Applying an EBP model

Develop a 3–5 page scholarly paper in which you explain the diagnosis you researched for Assessment 1, and then apply the steps of an EBP model to your search for evidence to address your diagnosis issue.

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Introduction

The goal of using evidence-based research findings is to enhance safety and quality of patient care and ensure optimal outcomes are achieved. It is not uncommon to hear a nurse say, “why change it as we’ve always done it this way.” However, this is no longer acceptable in today’s practice environment. The profession of nursing has evolved, and the expectation is that the professional nurse has a scientific foundation to support the care that is provided. As the profession of nursing continues to evolve and engage in healthcare transformation, baccalaureate-prepared nurses are expanding, taking on leadership roles that include incorporating EBPs. To be able to do this, the nurse needs to understand the criteria that make a resource credible, as this is crucial when deciding if the research is valid and reliable for implementation into healthcare settings. The nurse will need to incorporate the use of EBP models.

EBP models are designed to assist the nurse in developing a plan to gather evidence to answer a practice problem or question. It is a systematic approach to direct the user to incorporate scholarly findings into current practice. These EBP models lead the nurse through the decision-making process of evaluating the literature to determine the best practice evidence for the practice issue or question.

Professional Context

As a baccalaureate-prepared nurse, you will be responsible for locating and identifying credible and scholarly resources to incorporate the best available evidence for the purposes of enhancing clinical reasoning and judgement skills. When reliable and relevant evidence-based findings are utilized, patients, healthcare systems, and nursing practice outcomes are positively impacted.

Preparation

Review all resources for this assessment, as well as the scoring guide for details of how this assessment will be graded. You will use the specific diagnosis or health issue you selected for Assessment 1. You can refer to the overview of common EBP models in the  Evidence-Based Practice Models  media for help in choosing the most appropriate EBP model for your issue.

Instructions

Complete the following:

· Consider your diagnosis from Assessment 1.

· Explain an issue associated with this diagnosis that could benefit from an EBP approach.

· Choose the EBP model you wish to implement.

· Describe each step of the EBP model of your choice.

· Apply the steps of the model to your search for evidence for your diagnosis issue, and describe how you applied them.

· Locate at least three separate resources of evidence to assist with your diagnosis issue.

· Analyze the credibility and relevance of each resource as it relates to your diagnosis.

This is a paper and should be 3–5 pages, not including the title page or reference page. The paper must be in APA format.

Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

· Competency 2: Analyze the relevance and potential effectiveness of evidence when making a decision.

· Analyze the credibility and relevance of each resource as it relates to a diagnosis.

· Competency 3: Apply an evidence-based practice model to address a practice issue.

· Explain an issue associated with a chosen diagnosis that could benefit from an EBP approach.

· Describe each step of a chosen EBP model.

· Describe how the steps of a chosen EPB model were applied to search for evidence for a diagnosis issue.

· Competency 5: Apply professional, scholarly communication strategies to lead practice changes based on evidence.

· Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.

· Apply APA formatting to in-text citations and references, exhibiting adherence to most aspects of APA format.

Assessment 4

Final Care Coordination Plan

For this assessment, you will evaluate the preliminary care coordination plan you developed in Assessment 1 using best practices found in the literature.

This assessment provides an opportunity to research the literature and apply evidence to support what communication, teaching, and learning best practices are needed for a hypothetical patient with a selected health care problem.

You are encouraged to complete the Vila Health: Cultural Competence activity prior to completing this assessment. Completing course activities before submitting your first attempt has been shown to make the difference between basic and proficient assessment.

In this assessment, you will evaluate the preliminary care coordination plan you developed in Assessment 1 using best practices found in the literature.

To prepare for your assessment, you will research the literature on your selected health care problem. You will describe the priorities that a care coordinator would establish when discussing the plan with a patient and family members. You will identify changes to the plan based upon EBP and discuss how the plan includes elements of  Healthy People 2030.

