The problem, issue, suggestion, initiative, or educational need that will be the focus of the project

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  1. The problem, issue, suggestion, initiative, or educational need that will be the focus of the project
  2. The setting or context in which the problem, issue, suggestion, initiative, or educational need can be observed.
  3. A description providing a high level of detail regarding the problem, issue, suggestion, initiative, or educational need.
  4. Impact of the problem, issue, suggestion, initiative, or educational need on the work environment, the quality of care provided by staff, and patient outcomes.
  5. Significance of the problem, issue, suggestion, initiative, or educational need and its implications to nursing.
  6. A proposed solution to the identified project topic

You are required to retrieve and assess a minimum of 8 peer-reviewed articles. Plan your time accordingly to complete this assignment.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

1)  A brief description of the informatics functional area in which you are interested

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1)  A brief description of the informatics functional area in which you are interested

 

2) Then, identify at least four ANA, TIGER and/or QSEN competencies that you believe to be vital for success in this functional area, and justify your choices.

 

3) Explain how you might successfully develop and master each of these competencies

 

Required Resources

 

Readings

 

  • American Nurses Association. (2015). Nursing informatics: Scope and standards of practice (2nd ed.). Silver Spring, MD: Author.

    Read the following chapter:

    • “Informatics Competencies: Spanning Careers and Roles ”

      In this section, the authors explain the competencies necessary for nurse informaticists to be successful. The section also highlights which competencies are applicable for various informatics roles and functional areas.

  • Saba, V. K., & McCormick, K. A. (2015). Essentials of nursing informatics (6th ed.). New York, NY: McGraw-Hill.
    • Chapter 2, “Computer Hardware”

      This chapter discusses introduces the basics of computer hardware used for nursing informatics.

    • Chapter 4, “Computer Software”
      This chapter introduces computer software, as well as the programs that are most relevant to nursing informatics.
    • Chapter 11, System Life Cycle: A Framework”

      In this chapter, the authors introduce the systems life cycle (SDLC) and its stages. These stages are often used by organizations for large-scale projects, such as implementing or upgrading health information technology.

    • Chapter 13, “System Life Cycle Tools”

      Chapter 13 focuses on the tools needed to assist with each phase of the System Life Cycle. Successful implementation projects require clinical expertise as well as technical knowledge from nurse informaticists.

    • Chapter 9, “Computer Interaction ”

      This chapter explains the need for nurses to be informed about human-machine interactions to prevent unintended consequences. Increased awareness of these factors can result in improved performance and outcomes in nursing informatics and other technologies.

  • Preheim, G. J., Armstrong, G. E., & Barton, A. J. (2009). The new fundamentals in nursing: Introducing beginning quality and safety education for nurses’ competencies. The Journal of Nursing Education, 48(12), 694–697.
    Retrieved from the Walden Library databases.

    This article discusses the Quality and Safety Education for Nurses (QSEN) initiative and its six competencies, including informatics, that are essential for nursing practice. The authors emphasize that nursing education should shift from task-training and development to more current skills and competencies for informatics and patient-centered care.

Week 2 Case Studies

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Week 2 Case Studies

M.T. is an 18-month-old, 20-kg male who presents to the emergency department in status epilepticus, which has continued for approximately 20 minutes. He was brought to the emergency department from a small community via a family vehicle. He has not received any care at this point. The nursing staff has attempted several intravenous line insertions but were unable to gain access. M.T. continues to convulse without interruption.

1. Which of the following would be the most appropriate route of administration for an anticonvulsant to consider for M.T. and why?

a) Intramuscular

b) Percutaneous

c) Subcutaneous

d) Rectal

2. Midazolam is a benzodiazepine that can be used effectively for status epilepticus. Which of the following routes of administration has been used effectively for the delivery of midazolam when intravenous access in unobtainable?

a) Percutaneous

b) Mucosal

c) Oral

d) Subcutaneous

3. Which of the following is true regarding the percutaneous absorption of medications?

a) The absorption of compounds is inversely related to the thickness of the skin

b) The absorption of compounds is inversely related to the hydration of the skin

c) Body surface area (BSA) is decreased, relative to body mass, in the infant and young child when compared with older children and adults

d) The percutaneous administration of medications is reliable and safe in the infant and young child.

4. What are the advantages of utilizing the mucosal route of administration?

a) Some medications have very good absorption and systemic effect when administered by nasal spray

b) Nasal (mucosal) administration avoids the trauma of intravenous line placement

c) Nasal administration of medication is typically less expensive than intravenous administration

d) All of the above are advantages of the mucosal route of administration

K.F. is a 23-year-old female with a history of acne and bipolar disorder. She currently takes lithium to treat her bipolar disorder and isotretinoin (Accutane) for her acne. She also occasionally takes famotidine for reflux.

