NURS 6052 Assignment: Evidence-based Project Walden

NURS 6052 Assignment: Evidence-based Project Walden

NURS 6052 Evidence-Based Project, Part 1: Identifying Research Methodologies

Mental health disorders such as depression have immense impact on the affected populations and their significant others. Depression lowers the patient’s quality of life, as evidenced by the increased care needs, loss of productivity, and premature mortality. Nurses and other healthcare providers are increasingly involved in the implementation of evidence-based interventions to minimize burden due to depression in their populations. An example is exploring the effectiveness of technology incorporation into the treatments adopted for patients with major depression. Therefore, the purpose of this paper is to explore the effectiveness of telehealth interventions in improving the treatment outcomes in depression.

Full citation of selected article	Article #1	Article #2	Article #3	Article #4
	ReferencesBellanti, D. M., Kelber, M. S., Workman, D. E., Beech, E. H., & Belsher, B. E. (2022). Rapid review on the effectiveness of telehealth interventions for the treatment of behavioral health disorders. Military Medicine, 187(5–6), e577–e588. https://doi.org/10.1093/milmed/usab318	Egede, L. E., Dismuke, C. E., Walker, R. J., Acierno, R., & Frueh, B. C. (2018). Cost-effectiveness of behavioral activation for depression in older adult veterans: In-person care versus telehealth. The Journal of Clinical Psychiatry, 79(5), 3853. https://doi.org/10.4088/JCP.17m11888	Scott, A. M., Clark, J., Greenwood, H., Krzyzaniak, N., Cardona, M., Peiris, R., Sims, R., & Glasziou, P. (2022). Telehealth v. face-to-face provision of care to patients with depression: A systematic review and meta-analysis. Psychological Medicine, 52(14), 2852–2860. https://doi.org/10.1017/S0033291722002331	Zhao, L., Chen, J., Lan, L., Deng, N., Liao, Y., Yue, L., Chen, I., Wen, S. W., & Xie, R. (2021). Effectiveness of telehealth interventions for women with postpartum depression: Systematic review and meta-analysis. JMIR MHealth and UHealth, 9(10), e32544. https://doi.org/10.2196/32544
Why you chose this article and/or how it relates to the clinical issue of interest (include a brief explanation of the ethics of research related to your clinical issue of interest)	I chose this article because it examines the effectiveness of telehealth interventions for treating behavioral health disorders. The research shows that the use of telehealth in behavioral problems such as depression is comparable to face-to-face provision of psychiatry and psychotherapy services. The ethics of research related to my clinical issue of interest includes ensuring informed consent, privacy, and confidentiality when using telehealth interventions.	I chose this study because it supports the use of telehealth in mental health problems that include depression. The research shows that telehealth interventions are cost-effective as compared to face-to-face delivery of treatment interventions. The ethics of research that relate to my clinical issue of interest include safety, quality, efficiency, and patient empowerment.	I chose this article because it demonstrates the effectiveness of telehealth among patients with depression as compared to face-to-face. The article demonstrates the feasibility of telehealth interventions alongside their applicability to addressing the needs of patients suffering from depression. The research ethics that will inform my clinical issue of interest include beneficence, informed consent, and patient autonomy.	I chose this study because it explores the effectiveness of telehealth in improving depressive and anxiety symptoms among patients with post-partum depression. The study informs the relevance of telehealth use in the delivery of virtual care for patients suffering from mental health disorders. The issue of ethics that relates to my clinical issue is informed consent and data privacy and confidentiality.
Brief description of the aims of the research of each peer-reviewed article	The aim of this research was to investigate the effectiveness of behavioral health treatments delivered in person as compared to telehealth through telephone and teleconference.	The aim of this study was to examine whether the delivery of behavioral activation for depression through telehealth was cost-effective as compared to in-person care.	The aim of this study was to compare the real-time to face-to-face therapy for patients suffering from depression.	The aim of this study was to evaluate the effectiveness of telehealth interventions in reducing anxiety and depressive symptoms in women with post-partum depression.
Brief description of the research methodology used Be sure to identify if the methodology used was qualitative, quantitative, or a mixed-methods approach. Be specific.	This study was quantitative research. The researchers searched relevant articles on PubMed database where hand-searching of relevant systematic review, dual screening, dual of risk bias assessment, and data abstraction were done.	The research was quantitative. It was a randomized, non-inferior trial that involved assigning participants to 1 of 2 arms of 8-week behavioral activation therapy either through telehealth or in-person.	The study was quantitative. It was a systematic review that utilized evidence from articles that were obtained from databases that included Cochrane Central, Embase, and Medline. The included studies were mainly randomized controlled trials that compared the use of telehealth vs face-to-face for patients with major depression.	The study was quantitative. It was a systematic review and meta-analysis of evidence from articles that were obtained from databases that included CINAHL, Cochrane library, PsycINFO, CNKI, and Wanfang.
A brief description of the strengths of each of the research methodologies used, including reliability and validity of how the methodology was applied in each of the peer-reviewed articles you selected.	One of the strengths of this study is that it compares the effectiveness of telehealth interventions with the traditional face-to-face interaction in the delivery of behavioral interventions. It also reviewed best-available evidence on the topic to come up with conclusive evidence. The reliability and validity of findings were maintained by having a third researcher independently assessing the relevance, appropriateness, and need for the selected articles and data abstraction.	The strength of this research is that it randomized participants into either control or intervention groups to determine the true effect of the interventions. The randomization also enhanced the validity and reliability of the research. The other strength is the use of a large sample size, which strengthened the generalizability of findings.	One of the strengths of this study is that it reviewed evidence obtained from randomized controlled trials to come up with conclusive evidence on the effectiveness of telehealth as compared to face-to-face interventions in depression. The other strength is the inclusion of studies that used a high number of participants, which enhanced the generalizability of outcomes. The authors achieved reliability by using a large sample size. They ensured validity by selecting studies that related to the topic and using independent researchers in searching and extracting data from the selected articles.	The study is associated with the strength of utilizing randomized controlled trials for the systematic review and meta-analysis. It also used a large sample size to ensure reliability and validity of findings. The selected studies were reviewed for potential bias, to ensure the obtained results had a high reliability rate.
General Notes/Comments	This article informs the need for telehealth in the delivery of behavioral interventions for patients with mental health problems.	This research demonstrates that the use of telehealth is cost-effective as compared to the use of in-person interventions.	This article shows the effectiveness of telehealth interventions in improving treatment outcomes among patients with depression.	This study supports the use of telehealth interventions to improve outcomes among patients suffering from depression.

