Health Care Delivery Models and Nursing Practice
Examine changes introduced to reform or restructure the U.S. health care delivery system. In a 1,000-1,250 word paper, discuss action taken for reform and restructuring and the role of the nurse within this changing environment.
Include the following:
Outline a current or emerging health care law or federal regulation introduced to reform or restructure some aspect of the health care delivery system. Describe the effect of this on nursing practice and the nurse's role and responsibility.
Discuss how quality measures and pay for performance affect patient outcomes. Explain how these affect nursing practice and describe the expectations and responsibilities of the nursing role in these situations.
Discuss professional nursing leadership and management roles that have arisen and how they are important in responding to emerging trends and in the promotion of patient safety and quality care in diverse health care settings.
Research emerging trends. Predict two ways in which the practice of nursing and nursing roles will grow or transform within the next five years to respond to upcoming trends or predicted issues in health care.
You are required to cite to a minimum of three sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
Introduction to nursing
Discuss different career paths in nursing and your preferred nursing specialty - Minimum 250 words-No more than 350 words. Try to get straight to the point without adding any fluff to your discussion. Initial post due on Thursday, September 10, 2020
NURSING: EVIDENCED-BASED PRACTICE PROJECT
I need 150 words for each of the assignment. Please include each with its own references. I will also appreciate non-plagiarized work.
MODULE 1
DQ1
Based on the PICOT you developed for NUR-550, summarize the change initiative you will be proposing. How does this support the population of focus, your setting, and role? Justify how the problem you selected to investigate is amenable to a research-based intervention using the PICOT format.
The following PICOT question will guide as the basis of proposed evidence-based practice project. For Hispanic adults residing in Arizona (P), how does introducing exercise protocol and cultural health nutrition (I) compare with utilization of universal protocols (C) in minimizing pervasiveness of Type 2 Diabetes (O) in 10 months (T).
DQ2
Discuss the role of EBP in your specialty area of practice. Compare and contrast the role and implementation of EBP in your specialty with another advanced registered nurse specialty.
STUDY MATERIALS
Chapter 21 in Advanced Practice Nursing: Essential Knowledge for the Profession.
Chapters 1-3 in Advanced Nursing Research: From Theory to Practice.
Chapters 1 and 2 in Evidence-Based Practice in Nursing and Healthcare.
Read ""Striving for Evidence-Based Practice Innovations Through a Hybrid Model Journal Club: A Pilot Study,"" by Wilson, Ice, Nakashima, Cox, Morse, Philip, and Vuong, from Nurse Education Today (2015). URL: http://www.sciencedirect.com.lopes.idm.oclc.org/science/article/pii/S0260691715000817
Read ""Effect of Online Journal Club on Evidence-Based Practice Knowledge, Intent, and Utilization in School Nurses,"" by Sortedahl, from Worldviews on Evidence-Based Nursing (2012). URL:https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=edswss&AN=000303121300007&site=eds-live&scope=site
Read ""6 Steps for Transforming Organizational EBP Culture,"" by Ogiehor-Enoma, Taqueban, and Anosike, from Nursing Management (2010). URL:https://lopes.idm.oclc.org/login?url=http://gateway.ovid.com.lopes.idm.oclc.org/ovidweb.cgi?T=JS&NEWS=N&PAGE=fulltext&AN=00006247-201005000-00004&LSLINK=80&D=ovft
Read ""About the CEBM?"" located on the Centre for Evidence Based Medicine website. URL: http://www.cebm.net/about
Read the Evidence-Based Practice tutorial, located on the Duke University website. URL: http://guides.mclibrary.duke.edu/c.php?g=158201&p=1036002
Explore the Resources page on the Centre for Evidence Based Medicine website. URL: http://www.cebm.net/category/ebm-resources/
Explore the Evidence Based Medicine page of the University of Illinois Library of the Health Sciences website. Use this website as a resource for your project. URL: http://researchguides.uic.edu/eb
Explore the Evidence Based Medicine Toolkit website. URL: http://www.ebm.med.ualberta.ca/
MODULE 2
DQ1
Do you foresee any issues with implementation of your project? Identify stakeholders who could assist in supporting you, and any theoretical frameworks (organizational change, leadership, role-specific) or models that could help you adapt.
DQ2
What strategies will you use in your new practice as an advance registered nurse to review and critique literature pertinent to your practice?
STUDY MATERIALS
Read Chapter 22 in Advanced Practice Nursing: Essential Knowledge for the Profession.
