NRSE 6052 Week 1 Assignment: EBP and the Quadruple Aim

NURS 6052/NURS5052/NRSE6052 Essent of Evidence

Week 2 Quiz

Question 1 What type of study is described in the following excerpt?

An interprofessional team wants to test a new intervention to see whether it will improve central-line associated bloodstream infection (CLABSI) rates. Subjects were randomized into either the intervention or the control group by pulling a slip of paper with either a one or a two written on it from a manila envelope (those pulling ones were randomized to the intervention group; those pulling twos were randomized to the control group). When the study began, the intervention group received the intervention and the control group received equal attention. Data was collected and analyzed using the Statistical Package for the Social Sciences (SPSS). Descriptive statistics were used to report the data. What type of research article is this?

Question 2What type of information would help you identify a research study as qualitative? (Select all that apply.)

Question 3The methods used in conducting a systematic review are specific and rigorous.

Question 4Mixed-methods studies are a combination of which two methodologies?

Question 5In qualitative studies, results are reported using words or themes.

Question 6You are forming a team to do a systematic review of the literature about interventions to treat post-traumatic stress disorder (PTSD). Which of the following would be your first step?

Question 7Which of the following is a type of quantitative research study?

Question 8 What type of study is described in the following excerpt?

Surveys to evaluate nurse satisfaction, medical errors, depression and anxiety, and demographics were given to 5,432 nurses from hospitals of various sizes and geographic locations; some had nurses working 8-hour shifts and 12-hour shifts. Nurses were asked to complete the survey. Upon completion of the survey, nurses were invited to participate in video conference focus groups and one-on-one interviews with a research assistant by video conferencing. Survey results were reported using descriptive statistics, and themes were identified and reported from the data collected in the focus groups and one-on-one interviews.

Question 9Which of the following statements is true of narrative reviews? (Select all that apply.)

Question 10In a systematic review with a meta-analysis, researchers combine the results of each of the individual studies to create a larger sample size (and therefore greater power), then re-run the statistics to capture the true magnitude of the effect. The single-effect measure calculated and reported when the results from all the studies are combined is called what?

Question 11In quantitative studies, results are reported using words or themes.

Question 12What types of information would help you identify a research study as quantitative? (Select all that apply.)

Question 13What kind of study is described in the following excerpt?

Question 14What type of literature may a systematic review include to be considered Level 1 evidence on the Melnyk & Fineout-Overholt levels of evidence hierarchy?

Question 15Randomized controlled trials are which type of research?

Question 16Order the following types of research evidence reviews in order of rigor from most rigorous to least rigorous:

Question 17When trying to determine what type of research study is described in an article, which two sections of the article will give you the best information to make that determination?

Question 18Both literature reviews and systematic reviews are types of research evidence reviews.

Question 19A key characteristic of a systematic review is that it contains a meta-analysis.

Question 20Which of the following types of research can be categorized as primary research? Select all that apply.

HCA Healthcare

HCA Healthcare is a healthcare system comprised of 182 hospitals and 2,300 different sites of care throughout the United States and the United Kingdom (Who We Are, n.d.). HCA states that their mission statement is “Above all else, we are committed to the care and improvement of human life” (Our Mission and Values, n.d.).

Evidence Based Practice 

Evidence Based Practice is evident within HCA’s website in a couple different areas. HCA boasts that they provide quality care for their patients and that they were one of the first healthcare organizations to adopt a mandatory flu policy which provides safety to their patients and employees (Quality Care, n.d.). In addition, 84% of HCA hospitals ranked in the top performing hospitals around the country (Quality Care, n.d.). Both of these statistics contribute to the fact that HCA is using evidence based practice to inform the decisions they are making for the company.

HCA Healthcare also discusses the importance of nursing within the hospital system. HCA Healthcare emphasizes the importance of the nurses role in patient care and in the improvement of patient care (Nursing at HCA Healthcare, n.d.). In 2022 HCA Healthcare actually refined their nursing strategy approach based on nurses’ input and suggestions, which shows that HCA is valuing and implementing evidence based practice even in the way that their staff runs (Nursing at HCA Healthcare, n.d.).

HCA Healthcare clearly utilizes Evidence Based Practice in the way that they run their company and approach patient care with evidence based practice in mind.