Conclusion

          In summary, the reviewed data shows that telehealth interventions are effective in improving outcomes among patients suffering from depression. The studies show that telehealth interventions may be used to complement the use of face-to-face interventions. The results also show that telehealth reduce the costs associated with depression treatment. Therefore, its use should be explored in my practice site.

References

Bellanti, D. M., Kelber, M. S., Workman, D. E., Beech, E. H., & Belsher, B. E. (2022). Rapid review on the effectiveness of telehealth interventions for the treatment of behavioral health disorders. Military Medicine, 187(5–6), e577–e588. https://doi.org/10.1093/milmed/usab318

Egede, L. E., Dismuke, C. E., Walker, R. J., Acierno, R., & Frueh, B. C. (2018). Cost-effectiveness of behavioral activation for depression in older adult veterans: In-person care versus telehealth. The Journal of Clinical Psychiatry, 79(5), 3853. https://doi.org/10.4088/JCP.17m11888

Scott, A. M., Clark, J., Greenwood, H., Krzyzaniak, N., Cardona, M., Peiris, R., Sims, R., & Glasziou, P. (2022). Telehealth v. face-to-face provision of care to patients with depression: A systematic review and meta-analysis. Psychological Medicine, 52(14), 2852–2860. https://doi.org/10.1017/S0033291722002331

Zhao, L., Chen, J., Lan, L., Deng, N., Liao, Y., Yue, L., Chen, I., Wen, S. W., & Xie, R. (2021). Effectiveness of telehealth interventions for women with postpartum depression: Systematic review and meta-analysis. JMIR MHealth and UHealth, 9(10), e32544. https://doi.org/10.2196/32544

Module 2: An Introduction to Clinical Inquiry and Research Methodologies (Weeks 2-3)

Laureate Education (Producer). (2018). Research Methodologies [Video file]. Baltimore, MD: Author.

Due By	Assignment
Week 2, Days 1-4	Read the Learning Resources. Begin to check your knowledge with the Quiz. Begin to compose Part 1 of your Assignment.
Week 2, Days 5-6	Continue to check your knowledge with the Quiz. Continue to compose Part 1 of your Assignment.
Week 2, Day 7	Final day to complete Quiz. Continue to compose Part 1 of your Assignment. Begin to compose Part 2 of your Assignment.
Week 3, Days 1-6	Continue to compose Part 1 and Part 2 of your Assignment.
Week 3, Day 7	Deadline to submit Part 1 and Part 2 of your Assignment.

Learning Objectives

Students will:

• Differentiate between quantitative, qualitative, and mixed-method research methodologies
• Analyze the relationship between peer-reviewed articles and clinical issues
• Analyze research ethics related to clinical issues and peer-reviewed research
• Analyze the aims of research studies presented in peer-reviewed articles
• Analyze research methodologies described in peer-reviewed articles
• Analyze strengths, reliability, and validity of research methodologies in peer-reviewed research

Photo Credit: Tetra Images / Getty Images / Getty Images

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Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

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

• Chapter 2, “Asking Compelling Clinical Questions” (pp. 33–54)
• Chapter 21, “Generating Evidence Through Quantitative and Qualitative Research” (pp. 607–653)

Grant, M. J., & Booth, A. (2009). A typology of reviews: An analysis of 14 review types and associated methodologies. Health Information and Libraries Journal, 26, 91–108. doi:10.1111/j.1471-1842.2009.00848.x

Note: You will access this article from the Walden Library databases.

Hoare, Z., & Hoe, J. (2013). Understanding quantitative research: Part 2. Nursing Standard, 27(18), 48–55. doi:10.7748/ns2013.01.27.18.48.c9488

Note: You will access this article from the Walden Library databases.

Hoe, J., & Hoare, Z. (2012). Understanding quantitative research: Part 1. Nursing Standard, 27(15), 52–57. doi:10.7748/ns2012.12.27.15.52.c9485

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Note: You will access this article from the Walden Library databases.

Walden University Library. (n.d.-a). Databases A-Z: Nursing. Retrieved September 6, 2019, from https://academicguides.waldenu.edu/az.php?s=19981

Walden University Library. (n.d.-b). Evaluating resources: Primary & secondary sources. Retrieved January 22, 2020, from https://academicguides.waldenu.edu/library/evaluating/sources

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Walden University Library. (n.d.-f). Keyword searching: Finding articles on your topic: Boolean terms. Retrieved September 19, 2018, from http://academicguides.waldenu.edu/library/keyword/boolean

Walden University Library. (n.d.-g). Keyword searching: Finding articles on your topic: Introduction to keyword searching. Retrieved September 19, 2018, from http://academicguides.waldenu.edu/library/keyword/searching-basics

Walden University Library. (n.d.-i). Quick Answers: What are filtered and unfiltered resources in nursing? Retrieved September 6, 2019, from https://academicanswers.waldenu.edu/faq/73299

Document: Matrix Worksheet Template (Word document)

Required Media

Centers for Research Quality. (2015a, August 13). Overview of qualitative research methods [Video file]. Retrieved from https://youtu.be/IsAUNs-IoSQ

Centers for Research Quality. (2015b, August 13). Overview of quantitative research methods [Video file]. Retrieved from https://youtu.be/cwU8as9ZNlA

Laureate Education (Producer). (2018). Review of research: Anatomy of a research study [Mutlimedia file]. Baltimore, MD: Author.

