Disseminating EBP Projects

Many factors influence how successfully an EBP Project is implemented and evaluated. As noted in this week’s Learning Resources, using a translation framework can facilitate effective implementation and the evaluation of outcomes.
For this assignment you will prepare a scholarly product that reports the results and implications of your project to designed audience.  The scholarly product for dissemination reports the results and implications of your project to a specified audience. Your scholarly product may be in the form of a project summary and evaluation report, poster presentation, program evaluation report, or a media or technology-based deliverable.

To prepare for this week’s section of Application 5:

• Reflect      on the definitions and criteria for scholarship presented in the Learning      Resources and in your weekly discussions.
• Consider      AACN’s definition of scholarship and their vision of the role of the      DNP-prepared nurse in furthering nursing scholarship.

The full Application 5 is due by Tuesday 11/06/18 of this week. Instructions for how to prepare for previous sections of this Application have been provided in Weeks 9 and 10

To complete:

Assignment 5: Disseminating the EBP Project

For this assignment you will prepare a scholarly product that reports the results and implications of your project to designed audience.  The scholarly product for dissemination reports the results and implications of your project to a specified audience. Your scholarly product may be in the form of a project summary and evaluation report,  poster presentation, program evaluation report, or a media or technology-based deliverable, Your scholarly product must include the following:

• Background,      Purpose, and Nature of the Project (2 points)
  Describe the larger problem or issue you explored in your DNP Project.      Identify your practice-focused question. Explain how this problem or issue      affects nursing practice and the overall health care system, and describe      how your DNP Project explored possible strategies for addressing the      problem or issue.
• Evidence      (2 points)

Identify the practice setting and context in which you conducted your project, a summary of the evidence supporting the project, and the process for implementation and evaluation.

• Presentation      of Results (2 points)

Explain the results of your DNP Project and recommendations for change that you made to the organization

Required Readings

White, K. M., Dudley-Brown, S. & Terhan, M.F. (2016). Translation of evidence into nursing and health care practice (2nd ed.) New York, NY: Springer.

Chapter 18, Dissemination of Evidence (SEE ATTACHED FILE).

American Association of Colleges of Nursing. (1999). Defining scholarship for the discipline of nursing. Retrieved from http://www.aacn.nche.edu/publications/position/defining-scholarship

American Association of Colleges of Nursing. (2006). The essentials of doctoral education for advanced nursing practice. Retrieved from http://www.aacn.nche.edu/publications/position/DNPEssentials.pdf

Boyer, E. L. (1992). Scholarship reconsidered: Priorities of the professoriate. Issues in Accounting Education, 7(1), 87-91.

Carina, K., Chan, Y., Oldenburg, B., & Kasisomayajula, V. (2015). Advancing the science of dissemination and implementation in behavioral medicine: Evidence and progress. International Journal of Behavioral Medicine, 22, 277-282 doi 10.1007/s12529-015-9490-2

Glassick, C. E. (2000). Boyer’s expanded definitions of scholarship, the standards for assessing scholarship, and the elusiveness of the scholarship of teaching. Academic Medicine, 75(9), 877-880. Retrieved from http://www.academicpeds.org/events/assets/Glassick article.pdf

Lane, J.P. & Stone, V.J. (2015). Comparing three knowledge communication strategies – diffusion, dissemination and translation – through randomized controlled studies. Assistive Technology doi:10.3233/978-1-61499-566-1-92

Leeman, J., Myers, A.E.,Ribisl, K.M.,& Ammerman, A.S. (2015). Disseminating policy and environmental change interventions: Insights from obesity prevention and tobacco control. International Journal of Behavioral Medicine, 22:301–311 doi 10.1007/s12529-014-9427-1

Rieger, K. & Schultz, A.S. (2014). Exploring arts-based knowledge translation: Sharing research findings through performing the patterns, rehearsing the results, staging the synthesis. Worldviews on Evidence-Based Nursing, 11(2), 133–139.

Tricco, a.C., Ashoor, H.M., Cardoso, R., MacDonald, H., Cogo, E., Kastner, M., Perrier, L., McKibbon, A., Grimshaw, J.M. & Straus, S.E. (2016). Sustainability of knowledge translation interventions in healthcare decision making: a scoping review. Implementation Science, 11(55) doi 10.1186/s13012-016-0421-7

Common Models in Health Informatics Evaluation

Have you ever watched a movie in which the same scene was shown several times but as viewed by different individuals? Or, have you watched a detective show in which the witnesses all had differing accounts? The same can hold true for conducting an evaluation of a health information technology project. How you plan and conduct the evaluation is largely dependent on the viewpoint you assume and the perspective with which you approach the evaluation.

