Master’s-level nurses need to be able to think critically about the evidence, outcomes data, and other relevant information they encounter throughout their daily practice. Often t
Master's-level nurses need to be able to think critically about the evidence, outcomes data, and other relevant information they encounter throughout their daily practice. Often the evidence or information that a nurse encounters, researches, or studies is not presented in the exact context of that nurse's practice. A key skill of the master's-level nurse is to transfer evidence from the context in which it was presented and apply it to a different context in order to maximize the benefit to patients in that new context.
Critical appraisal of evidence is essential for nurses to practice evidence-based nursing, improve patient outcomes, contribute to research quality, make informed decisions, and fulfill their professional responsibilities. It is a key component of promoting excellence and continual improvement in nursing practice.
Ethical research ensures that the rights and well-being of research participants are protected. This includes obtaining informed consent, maintaining confidentiality, and minimizing any potential harm to individuals involved in the research. Ethical research contributes to the long-term impact of evidence-based practice and greater acceptance of evidence-based practices. By conducting research ethically, you will generate knowledge that is more likely to stand the test of time and continue to inform practice and policy in the future.
Master's-level nurses understand the importance of utilizing evidence-based practice in their health care setting. The challenge is bridging the gap between the evidence and clinical practice. "This is the way we've always done it," is a common response and may not indicate evidence-based practice is being utilized. Furthermore, when a practice problem is identified, what are the steps to communicate the need for change with the interprofessional team?
One way to communicate the need for quality improvements, as well as your plans for achieving specific changes, is through a presentation poster. This type of communication tool is used in workplaces as well as professional and academic conferences. Being able to convey the essence and value of a project in a compelling and succinct way is a valuable skill, and it is vital within the constraints of a single poster.
You have been asked to give a poster presentation based on your work and research on a clinical problem in your practice setting. The purpose is to lay out the evidence and a potential implementation plan to your colleagues in order to bridge the gap between the evidence and the practice and improve the quality and outcomes of care.
Identify a clinical problem in your work setting and develop an implementation plan to carry out your evidence-based practice proposal using a poster presentation. You may use the Poster Presentation Template [PPTX] to help structure and organize your assessment submission.
Your Implementation Plan should include the following:
· Background on the clinical problem.
· PICOT question.
· Stakeholders that will be impacted.
· Action plan for implementation.
· Potential barriers to project implementation.
· Baseline data that will be needed to evaluate outcomes.
· Search strategy and databases used.
· Summary of the evidence with a critical appraisal of its quality.
The bullet points below correspond to the grading criteria in the scoring guide. Be sure that your poster presentation addresses all of them.
· Develop a PICOT question for a chosen clinical problem.
· Include a graphic that is relevant to the clinical problem.
· Provide a background on the clinical problem identified.
· Outline an action plan to implement the evidence-based project that includes:
· The recommended practice change.
· Proposed timeline for implementation.
· The tools or resources that will be needed to support the project.
· Identify the stakeholders, opportunities for innovation, and potential barriers to the practice change needed for project implementation.
· Who are the stakeholders who will be impacted?
· What are areas of the project that present opportunities for innovation?
· What are the potential barriers, such as a lack of knowledge, time, skill level, motivation, or resources that could impact project implementation?
· Propose outcome criteria to evaluate the evidence-based practice project and how they will be measured.
· How will outcomes be measured?
· How do your outcomes align with the Quadruple Aim?
· How will your outcome measures inform evidence-based practice, guidelines, or policies?
· Evaluate the evidence that supports the need for practice change.
· In the notes section of your poster presentation:
· Describe your search strategy and databases that were used.
· Summarize your findings with a critical appraisal of the quality, relevance, and validity of your resources.
· Note ethical considerations such as informed consent, protection of participant rights, and potential conflicts of interest.
· Convey purpose of the poster presentation, in an appropriate tone and style, incorporating supporting evidence and adhering to organizational, professional, and scholarly communication standards.
· Integrates relevant and credible sources of evidence to support assertions, using current APA style.
If you choose not to use the provided template, there are templates in PowerPoint or on the Internet that can help you get started designing your poster.