Schulich Library McGill. (2017, June 6). Types of reviews [Video file]. Retrieved from https://youtu.be/5Rv9z7Mp4kg

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Quiz: Is It Quantitative, Qualitative, or Mixed Methods?

An effective understanding and application of research requires an understanding of the underlying methodologies employed. This quiz will assess your understanding of the quantitative, qualitative, and mixed-method research methodologies.

Johns Hopkins is a world renowned influential hospital in patient care; located in my hometown, Baltimore, Maryland. The Johns Hopkins Hospital is ranked #5 out of more than 4,500 hospitals in the nation. Johns Hopkins provides patient support through a variety of specialties from primary care to emergency medicine. (Johns Hopkins Medicine, 2022b). On the hospitals main website, it discusses COVID-19 vaccine updates and resources. The website also provides quick links for research, education, and training. Evidence-Based Practice information appears under a Center for Nursing Inquiry link from the main page. The website discusses how Johns Hopkins Health System uses the Johns Hopkins Evidence-Based Practice (JHEBP) model, which is a three-phase approach: practice question, evidence, and translation. Johns Hopkins nurses have free access to an online course to learn more about the JHEBP Model. (Johns Hopkins Medicine, 2022a).

Johns Hopkins Hospital’s work is clearly grounded in EBP as they have created their own Evidence-Based Practice Model as discussed above. This model is a powerful problem-solving approach for clinical decision-making that includes user-friendly tools to guide use. This model was driven by feedback from both academic and clinical users to aid in the development and improvement of the JHEBP Model. The goal is to build capacity among front-line workers to determine best practices and incorporate them into everyday patient care. (Johns Hopkins Medicine, 2017).

My perception of Johns Hopkins Medicine is unchanged as I currently work for the University and have a great understanding of the work that Hopkins does with including EBP. I did learn that Johns Hopkins has an EBP Model and Guidelines book that is one of the most foundational books on EBP in healthcare. The JHEBP Model is discussed in this book. (Sigma Marketplace, 2022). Researching Johns Hopkins and learning more about their EBP has given me an even better understanding and appreciation for their diligence in the incorporation of EBP in patient care.

To Prepare:

• Review the research methodology terms and concepts presented to you this week.

By Day 7 of Week 2

Submit your Quiz.

Note: You may submit your Quiz as many times as you like until Day 7 of Week 2.

Submission and Grading Information

Submit Your Quiz by Day 7 of Week 2

To submit your Quiz:

Week 2 Quiz

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Assignment: Evidence-Based Project

Is there a difference between “common practice” and “best practice”?

When you first went to work for your current organization, experienced colleagues may have shared with you details about processes and procedures. Perhaps you even attended an orientation session to brief you on these matters. As a “rookie,” you likely kept the nature of your questions to those with answers that would best help you perform your new role.

Over time and with experience, perhaps you recognized aspects of these processes and procedures that you wanted to question further. This is the realm of clinical inquiry.

Clinical inquiry is the practice of asking questions about clinical practice. To continuously improve patient care, all nurses should consistently use clinical inquiry to question why they are doing something the way they are doing it. Do they know why it is done this way, or is it just because we have always done it this way? Is it a common practice or a best practice? NURS 6052 Assignment: Evidence-based Project Walden

In this Assignment, you will identify clinical areas of interest and inquiry and practice searching for research in support of maintaining or changing these practices. You will also analyze this research to compare research methodologies employed.

To Prepare:

• Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry.
• Based on the clinical issue of interest and using keywords related to the clinical issue of interest, search at least four different databases in the Walden Library to identify at least four relevant peer-reviewed articles related to your clinical issue of interest. You should not be using systematic reviews for this assignment, select original research articles.
• Review the results of your peer-reviewed research and reflect on the process of using an unfiltered database to search for peer-reviewed research.
• Reflect on the types of research methodologies contained in the four relevant peer-reviewed articles you selected.

Part 1: An Introduction to Clinical Inquiry

Create a 4- to 5-slide PowerPoint presentation in which you do the following:

• Identify and briefly describe your chosen clinical issue of interest. This clinical issue will remain the same for the entire course and will be the basis for the development of your PICOT question
• Describe how you used keywords to search on your chosen clinical issue of interest.
• Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected.
• Provide APA citations of the four peer-reviewed articles you selected.

Part 2: Identifying Research Methodologies

After reading each of the four peer-reviewed articles you selected, use the Matrix Worksheet template to analyze the methodologies applied in each of the four peer-reviewed articles. Your analysis should include the following:

• The full citation of each peer-reviewed article in APA format.
• A brief (1-paragraph) statement explaining why you chose this peer-reviewed article and/or how it relates to your clinical issue of interest, including a brief explanation of the ethics of research related to your clinical issue of interest.
• A brief (1-2 paragraph) description of the aims of the research of each peer-reviewed article.
• A brief (1-2 paragraph) description of the research methodology used. Be sure to identify if the methodology used was qualitative, quantitative, or a mixed-methods approach. Be specific.
• A brief (1- to 2-paragraph) description of the strengths of each of the research methodologies used, including reliability and validity of how the methodology was applied in each of the peer-reviewed articles you selected.

By Day 7 of Week 3

Submit Part 1 and Part 2 of your Evidence-Based Project.