Knowledge Gained 

I was able to learn a lot through looking at HCA’s website and discovering more about the company. It is difficult to understand what a company’s mission and values are when they have so many sites across the United States. By looking at the website, I was able to gain a deeper understanding of what HCA stands behind and what their mission and goals truly are. I was also able to gain knowledge on how HCA views their employees. It is evident that HCA places an emphasis on their employees and they value their satisfaction in work and in the company. This is important because employees who feel valued are going to put more effort and emphasis on the care that they provide to their patients.

NRSE 6052 Week 1 Assignment: EBP and the Quadruple Aim References 

Nursing at HCA Healthcare. (n.d.). hcahealthcare.com. https://hcahealthcare.com/nurses/nursing-at-hca/

Our Mission and Values. (n.d.). hcahealthcare.com. https://hcahealthcare.com/about/our-mission-and-values.dot

Quality Care. (n.d.). hcahealthcare.com. https://hcahealthcare.com/about/quality-care.dot

Who We Are. (n.d.). hcahealthcare.com. https://hcahealthcare.com/about/

As the demand for quality, accessible, and patient-centered care increases, healthcare providers must develop inventive interventions to address patients’ needs. They must also broaden their focus to ensure that disease-causing elements are avoided and populations play an active role in illness prevention. Accordingly, evidence-based practice (EBP) application is inevitable since it integrates the best scientific evidence, patient preferences and clinical proficiency to enhance patient care (Melnyk & Fineout-Overholt, 2018). An EBP’s approach to healthcare delivery helps to reach the Quadruple Aim since it positively impacts the Aim’s measures primarily patient experience and population health. It is also instrumental in reducing costs and promoting the work-life of healthcare professionals.

EBP and Patient Experience

From a practice viewpoint, EBP prompts healthcare professionals to translate scientific findings into practice. As a key component of the Quadruple Aim, patient experience includes general satisfaction with healthcare services and improving outcomes as situations necessitate (Valaitis et al., 2020). Translating research findings into practice improves patient experience since healthcare providers learn and implement innovative ways of addressing patient needs. It enables healthcare professionals to apply relevant and up-to-date strategies in healthcare delivery as they focus on patient-centeredness and holism among other practices that impact care positively to enhance the patient experience.

EBP and Population Health

An EBP approach to care and health promotion is integral to improving population health. Giving the example of the response towards COVID-19 pandemic, Van Bavel et al. (2020) observed that evidence-based public health practices are characterized by implementing effective programs and policies based on scientific reasoning. In public health, scientific reasoning includes an in-depth evaluation of population needs, systematic data use, and applying appropriate theories. Health promotion programs and policies, awareness programs, and strategies to promote equitable access to care respond directly to people’s needs (Van Bavel et al., 2020). They apply scientific reasoning since they evaluate data to determine the extent of populations’ needs depending on locations, cultures, and social class, among other determinants.

Costs

In today’s practice, healthcare providers face a significant challenge to provide optimal patient while utilizing the least resources possible. To address this challenge, EBP enables healthcare providers to apply cost-effective approaches in healthcare delivery including recent healthcare technologies and treatment methods. For instance, telehealth reduces distance and cost of care by eliminating avoidable physical visits to providers (Snoswell et al., 2020). Increased focus on preventive care reduces the treatment costs, which reduces the overall healthcare costs.

EBP and the Work-Life of Healthcare Providers

An EBP approach to care recommends practices that help to create a favorable work environment for healthcare providers. Evidence shows that conducive work environments characterized by the support of healthcare providers and interprofessional collaboration improve the health of healthcare providers (Hlongwa & Rispel, 2021). Scientific evidence further shows healthcare managers how to enhance staff productivity and ensure that they stay physically and mentally healthy.  A healthy workforce is integral for quality healthcare hence the need to ensure that healthcare providers are satisfied and with a positive mindset.

NRSE 6052 Week 1 Assignment: EBP and the Quadruple Aim Conclusion

EBP is a practical problem-solving approach pivotal in achieving the Quadruple AIM in health practice. By utilizing EBP’s central components, healthcare providers can improve overall patient experience, public health, and the work-life of healthcare professionals. An EBP approach also enables healthcare providers to apply cost-effective interventions in healthcare delivery. Achieving these goals aligns with the general purpose of the Quadruple Aim which looks forward to promoting health among patients and across populations.

