Question Description

Respond to the 6 statements with a 175 word response also with source APA required

Question: Describe one internal and one external method for the dissemination of your EBP project results. For example, an internal method may be the hospital board, and an external method may be a professional nursing organization. Discuss why it is important to report your results to both of these groups. How will your communication strategies change for each group?

Response 1:For patients to be successful with self-management, they have to have more resources for follow up after education is done in the Emergency Department (ED). “Dissemination strategies aim to spread knowledge and the associated evidence-based interventions on a wide scale within or across geographic locations, practice settings, or social or other networks of end-users such as patients and health care providers” (Agency for Healthcare Research and Quality, 2012). The internal method for dissemination of my EBP project is the medical staff. This group of phyicians and the CEO is responsible for approving new policies and procedures. Reporting the results to this group is important so that they can have facts that EBP works and new EBP can be introduced in the future to continue to make care better for our patients. This group is going to be concerned with facts and require charts that show a decrease in the amount of recurrent visits for complications of diabetes. All of the information will have to be communicated at a monthly medical staff meeting. The external method for dissemination is the local primary care clinic. Patients with chronic diseases need follow up with primary care for medication management and referrals to dieticians and physical therapy. A meeting will need to be set up with power point presentation to discuss the education being done in the Emergency Department and how to include follow up with primary care to have the best patient outcomes. Discussing the results of the EBP will allow primary care physicians and nurses to see trends of recurrence and hopefully develop strategies in line with the ED to teach patients about self-management.

Agency for Healthcare Research and Quality. (2012, July 31). Communication and dissemination strategies to facilitate the use of health-related evidence | Effective Health Care Program. Retrieved from

https://effectivehealthcare.ahrq.gov/topics/medical-evidence-communication/research-protocol

a 175 word response also with source APA required

Response 2

The hours spent researching and evaluating data will serve little purpose if we do not share our findings with others. Many methods exist that help us in sharing our project with stakeholders both within and outside the hospital system. Sharing our work also helps provide legitimacy and it is important that we share it with others, so they can evaluate and utilize the information for themselves.

Two methods I have personally used in the past include poster presentations and speaking engagements at seminars. The poster presentation was used at was called the Annual Spring Blitzat our hospital, where department come together to share updates and educate staff on programs within their departments. This is an example of internal method of dissemination because the focus group were staff members within the institution. At the time I was part of a growing transport team, and we had posters and set up a mock scenario that helped staff to know what we would be doing and expecting during a transport. Hanrahan, Marlow, Aldrich and Hiatt (2010), suggest that poster presentations have three panels; Panel one describing background, problem and purpose, panel two demonstrating what was done or methodology, and panel three showing findings and implications. The panels should “tell a story” and be a combination of text and graphics.

The speaking engagement was for an outside audience and was utilized to facilitate conversation and share information and ideas. As part of this course, I recently participated in the Spring Cancer Screening Symposium, where experts presented a number of studies and new protocols in relation to cancer screening for a variety of cancers including skin, lung, breast, prostate and pancreatic. The seminar is an example of external dissemination because the method of sharing information was open to a large audience outside the organization. According to the Rural Health Information Hub (2018), other examples of external dissemination include reaching out to city or county health professionals, health associations, universities or charitable organizations, schools and faith-based organizations. Methods of communication may include social networking, pamphlets, DVD’s, press releases or health fairs. There are many ways to gwet the word out, especailly in the day of electronic media and social networking. The methods to get the word can go as far as your imagination carries you.

References

Hanrahan, K., Marlow, K., Aldrich, C., and Hiatt, A. (2010). Dissemination of nursing knowledge: tips and resources. The University of Iowa College of Nursing. Retrieved from https://nursing.uiowa.edu/sites/default/files/documents/research/Disseminating%20nursing%20knowledge.pdf

Rural Health Information Hub (2018). Methods of dissemination. Rural Health Information Hub. Retrieved from https://www.ruralhealthinfo.org/toolkits/rural-toolkit/6/dissemination-methods

a 175 word response also with source APA required

Response 3

Using internal and external dissemination is necessary in implementing EBP proposals by its positive influence on the process and help it be more successfully implemented. For my EBP proposal, one internal method would be to give s presentation with the management team at my home health organization. Since their team is made up of health care and management professionals they will have invaluable insight from different angles on how to go about the implementation process of the change proposal (Agency of Healthcare and Research Quality, 2013). Reporting to this internal group will also help control certain parameters of expansion the program may have. For instance, starting with several education courses to our patients families can be the initial stage of the implementation. After evaluating the success of these in various areas and with different patient needs, the management team can help determine what alterations will help it be more financially and medically successful. Having good patient outcomes is a priority but the management team can help determine how to make the program beneficial for the company as well. Communicating with the internal group would largely focus on presenting data on the number of patient families in attendance, the feedback from the families on their education benefits and competency to provide care, and on evaluation of the patients health over a 3-6 month span. Using this information along with the costs of the program will help to enhance and improve the method of education provided by the program. Using external methods would help to get an outside perspective and think of ways to better the presentation of the education to the families. Communicating with an external group such as the public health center in my neighborhood would help create a plan based on previous successful programs (AHRQ, 2013). Since the public and community health programs would be designed to be low cost and reach different demographics, their influence would be beneficial in helping create a good model for our organizations education program. Communicating with the external group would mostly be brainstorming and expanding on ideas to improve the process as well as getting input on previous successful methods. Getting both internal and external dissemination methods helps to increase the awareness and helps produce the most effective program possible.