Consider a new patient discharge protocol at a small hospital. Do you want to know how the patient feels about the process? Do you want to gather the opinions of nurses who are using this process? Perhaps you want to determine if it is saving the hospital money by freeing up bed space in a more timely fashion. Obtaining each of these viewpoints would require a different approach. Depending on the goal of your evaluation, the model and viewpoint you opt to use will likely vary.

In this Discussion, determine which evaluation model would be most effective for evaluating the health information technology described in one of the scenarios below. Your Instructor will assign a specific scenario by Day 1 of this week.

• Scenario 1: You have recently provided a training program to help nurses and physicians become proficient in the use of a new bedside medication verification (BMV) system.

• Scenario 2: The Chief Medical Officer at your hospital is interested in finding out the impact of a new decision support system on the number of adverse events occurring in the past year.

• Scenario 3: You are helping with the design of a new outpatient surgery center to be built adjacent to the hospital. You are tasked with evaluating the opinions of physicians, nurses, and the general public toward this facility.

To prepare:

• Review the information on the types of evaluation models covered in this week’s Learning Resources.
• Determine which model would be most appropriate to use for evaluation in the scenario to which you were assigned.
• Consider why the viewpoint of the scenario or situation would impact the model used.
• View the scenario from a different viewpoint, and consider how a different model might be used.
• Reflect on the importance of basing an evaluation on a model.

By tomorrow 12/13/2016 at 9pm, post a minimum of 550 words in APA format with a minimum of 3 references from the list below, which include the level one headings as numbered below:

1)      Post which scenario (1, 2, or 3) you were assigned and two different models that could be utilized to approach the evaluation.

2)      Explain why you selected those models and how you would use them.

3)       Explain why it is important to consider the intended goal of the evaluation and the viewpoint that is selected.

4)      Finally, assess the importance of basing an evaluation on a model. Justify your response.

 

 

 

 

Required Readings

 

Technology Acceptance Model

 

Kowitlawakul, Y. (2011). The Technology Acceptance Model: Predicting nurses’ intention to use telemedicine technology (eICU). Computers, Informatics, Nursing, 29(7), 411–418.

Retrieved from the Walden Library databases.

Nurses encounter a variety of technological tools that are used in their field. This article explores the technology acceptance model and how it applies to nurses’ intention to use telemedicine technology.

 

    Pai, F.-Y., & Huang, K. (2011). Applying the Technology Acceptance Model to the introduction of healthcare information systems. Technological Forecasting and Social Change, 78(4), 650–660.

Retrieved from the Walden Library databases.

This article focuses on the attempt to develop a model that will assist nurses in mastering the use of health information technology (HIT), thus enabling them to spend more time on patient care and less on clerical-type duties. The authors also studied how the use of HIT could increase patient safety.

 

    Rippen, H. E., Pan, E. C., Russell, C., Byrne, C. M., & Swift, E. K. (2013). Organizational framework for health information technology. International Journal of Medical Informatics, 82(4), e1–e13.

Retrieved from the Walden Library databases.

In this article, the authors highlight results of a literature review on the implementation of health information technology and the related theories and models. Based on their research, the authors developed a framework of key areas that provides a structure to organize and capture information on the use of health IT.

 

    Mohamed, A. H., Tawfik, H. M., Al-Jumeily, D., & Norton, L. (2011). MoHTAM: A Technology Acceptance Model for mobile health applications. Developments in E-systems Engineering (DeSE) Conference, 13–18.

Retrieved from the Walden Library databases.

In this article, the authors highlight a model they developed to determine how the decision to use a mobile health application is influenced by the design of the technology, the perceived ease of using it, and the perceived usefulness of the technology.

 

Diffusion of Innovations

 

Barnett, J., Vasileiou, K., Djemil, F., Brooks, L., & Young, T. (2011). Understanding innovators’ experiences of barriers and facilitators in implementation and diffusion of healthcare service innovations: A qualitative study. BMC Health Services Research, 11, 342.

Retrieved from the Walden Library databases

In this article, the authors describe the experiences of innovators in the medical field and the barriers that they have experienced in the implementation and diffusion of health care service innovations.

 

    Kaissi, A. (2012). “Learning” from other industries: Lessons and challenges for health care organizations. Health Care Manager, 31(1), 65–74.

Retrieved from the Walden Library databases.

 

 

 

In this paper, the author explores how diffusion of innovations occurs in a variety of different industries and how these lessons can be adapted for use in the health care industries.