Note: Part 1 is a 4-5 slide PowerPoint and Part 2 is the Matrix. Be sure to attach both of your documents (Part 1 and Part 2) before you click Submit.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

• Please save your Assignment using the naming convention “WK#Assgn+last name+first initial.(extension)” as the name.
• Click the Weeks 2 and 3 Assignment Rubric to review the Grading Criteria for the Assignment.
• Click the Weeks 2 and 3 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
• Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK3Assgn+last name+first initial.(extension)” and click Open.
• If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
• Click on the Submit button to complete your submission.
• Due to the nature of this assignment, your instructor may require more than 5 days to provide you with quality feedback.

Grading Criteria

To access your rubric:

Weeks 2 and 3 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Weeks 2 and 3 Assignment drafts and review the originality report.

Submit Part 1 and Part 2 of Your Assignment by Day 7 of Week 3

To submit your Assignment:

Weeks 2 and 3 Assignment

To go to the next week:

Module 3

Assignment: Evidence-Based Project, Part 3: Advanced Levels of Clinical Inquiry and Systematic Reviews

Your quest to purchase a new car begins with an identification of the factors important to you. As you conduct a search of cars that rate high on those factors, you collect evidence and try to understand the extent of that evidence. A report that suggests a certain make and model of automobile has high mileage is encouraging. But who produced that report? How valid is it? How was the data collected, and what was the sample size?

In this Assignment, you will delve deeper into clinical inquiry by closely examining your PICO(T) question. You also begin to analyze the evidence you have collected.

To Prepare:

• Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry.
• Develop a PICO(T) question to address the clinical issue of interest you identified in Module 2 for the Assignment. This PICOT question will remain the same for the entire course.
• Use the key words from the PICO(T) question you developed and search at least four different databases in the Walden Library. Identify at least four relevant systematic reviews or other filtered high-level evidence, which includes meta-analyses, critically-appraised topics (evidence syntheses), critically-appraised individual articles (article synopses). The evidence will not necessarily address all the elements of your PICO(T) question, so select the most important concepts to search and find the best evidence available.
• Reflect on the process of creating a PICO(T) question and searching for peer-reviewed research.

The Assignment (Evidence-Based Project)

Part 3: Advanced Levels of Clinical Inquiry and Systematic Reviews

Create a 6- to 7-slide PowerPoint presentation in which you do the following:

• Identify and briefly describe your chosen clinical issue of interest.
• Describe how you developed a PICO(T) question focused on your chosen clinical issue of interest.
• Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected.
• Provide APA citations of the four relevant peer-reviewed articles at the systematic-reviews level related to your research question. If there are no systematic review level articles or meta-analysis on your topic, then use the highest level of evidence peer reviewed article.
• Describe the levels of evidence in each of the four peer-reviewed articles you selected, including an explanation of the strengths of using systematic reviews for clinical research. Be specific and provide examples.

By Day 7 of Week 5

Submit Part 3 of your Evidence-Based Project.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

• Please save your Assignment using the naming convention “WK5Assgn+last name+first initial.(extension)” as the name.
• Click the Week 5 Assignment Rubric to review the Grading Criteria for the Assignment.
• Click the Week 5 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
• Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK5Assgn+last name+first initial.(extension)” and click Open.
• If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
• Click on the Submit button to complete your submission.
• Due to the nature of this assignment, your instructor may require more than 5 days to provide you with quality feedback.

Grading Criteria

To access your rubric:

Week 5 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 5 Assignment draft and review the originality report.

Submit Your Assignment by Day 7 of Week 5

To submit your Assignment:

Week 5 Assignment

To go to the next week:

Module 4

NURS 6052 Assignment: Evidence-Based Project, Part 4: Critical Appraisal of Research

Realtors rely on detailed property appraisals—conducted using appraisal tools—to assign market values to houses and other properties. These values are then presented to buyers and sellers to set prices and initiate offers.

Research appraisal is not that different. The critical appraisal process utilizes formal appraisal tools to assess the results of research to determine value to the context at hand. Evidence-based practitioners often present these findings to make the case for specific courses of action.

In this Assignment, you will use an appraisal tool to conduct a critical appraisal of published research. You will then present the results of your efforts.

To Prepare:

• Reflect on the four peer-reviewed articles you selected in Module 2 and the four systematic reviews (or other filtered high- level evidence) you selected in Module 3.
• Reflect on the four peer-reviewed articles you selected in Module 2 and analyzed in Module 3.
• Review and download the Critical Appraisal Tool Worksheet Template provided in the Resources.

The Assignment (Evidence-Based Project)

Part 4A: Critical Appraisal of Research

Conduct a critical appraisal of the four peer-reviewed articles you selected by completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template. Choose a total of four peer- reviewed articles that you selected related to your clinical topic of interest in Module 2 and Module 3.

Note: You can choose any combination of articles from Modules 2 and 3 for your Critical Appraisal. For example, you may choose two unfiltered research articles from Module 2 and two filtered research articles (systematic reviews) from Module 3 or one article from Module 2 and three articles from Module 3. You can choose any combination of articles from the prior Module Assignments as long as both modules and types of studies are represented.

Part 4B: Critical Appraisal of Research

Based on your appraisal, in a 1-2-page critical appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with APA citations of the research.

By Day 7 of Week 7

Submit Part 4A and 4B of your Evidence-Based Project.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

• Please save your Assignment using the naming convention “WK7Assgn+last name+first initial.(extension)” as the name.
• Click the Week 7 Assignment Rubric to review the Grading Criteria for the Assignment.
• Click the Week 7 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
• Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK7Assgn+last name+first initial.(extension)” and click Open.
• If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
• Click on the Submit button to complete your submission.

Grading Criteria

To access your rubric:

Week 7 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 7 Assignment draft and review the originality report.