Agency for Healthcare Research and Quality [AHRQ]. (2013). Evidence-based Practice Center Systematic Review Protocol. Retrieved from https://effectivehealthcare.ahrq.gov/sites/default…

a 175 word response also with source APA required

Question In order to evaluate an evidence-based practice project, it is important to be able to determine the effectiveness of your change. Discuss one way you will be able to evaluate whether your project made a difference in practice.

Response 4

Several factors can influence the outcome of our projects and each can have a dramatic influence on the outcome, either good or bad. It may be the quality or quantity of the data available and utilized, it may be affected by our own expertise (or lack of), as well as our ability to process the information into a comprehensive and logical project. Whatever the reason or reasons, they can each have an influence upon the effectiveness of the change we are seeking.

In order to help gauge the effectiveness of change, the University of Saint Mary (2018), suggest that we ask ourselves some tough questions:

• Was the expected outcome achieved?
• If not, then why not?
• Was the lack of change due to non-adherence to the treatment plan, various prognostic factors, or were providers (nurses) not ready for change?
• Was it because of the skills, evidence, interpretation or implementation of the intervention?

I anticipate that not all of us will be able to answer all these answers in the affirmative, although from reading the posts from some of you I believe that some might achieve this level of success. For myself, I believe implementation will be the ultimate affirmation, but I also believe that the finished project, along with dissemination of the material may prove to be most helpful beyond the work in this course. It may tough for use to acknowledge, but it is quite possible that not all of our projects are going to have the glowing outcome that we hope, for and be adapted to practice.

I do believe though, that recognition of the shortfalls through critical self-evaluation (and that of our peers) is really what the process is all about. Research can take months and years to bring to fruition by an experienced team, so I think we should applaud ourselves for what we have learned and accomplished, whether our projects ultimately see implementation or not.

Reference

University of Saint Mary (2018). 6 steps of the evidence-based practice process. University of Saint Mary. Retrieved fromhttps://online.stmary.edu/msn/resources/evidence-based-practice-for-the-busy-nurse-practitioner

Response 5

Measuring effectiveness is essential for any scientific or evidence-based study. This is why the time element is essential for any PICOT statement. The results need to be measurable and can not be subjective. There are a few ways I would measure the outcome of my change project. The goal of my project is to determine if education is an effective measure to improve patient’s fluid compliance between dialysis treatments. Improved fluid control improves morbidity and mortality rates, along with generally making patients feel better. In dialysis we weigh patients before and after each treatment as a determinant of their fluid status. The nursing assessment also includes listening for fluid in their lungs, shortness of breath, and looking for edema. According to Lindley, Aspinall, Gardiner, & Garthwaite, (2012) clinical indicators of hydration status that nurses are able to assess incenter include blood pressure, neck vein (distention), edema, breathing patterns. Basing fluid status solely on weight could be inaccurate due to actual weight loss or gain that is not related to fluid status. Using nursing assessments is essential even though it can be controversial because it is in some way subjective.

Lindley, E., Aspinall, L., Gardiner, G., & Garthwaite, E., (2012). Management of Fluid Status in Haemodialysis Patients: The Roles of Technology and Dietary Advice. Department of Renal Medicine, Leeds Teaching Hospitals NHS Trust United Kingdom. ISBN 978-953-307-403-0. Retrieved from, http://cdn.intechopen.com/pdfs/24619/intech-manage…

Response 6

Evidence-based nursing practice is a 5-step systematic process. These five steps include:

• Asking the Clinical Question
• Evidence Acquisition
• Evidence Appraisal
• Evidence Application
• Outcome Evaluation

The fifth step of the process, outcome evaluation, attempts to interpret the results and evaluate the outcomes of the applied intervention. Outcome measures may be psychosocial (quality of life, improved patient perception of care, reduction in depressive and anxiety symptoms), physiologic (improved health, reduced complications), or functional improvement. Evaluation of the process and the results may occur through peer assessment, audit, or even self-reflection. Depending on the type of outcomes achieved, it may be possible to compare the outcomes of a study with similar outcomes on a local, regional, national, or international level (University of Massachusetts Medical School, 2017). One way I would evaluate if the project made a difference would be to assess unit turnover rates among new nurses. I would also evaluate new nurse morale via confidential surveys/questionnaires and mentor evaluations.

 

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