 

Thakur, R., Hsu, S. H. Y., & Fontenot, G. (2012). Innovation in healthcare: Issues and future trends. Journal of Business Research, 65(4), 562–569.

Retrieved from the Walden Library databases.

The medical field is a constantly evolving and improving. This article explores important innovations in the health care industry while highlighting certain issues and trends that may affect the future of the field.

 

    Dickinson, A. D., & Scott, M. (2012). Diffusion of innovations in the National Health Service: A case study investigating the implementation of an electronic patient record system in a UK secondary care trust. In UK Academy for Information Systems (UKAIS) 17th Annual Conference, 27–28 March 2012, New College, Oxford. Retrieved from http://nrl.northumbria.ac.uk/6223/2/UKAIS_2012_paperDD_MS.pdf

This article examines a case study that focuses on the implementation of an electronic patient record system in a UK secondary care trust. In particular, the study highlights how new users adopt the system.

 

Valente, T. W., & Rogers, E. M. (1995). The origins and development of the diffusion of innovations paradigm as an example of scientific growth. Science Communication, 16(3), 242–273.

Copyright 1995 by Sage Publications Inc. Reprinted by permission of RISage Publications Inc. via the Copyright Clearance Center.

In this article, Valente and Rogers explore the origins and development of the diffusion of innovations paradigm. Through examining the different stages, it is possible to better understand how innovations are spread, accepted, and adopted within a health care organization.

 

Disruptive Innovation

 

Christensen, C. M., Bohmer, R., & Kenagy, J. (2000). Will disruptive innovations cure health care? Harvard Business Review, 78(5), 102–112.

 

Retrieved from the Walden Library databases

The health care field is constantly in need of new technologies to fill specific needs and niches. In this article, the authors discuss the role disruptive innovations could play in the development of the needed technologies.

 

Dhar, M., Griffin, M., Hollin, I., & Kachnowski, S. (2012). Innovation spaces: Six strategies to inform health care. Health Care Manager, 31(2), 166–177.

Retrieved from the Walden Library databases.

In this article, the authors use the disruptive innovation model as the framework to examine how innovation occurs in health care organizations. They determined six strategies to encourage innovation: dedicated times, formal teams, outside ideas, idea-sharing platforms, company/job goals, and incentives.

 

    Poll, W. (2011). Derision is the sweet spot of adoption: Unleashing disruptive growth.  Hospital Topics, 89(1), 23–25.

Retrieved from the Walden Library databases.

It is common that many people look at change and new technologies with a hint of disdain or distrust. The author of this article discusses how new ideas and disruptive innovations can be effectively presented to a somewhat hesitant organizations.

 

Sociotechnical Theory Models

 

    Ancker, J. S., Kern, L. M., Abramson, E., & Kaushal, R. (2012). The Triangle Model for evaluating the effect of health information technology on healthcare quality and safety. Journal of American Medical Informatics Associations, 19(1), 61–65.

Retrieved from the Walden Library databases.

The authors of this article explain the Triangle Model for designing studies on the safety and quality outcomes of health information technology projects. The article focuses on the predictors of the model, including attributes of the technology in question, the technology provider, the organizational setting, and the population involved.

 

    Currie, L., Sheehan, B., Graham, P., Stetson, P., Cato, K., & Wilcox, A. (2009). Sociotechnical analysis of a neonatal ICU. Studies In Health Technology and Informatics, (146), 258–262.

Retrieved from the Walden Library databases.

In this article, the authors provide a brief overview of sociotechnical theory. The authors also describe the results of a sociotechnical analysis of a neonatal intensive care unit.

 

    Molleman, E., & Broekhuis, M. (2001). Sociotechnical systems: Towards an organizational learning approach. Journal of Engineering and Technology Management, 18(3), 271–294.

Retrieved from the Walden Library databases.

The authors of this article explore the application of sociotechnical systems (STS) theory for designing work processes to improve organizational performance. The authors examine the application of STS with four organizational performance indicators: price, quality, flexibility, and innovation.

 

    Scott‐Findlay, S., & Estabrooks, C. A. (2006). Mapping the organizational culture research in nursing: A literature review. Journal of Advanced Nursing, 56(5), 498–513.

Retrieved from the Walden Library databases.

This article provides an empirical review of the nursing literature on organizational culture and its influence on practitioners.

