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Evidence-Based Practice Proposal
Evidence-Based Practice Proposal
Evidence-Based Practice Proposal
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A formal approval from the management or change control board as well as an informal approval from the unit leadership and co-workers will be sought for implementing this evidence-based proposal. An informal approval from the co-workers and leaders is key factor in successfully implementing changes in an organization. The first step in getting an informal approval is to identify the key stakeholders of this project. In this proposal besides the residents, nurses including admission nurses, physicians, and clinical laboratory staff are the main stakeholders. Since “the Situation, Background, Assessment and Recommendation (SBAR) technique has become the Joint Commission's stated industry best practice for standardized communication in healthcare”
(SaferHealthcare, 2016, para. 1), this author will utilize it as the key communication tool for the stakeholder’s approval. When stakeholders need clarification this author will conduct an open forum to clarify their doubts. For the formal approval, there is a management steering committee in the TILLERS. All proposal need to be approved by this committee before they send the proposal to the final approval from the board of directors. An executive summary with highlights will be provided for the board of directors. The board members, director of nursing, and charge nurse will be approving the proposal.
The adoption of clinical information systems is one way that healthcare organizations are making an effort to improve patient safety, provide a means to exemplify regulatory compliance, and facilitate exchange of patient information between care providers (Kirkley & Stein, 2004; Nadzam, 2009). To achieve this goal, Barnes-Jewish Hospital (BJH) recently implemented a new CPOE/clinical documentation system. One of the objectives of the new system was to give bedside clinicians a standardized electronic tool, known as the Clinical Summary, for bedside shift hand-off reporting. Soon after go-live, it was identified that the standard nursing Clinical Summary did not meet specialized the reporting needs of the nurses on the Women and Infants divisions. Consequently, an application enhancement request was submitted. The goal of this project is to synthesize the knowledge gained throughout this Masters Degree program to initiate, plan, and execute changes to the current clinical documentation system to provide a standardized Clinical Summary review screen to meet the specialized hand-off reporting needs of the nurses on the Women and Infants divisions at BJH. This paper includes project objectives, a supporting evidence-based literature review, project methodology, formative and summative evaluation criteria, and a graphical timeline with a narrative description for the Women and Infants Clinical Summary project.
On a broad scope, keeping up with the latest evidence-based practice in healthcare can be a difficult task for nurses. The amount of evidence-based information available can be overwhelming. When you compound that with the challenge of finding the latest information on a smaller scope in a specialized area of the medical field it can be even more daunting. One tool that nurses can use to make that search easier is to formulate a clinical question in the PICOT format. A PICOT question is designed to make searching for that information easier by gathering feedback from others. This paper will define what a PICOT question is, identify a need for change in my current work environment and formulate a PICOT question to help me gather evidence to help facilitate that change.
When performing evidence based practice research, the Iowa Model uses a team or individual approach to assist nurses in the journey to quality care. The Iowa Model begins by offering a process of selecting a proper clinical topic, which is often a recurring problematic issue (Polit & Beck, 2012). This topic is formulated as a question to improve a technique or procedure. Once the researcher determines that an ample amount of reported investigation exists on the desired question, information may be gathered and presented for approval (Polit & Beck, 2012). The research may lead to a gradual change in nursing practice.
Laub and Sampson (2003) believe that age-graded informal social controls are crucial in understanding persistence and desistance in offending, although more research is necessary. Laub and Sampson (2003) argue that certain turning points in life influence persistence and desistance in offending through informal social controls highly associated with the age of the individual via intervening mechanisms. The age-graded informal social control theory aims to explain persistence and desistance, thus explaining important aspects of crime over the life course. Persistence and desistance are explained through age-graded informal social controls such as marriage, employment, and military service and their accompanying intervening mechanisms making the relationship between informal social controls and persistence and desistance somewhat more complex.
For this practice guideline, the original development panel of six members included; a Chief Nursing Officer, Charge Nurse, Clinical Nurse Specialist, Clinical Practice Facilitator, a Professor from a School of Nursing, and an Education Coordinator. The revision panel members included; a Chief of Nursing & Professional Practice, an Assistant Lecturer from York University, a Clinical Nurse Specialist, Clinical Practice Facilitator, a Nursing Professional Development Educator, an Internist/Geriatrici...