Before starting to record your presentation make sure you have:
· Set up and tested your microphone and headset using the installation instructions provided by the manufacturer. You only need to use the headset if your audio is not clear or high quality when captured by the microphone.
· Practice using the equipment to ensure the audio quality is sufficient.
· Consult Using Kaltura for guidance on how to record your presentation and upload it in the courseroom.
· Microsoft PowerPoint also allows you to record your narration with your slides. If you choose this option, simply submit your presentation to the appropriate area of the courseroom. Your narration will be included with your stories.
· Remember to practice delivering and recording your presentation multiple times to ensure effective delivery.
· Font and font size: Appropriate size and weight for a presentation, generally 24–28 points for headings; no smaller than 18 points for bullet-point text. Use a suitable professional typeface, such as Times or Arial, throughout the presentation.
· Length of presentation: No more than five minutes.
· Number of references: Cite a minimum of 3–5 sources of current scholarly or professional evidence that support your evaluation, recommendations, and plans. Current source material is defined as no older than five years unless it is a seminal work.
· APA formatting: Resources and citations are formatted according to current APA style.
RUBRIC
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:
· Competency 1: Apply evidence-based practice to plan patient-centered care.
· Outline an action plan to implement the evidence-based practice project that includes the recommendations for practice change, a timeline, and tools or resources needed.
· Propose outcome criteria for evaluating the evidence-based practice project and how the outcomes will be measured.
· Competency 2: Apply evidence-based practice to design interventions to improve population health.
· Identify the stakeholders, opportunities for innovation, and potential barriers to the practice change needed for project implementation.
· Competency 3: Evaluate the value, relevance, and ethics of available evidence upon which clinical decisions are made.
· Develop a PICOT question for a chosen clinical problem.
· Evaluate the value and relevance of the evidence that supports the need for a practice change.
· Competency 5: Communicate effectively with diverse audiences, in an appropriate form and style, consistent with organizational, professional, and scholarly standards.
· Convey purpose of the poster presentation in an appropriate tone and style, incorporating supporting evidence and adhering to organizational, professional, and scholarly communication standards.
· Integrate relevant and credible sources of evidence to support assertions, correctly formatting citations and references using APA style.
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Quality Improvement Presentation Poster Learner’s Name Capella University Evidence-Based Practice for Patient-Centered Care and Population Health Evidence-Based Practice Implementation Plan April, 2022
Background on Clinical Problem
Increase in falls on Med Surg unit
Currently using Fall Risk patient bands and sign on patient's door
Stakeholders
Nurses
Patient care tech
Physical therapist
Physician
Potential Barriers
Outcome Measures
Time
Skill level
Resistance to change
Lack of knowledge
Motivation
Current Fall data
Fall data at 1 month
Fall data at 3 months
Fall data at 6 months
PICOT Question
(P)opulation
(I)intervention
(C)omparison
(O)outcome
(T)ime
Action Plan
Practice change
Timeline
Tools or resources
Quadruple Aim
References
Patient experience
Population health
Reduce healthcare costs
Health care provider work life
Make sure you are adding the following to the notes section.
Describe your search strategy and databases that were used.
Summarize your findings with a critical appraisal of the quality and relevance of your resources.
Notes on why the Action Plan is reasonable and realistic.
Notes on specific actions that could be taken to overcome barriers.
Notes that explain how the outcome measures align to the Quadruple Aim.
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Quality Improvement Presentation Poster Capella University Evidence-Based Practice for Patient-Centered Care and Population Health Evidence-Based Practice Implementation Plan
Background on Clinical Problem
HAPI/HAPU is a localized injury to the skin and or the underlying tissue during an inpatient hospital stay.
It leads to skin lesions exposing individuals to pain, severe infections, and increased health utilization.
There is longer hospital stays and an increase in cost, morbidity and mortality due to infection.
It is also poor healthcare practices that reduce the effectiveness of assessing the risk factors (Goodman et al., 2018).
