's model stresses the need to work with patients to empower them to make positive life choices. When healthcare access is limited, it is essential that patients are given the tools to make empowering choices regarding their healthcare on a day-to-day basis. ural patients are often hampered by access to both information and regular quality care. The model suggests that with knowledge and support provided by more accessible care at local clinics this can change.
The philosophy of the model is that health is "a positive dynamic state not merely the absence of disease"…… [Read More]
By using a review technique, evidence from many different studies and types of research could be compared and analyzed, leading to the result of a higher grade. The few guidelines that were reviewed were the most clear in their recommendations, yet because the direct evidence that led to the formation of these guidelines was not fully provided the recommendations received a lower score. This is not to suggest that these guidelines, when produced by reputable organizations, are not worthy of implementation or consideration, but rather that further investigation into the guideline areas, such that primary research data is found that supports the recommendations in the guidelines published. Having this data directly available will enable the guidelines to be viewed with a higher score of validity and reliability.
The majority of the experimental or observational studies in this set of research received low grades for their recommendation for a variety of…… [Read More]
The main findings, are related to the reactivation of newly acquired memory representations in hippocampal networks that stimulates a transfer and integration of these representations into neocortical neuronal networks as the most important mechanism of memory consolidation. However, the authors give an account of these findings in the article discussed as well.
A more comprehensive review is offered by Frank Marcos and Benington Joel in an article called "The Role of Sleep in Memory Consolidation and Brain Plasticity: Dream or Reality?" published in the Neuroscientist (12/2006). The authors make reference to current evidence for and against the hypothesis that sleep facilitates memory consolidation and promotes plastic changes in the brain. The findings of the study refer to the fact that despite recent accumulation of positive outcomes the precise role of sleep in memory and brain plasticity remains uncertain. They suggest the employment of more integrated approaches that combine behavioral and…… [Read More]
This is largely related to the fact that larger words have more letters to analyze, and therefore require more time (in milliseconds) to decode. This information is largely gained through a methodology known as serial letter recognition, in which words are examined individually from a left to right situation, much the way people look up words in the dictionary. However, evidence suggests that this model is not as effective as the parallel letter recognition theory, which posits that words are internalized simultaneously (Larsen).
Another fairly important facet of word recognition has to do with context. The theory that considers context is known as word shape, which contends that people are able to recognize words based on the shape and the usage of those words, as well as on the structure of sentences. There are aspects of word shape that operate in conjunction with serial letter recognition, such as the fact…… [Read More]
Latinos participations are low in CAPS, and most of their members are unaware of the strategies of CAPS. Their levels of awareness have been on a declining state since the year 1990. Their involvement in these meetings was driving by the levels of crime, moral decay on the community and at the level of social disorder. The problem with the Latino population is that they do not turn up in numbers to these meetings. The community's representation is low in these meetings.
However, research further shows that the community lacks representation in the district advisory committees that meet on a regular basis with the police department. Compared to the African-Americans and the Whites Latinos have young families are they are more likely to be working and having families at home. Their involvement with the police department is variedly mixed. There is evidence that their community avoids police contacts, including not…… [Read More]