Submit Your Assignment by Day 7 of Week 7

To submit your Assignment:

Week 7 Assignment

To go to the next week:

Module 5

Assignment: Evidence-Based Project, Part 5: Recommending an Evidence-Based Practice Change

The collection of evidence is an activity that occurs with an endgame in mind. For example, law enforcement professionals collect evidence to support a decision to charge those accused of criminal activity. Similarly, evidence-based healthcare practitioners collect evidence to support decisions in pursuit of specific healthcare outcomes.

In this Assignment, you will identify an issue or opportunity for change within your healthcare organization and propose an idea for a change in practice supported by an EBP approach.

To Prepare:

• Reflect on the four peer-reviewed articles you critically appraised in Module 4, related to your clinical topic of interest and PICOT.
• Reflect on your current healthcare organization and think about potential opportunities for evidence-based change, using your topic of interest and PICOT as the basis for your reflection.

The Assignment: (Evidence-Based Project)

Part 5: Recommending an Evidence-Based Practice Change

Create an 8- to 9-slide PowerPoint presentation in which you do the following:

• Briefly describe your healthcare organization, including its culture and readiness for change. (You may opt to keep various elements of this anonymous, such as your company name.)
• Describe the current problem or opportunity for change. Include in this description the circumstances surrounding the need for change, the scope of the issue, the stakeholders involved, and the risks associated with change implementation in general.
• Propose an evidence-based idea for a change in practice using an EBP approach to decision making. Note that you may find further research needs to be conducted if sufficient evidence is not discovered.
• Describe your plan for knowledge transfer of this change, including knowledge creation, dissemination, and organizational adoption and implementation.
• Describe the measurable outcomes you hope to achieve with the implementation of this evidence-based change.
• Be sure to provide APA citations of the supporting evidence-based peer reviewed articles you selected to support your thinking.
• Add a lessons learned section that includes the following:
  • A summary of the critical appraisal of the peer-reviewed articles you previously submitted
  • An explanation about what you learned from completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template (1-3 slides)

By Day 7 of Week 9

Submit Part 5 of your Evidence-Based Project.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

• Please save your Assignment using the naming convention “WK9Assgn+last name+first initial.(extension)” as the name.
• Click the Week 9 Assignment Rubric to review the Grading Criteria for the Assignment.
• Click the Week 9 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
• Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK9Assgn+last name+first initial.(extension)” and click Open.
• If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
• Click on the Submit button to complete your submission.
• Due to the nature of this assignment, your instructor may require more than 5 days to provide you with quality feedback.

Grading Criteria

To access your rubric:

Week 9 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 9 Assignment draft and review the originality report.

Submit Your Assignment by Day 7 of Week 9

To submit your Assignment:

Week 9 Assignment

To go to the next week:

Module 6

Assignment: Evidence-Based Capstone Project, Part 6: Disseminating Results

The dissemination of EBP results serves multiple important roles. Sharing results makes the case for your decisions. It also adds to the body of knowledge, which creates opportunities for future practitioners. By presenting results, you also become an advocate for EBP, creating a culture within your organization or beyond that informs, educates, and promotes the effective use of EBP.

To Prepare:

• Review the final PowerPoint presentation you submitted in Module 5, and make any necessary changes based on the feedback you have received and on lessons you have learned throughout the course.
• Consider the best method of disseminating the results of your presentation to an audience.

To Complete:

Create a 5-minute, 5- to 6-slide narrated PowerPoint presentation of your Evidence-Based Project.

• Be sure to incorporate any feedback or changes from your presentation submission in Module 5.
• Explain how you would disseminate the results of your project to an audience. Provide a rationale for why you selected this dissemination strategy.

By Day 5 of Week 11

Submit Part 6, your revised PowerPoint presentation of your Evidence-Based Project.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

• Please save your Assignment using the naming convention “WK11Assgn+last name+first initial.(extension)” as the name.
• Click the Week 11 Assignment Rubric to review the Grading Criteria for the Assignment.
• Click the Week 11 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
• Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK11Assgn+last name+first initial.(extension)” and click Open.
• If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
• Click on the Submit button to complete your submission.

Grading Criteria

To access your rubric:

Week 11 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 11 Assignment draft and review the originality report.

Submit Your Assignment by Day 5 of Week 11

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Week 11 Assignment

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Name: NURS_6052_Module02_Week03_Assignment_Rubric

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Part 1: An Introduction to Clinical Inquiry

Create a 4- to 5-slide PowerPoint presentation in which you do the following:

·   Identify and briefly describe your chosen clinical issue of interest.

·   Describe how you used keywords to search on your chosen clinical issue of interest.

·   Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected.

·   Provide APA citations of the four-peer reviewed articles you selected.

Points Range: 36 (36%) – 40 (40%)
The presentation clearly and accurately identifies and describes in detail the chosen clinical issue of interest.

The presentation accurately and thoroughly describes in detail how keywords were used to search on the chosen clinical issue of interest.

The presentation accurately and clearly identifies in detail four or more research databases that were used to conduct a search for selected peer-reviewed articles.

The presentation accurately provides APA citations of four or more peer-reviewed articles selected.

Points Range: 32 (32%) – 35 (35%)
The presentation accurately identifies and describes the chosen clinical issue of interest.

The presentation accurately describes how keywords were used to search on the chosen clinical issue of interest.

The presentation accurately identifies at least four research databases that were used to conduct a search for selected peer-reviewed articles.

The presentation accurately provides APA citations of at least four peer-reviewed articles selected.

Points Range: 28 (28%) – 31 (31%)
The presentation inaccurately or vaguely identifies and describes the chosen clinical issue of interest.

The presentation inaccurately or vaguely describes how keywords were used to search on the chosen clinical issue of interest.

The presentation inaccurately or vaguely identifies at least four research databases that were used to conduct a search for selected peer-reviewed articles.

The presentation inaccurately provides APA citations of the peer-reviewed articles selected.