INSTRUCTIONS

For this assessment:

· Build on the preliminary plan, developed in Assessment 1, to complete a comprehensive care coordination plan.

Document Format and Length

Build on the preliminary plan document you created in Assessment 1. Your final plan should be a scholarly APA-formatted paper, 5–7 pages in length, not including title page and reference list.

Supporting Evidence

Support your care coordination plan with peer-reviewed articles, course study resources, and Healthy People 2030 resources. Cite at least three credible sources.

Grading Requirements

The requirements, outlined below, correspond to the grading criteria in the Final Care Coordination Plan Scoring Guide, so be sure to address each point. Read the performance-level descriptions for each criterion to see how your work will be assessed.

· Design patient-centered health interventions and timelines for a selected health care problem.

· Address three health care issues.

· Design an intervention for each health issue.

· Identify three community resources for each health intervention.

· Consider ethical decisions in designing patient-centered health interventions.

· Consider the practical effects of specific decisions.

· Include the ethical questions that generate uncertainty about the decisions you have made.

· Identify relevant health policy implications for the coordination and continuum of care.

· Cite specific health policy provisions.

· Describe priorities that a care coordinator would establish when discussing the plan with a patient and family member, making changes based upon evidence-based practice.

· Clearly explain the need for changes to the plan.

· Use the literature on evaluation as a guide to compare learning session content with best practices, including how to align teaching sessions to the Healthy People 2030 document.

· Use the literature on evaluation as guide to compare learning session content with best practices.

· Align teaching sessions to the Healthy People 2030 document.

· Apply APA formatting to in-text citations and references, exhibiting nearly flawless adherence to APA format.

· Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.

CONTEXT

Care coordination is the process of providing a smooth and seamless transition of care as part of the health continuum. Nurses must be aware of community resources, ethical considerations, policy issues, cultural norms, safety, and the physiological needs of patients. Nurses play a key role in providing the necessary knowledge and communication to ensure seamless transitions of care. They draw upon evidence-based practices to promote health and disease prevention to create a safe environment conducive to improving and maintaining the health of individuals, families, or aggregates within a community. When provided with a plan and the resources to achieve and maintain optimal health, patients benefit from a safe environment conducive to healing and a better quality of life.

COURSE COMPETENCIES.

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

· Competency 1: Adapt care based on patient-centered and person-focused factors.

· Design patient-centered health interventions and timelines for a selected health care problem.

· Competency 2: Collaborate with patients and family to achieve desired outcomes.

· Describe priorities that a care coordinator would establish when discussing the plan with a patient and family member, making changes based upon evidence-based practice.

· Competency 3: Create a satisfying patient experience.

· Use the literature on evaluation as a guide to compare learning session content with best practices, including how to align teaching sessions to the Healthy People 2030 document.

· Competency 4: Defend decisions based on the code of ethics for nursing.

· Consider ethical decisions in designing patient-centered health interventions.

· Competency 5: Explain how health care policies affect patient-centered care.

· Identify relevant health policy implications for the coordination and continuum of care.

· Competency 6: Apply professional, scholarly communication strategies to lead patient-centered care.

· Apply APA formatting to in-text citations and references, exhibiting nearly flawless adherence to APA format.

· Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.

This week, you will dive more in depth into special patient populations. You will look at considerations for older adult clients, women of reproductive years, children and adolescents, and those who are most likely to struggle with medication adherence. You will also practice the act of prescribing.

The Practicum Assignment, due this week, is a requirement in order to progress from this course; however, no point value is associated with the assignment. An incomplete will be submitted as the final grade if the practicum assignment is not completed.

Assignment 1

To complete this Assignment, you will choose a case study for a patient population for special consideration during prescribing practices. You will consider the specific patient and determine the appropriate medication to prescribe, based on the patient specifics and medication attributes in various case studies. You will construct a 4- to 5-page paper in which you determine the medication, the dosing, necessary patient education, and potential side effects. You will also indicate why the other medications would not be appropriate, as well as any necessary labs or diagnostics that might be needed. You will develop a plan to enhance medication adherence for the nonadherent patient.

