response to michael translating wk3
Define evidence-based practice (EBP).

EBP can be thought of as five step process , however many different definitions exist. First, EBP begins with the process of asking a clinical question . Secondly , collecting relevant evidence on the clinical question. Thirdly, critically appraising the found evidence. Fourthly, one integrates their clinical expertise , patient preferences and values into the appraised evidence to make a private elections and lastly one evaluates the outcome of this practice change. Thus EBP is a five step process of answering a clinical question via searching for the most relevant data, appraising it , integrating it , and evaluating the outcome of it (Larsen et al., 2019) . Importance of EBP

EBP is important in patients, practice , populations , policy , and health care systems due to the following. Implementation of evidence-based practice (EBP) is essential for ensuring high-quality health care at minimum cost (Clarke et al., 2021).When EBP is not used healthcare in ineffective , inefficient, and dangerous . Thus quality of health care is ensured via the implementation of EBP. EBP ensures that patient’s, populations are receiving treatments that are shown to be effective in providing a solution and thus are imperative in any practice of nursing or healthcare. EBP validates healthcare policy for funding treatments and research because EBP ensures that it is valid and reliable practice for any number of conditions that need to be treated (Clarke et al., 2021; Robinson et al., 2021).

References

Clarke, V., Lehane, E., Mulcahy, H., & Cotter, P. (2021). Nurse Practitioners’ Implementation of Evidence-Based Practice Into Routine Care: A Scoping Review. Worldviews on evidence-based nursing, 18(3), 180–189. https://doi.org/10.1111/wvn.12510Links to an external site.

Larsen, C. M., Terkelsen, A. S., Carlsen, A. F., & Kristensen, H. K. (2019). Methods for teaching evidence-based practice: a scoping review. BMC medical education, 19(1), 259. https://doi.org/10.1186/s12909-019-1681-0Links to an external site.

Robinson, K. A., Brunnhuber, K., Ciliska, D., Juhl, C. B., Christensen, R., Lund, H., & Evidence-Based Research Network (2021). Evidence-Based Research Series-Paper 1: What Evidence-Based Research is and why is it important?. Journal of clinical epidemiology, 129, 151–157. https://doi.org/10.1016/j.jclinepi.2020.07.020

reply to Stacy and Michael week 3

Stacy Harvey
8:36amSep 4 at 8:36am
Good day Dr. Brown and classmates,

The National Quality Forum (NQF) is a nonpartisan organization that seeks to set standards for quality improvement and reporting in the United States. The aim is to address complex issues, reduce healthcare costs, and increase patient safety. Several stakeholders that utilize the resources of the NQF have positively seen and noted improvements in healthcare quality in their organizations. The NQF also has several measure specifications endorsed by several health and non-health organizations (Namburi & Lee, 2022).

The description of the metric addresses nursing hours per patient day, which the American Nurses Association endorses. The identified clinical issue looks at the variations in nursing work hours that have been inconsistent. The healthcare system is under strain when patients lack the required total nursing time, leading to fatigue and burnout. This hazardous situation compromises patient safety (National Quality Forum, 2023).

The healthcare environment must be conducive to quality work output and promote patient safety. Working hours of nurses have been a long-standing concern because of the correlation between adverse nursing outcomes and work-related hazards. Most nurses work over their 40-hour work week due to nurse shortage, a common challenge in acute care. Many nurse leaders are constrained when trying to avoid scheduling nurses over their required working hours; therefore, it is considered a clinical quality improvement issue. Despite the shifts in healthcare, optimal patient care must remain consistent, and efforts from the Government to expand nursing schools to fill the nursing gap have not been as successful as desired and the research shows that staff nurses are still working more than 40 hours per week (Son et al., 2019). In addition, nurses work long hours within a given day, and increasing patient contact time can lead to sleeping issues, which impacts the ability to make critical decisions and impairs work performance and quality of care (Stimpfel et al., 2020).

Doctor of Nursing Practice (DNP) nurse leaders can address the long working hours experienced by nurses and their workload by conducting a root cause analysis. Presenting findings to the administration and advocating for more nurse hire and recruitment is vital. In addition, retention of experienced nurses means building relationships and promoting a positive work culture, offering more flexibility, incentives, and equality in task distribution (Miller & Hemberg, 2023).

Title of Metric

Number of Metric

Description of the Metric

Type of Metric

Endorsed By NQF

Nursing Hours per Patient Day

which is organized according to NQF’s evaluation, criteria, and process.