Points Range: 0 (0%) – 27 (27%)
The presentation inaccurately and vaguely identifies and describes the chosen clinical issue of interest or is missing.

The presentation inaccurately and vaguely describes how keywords were used to search on the chosen clinical issue of interest or is missing.

The presentation inaccurately and vaguely identifies less than four research databases that were used to conduct a search for selected peer-reviewed articles or is missing.

The presentation inaccurately provides APA citations of the peer-reviewed articles selected.
Part 2: Identifying Research Methodologies

After reading each of the four peer-reviewed articles you selected, use the Matrix Worksheet template to analyze the methodologies applied in each of the four peer-reviewed articles. Your analysis should include the following:

·  The full citation of each peer-reviewed article in APA format.

·   A brief statement explaining why you chose this peer-reviewed article and/or how it relates to your clinical issue of interest, including a brief explanation of the ethics of research related to your clinical issue of interest.

·   A brief description of the aims of the research of each peer-reviewed article.

·  A brief description of the research methodology used. Be sure to identify if the methodology used was qualitative, quantitative, or a mixed-methods approach. Be specific.

Points Range: 45 (45%) – 50 (50%)
The response accurately and clearly provides a full citation of each article in APA format.

The responses accurately and thoroughly explain the selection of these articles and/or how they relate to a clinical issue of interest, including a detailed explanation of the ethics of research.

The responses accurately and clearly describe the aims of the research.

The responses accurately and clearly describe the research methodology used, and clearly identify the type of methodology used with specific and relevant examples.

The responses accurately and clearly describe the strengths of each of the research methodologies used, including a detailed explanation of the reliability and validity of how the methodology was applied in each of the articles selected.

The responses provide a complete, detailed, and specific synthesis of two outside resources related to the selection of articles and two or three course-specific resources.

Points Range: 40 (40%) – 44 (44%)
The response accurately provides a citation of each peer-reviewed article in APA format.

The responses accurately explain the selection of these peer-reviewed articles and/or how they relate to a clinical issue of interest, including an accurate explanation of ethics.

The responses accurately describe the aims of the research of each peer-reviewed article.

The responses accurately describe the research methodology used and type of methodology used with some examples.

The responses accurately describe the strengths of each of the research methodologies used, including an explanation of the reliability and validity of how the methodology was applied in each of the peer-reviewed articles selected.

The responses provide an accurate synthesis of at least one outside resource related to the selection of the peer-reviewed articles. The response integrates at least one outside resource and two or three course-specific resources.

Points Range: 35 (35%) – 39 (39%)
The response inaccurately or vaguely provides a citation of each peer-reviewed article in APA format.

The responses inaccurately or vaguely explain the selection of these articles and/or how they relate to a clinical issue of interest, including the explanation of the ethics.

The responses inaccurately or vaguely describe the aims of the research of each article.

The responses inaccurately or vaguely describe the research methodology used and the type of methodology used, with only some examples.

The responses inaccurately or vaguely describe the strengths of each of the research methodologies used, including the explanation of the reliability and validity of how the methodology was applied in each of the articles selected.

The responses provided vaguely or inaccurately synthesize outside resources related to the selection of the articles. The response minimally integrates resources that may support the responses provided.

Points Range: 0 (0%) – 34 (34%)
The response inaccurately and vaguely provides a citation of each peer-reviewed article in APA format or is missing.

The responses inaccurately and vaguely explain the selection of these articles and/or how they relate to a clinical issue, including the explanation of ethics of research, or they are missing.

The responses inaccurately and vaguely describe the aims of the research, or they are missing.

The responses inaccurately and vaguely describe the research methodology used, the type of methodology used with no examples present, or they are missing.

The responses inaccurately and vaguely describe the strengths of each of the methodologies used, including the explanation of the reliability and validity of the methodology, or they are missing.

The responses provide a vague and inaccurate synthesis of outside resources related to the selection of the articles and fail to integrate any resources to support the responses provided, or is missing.
Written Expression and Formatting—Paragraph Development and Organization:
Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided, which delineates all required criteria.

Points Range: 5 (5%) – 5 (5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity.

A clear and comprehensive purpose statement, introduction, and conclusion are provided, which delineates all required criteria.

Points Range: 4 (4%) – 4 (4%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.

Purpose, introduction, and conclusion of the assignment are stated but are brief and not descriptive.

Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60–79% of the time.

Purpose, introduction, and conclusion of the assignment is vague or off topic.

Points Range: 0 (0%) – 3 (3%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time.

No purpose statement, introduction, or conclusion is provided.
Written Expression and Formatting—English Writing Standards:

Correct grammar, mechanics, and proper punctuation.

Points Range: 5 (5%) – 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors.

Points Range: 4 (4%) – 4 (4%)
Contains a few (one or two) grammar, spelling, and punctuation errors.

Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Contains several (three or four) grammar, spelling, and punctuation errors.

Points Range: 0 (0%) – 3 (3%)
Contains many (five or more) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
Total Points: 100
Name: NURS_6052_Module02_Week03_Assignment_Rubric

The clinical issue of interest is Diabetes Mellitus (DM) type 1 and why it’s usually misdiagnosis and how to prevent it. However, I recently identified ten patients with glucose levels of 350 to 400 who were unaware of they were typed 1 DM. These individuals were told they were type 2 and their treatment was not effective. They spent a lot of time in the hospital for uncontrolled DM and suffered from kidney disease, and neuropathy.