NRSE 6052 Week 1 Assignment: EBP and the Quadruple Aim References

Hlongwa, P., & Rispel, L. C. (2021).Interprofessional collaboration among health professionals in cleft lip and palate treatment and care in the public health sector of South Africa. Human resources for health, 19(1), 1-9.

Melnyk, B. M., &Fineout-Overholt, E. (2018).Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Wolters Kluwer.

Snoswell, C. L., Taylor, M. L., Comans, T. A., Smith, A. C., Gray, L. C., &Caffery, L. J. (2020). Determining if telehealth can reduce health system costs: Scoping review. Journal of Medical Internet Research, 22(10), e17298.doi: https://doi.org/10.2196/17298

Valaitis, R. K., Wong, S. T., MacDonald, M., Martin-Misener, R., O’Mara, L., Meagher-Stewart, D., …& Savage, R. (2020). Addressing quadruple aims through primary care and public health collaboration: ten Canadian case studies. BMC Public Health, 20(1), 1-16. https://doi.org/10.1186/s12889-020-08610-y

Van Bavel, J. J., Baicker, K., Boggio, P. S., Capraro, V., Cichocka, A., Cikara, M., … &Willer, R. (2020). Using social and behavioural science to support COVID-19 pandemic response. Nature Human Behaviour, 4(5), 460-471. https://doi.org/10.1038/s41562-020-0884-z

ADDITIONAL INSTRUCTIONS FOR THE CLASS

Discussion Questions (DQ)

• Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.
• Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.
• One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.
• I encourage you to incorporate the readings from the week (as applicable) into your responses.

Weekly Participation

• Your initial responses to the mandatory DQ do not count toward participation and are graded separately.
• In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
• Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).
• Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

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• Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).
• Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
• I highly recommend using the APA Publication Manual, 6th edition.

Use of Direct Quotes

• I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.
• As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.
• It is best to paraphrase content and cite your source.

 

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Communication

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  • Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
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With increasing healthcare demand, the healthcare system has been advancing drastically over the years, with the introduction of  Evidence-based Practice (EBP) for the provision of safe and quality care. Several models such as the triple aim which has evolved to quadruple aim have also been established to promote population health with enhanced patients experience at a reduced cost (Bowles et al., 2018). Healthcare experts believe that the incorporation of EBP into current clinical practice will help reach the Quadruple Aim. As such, the purpose of the present paper is to discuss the quadruple aim and its role in evidence-based practice.

EBP and the Quadruple Aim on Patient Experience

The quadruple aim is focused on the creation of better care output among patients, at a reduced cost, with an improved experience for both the patient and the healthcare provider. With EBP, all the four measures of the quadruple aim can be achieved. For instance, utilization of EBP in the delivery of care and decision-making process on the most appropriate intervention promotes the experience of the patient, with improved care outcome (Haverfield et al., 2020). Patients tend to feel safe when clinicians utilize evidence-based treatment approaches when taking care of them.

EBP and the Quadruple Aim on Population Health

Concerning population health, EBP promotes the utilization of research in better understanding the characteristics, values, needs, and preferences of a certain population, which are key elements in care delivery. For instance, common chronic illnesses such as diabetes and cardiovascular conditions have posed great challenges over the years, with increasing morbidity and mortality rates (Wagner et al., 2018). However, EBP, through research has led to the introduction of novel approaches which are time efficient and easily accessible helping populations with the highest prevalence of these comorbidities hence promoting the achievement of the quadruple aim.

EBP and the Quadruple Aim on Healthcare Cost

Additionally, with the introduction of EBP, clinicians have reported improved prognosis of several health complications with has reduced hospitalization rate hence reduced healthcare costs. Consequently, the use of proven diagnostic tools and treatment approaches has led to a reduced treatment period, hence reducing the costs associated with diagnostic tests and medication (Haverfield et al., 2020). Clinicians have also been trained to utilize cost-effective care approaches and avoid unnecessary procedures to help reach the quadruple aim.

EBP and the Quadruple Aim on Work-Life of Healthcare Providers

Lastly, despite EBP promoting patient-centered care, the experience of the healthcare workforce has also been considered for optimal care benefits. As the fourth element of the quadruple aim, EBP has ensured that clinicians are adequately trained to utilize time-saving and effective medical tools, to improve the efficiency of the care process (Haverfield et al., 2020). The current healthcare system has introduced several interventions through EBP to decrease provider burnouts, stress, and depression which would otherwise lead to poor health outcomes and decreased patient satisfaction.