A provider performs _______ to signify that everything in the note is correct

1. Plan of care, evaluation, subjective data, and objective data are all parts of

A. a telephone encounter.

B. documentation.

C. the progress note.

D. a clinic visit.

 

2. Mr. Smith has an appointment with Dr. Johnson at 9:00 A.M. for his annual wellness exam. Mrs. Adams calls the clinic first thing in the morning due to fever, chills, and cough for 3 days and is given an appointment at 9:00 A.M. with Dr. Johnson as well. This is an example of

A. overlap.

B. accommodating.

C. jamming.

D. double-booking.

 

3. A provider performs _______ to signify that everything in the note is correct.

A. technological signature

B. digital signature

C. annotation

D. autograph

 

4. Dan has made an appointment for review of his medication, as he recently relocated to the area with his family. Before his appointment, he has been asked to fill out and bring _______ form.

A. disclosure

B. health history

C. review of systems

D. consent

 

5. Incident reports are reviewed by the staff to aid in

A. policies.

B. prevention.

C. change.

D. procedures.

 

6. Which of the following is an appropriate way to reduce no-show appointments?

A. Ensure the patient writes down their appointment.

B. Perform reminder calls one to two days preceding the appointment.

C. There are no good ways to reduce no-shows.

D. Schedule all appointments within seven days of the appointment day.

 

7. A patient notes that they smoke a half a pack of cigarettes per day and drink a six pack of beer every night. Where would this be documented in the chart?

A. Medical history

B. Social history

C. Chief complaint

D. Problem list

 

8. Which of the following is not considered an integrated device?

A. Telephone

B. Signature pad

C. Scanners

D. Camera

 

9. _______ allows for disclosure of protected health information (PHI) through phone, fax, or email without specific patient authorization.

A. Confidentiality

B. HIPAA Security Rule

C. HIPAA Privacy Rule

D. Clinic policies and procedures

 

10. _______ is the most important responsibility of all members of the medical office.

A. Communication

B. Accountability

C. Documentation

D. Punctuality

 

11. All of the following require an incident report to be filed except

A. if the wrong patient is contacted for an appointment reminder.

B. if the employee suffers a needle stick.

C. if the wrong medication is administered to the patient.

D. if the patient falls in the hallway.

 

12. The process of a data code being unreadable until its destination is reach is called

A. cryptic.

B. jumble.

C. decryption.

D. encryption.

 

13. The _______ is a centralized location for a summary of a patient’s acute and chronic conditions.

A. chief complaint

B. medical history

C. disease list

D. problem list

 

14. Which of the following are not guidelines for proper telephone etiquette?

A. Answer by the third ring is possible

B. Answer with a pleasant greeting

C. Speak slowly and clearly

D. Keep a straight, professional face

 

15. Myrtle uses a cane to ambulate. She came to the clinic for an appointment, but before making it inside the building she tripped and fell on the curb. What type of document needs to be created?

A. Incident report

B. Fall report

C. Accident report

D. Injury report

 

16. Through the use of _______ a patient may view open appointments or schedule their own appointment.

A. patient access

B. patient flow

C. patient gateway

D. patient portal

 

17. Cindy has a hand-written fax number from a patient’s parent to fax a note to the school for use of a medication while at school. Cindy is unable to read all of the fax numbers. What should she do?

A. Avoid sending the note since the correct number wasn’t given

B. Call the patient to confirm the number

C. Send to the closest number

D. Ask other office staff

 

18. What’s the default landing page in SCMO when entering a patient encounter?

A. Allergies

B. Chief complaint

C. Vital signs

D. Progress note

 

19. _______ is a rundown of organ systems that can be used to pinpoint certain concerns or unusual findings.

End of exam

A. Review of systems

B. Report of symptoms

C. Report of systems

D. Review of symptoms

 

20. “It feels like an ice pick in my head” and “I’m coughing up a lung” are considered

A. chief complaints.

B. reason for visit.

C. presenting symptom.

D. medical concerns.

Refection Paper

The IOM published report, “Future of Nursing: Leading Change, Advancing Health,” makes recommendations for lifelong learning and achieving higher levels of education.

In 1,000-1,250 words, examine the importance of nursing education and discuss your overall educational goals.

Include the following:

1. Discuss your options in the job market based on your educational level.
2. Review the IOM Future of Nursing Recommendations for achieving higher levels of education. Describe what professional certification and advanced degrees (MSN, DNP, etc.) you want to pursue and explain your reasons for wanting to attain the education. Discuss your timeline for accomplishing these goals.
3. Discuss how increasing your level of education would affect how your competitiveness in the current job market and your role in the future of nursing.
4. Discuss the relationship of continuing nursing education to competency, attitudes, knowledge, and the ANA Scope and Standards for Practice and Code of Ethics.
5. Discuss whether continuing nursing education should be mandatory. Provide support for your response.