However, searching for the subject I used the Walden library and Medline database. I modified the search four times to obtain quality scholarly articles and I found four scholarly articles. The language I use was -misdiagnosis type 1 DM. Therefore, the rigor will occur by confirming a valid question by following the PICOT format which will ensure I have the correct patient population, intervention, comparison intervention, group outcome, and timeframe (Melnyk & Fineout-Overholt, 2019). The second step is searching for evidence-based practice (EBP) to evaluate the best practice (Melnyk & Fineout-Overholt, 2019). It would be interesting to learn about the components which contribute to the misdiagnosis. However, the third step involves massaging the information for validation and sustainability, and feasibility (Melnyk & Fineout-Overholt, 2019). Hence, it is essential to follow all the steps, but steps 4 & 5 ensure the outcomes and clinical decisions. Step 4 guides PICOT to integrate the information to decide if it is EBP and if it’s understandable. The goal is to justify the research and evaluate the outcomes based on the evidence (Melnyk & Fineout-Overholt, 2019). The last step is to share the information among those whom it will affect, to change their behavior.

In addition, to the research, there will be challenges, and how to overcome negative outcomes. The acuity of the patients, shortage of nurses, and lack of knowledge of EBP are challenges (Melnyk & Fineout-Overholt, 2019). As clinicians learn about the research, it becomes rigorous and effective. It is essential to assess and evaluate frequently to identify challenges.

I really enjoyed reading your discussion post, Samantha! It was nice to learn more about The Joint Commission and have a better understanding of their goals and mission, versus just fearing them when they come to visit the hospital for inspections. I do agree with you that The Joint Commission website is rooted in evidence-based practice. While browsing on the Joint Commission website, one thing that I found to be extremely eye-opening was the sentinel event data released for 2021. In 2021, the top ten frequently reported sentinel events included falls (485), delay in treatment (97), unintended retention of a foreign object (97), wrong-site surgery (85), suicide (79), self-harm (45), fire (38), medication management (35), assault (34), and clinical alarm response (22). It’s estimated that fewer than 2% of sentinel events are reported to The Joint Commission, so these numbers are a lot lower than the amount of sentinel events that actually happen (The Joint Commission, 2022). Reviewing this data can help us to prevent future harm and keep patients as safe as possible.

One thing I didn’t know about The Joint Commission is that hospitals pay about $46,000 per year to keep their accreditation from the Joint Commission. One may think, “Why would hospitals put themselves through the stress of having The Joint Commission present and analyze them AND have to pay for this?”…but, this is because The Joint Commission certification is necessary to obtain liability insurance and receive support from the government in terms of Medicaid and Medicare payors (Wadhwa and Huynh, 2022).

Every few months, I’ve witnessed at least twenty nurses leave the profession—both new graduates and seasoned professionals—and either resign right away or postpone their departure until the conclusion of their six-month probationary period. The significant nursing turnover rate in recent years, particularly after Covid, is due to various factors. Due to the high burnout rate among nurses, you chose a popular and alarming topic. The care provided to residents can suffer from high staff turnover, hurting their health. Any reason can lead a nurse to leave a job, although retirement, career changes, and switching employers are the most frequent. The stresses of challenging physical and mental work, feeling unappreciated, and inadequate staffing are some of the most common reasons nurses leave their jobs. One of healthcare leaders’ many challenges is determining what factors contribute to nursing turnover and what can be done to reduce it. Staffing methods like patient-to-nurse ratios and workload measurement systems are crucial for nursing turnover. To support nurses, organizations should consider adopting innovative technologies that automate clinical workflows, remove repetitive and redundant administrative tasks and enable nurses to connect at a more personal level with patients (Wood, 2022)

MBIs have been used to increase the psychological well-being of nurses. Although the benefits of mindfulness for nurses have been studied more and more, researchers still do not have a complete understanding of the types of MBIs that have been used to improve nurses’ psychological well-being, the outcome measures used to assess nurses’ psychological well-being, or the overall efficacy of MBIs in enhancing nurses’ psychological well-being( Sulosaari et al., 2022). Many organizations should implement the use of MBIs to reduce nurse burnout.

Sulosaari, V., Unal, E., & Cinar, F. I. (2022). The effectiveness of mindfulness-based interventions on the psychological well-being of nurses: A systematic review. Applied Nursing Research, 64, 151565. https://doi.org/10.1016/j.apnr.2022.151565

Wood, heather. (2022, November 18). Reducing nursing turnover rates with help of current technologies. Health Data Management. Retrieved March 23, 2023, from https://www.healthdatamanagement.com/articles/reducing-nursing-turnover-rates-with-help-of-current-technologies?id=130439

Main Post

The clinical issue of interest that I chose is nurse-patient ratios that has become more of a safety issue more recently. The Covid-19 pandemic has changed healthcare in many ways which has caused lots of nurses to change positions or leave healthcare all together. This has caused nursing shortages which has resulted in higher nurse-patient ratios. More patients means less time that is able to be spent with each patient thus affecting patient care and potential for safety events. As described by Anders (2021):

Many facilities were forced to expand capacity beyond their normal operating limits to meet surging patient admissions. The added number of patients placed additional burden on the nursing staff already stretched to their limits, which meant that the normal RN-to-patient ratio changed. Covid-19 hit when many nurses were burned out and working in understaffed conditions (p. 1039).

As I developed my PICOT question, I used the key words in the question as the subject of my search in databases (Melynk & Fineout-Overholt, 2019). I used CINAHL Plus with Full Text as the primary database for my research. I typed in “nurse patient ratio” in the search box. This initial search yielded 3,792 results. Then, I changed the publication date to only show articles published between 2018-2023, and this resulted in 738 articles. Next, I selected “peer-reviewed scholarly journals” as an option, and this resulted in 473 articles. As the results were narrowed down, I was able to select relevant articles related to nurse-patient ratios. I may be able to narrow the search even more by adding more key words like “patient safety” or “nurse burnout.”

References

Anders, R.L. (2021). Patient safety time for federally mandated registered nurse to patient ratios. Nursing Forum, 56(4), 1038–1043. https://doi.org/10.1111/nuf.12625

Melnyk, B. M., & Finout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare (4th ed.). Wolters Kluwer.