NRSE 6052 Week 1 Assignment: EBP and the Quadruple Aim Conclusion

            The healthcare system has evolved over the years towards the provision of safe and quality services. Currently, clinicians are encouraged to utilize EBP in care provision to improve the quality and efficiency of care provided at a reduced cost (Wagner et al., 2018). In the same line, the quadruple aim which evolved recently from the triple aim focuses on four main elements which can be achieved with the incorporation of EBP into current clinical practice.

NRSE 6052 Week 1 Assignment: EBP and the Quadruple Aim References

Bowles, J. R., Adams, J. M., Batcheller, J., Zimmermann, D., & Pappas, S. (2018). The role of the nurse leader in advancing the Quadruple Aim. Nurse Leader, 16(4), 244-248. https://doi.org/10.1016/j.mnl.2018.05.011

Haverfield, M. C., Tierney, A., Schwartz, R., Bass, M. B., Brown-Johnson, C., Zionts, D. L., … & Zulman, D. M. (2020). Can Patient-Provider Interpersonal Interventions Achieve the Quadruple Aim of Healthcare? A Systematic Review. Journal of general internal medicine, 1-11. https://doi.org/10.1007/s11606-019-05525-2

Wagner, E. H., LeRoy, L., Schaefer, J., Bailit, M., Coleman, K., Zhan, C., & Meyers, D. (2018). How do innovative primary care practices achieve the quadruple aim?. The Journal of ambulatory care management, 41(4), 288-297. DOI: 10.1097/JAC.0000000000000249

The healthcare organization website I have chosen is American Heart Association (AHA), which focuses on heart attacks and strokes. Its mission is “to be a relentless force for a world of longer, healthier lives” (AHA, n.d.). This organization was founded by six cardiologists in 1924, and is the oldest and largest organization in the nation that is dedicated to fighting heart disease and stroke, with over 35 millions volunteers and more than 2900 employees (AHA, n.d.).

Evidence-based practice (EBP) is essential in nursing to provide a high quality of patient care and improve patient safety. It “prepares [nurses] to frame clinical questions, perform literature searches, analyze and evaluate evidence, and translate that knowledge into something clinically meaningful” (Crabtree et al., 2016). The word “EBP” was not directly mentioned in the website, but I could tell that they use EBP as their strategy for their organization in various places throughout the website. It appears in their about us introduction page, mentioning that heart disease and stroke rank first and second in mortality worldwide, respectively (AHA, n.d.). They’ve invested so much money in cardiovascular and cerebrovascular disease research for decades that those can be used as EBP to better care for patients. By reviewing their website, I saw that their practices and beliefs are based on EBP research.

The information I found on their website has changed my perception of this organization. When I thought of American Heart Association, it was an organization that I would renew my BLS and ACLS. Knowing they’ve been working hard to prevent and treat mainly stroke and heart disease, using EBP for many years, I happen to take obtaining information while renewing my certificates more seriously and possibly be part of their volunteers. “While it may require a different skill set, research has shown that when providers deliver evidence-based care, patient outcomes are markedly improved” (American Association of Nurse Practitioners, 2018).

Evidence-Based Practice (EBP)

Evidence-based practice (EBP) is a paradigm used in the healthcare industry to enhance treatment excellence and produce desirable outcomes for individuals, medical practitioners, and the overall health service. EBP combines clinical skills with the most recent and reliable scientific data and the patient’s preferences and experiences (Abu-Baker et al., 2021). For nursing professionals, this technique is essential since it offers a wide variety of benefits. It helps nurses build their unique knowledge repositories, bridges the knowledge gap between education and practice, standardizes caregiving practices, improves medicinal care delivery, elevates care quality, and lowers expenditures (Abu-Baker et al., 2021). Several healthcare organizations have adopted EBP to give treatment with superior quality, lower expense, and improved patient outcomes.

EBP is currently acknowledged as the benchmark for delivering ethical and considerate treatment by healthcare decision administrators, healthcare personnel, academics, and governmental authorities (Kaseka & Mbakaya, 2022). EBP is currently universally recognized as the most effective care framework for facilitating the integration of findings into healthcare situations. The implementation of Quality Improvement (QI) programs is the subject of an expanding body of research, and EBP is a crucial necessity within healthcare entities (Abou Hashish & Alsayed, 2020).