You are required to cite to a minimum of three sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

As an advanced practice nurse, you will examine patients presenting with a variety of disorders. You must, therefore, understand how the body normally functions so that you can identify when it is reacting to changes. Often, when changes occur in body systems, the body reacts with compensatory mechanisms. These compensatory mechanisms, such as adaptive responses, might be signs and symptoms of alterations or underlying disorders. In the clinical setting, you use these responses, along with other patient factors, to lead you to a diagnosis.

Consider the following scenarios:

Scenario 1:

Jennifer is a 2-year-old female who presents with her mother. Mom is concerned because Jennifer has been “running a temperature” for the last 3 days. Mom says that Jennifer is usually healthy and has no significant medical history. She was in her usual state of good health until 3 days ago when she started to get fussy, would not eat her breakfast, and would not sit still for her favorite television cartoon. Since then she has had a fever off and on, anywhere between 101oF and today’s high of 103.2oF. Mom has been giving her ibuprofen, but when the fever went up to 103.2oF today, she felt that she should come in for evaluation. A physical examination reveals a height and weight appropriate 2-year-old female who appears acutely unwell.  Her skin is hot and dry. The tympanic membranes are slightly reddened on the periphery, but otherwise normal in appearance. The throat is erythematous with 4+ tonsils and diffuse exudates. Anterior cervical nodes are readily palpable and clearly tender to touch on the left side. The child indicates that her throat hurts “a lot” and it is painful to swallow. Vital signs reveal a temperature of 102.8oF, a pulse of 128 beats per minute, and a respiratory rate of 24 beats per minute.

Scenario 2:

Jack is a 27-year-old male who presents with redness and irritation of his hands. He reports that he has never had a problem like this before, but about 2 weeks ago he noticed that both his hands seemed to be really red and flaky. He denies any discomfort, stating that sometimes they feel “a little bit hot,” but otherwise they feel fine. He does not understand why they are so red. His wife told him that he might have an allergy and he should get some steroid cream. Jack has no known allergies and no significant medical history except for recurrent ear infections as a child. He denies any traumatic injury or known exposure to irritants. He is a maintenance engineer in a newspaper building and admits that he often works with abrasive solvents and chemicals. Normally he wears protective gloves, but lately they seem to be in short supply so sometimes he does not use them. He has exposed his hands to some of these cleaning fluids, but says that it never hurt and he always washed his hands when he was finished.

Scenario 3:

Martha is a 65-year-old woman who recently retired from her job as an administrative assistant at a local hospital. Her medical history is significant for hypertension, which has been controlled for years with hydrochlorothiazide. She reports that lately she is having a lot of trouble sleeping, she occasionally feels like she has a “racing heartbeat,” and she is losing her appetite. She emphasizes that she is not hungry like she used to be. The only significant change that has occurred lately in her life is that her 87-year-old mother moved into her home a few years ago. Mom had always been healthy, but she fell down a flight of stairs and broke her hip. Her recovery was a difficult one, as she has lost a lot of mobility and independence and needs to rely on her daughter for assistance with activities of daily living. Martha says it is not the retirement she dreamed about, but she is an only child and is happy to care for her mother. Mom wakes up early in the morning, likes to bathe every day, and has always eaten 5 small meals daily. Martha has to put a lot of time into caring for her mother, so it is almost a “blessing” that Martha is sleeping and eating less. She is worried about her own health though and wants to know why, at her age, she suddenly needs less sleep.

To Prepare

· Review the three scenarios, as well as Chapter 6 in the Huether and McCance text.

· Identify the pathophysiology of the disorders presented in each of the three scenarios, including their associated alterations. Consider the adaptive responses to the alterations.

· Review the examples of “Mind Maps—Dementia, Endocarditis, and Gastro-oesophageal Reflux Disease (GERD)” media in this week’s Learning Resources. Then select one of the disorders you identified from the scenarios. Use the examples in the media as a guide to construct a mind map for the disorder you selected. Consider the epidemiology, pathophysiology, risk factors, clinical presentation, and diagnosis of the disorder, as well as any adaptive responses to alterations.

· Review the Application Assignment Rubric found under Course Information

Assignment: To Complete

Write a 2- to 3-page paper excluding the title page, reference page and Mind Map that addresses the following:

· For each of the three scenarios explain the pathophysiology, associated alterations and the patients’ adaptive responses to the alterations caused by the disease processes.  You are required to discuss all three scenarios within the paper component of this assignment.

· Construct one mind map on a selected disorder presented in one of the scenarios. Your Mind Map must include the epidemiology, pathophysiology, risk factors, clinical presentation, and diagnosis of the disorder, as well as any adaptive responses to alterations.

Note: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references.