Walden University Library. (n.d.-c). Evidence-based practice research: CINAHL search help. Retrieved from https://academicguides.waldenu.edu/library/healthevidence/cinahlsearchhelp

The clinical issue of interest that I chose is nurse-patient ratios that has become more of a safety issue more recently. The Covid-19 pandemic has changed healthcare in many ways which has caused lots of nurses to change positions or leave healthcare all together. This has caused nursing shortages which has resulted in higher nurse-patient ratios. More patients means less time that is able to be spent with each patient thus affecting patient care and potential for safety events. As described by Anders (2021):

Many facilities were forced to expand capacity beyond their normal operating limits to meet surging patient admissions. The added number of patients placed additional burden on the nursing staff already stretched to their limits, which meant that the normal RN-to-patient ratio changed. Covid-19 hit when many nurses were burned out and working in understaffed conditions (p. 1039).

As I developed my PICOT question, I used the key words in the question as the subject of my search in databases (Melynk & Fineout-Overholt, 2019). I used CINAHL Plus with Full Text as the primary database for my research. I typed in “nurse patient ratio” in the search box. This initial search yielded 3,792 results. Then, I changed the publication date to only show articles published between 2018-2023, and this resulted in 738 articles. Next, I selected “peer-reviewed scholarly journals” as an option, and this resulted in 473 articles. As the results were narrowed down, I was able to select relevant articles related to nurse-patient ratios. I may be able to narrow the search even more by adding more key words like “patient safety” or “nurse burnout.”

References

Anders, R.L. (2021). Patient safety time for federally mandated registered nurse to patient ratios. Nursing Forum, 56(4), 1038–1043. https://doi.org/10.1111/nuf.12625

Melnyk, B. M., & Finout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare (4th ed.). Wolters Kluwer.

Walden University Library. (n.d.-c). Evidence-based practice research: CINAHL search help. Retrieved from https://academicguides.waldenu.edu/library/healthevidence/cinahlsearchhelp

Week 11: Initial Discussion Post 

I work at a medication assisted treatment clinic, where we offer Methadone or Suboxone to patients to help aid in their sobriety by combating withdrawal symptoms and curbing cravings. Patients have the option to choose between methadone or Suboxone, but there are differences. Suboxone is a combination of naloxone and buprenorphine, so patients need to be free of opiates for 48-hours (or greater) prior to starting on Suboxone. If not, patients will be sent into a precipitated withdrawal. Methadone can be started at any time, as it does not have naloxone and is a full opioid agonist. In regards to state regulations, it is easier and quicker to obtain take-homes with Suboxone than it is with Methadone, which makes it appealing to patients. Sublocade is also offered to patients that have been on Suboxone for a week or longer, which is a long-acting, 28-day injection of Suboxone. There is a newer concept called micro-dosing. If patients have used an opiate in 48-hours or less to their Suboxone induction, they can be started on a micro-dose of Suboxone, which decreases the chance of precipitated withdrawal. Micro-inductions are a very lengthy and tedious process for both nurses and providers, as it requires multiple batches of orders to be placed into the system, as well as lengthy monitoring of the patient and obtaining three COWS scores, 30 minutes apart.

We recently had a patient in the clinic who had used an opiate less than 48 hours prior to his intake. It was 3:00 p.m. on a Friday, and everyone was exhausted and ready to go home, as the clinic closed at 4:00 p.m. This patient was seen and not given an option on starting either Methadone or Suboxone. The provider and his nurse decided it would just be quickest to start the patient on Methadone as no follow-up would be needed that day like there would be if he was started on Suboxone, which would have required a lengthy micro-induction. A few days went by, and the patient was having trouble getting into the clinic for dosing. After missing three days of dosing, we stopped him when he came into the clinic, and he stated that he had just started a new job, and it was difficult for him to find time to leave work and dose. If the patient was offered Suboxone, this would have been an easy fix, as he would have been eligible by the state guidelines to give take-homes. Or, he could have received the Sublocade injection, and not had to worry about dosing for a whole month. But, since we as healthcare providers didn’t thoroughly educate him, or even provide him with all of his options, his sobriety and quality of living were suffering. The patient kept relapsing due to missing dosing, and eventually ended up not coming back to the clinic. This patient could have experienced success if we had provided him with all available options.

Social determinants of health refers to non-medical factors that influence health outcomes. The five domains that social determinants of health can be grouped into include education access and quality, healthcare access and quality, economic stability, social and community context, and neighborhood and built environment (Walden University Library, 2023). Some examples of social determinants of health include racism, discrimination, and violence, polluted air and water, safe housing, transportation, and neighborhoods, education, job opportunities, and income, and language and literary skills (U.S. Department of Health and Human Services, 2020).

Patient decision aids are “tools that help people become involved in decision making by making explicit the decision that needs to be made, providing information about the options and outcomes, and by clarifying personal values”, and they are designed to not replace counseling from a healthcare provider, but instead, complement it (The Ottawa Hospital, 2022). The decision aid I selected to review and analyze was titled “HIV: Should I Get Tested for the Human Immunodeficiency virus?” All new intakes at our clinic are tested for Hepatitis C and HIV, and intravenous drug use is common with our population. Patients often ask why they need to be tested for HIV and Hep C. This decision aid would be beneficial in breaking the information down further for patients, and I also really enjoyed the interactiveness of it, including the quiz for patients to take if they’re on the fence about being tested. I will use this in my daily practice.

I will be sure to keep this situation in mind when caring for patients in the future. I will make it my duty to advocate for patients and thoroughly provide them with education about all of their treatment options, even if it expands my workload and creates more of a hassle for me. I know that if I was a patient, I would want to be thoroughly informed of all of my available options, able to weigh these options, and decide what is the best fit for myself and my lifestyle.