Stakeholders
Physicians
Nurses
Techs
Family Members
Patients
Insurance companies
Potential Barriers
Goodman, L., Khemani, E., Cacao, F., Yoon, J., Burkoski, V., Jarrett, S., Collins, B., & Hall, T. N. T. (2018). A comparison of hospital-acquired pressure injuries in intensive care and non-intensive care units: a multifaceted quality improvement initiative. BMJ Open Quality, 7(4), e000425. https://doi.org/10.1136/bmjoq-2018-000425
Cruz, C. (2020 ). Reducing the Incidence of Pressure Injuries in Adult Patients at Veterans Affairs n Medical Center with the Implementation of a Pressure Injury Preventive Bundle: A Quality Improvement Project.
Outcome Measures
Self-reported deficits in knowledge and skills
Patients concerns on assessing patient’s perennial area
Challenge in patient’s compliance to care regimen
Staff not adhering to treatment regimen (Cruz, 2020).
Lack of communication or bridge in communication between staff members and from staff to patients
Poor Staffing Ratios
Associated Cost to Hospital
Patient's Perception of pressure ulcer
Patient Acuity Levels
Assessment is done to determine a drop in the incidences of hospital-acquired pressure ulcers
Number of new pressure ulcer cases compared to previous numbers as well as he frequency..
PICOT Question
P: Adult patients in the medical surgical care units
I: Implementation of the research-based skincare integrity bundle
C: standard care practice that influences hospital-acquired pressure ulcers
O: reduction in the reported rates of hospital-acquired pressure ulcers
T: Assessment within 24 hours of admission and skin assessment every 12hour shift
Action Plan
Quadruple Aim
References
Low readmission cases
Reduced length of stay in the hospital
Improvement in the skin care
Low rate of morbidity
Low rate of mortality
Improved healthcare quality
Pressure Ulcers
Determine the patient's ability to ambulate on admission
Determine the ability to provide self-care and plan to provide care if not capable
Every two hours turn while in bed and offload pressure of the bed example heels, and elbow, and provide protective foam dressing to pressure areas like the coccyx, sacrum
Provide perennial care as soon as soiled
Moisturize skin as indicated
Consult with the dietician for modification of the patients diet to promote wound healing
Give medications as prescribed and carry out wound care orders as indicated.
Hospital-Acquired Pressure injury or ulcers (HAPI/HAPU) is a localized injury to the skin and or the underlying tissue during an inpatient hospital stay. Numerous healthcare issues are associated with HAPI. The skin lesions lead to pain, severe infections, and increased health utilization. They also lead to longer hospital stays and an increase in morbidity and mortality. The increase in pressure ulcers within the facility is also linked to poor healthcare practices that reduce the effectiveness of assessing the risk factors. Addressing this issue requires an evidence-based intervention that is guided by the PICOT Question: among the adults in the medical surgical care units, does implementation of the research-based skin care integrity bundle which involves : (Surface: make sure your patients have the right support, Skin inspection: early inspection means early detection, Keep your patients moving, Incontinence/moisture: your patients need to be clean and dry, Nutrition/hydration: help patients have the right diet and plenty of fluids.) compared to the standard care practice helps in the reduction of the reported incidences of pressure ulcers every 12 hour shift maximum 24 hour period.
The successful implementation of the proposed evidence-based intervention requires teamwork from both providers, patients, and family members. The team of healthcare providers, in this case, is the critical healthcare providers that include nurses and physicians. Each stakeholder plays important role in the prevention of pressure ulcer development. The patient is required to cooperate and inform about the need for change in the position. Family members act as a link between the providers and the patients. They make it easier for healthcare providers to communicate with patients.
The actions involved in the implementation of the research-based skincare integrity bundle involve the moisturization of the dry skin to ensure maximum lipid barriers. The moisturization is done at a minimum of twice daily. Hot water is avoided during bathing to prevent the increase in dryness and cracking of the skin. The patient’s skin is protected using moisture lotion or barrier as indicated.
The potential barriers that can affect the implementation process include self-reported deficits in knowledge and skills (allied healthcare professionals-AHPs), worries about inspecting intimate anatomical locations (AHPs), difficulties initiating conversations with patients about risk and behavior change, high workloads, and clutter in the home. The expected outcome is the reduction in the reported rates of hospital-acquired pressure ulcers.
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