This systems limits patient involvement creates a delay in patient and nurse visualization. Prior to implementation of bedside shift reporting an evidenced based practice educational sessions will be provided and mandatory for nursing staff to attend (Trossman, 2009, p. 7). Utilizing unit managers and facility educators education stations will be set up in each participating unit. A standardized script for each nurse to utilize during the bedside shift report will be implemented to aid in prioritization, organization and timeliness of report decreasing the amount of information the nurse needs to scribe and allowing the nurse more time to visualize the patient, environment and equipment (Evans 2012, p. 283-284). Verbal and written bedside shift reporting is crucial for patient safety. “Ineffective communication is the most frequently cited cause for sentinel events in the United States and in Australian hospitals 50% of adverse events occur as a result of communication failures between health care professionals.” Utilizing written report information creates accountability and minimizes the loss in important information during the bedside shift report process (Street, 2011 p. 133). To minimize the barriers associated with the change of shift reporting process unit managers need to create a positive environment and reinforce the benefits for the procedural change (Tobiano, et al.,
A team led by RN, should mentally prepare their patients to understand their responsibility towards good health. This can be done by showing them special documentaries during their stay in the hospital, in a common room where other patients can also join them in a group of six to twelve. After the session, patients should be given a short comments form with multiple choice answers (Appendix A). The purpose is to check their positivity towards the message conveyed through the documentary. At this time patient's vitals should be checked and recorded for the future
Evidence-based practice integrates best current evidence with clinical expertise and patient/family preferences and values for the delivery of optimal health care (qsen.org). Like most medical professions, nursing is a constantly changing field. With new studies being done and as we learn more about different diseases it is crucial for the nurse to continue to learn even after becoming an RN. Using evidence-based practice methods are a great way for nurses and other medical professionals learn new information and to stay up to date on new ways to practice that can be used to better assess
The medical secretary, registered nurses, licensed practical nurses, and physicians communicated consistently and appropriately so that all staff could effectively complete the actions required of their respective roles. I noted the strong relationship between the nurses and the physicians. The nurses held a heavy influence on the physician’s decisions regarding a situation, because the nurses were the ones conveying pertinent information related to the patient’s status. Based on the information provided, the physician would make recommendations and provide guidance to the nurses. The physician’s directions were then carried out by the nurse, influencing the nurse’s plan of care for his/her
...ully aware of what the procedure involves and the possible risks and complications. I feel that the pre-assessment form used within the unit to be far to fundamental, If elements of the roper et al activities of daily living were to be incorporated this would help in achieving a much more in-depth holistic nursing assessment enabling for the best quality and level of care to be given to all patients arriving in the unit. Whilst I feel a full nursing assessment not to be fully necessary for a day case unit, as previously stated I feel that the communication element to be an excellent way of ensuring a better holistic approach is achieved, it will also help to achieve better documentation and communication between all staff members. Good documentation remains in line with the NMC code of professional conduct 2008 and to promote better communication (NMC 2008).
Dougherty, L. & Lister, s. (2006) ‘The Royal Marsden Hospital manual of Clinical Nursing Procedures: Communication 6th Edition Oxford: Blackwell Publishing Ltd
The aim of this assignment is to establish whether informal communication is just as important as formal communication in a school environment. My hypothesis at the start of the assignment is that both will be essential in order for a school to run efficiently and for a healthy culture to exist in an educational establishment. However, I first need to outline the nature of the school used for this study.
The term “Impersonal communications” is defined as a behavior that treats others as objects rather than individuals (13). This word was shown throughout the movie as Sharpay fakes being nice to Gabriella the new girl. This connection occurs because Sharpay tells Gabriella about the spring musical, knowing Gabriella wanted to try out for it she shot the idea of trying out down because she says she always get the lead role and no one else will. She then writes her name covering the entire sign-up sheet so no one else could write their name down if they wanted to. Sharpy is portrayed as a mean girl, and treats others as if they are less than she is.
My employer has a fairly structured approach to performance evaluations that starts with an annual performance agreement review that outlines the expectations of the position, then there is an unranked mid-year review that serves as a pulse check, and finally culminates with a performance evaluation graded against the performance agreement. Robbins & Judge (2009) outline a performance evaluation as focusing on three behavioral types that include: task performance, citizenship, and counter-productivity. The format provided by the authors has worked well for me when I have been tasked with conducting formal and informal performance evaluations, and when it comes to the formal year-end evaluation I always make sure that there are no surprises.
Interpersonal communication is one of the significant skills while communicating with other individuals. It normally covers an extensive area and includes both verbal and non-verbal communication. Body language and facial expression may affect the accurateness of the message transmission directly. Interpersonal communication skills normally ensure that the message is sent and received correctly without any alteration thus improving the communication efficiency. Learning diverse aspects of interpersonal communication has greatly aided me in better understanding of what it consists. I am capable of applying the knowledge gained from this course to my personal experiences. This paper reflects on my personal experience in learning interpersonal communication.