Read Chapter 25 in Advanced Nursing Research: From Theory to Practice.URL:
Read Chapter 3 in Evidence-Based Practice in Nursing and Healthcare. URL:
Use the Joanna Briggs Institute EBP Database to search for EBP resources related to your project. URL: https://joannabriggs.org/jbi-approach-to-EBHC
Read the Guide to Clinical Preventive Services located on the Agency for Healthcare Research and Quality website. URL: https://www.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/guide/index.html
Explore the Centre for Evidence-Based Medicine (CEBM) website. URL: http://www.cebm.net/
Explore the National Guideline Clearinghouse website.URL: http://www.guideline.gov/
Explore The Cochrane Collaboration website. URL: http://www.cochrane.org/
Explore the Star Model Research website.URL: https://www.uthscsa.edu/academics/nursing/star-model
Explore the Cochrane Library website.URL: http://www.thecochranelibrary.com/view/0/index.html
Explore the Agency for Healthcare Research and Quality website. URL: http://www.ahrq.gov/
MODULE 3
DQ1
What levels of evidence are present in relation to research and practice, and why are they important regardless of the method you use?
DQ2
What factors must be assessed when critically appraising quantitative studies (e.g., validity, reliability, and applicability)? Which is the most important? Why?
STUDY MATERIALS
Read ""Supporting the Uptake of Nursing Guidelines: What You Really Need to Know to Move Nursing Guidelines Into Practice,"" by Matthew-Maich, Ploeg, Dobbins, and Jack, from Worldviews on Evidence-Based Nursing (2013). URL:https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com.lopes.idm.oclc.org/login.aspx?direct=true&db=ccm&AN=2012100833&site=ehost-live&scope=site
Read ""Evidence Based Medicine: Levels of Evidence"" located on the University of Illinois Library website. URL: http://researchguides.uic.edu/content.php?pid=232200&sid=1921074
Read ""Critical Appraisal Tools,"" located on the Centre for Evidence Based Medicine website. URL: http://www.cebm.net/critical-appraisal/
Study ""Worksheet for Using Practice Guidelines,"" located on the Evidence Based Medicine Toolkit website. URL: http://www.ebm.med.ualberta.ca/CPGWorksheet.html
Study ""Template of Guideline Attributes,"" located on the National Guideline Clearinghouse website. URL: http://www.guideline.gov/about/template-of-attributes.aspx
Review ""Study Designs,"" located on the Centre for Evidence Based Medicine website. URL: http://www.cebm.net/index.aspx?o=1039
Investigate the Nursing Best Practice Guidelines page of the Registered Nurses Association of Ontario website. URL: http://www.rnao.org/Page.asp?PageID=861&SiteNodeID=133
MODULE 4
DQ1
What are some of the obstacles or barriers to implementing EBP in nursing? Provide a rationale for your answer. Since there are numerous topics on the issue, it is not appropriate to repeat one that has already been mentioned unless providing new information.
DQ2
Ensuring the protection of human subjects is necessary when conducting research projects. What are some methods that can be used to protect personal rights of someone in one of the groups that is labeled as vulnerable? Consider how a patient's values and your own clinical judgment must be considered before applying the evidence in clinical decision making for an individual patient.
STUDY MATERIALS
Read ""The Role of a Research Nurse in Translating Evidence Into Practice,"" by Houlston, from Nursing Management (2012). URL:https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104555531&site=eds-live&scope=site
Explore the Office for Human Research Protections (OHRP) website. URL: http://www.hhs.gov/ohrp/
MODULE 5
DQ1
Identify the components of implementing your evidence-based practice project. What has been the most difficult component, and why? What do you think has gone well? Provide one piece of advice you would give to a colleague about the implementation process.
DQ2
Identify two stakeholder barriers you might experience during the implementation phase of your evidence-based practice project. This could range from support of the evidence-based project proposal to communication gaps. How could you address these problems?
STUDY MATERIALS
Read Chapters 16 and 17 in Advanced Nursing Research: From Theory to Practice.
Read Chapters 11, 18, and 20 in Evidence-Based Practice in Nursing and Healthcare.