1. Should K.F. become pregnant, which of the following would be considered safe for her to continue taking? Why? Why are the others considered unsafe during pregnancy (pregnancy rating, potential adverse fetal and maternal effects)?

a) Accutane

b) Lithium

c) Famotidine

2. One year later, K.F. is seen again in your clinic. Her acne and bipolare medications have been discontinued and she now presents 4 months pregnant with a complaint of pain and rising fever over the last 5 days. Lab tests show gram-negative bacilli and Widal test comes out positive. Which of the following drugs will most likely be administered and why? Why will the other drugs not be administered?

a) Ampicillin

b) Ciprofloxacin

c) Levofloxacin

d) Tetracycline

R.S. is an 85-year-old female who has congestive heart failure. Over the past 3 months, she has had four hospitalizations. Like many older adults, R.S. is experiencing difficulty swallowing and psychologic changes affecting her medication absorption.

1. Which of the following would be an appropriate starting point for identifying causes for R.S.’’s frequency of hospitalizations?

a) Simply ask if she is taking her medications as directed

b) Assume that her frequent hospitalizations are secondary to expected changes, which are normal parts of aging

c) Examine all of R.S.’s medication vials to complete an assessment including pill count for adherence

d) Assume that her frequent hospitalizations are the result of undertreating her conditions.

2. In determining the most appropriate course of treatment for R.S., assessing her life expectancy should never be taken into account. Rather, the same course of treatment should be pursued without regard for life expectancy. WHY?

a) True

b) False

3. Which of the following best describes a concern that R.S. is taking OTCs, which may impact her cardiac function?

a) Assume that if R.S. has not discussed her taking OTCs with her health care providers that this is most likely not an issue

b) Assume because older adults typically do not take OTCs that this is not an issue with R.S.

c) Because older adults take a significant number of OTCs without knowledge of their physicians, that R.S.’s use if best assessed through a home visit and the asking of open-ended questions

L.L. is a 67-year-old male who has been diagnosed with benign prostatic hypertrophy (BPH). He is having difficulty with urination. He is currently on Cozaar 100 mg qd for HTN and his BP is well controlled. He is taking no other medications. The doctor has recommended medication for his BPH, but he would like to try an herbal supplement before taking prescription medication.

1. What herbal supplement should he take?

2 .What is the recommended dosage?

3. What are possible side effects and/or drug interactions of the herbal supplement?

4. What warnings should you give L.S. before he starts the herbal supplement?

M.C. is a 54-year-old female who presents with menopausal symptoms of hot flashes, mood swings, decreased libido and vaginal dryness. She wishes to try an herbal supplement to reduce her symptoms, as she is concerned about potential side effects of prescription medications.

1. What herbal supplement would you recommend?

2. What is the recommended dosage?

3. What are possible side effects and/or drug interactions of the herbal supplement?

4. What warnings should you give M.C. before she starts the herbal supplement?

P.K. is a 26-year-old female who presents with depression and anxiety. She is hesitant to start prescription antidepressants as she feels their use will negatively affect her libido and sexual function. She states that she has been taking St. John’s worth for the past couple of weeks and wishes to know if this supplement is okay to use.

1. What are possible side effects and/or drug interactions of the herbal supplement?

2. What warnings should you give P.K. about the herbal supplement?

Course Project: Part 1—Identifying a Researchable Problem

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Course Project: Part 1—Identifying a Researchable Problem

One of the most challenging aspects of EBP is to actually identify the answerable question.

—Karen Sue Davies

Formulating a question that targets the goal of your research is a challenging but essential task. The question plays a crucial role in all other aspects of the research, including the determination of the research design and theoretical perspective to be applied, which data will be collected, and which tools will be used for analysis. It is therefore essential to take the time to ensure that the research question addresses what you actually want to study. Doing so will increase your likelihood of obtaining meaningful results.

In this first component of the Course Project, you formulate questions to address a particular nursing issue or problem. You use the PICOT model—patient/population, intervention/issue, comparison, and outcome—outlined in the Learning Resources to design your questions.

To prepare:

  • Review the article, “Formulating the Evidence Based      Practice Question: A Review of the Frameworks,” found in the Learning      Resources for this week. Focus on the PICOT model for guiding the      development of research questions.
  • Review the section beginning on page 71 of the course      text, titled, “Developing and Refining Research Problems” in the course      text, which focuses on analyzing the feasibility of a research problem.
  • Reflect on an issue or problem that you have noticed in      your nursing practice. Consider the significance of this issue or problem.
  • Generate at least five questions that relate to the      issue which you have identified. Use the criteria in your course text to      select one question that would be most appropriate in terms of      significance, feasibility, and interest. Be prepared to explain your      rationale.
  • Formulate a preliminary PICO question—one that is answerable—based      on your analysis. What are the PICO variables (patient/population,      intervention/issue, comparison, and outcome) for this question?

Note: Not all of these variables may be appropriate to every question. Be sure to analyze which are and are not relevant to your specific question.