0205

NSC-13.1 (RN hours per patient day) – The number of productive hours worked by RNs with direct patient care responsibilities per patient day for each in-patient unit in a calendar month.

NSC-13.2 (Total nursing care hours per patient day) – The number of productive hours worked by nursing staff (RN, LPN/LVN, and UAP) with direct patient care responsibilities per patient day for each in-patient unit in a calendar month (National Quality Forum, 2023).

Structure.

The measure focus is the structure of care quality in acute care hospital units (National Quality Forum, 2023).

No. Endorsed by the American Nurses Association

References

Miller, M & Hemberg, J. (2022). Nurse leaders’ perceptions of workload and task distribution in public healthcare: A qualitative explorative study. Journal of Clinical Nursing 32(13), 3557-3567. https://doi.org/10.1111/jocn.16428Links to an external site.

Namburi, N & Lee, L. S. (20222). National Quality Forum. StatsPearl

National Quality Forum (2023). Measures. https://www.qualityforum.org/Links to an external site.

Son, Y.J., Lee, E.K & Ko, K. (2019). Association of working hours and patient safety Competencies with adverse nurse outcomes: A cross-sectional study. International Journal of Environmental Research and Public Health 16(21), 4083. https://doi.org/10.3390/ijerph16214083Links to an external site.
Stimpfel, A. W., Fatehi, F & Koyner, C. (2020). Nurses’ sleep, work hours, and patient care quality, and safety. Sleep Health 6(3), 314-320. https://doi.org/10.1016/j.sleh.2019.11.001Links to an external site.

Respond to Michael is the following

Identify the quality improvement issue of interest

Dementia is thought of as any noted cognitive function decline that is significant to interfere with daily function and independence . It is best described as a syndrome and the causes are many ranging from: neurological , neuropsychiatric, and medical conditions. The most common cause in the elderly is Alzheimer’s disease and Lewy bodies . While the younger population has dementia due to traumatic brain injury and brain tumors (Gale et al., 2018; Day, 2022). One quality improvement issue of interest that the National Quality Forum (NQF), Alzheimer’s Disease (AD) and Related Dementias project, wishes to address the high complex medical and social impact that AD and related dementias have on patients, their family members, and caregivers . Thus NQF’s project addresses performance measure gaps for AD and Dementias via a framework with five measurement and eleven subdomains

Formatted table :ENVIRONMENTAL SCAN RESULTS BY MEASUREMENT

Title of Metric

Health and Well-being

Number of Metric

2

Description of the Metric

Measures the experiences of both the person with dementia and the caregiver

Type of Metric

Qualitative

This metric measures the health and wellbeing report by those with dementias and their caregivers

Endorsed By NQF

Yes this one main metric domain of NQF’s environmental scan falls on a report of 6 years of data and is used to measure development for dementia research and policy in general

(NQF,2023)

https://www.qualityforum.org/priority_setting_for_healthcare_performance_measurement_alzheimers_disease.aspxLinks to an external site.

Propose one current evidence-based practice improvement the Doctor of Nursing Practice (DNP) could utilize that has successfully addressed this identified quality improvement issue.

The Doctor of Nursing Practice (DNP) can utilize advance care planning (ACP) to address the identified quality issue of health and wellbeing in those with AD and Dementia . ACP is the evidence-based practice (EBP) of having a continuous , dynamic process of reflection and dialogue between the patient, caregivers, family members and healthcare professionals . This reflection and dialogue identifies the patient’s preferences , values, care , future care , and end of life care (Piers et al., 2018). Piers et al. (2018) combined recent EBP literature and expert opinion to form this valuable EBP tool of ACA to help improve the quality of the life and care of thus with dementia and AD.

References

Day G. S. (2022). Rapidly Progressive Dementia. Continuum (Minneapolis, Minn.), 28(3), 901–936. https://doi.org/10.1212/CON.0000000000001089Links to an external site.

Gale, S. A., Acar, D., & Daffner, K. R. (2018). Dementia. The American journal of medicine, 131(10), 1161–1169. https://doi.org/10.1016/j.amjmed.2018.01.022Links to an external site.