One of the certified medical establishments that support EBP is John Hopkins Hospital. The Johns Hopkins Nursing Center for EBP offers guidance, consultation, coaching, industry standards, and scholarship to help nurses use the most up-to-date science in their clinical work. It’s goal is to improve global and regional health via cutting-edge therapeutic practice, scientific investigation, and teaching (Dang et al., 2022). With user-friendly instruments to assist individuals or collaborative usage, the Johns Hopkins EBP for Nurses and Healthcare Professionals Model offers a potent natural concern alternative to therapeutic selection. The institute undertakes investigations to evaluate and examine all the information on a particular healthcare topic. This is done to deliver less skewed, more precise, and relevant outcomes, improve EBP and policymaking choices, and recognize and fill shortcomings (Dang et al., 2022). This approach supports the results of recent studies. In addition, a broad spectrum of end recipients, comprising experts and scientific partners, provide feedback on the Johns Hopkins EBP Model’s ongoing development and improvement. To improve team cooperation and care synchronization, the freshly redesigned framework and instruments highlight the value-added contributions of EBP as an interdisciplinary engagement (Dang et al., 2022).

Additionally, the hospital’s mission, vision, and values assert that Johns Hopkins Medicine explores research limits, changes nursing, improves clinical training, and inspires optimism for humanity, echoing the EBP notion (John Hopkins Hospital, n.d.-a). As a result, the website’s libraries offer a variety of training packages that can aid medical professionals in developing their expertise, abilities, and conduct which improves their patients’ overall results. Additionally, the institution’s webpage includes a research repository that showcases the tools it has set up to support clinical scientific studies on various study issues. This advances the search for novel, efficient therapies for various illnesses and ailments. Additionally, the webpage offers articles from other research to broaden understanding and the body of findings (John Hopkins Hospital, n.d.-b). The webpage also includes a patient care registry that combines the individual choices component of EBP. This area improves patient engagement, medical professionals’ access to health information, and both. It also includes a part with patient testimonials and recommendations that makes it easier to determine the needs of patients (John Hopkins Hospital, n.d. -c).

In conclusion, EBP has been adopted by several healthcare organizations to give treatment with superior quality, at lower expense, and with improved patient outcomes. One of the certified medical establishments that support EBP is John Hopkins Hospital. Through Johns Hopkins Nursing Center for EBP, it was noted in this analysis that the institution offers guidance, consultation, coaching, industry standards, and scholarship to help nurses use the most up-to-date science in their clinical work. Its goal is to improve global and regional health via cutting-edge therapeutic practice, scientific investigation, and teaching.

References

Abou Hashish, E. A., & Alsayed, S. (2020). Evidence-based practice and its relationship to quality improvement: A cross-sectional study among ‎Egyptian nurses. The Open Nursing   Journal, 14(1), 254–262. https://doi.org/10.2174/1874434602014010254

Links to an external site.

Abu-Baker, N. N., AbuAlrub, S., Obeidat, R. F., & Assmairan, K. (2021). Evidence-based practice beliefs and implementations: A cross-sectional study among undergraduate   nursing students. BMC Nursing, 20(1), 1–8. https://doi.org/10.1186/s12912-020-00522-x

Links to an external site.

Dang, D., Dearholt, S., Bissett, K., Ascenzi, J., & Whalen, M. (2022). Johns Hopkins evidence-based practice for nurses and healthcare professionals: Model and guidelines. 4th ed. Sigma Theta Tau International

John Hopkins Hospital. (n.d. -a). Johns Hopkins Medicine Mission, Vision and Values. Johns Hopkins Medicine. https://www.hopkinsmedicine.org/about/mission.html

Links to an external site.

John Hopkins Hospital. (n.d. -b). Evidence-Based Practice Resources. Johns Hopkins Medicine.             https://www.hopkinsmedicine.org/evidence-based-practice/ebp_resources.html

Links to an external site.

John Hopkins Hospital. (n.d. -c). Patient Safety, Quality and Outcomes. Johns Hopkins Medicine. https://www.hopkinsallchildrens.org/About-Us/Patient-Safety

Links to an external site.

Kaseka, P. U., & Mbakaya, B. C. (2022). Knowledge, attitude and use of evidence-based practice (EBP) among registered nurse-midwives practicing in central hospitals in    Malawi: A cross-sectional survey. BMC Nursing, 21(1), 1–13.             https://doi.org/10.1186/s12912-022-00916-z