  • Using the PICOT variables that you determined for your      question, develop a list of at least 10 keywords that could be used when      conducting a literature search to investigate current research pertaining      to the question.

To complete:

Write a 3- to 4-page paper that includes the following:

  • A summary of your area of interest, an identification      of the problem that you have selected, and an explanation of the      significance of this problem for nursing practice
  • The 5 questions you have generated and a description of      how you analyzed them for feasibility
  • Your preliminary PICOT question and a description of      each PICOT variable relevant to your question
  • At least 10 possible keywords that could be used when      conducting a literature search for your PICOT question and a rationale for      your selections

identify the stakeholders, and determine the responsibility of the team members.

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    1. Introduction: Write an introduction but do not use “Introduction” as a heading in accordance with the rules put forth in the Publication manual of the American Psychological Association(2010, p. 63). Introduce the reader to the plan with evidence-based problem identification and solution.
    2. Change Model Overview: Overview of the ACE Star model (the model we have been discussing this session); define the scope of the EBP; identify the stakeholders, and determine the responsibility of the team members.
    3. Evidence: Conduct internal and external searches of evidence; integrate and summarize the evidence summary worksheet from Milestone 1; develop a recommendation for change.
    4. Translation: develop a hypothetical action plan; include measurable outcomes, reporting to stakeholders; identify next steps and disseminate the findings.
    5. Conclusion: Provide a clear and concise summary, inclusive of the problem issue, the five points of the ACE Star change model; and ways to maintain the change plan.
  2. Citations and References must be included to support the information within each topic area. Refer to the APA manual, Chapter 7, for examples of proper reference format. In-text citations are to be noted for all information contained in your paper that is not your original idea or thought. Ask yourself, “How do I know this?” and then cite the source. Scholarly sources are expected, which means using peer-reviewed journals and credible websites.
  3. Tables and Figures may be added as appropriate to the project. They should be embedded within the body of the paper (see your APA manual for how to format and cite). Creating tables and figures offers visual aids to the reader and enhances understanding of your literature review and design for change.

2) Discuss the interrelationship between theory, knowledge, research and evidence-based practice.

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1) How do Fawcett and Garity’s (see attached file)definitions align with your understanding of knowledge, theory, research and evidence-based practice? Support your response with evidence from the literature (quote the literature below in the required readings).

2) Discuss the interrelationship between theory, knowledge, research and evidence-based practice.

3) How does this interrelationship support or guide your EBP Project?

Required Readings

Terry, A. J. (2018). Clinical research for the Doctor of Nursing practice (3rd ed.). Burlington, MA: Jones & Bartlett Learning.

With your EBP project in mind, select and read the chapter that best fits your proposed methodologies: (I can attach the following chapters, let me know if you don’t have them and need me to attach them)

  • Chapter      6, “Designing a Clinically-Based Quantitative Capstone Research Project”
  • Chapter      7, “Designing a Clinically-Based Qualitative Capstone Research Project”
  • Chapter      8, “Designing a Clinically-Based Mixed Method Capstone Research Project”

Fawcett, J., & Garity, J. (2009). Chapter 1: Research and evidence-based nursing practice. In Evaluating Research for Evidence-Based Nursing, (pp. 3-20). Philadelphia, PA: F. A. Davis.

Adams, J.M., & Natarajan, S. (2016). Understanding influence within the context of nursing: Development of the Adams influence model using practice, research, and theory. Advances in Nursing Science, 39(3), E40-E56.

Djulbergovic, B. (2014). A framework to bridge the gaps between evidence-based medicine, health outcomes, and improvement and implementation science. Journal of Oncology Practice, 10(3), 200-202.

Hutchinson, A.M., Bioeth, M., Wilkinson, J.E., Kent, B., & Harrison, M.B. (2012). Using the promoting action on research implementation in health services framework to guide research use in the practice setting. Worldviews on Evidence-Based Nursing, First Quarter, 59-61.

Leung, K., Trevena, L., & Waters, D. (2014). Systematic review of instruments for measuring nurses’ knowledge, skills and attitudes for evidence-based practice. Journal of Advanced Nursing 70(10), 2181–2195.

Leung, K., Trevena, L., & Waters, D. (2016). Development of a competency framework for evidence-based practice in nursing. Nurse Education Today, 39, 189-196.

PIICOT Question

In patients in extended intensive care within an urban acute care facility in Eastern United States, how does early mobilization as recommended by National Institute of Health and Care Excellence clinical guidelines on rehabilitation of patients after critical illness impact early transfers from intensive care as measured 6 months post-implementation when compared to the current standard of care including minimal mobilization of patients?

P: Adult patients

I: in extended intensive care within an urban acute care facility

I: increased mobilization of the patients

C: minimal mobilization of the patients

O: early transfers of the patients from intensive care

T: 6 months