Piers, R., Albers, G., Gilissen, J., De Lepeleire, J., Steyaert, J., Van Mechelen, W., Steeman, E., Dillen, L., Vanden Berghe, P., & Van den Block, L. (2018). Advance care planning in dementia: recommendations for healthcare professionals. BMC palliative care, 17(1), 88. https://doi.org/10.1186/s12904-018-0332-2

Please see the attached file for detailed instructions. Incorporate weekly resources into the assignment and adhere to the 7th edition APA guidelines. Also, address each component outlined in the grading rubric. Assignment due 9/5/23 by 11:59pm EST

Leading week 6

Discussion Board Posting (3 points):
One of the most significant challenges to leadership is balancing multiple roles. Belasen et al., Figure 7.1 (page 207) depict the four leadership roles of motivator, vision-setter, analyzer, and taskmaster. Think about leaders within your professional organizational network.
• Identify one leader for each leadership role (no names, please) and discuss the leadership attributes and communication skills that make that person fit the role and how the roles may complement strategic planning in an organization.
o Motivator
o Vision-setter
o Analyzer
o Taskmaster

Assignment 2: Cost-Benefit Analysis/Paper (25 points)
A cost-benefit analysis (CBA) compares anticipated financial benefits against the proposed project’s costs to implement and sustain the project’s changes. Differences between the two identifies financial return on investment (ROI). The student will conduct a cost/benefit analysis on the proposed Doctor of Nursing Practice (DNP) project and write a scholarly paper that explains the CBA and anticipated ROI.

Assignment Criteria
Develop a scholarly paper that addresses the following criteria:
1. Provide a brief overview of the proposed DNP project.
2. Determine the direct and indirect costs for the implementation of the proposed DNP project.
3. Identify all the financial benefits that will be gained as a result of the project.
4. Use an Excel worksheet to Compare and contrast all findings (performing the cost-benefits analysis).
o Attach the Excel worksheet as an Appendix that reflects/illustrates the CBA breakdown of costs and benefits.
o Use supporting evidence from literature, organizations, and/or expert opinions for estimated costs/benefits numbers.
5. Summarize the CBA and ROI findings.
6. The scholarly paper should be in narrative format, 3 to 4 pages, excluding the title and reference page.
7. Include an introductory paragraph, a purpose statement, and a conclusion.
8. Include level 1 and 2 headings to organize the paper.
9. Write the paper in the third person, not the first person (meaning do not use ‘we’ or ‘I’) and in a scholarly manner. To clarify: I, we, you, me, our may not be used. In addition, describing yourself as the researcher or the author should not be used.
10. Include a minimum of five (5) professional peer-reviewed scholarly journal references to support the paper (review in Ulrich Periodical Directory) and be less than five (5) years old.
11. APA format is required (attention to spelling/grammar, a title page, a reference page, and in-text citations).
12. Submit the assignment to Turnitin prior to the final submission, review the originality report, and make any needed changes.
13. Submit by the posted due date.

Assignment 2: Cost-Benefit Analysis/Paper Grading Rubric (25 points)
Assignment Criteria 10 points 9 points 4 points 2 points
All topics/criteria addressed, and all questions fully answered. All topics/criteria addressed, and most questions fully answered. All topics/criteria addressed, and most questions partially answered. One or more topics/criteria not addressed or completely answered.
Quality/Accuracy of Information 10 points 8 points 4 points 0 point
Information clearly relates to the main topic/criteria. It includes several supporting details and/or examples. Information clearly relates to the main topic/criteria. It provides supporting details and/or examples. Information clearly relates to the main topic/criteria. A few details and/or examples are given. Information has little or nothing to do with the main topic/criteria.
Organization 3 points 2 points 1 point 0 point
Information is very organized with well-constructed paragraphs and levels of heading. Information organized with well-constructed paragraphs and levels of heading. There is an attempt at organization, but errors exist. No levels of heading. The information or overall structure appears disorganized.
Sources 2 points 1 point 0.5 point 0 point
All references are from a relevant professional peer-reviewed scholarly journal, within a 5-year timeframe, or a classic/ historical source. The majority of references are from a relevant professional peer-reviewed scholarly journal, within a 5-year timeframe or a classic/historical source. Some references are from non-peer-reviewed scholarly sources or older than 5-years. Majority of references are from non-peer-reviewed scholarly sources or older than 5-years.
Earned Points
Up to 10% of the assigned points (total points of assignment) can be deducted from the earned points for errors in APA style [title page, introduction, purpose statement, level heading, conclusion, references, citations, and format], spelling, and/or grammar.
Final Total