Read ""An Example of Qualitative Comparative Analysis in Nursing Research,"" by Donnelly and Wiechula, from Nurse Researcher (2013). URL:https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=107955325&site=eds-live&scope=site
Read ""Mechanisms Which Help Explain Implementation of Evidence-Based Practice in Residential Aged Care Facilities: A Grounded Theory Study,"" by Masso, McCarthy, and Kitson, from International Journal of Nursing Studies (2014). URL:https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=96521319&site=eds-live&scope=site
Study ""Diffusion of Innovation in Health Care,"" by Cain and Mittman (2002), located on the California Health Care Foundation website. URL: http://www.chcf.org/publications/2002/05/diffusion-of-innovation-in-health-care
Read ""30 Safe Practices for Better Health Care,"" located on the Agency for Healthcare Research and Quality (AHRQ) website. URL: http://archive.ahrq.gov/research/findings/factsheets/errors-safety/30safe/30-safe-practices.html
Explore the Center for Theory of Change website. URL: http://www.theoryofchange.org/
MODULE 6
DQ1
When reviewing the literature and different types of evidence for your project, what gaps in the findings did you encounter? How could these gaps influence other researchers?
DQ2
What is the difference between statistically significant evidence and clinically significant evidence? How would each of these findings be used to advance an evidenced-based practice project?
STUDY MATERIALS
Read Chapter 27 in Advanced Nursing Research: From Theory to Practice.
Read Chapters 12 and 16 and Appendix F in Evidence-Based Practice in Nursing and Healthcare.
Read ""Research, Evidence-Based Practice, and Clinical Improvement/Innovation Posters,"" from the AORN Journal (2015). URL:https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=109809571&site=eds-live&scope=site
Read ""Round and Round We Go: Rounding Strategies to Impact Exemplary Professional Practice,"" by Reimer and Herbener, from Clinical Journal of Oncology Nursing (2014). URL:https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=99713777&site=eds-live&scope=site
Read ""Discharge Planning Rounds to the Bedside: A Patient- and Family-Centered Approach,"" by Wrobleski, Joswiak, Dunn, Maxson, and Holland, from MEDSURG Nursing (2014). URL:https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=hch&AN=95701875&site=eds-live&scope=site
MODULE 7
DQ1
Identify the audience for your EBP proposal and discuss strategies for disseminating the proposal.
DQ2
How will you ensure that all appropriate audiences receive information about research and EBP initiatives?
STUDY MATERIALS
Read Chapters 22-24 in Advanced Nursing Research: From Theory to Practice.
Review Chapters 11 and 16 and Appendix F in Evidence-Based Practice in Nursing and Healthcare.
Read ""A Foundation for Patient Safety: Phase I Implementation of Interdisciplinary Bedside Rounds in the Pediatric Intensive Care Unit,"" by Licata, Aneja, Kyper, Spencer, Tharp, Scott, Fiedor, and Pasek, from Critical Care Nurse (2013). URL:https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=hch&AN=87974048&site=eds-live&scope=site
MODULE 8
DQ1
Post a rough draft of your ""Evidence-Based Practice Presentation."" The purpose of this draft is to get feedback from your peers. Identify at least two areas you would like specific feedback for improvement.
Peers are encouraged to also comment on anything they feel is successful or could be further improved. Review all of the presentations, but provide critical commentary for at least one other posted presentation.
DQ2
The EBP process is a powerful way of advancing improvements in health care. Identify three strategies that you will now incorporate into your practice based on this course. Explain your rationale.
STUDY MATERIALS
Review Chapters 22-24 in Advanced Nursing Research: From Theory to Practice.
Politics and the Patient Protection and Affordable Care Act
Regardless of political affiliation, individuals often grow concerned when considering perceived competing interests of government and their impact on topics of interest to them. The realm of healthcare is no different. Some people feel that local, state, and federal policies and legislation can be either helped or hindered by interests other than the benefit to society.
Consider for example that the number one job of a legislator is to be reelected. Cost can be measured in votes as well as dollars. Thus, it is important to consider the legislator’s perspective on either promoting or not promoting a certain initiative in the political landscape.
To Prepare:
Review the Resources and reflect on efforts to repeal/replace the Affordable Care Act (ACA).
Consider who benefits the most when policy is developed and in the context of policy implementation.
Post an explanation for how you think the cost-benefit analysis in terms of legislators being reelected affected efforts to repeal/replace the ACA. Then, explain how analyses of the voters views may affect decisions by legislative leaders in recommending or positioning national policies (e.g., Congress' decisions impacting Medicare or Medicaid). Remember, the number one job of a legislator is to be re-elected. Please check your discussion grading rubric to ensure your responses meet the criteria.
ACCOUNTABILITY
What are the differences you see between a culture of accountability, where people are held accountable for the mistakes they make, and the Just Culture approach, where mistakes are not punished, but seen as methods of learning? What are the pros and cons of each?
