Compare and contrast two change theories, and determine which theory makes the most sense for implementing your specific EBP intervention. Why? Has your preceptor used either theory, and to what result?

In nursing practice, accurate identification and application of research is essential to achieving successful outcomes. The ability to articulate research data and summarize relevant content supports the student’s ability to further develop and synthesize the assignments that constitute the components of the capstone project.

The assignment will be used to develop a written implementation plan.

For this assignment, provide a synopsis of the review of the research literature. Using the “Literature Evaluation Table,” determine the level and strength of the evidence for each of the eight research articles you have selected. The articles should be current (within the last 5 years) and closely relate to the PICOT question developed earlier in this course. The articles may include quantitative research, descriptive analyses, longitudinal studies, or meta-analysis articles. A systematic review may be used to provide background information for the purpose or problem identified in the proposed capstone project.

Formulate one new comment of your own. It must be a logical and thoughtful response that synthesizes the comments of at least 3 classmates into one comment. Be sure to synthesize; do not simply reply to each of the 3 classmates.

1. Ashley Homme posted Sep 24, 2020 5:48 AMSubscribe

The United States is one of many developed countries. Based on the Commonwealth Fund (2017), the US is ranked last on performance and access, even though they spend the most on healthcare each year. The Commonwealth Fund (2017) has also outlined ranking of other countries compared to the US in 5 categories: care process, access, administration efficiency, equity, and health care outcomes. As mentioned above, the United States spends significantly more each year on healthcare. According to data charts, in 2014 the US spent about 16.5% of their yearly budget on healthcare. That same year, Switzerland was a close second with 11.4%, followed by Sweden, France, and then Germany (The Commonwealth Fund, 2017). With 11 countries total, the US ranked 11th for overall healthcare system performance. The top country for overall performance was the United Kingdom followed by Australia. The care process was the first of the five categories. The United Kingdom was ranked first and the United States was ranked at number (The Commonwealth Fund, 2017)5. The US fell last in access to care. The first with the best access was the Netherlands. Administrative efficiency was highest in Australia and the US was the 10 (The Commonwealth Fund, 2017). Equity showed up best in the UK and the US was last. Finally, Australia was first in health care outcomes and the US was, once again, last (The Commonwealth Fund, 2017). In Australia and the UK, healthcare spending was lower while also offering better quality healthcare performance. Even with lower costs, these countries came in first for overall, compared to the US that spent a lot on healthcare with poor quality. This goes to show that spending more on healthcare does not directly correlate to better healthcare rendered to the persons. 

The Commonwealth Fund. (2017). Mirror, Mirror 2017: International Comparison Reflects Flaws and Opportunities for Better U.S. Health Care. Retrieved September 21, 2020, from https://interactives.commonwealthfund.org/2017/july/mirror-mirror/

2. It is not a shock that the U.S. spends more on healthcare than any other country because of new and emerging technology in the country, but the U.S is currently ranked last in health care system performance and acquires poorer health. Schneider et al. (2014) state that “poor access to primary care has contributed to inadequate prevention and management of chronic diseases, delayed diagnoses, incomplete adherence to treatments, wasteful overuse of drugs and technologies, and coordination and safety problems” (para 2). Overall, the U.K. ranks the highest in system performance, ranking number 1 in the care process and equity, and number 3 in access and administrative efficiency; although it is ranked number 10 in health care outcomes, one less than the U.S. Schneider et al. (2014) mentions, “in contrast to the U.S., over the past decade the U.K. saw a larger decline in mortality amenable to health care (i.e., a greater improvement in the measure) than the other countries studied” and “(the U.S. has had the smallest decline or lowest level of improvement)” (para 22). Thanks to the UK’s National Health Service (NHS), health services are not paid for through insurance premiums and have more government impact on delivering health care, unlike the U.S. The U.S. health care system is unique because the expenditure does not match up to the outcomes in this country, compared to other countries.   

References:

Schneider, E. C., Sharnak, D. O., Squries, D., Shah, A., & Doty, M. M. (2014, July 14). Mirror, Mirror 2017: International Comparison Reflects Flaws and Opportunities for Better U.S. Health Care. Retrieved September 22, 2020, from https://interactives.commonwealthfund.org/2017/july/mirror-mirror/

3. Research shows that the U.S. spends the most money on health care compared to other high-income countries. Although the United States spends more money, United States citizens’ health quality is lower.

The United States is the lowest ranking for overall quality of health out of the eleven high income countries. Canada is ranked number 9 out of 11. The United States and Canada are similar when comparing aspects of their healthcare system. For example, both countries are ranked below average for access to health care, equity, and health care outcomes. Additionally, Canada and the United States are ranked above average for care processes related to prevention, safety, and engagement from patients and doctors. For administrative efficiency, Canada ranks above the average while the U.S. remains below average. (The Commonwealth Fund 2017)

One major difference between Canada and the United States is that Canada provides universal health care and the U.S. does not. Non-citizens living in the United States may not qualify to receive health care. As for Canada, temporary visitors and immigrants are eligible for limited health care benefits. (American Institute of Medical Sciences & Education 2018)

References

American Institute of Medical Sciences & Education. (2020, June 24). US vs Canadian Healthcare: What Are the Differences? Retrieved September 21, 2020, from https://aimseducation.edu/blog/us-vs-canadian-healthcare-differences

The Commonwealth Fund. (2017). Mirror, Mirror 2017: International Comparison Reflects Flaws and Opportunities for Better U.S. Health Care. Retrieved September 21, 2020, from https://interactives.commonwealthfund.org/2017/july/mirror-mirror/

Why is understanding the health care system at the local level important to consider when planning an EBP implementation? Conduct research and solicit anecdotal evidence from your course preceptor that you will take into consideration for your own change project.

 For this assignment, you will research and prepare a community-level strategic plan that addresses a key public health issue.

Potential topics may include:

•      Using prenatal and infancy home visits to prevent child abuse and neglect

•      Preventing falls in the elderly

•      Reducing population salt intake

•      Reducing tobacco use among adults

•      Preventing risky sexual behavior among youth and young adults

•      Reducing drug experimentation among young adults

Include the following in your paper:

• Introduction:
  • Provide an overview of the community health issue as described in Part A with identified causes and influences, including knowledge gaps. 
  • Detail the prevalence of the issue inside and outside the United States.
  • Describe potential monetary costs associated with the issue in the United States.
  • You must include data as part of your introduction (images, charts, graphs, etc., may be included as well as written data).
• Describe advance practice roles and management strategies that affect change at the community level.
• Identify key community and social resources that negatively and positivelyaffect the selected issue.
• Identify changes or enhancements in community-related services for your selected topic.
• Develop a strategic plan that could decrease the prevalence of your selected topic.The goals for this plan needs to be specific, measurable, attainable, realistic, and time-bound. Include how your plan takes into consideration health literacy, socioeconomic factors, and cultural differences.
• Conclusion:
  • A summary of the goals and challenges
  • An assessment of the outlook for action/progress
• Appendix A: Include your community assessment from Week 3 as Appendix A.

Your paper should be 3–5 pages in length (not including the cover or reference pages). Use APA throughout.

Include 2–3 scholarly sources that are carefully selected and appropriate to the topic. References should be current—no more than four years old.