Healthcare Policy Advocate
Opportunity to be politically involved in community-
Opportunities to be involved in political matters are endless these days. I feel as a Nurse Practitioner I need to be cautious of how I represent my profession and ensure that I use EBP to be professional regarding change. In the past I have donated to AANP PAC in support of legislative change that impacts our profession specifically.
In the past I have reached out to my areas congressman (without response) and advocated for improved scope of practice for Nurse Practitioners in the State of Florida. I come from areas of Full Practice Authority (FPA) and am shocked by the Florida reduced practice restrictions. Florida is considered Restricted Practice, which means the state practice and/or laws regarding licensure are restrictive and require physician oversight (AANP, 2021). This professional baffles me and I believe it reduces access for patients to seek care from all providers that could be readily available to them. This is especially unnecessary in the times of COVID-19 and creates a barrier to care. In addition, the cost of collaboration agreements can cost several thousand dollars per month, which arguably questions the ethical nature of this supervision (Sibilla, 2020).
Area of political competency that needs further development-
As a student and as a professional I know there are always areas that need further development. To improve my political competence it would be wise to improve my understanding of legislative processes, as it can take sometimes up to ten years to complete (Handzel, 2021). Being prepared with EBP and organized with the specifics of what I am advocating for, I can meet with my local leaders to discuss the general importance of ideas. Having focused, yet brief, conversation will help start a relationship to start the legislative process (Handzel, 2021).
Twitter article-
I selected the CDC article dated 8/15/2021 discussing pregnant and recently pregnant patients are more likely to have a severe illness if they get COVID-19, even though the risk is low. There is a link to the CDC page included in the article.
Tweet-
I would quote the tweet (retweet with a quote attached):
If you are pregnant please get #covid19 vaccination ASAP. Per #ACOG and #CDC it is recommended to get your #vaxx to keep you and baby healthy! #vaccinessavelives #baby #pregnancy #vaccination #makegoodchoices #NPsLead #womenshealth #OBGYN
Reference
AANP. State policy fact sheet. Florida; Information and resources for Florida NPs. America Association of Nurse Practitioners. www.aanp.org/advocacy/florida (Links to an external site.)
Handzel, S. (2021). Political competence and essential skill in nursing professional development. www.wolterskluwer.com/en/expert-insights/continued-leadership-development-for-npd-professionals
Sibilla, N. (2020. How red tape keeps nurse practitioners from working. Forbes. www.forbes.com/sites/nicksibilla/2020/04/29/how-red-tape-keeps-nurse-practitioners-from-working/?sh=3d4aca4727a0
I NEED A COMMENT FOR THIS DISCUSSION BOARD WITH AT LEAST 2 PARAGRAPHS AND USE 3 SOURCES NO LATER THAN 5 YEARS.
Discussion
Please watch the following video on India's train station: https://www.youtube.com/watch?v=axwXhqKQzIs
Write a 250-word response that addresses how global inequality plays out in India. Why are there so many poor children living at the train station? How are they often criminalized? How do they participate in the global economy? How are their lives different or similar to children's lives in the U.S.?
Discussion
Explain how the advanced practice nurse can apply research-based evidence to inform clinical practice.Expectations
Due: 9/2/21 , 5:00 pm PT
Length: A minimum of 250 words, not including references
Citations: At least one high-level scholarly reference in APA from within the last 5 years
Format: APA 7th edition
Mental Health Discussion
Describe how you achieved each course competency including at least one example of new knowledge gained related to that competency
Describe how you achieved the transferable skill, Communication, including at least one example of new knowledge gained related to the transferable skill
Describe how this new knowledge will impact your nursing practice.
Course Competencies
Describe the foundations of mental health nursing.
Explain current legal issues and social concerns in mental healthcare.
Select appropriate nursing interventions for clients with certain cognitive, addictive and psychotic conditions.
Evaluate nursing care strategies for clients with certain mental health/mood/personality and eating disorders.
Assemble nursing care interventions for clients with mental health/stress related disorders.
Identify factors that impact mental health in special populations.
Transferable Skills
Communication: Displaying capability in writing, reading and oral communication; understanding of non-verbal language
Strategies for Addressing Questions
In this Discussion, focus on the questions you are ready to ask as your journey begins. Keep in mind that sharing questions is often a great way to help others who have similar questions even if they do not realize it!
To prepare:
Reflect on questions or concerns you might have as you begin the MSN program.
Consider the individuals, teams, and departments you previously considered in Module 1 as well as how they may provide support with addressing these questions and concerns