Construct a paper concerning your assigned vulnerable population patient case. In your paper include the following:

· Determine which medication would be most appropriate to prescribe from the assigned vulnerable population patient case medication choices.

· Explain your rationale for choosing this medication. Explain why the other medications listed are not appropriate for this patient.

· Explain the dosing schedule for the specific patient including the therapeutic endpoint.

· Provide necessary education to the patient to review risks, benefits, and potential side effects of the medication.

· Describe any necessary labs or additional diagnostics needed prior to prescribing this medication.

· Explain how you might monitor efficacy or side effects of the medication.

· Include any additional collaboration or education to others that would be necessary for this patient. Consider family members, home health care, primary care providers, etc.

· What would you need to include in your assessment for a patient who may become nonadherent with your prescribing plan for your scenario? What are alternative treatment solutions based upon how you assessed? Describe your new treatment plan.

This Assignment requires a minimum of  five (5) peer-reviewed, evidence-based scholarly references outside of course resources.

Note: You will need to include the APA style formatting.

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

Special Considerations for Patient Population Cases:

· Patient 1: 82-year-old male presenting with cognitive decline. He had always been a very active individual. Over the past year, he has become less active in the community. Previously, he played cribbage weekly with friends at the local senior center but has been struggling with the math involved with the game and no longer attends the weekly card game. He had also volunteered as a crossing guard for the local public school. He quit doing that after he took the wrong turn to get home and drove around the town feeling lost. He acknowledges he is “sensitive” to this and can be irritable towards his children when they bring up these concerns. He was diagnosed with mild neurocognitive disorder after completing neuropsychological testing. Of the following medications, which would be the most appropriate to prescribe? Explain why you chose this medication. What would be the dosing schedule for this patient? Provide education to the patient and review risks, benefits, and potential side effects of the medication. In addition, explain why the other medications listed are not appropriate for this patient.  Med List: lorazepam, olanzapine, memantine

· Patient 2: 76-year-old female who recently moved from her home to an assisted living. After 1 week of moving in, she has become extremely confused. Staff have attempted to re-orient her, and she struggles to focus on what they are saying. She is only oriented to self. She has become very agitated and has even thrown breakable objects in her room. Her family is concerned stating she is “out of it.” The PCP ordered labs and UA. Labs are unremarkable outside of mild leukocytosis and positive dipstick analysis for nitrite and red blood cells.  Med List: valproate, alprazolam, trimethoprim

· Patient 3: A 33-year-old female that is 6 weeks postpartum. She presents with depressed mood, sadness, easily emotional, difficulties with sleep even when the infant is sleeping. She has lost weight and has a poor appetite. You note psychomotor retardation. She has limited interests in hobbies or bonding with the infant. Her partner is concerned and reports she is typically active and “bubbly” and enjoys the outdoors. She is diagnosed with major depressive disorder, with postpartum onset. She denies suicidal ideation, homicidal ideation, or infanticidal ideation. No psychotic symptoms are present. She is nursing the infant and wants to continue this hoping it will assist with bonding with the infant.  Med List: lithium, paroxetine, sertraline

· Patient 4: 10-year-old male who comes in with his father. He has been diagnosed with generalized anxiety disorder. He has constant worries that he cannot control. He feels nervous and tense. He is easily irritable. He struggles to settle down or relax. He is also quite fidgety and restless. He and his father are interested in medications to manage these symptoms.  Med List: quetiapine, duloxetine, fluoxetine

· Patient 5: 27-year-old male with a diagnosis of schizophrenia. He has been hospitalized three (3) times in the past 1 year due to symptoms. When symptomatic, he becomes disorganized and paranoid. He will respond to auditory hallucinations. He will scream out at night after seeing a shadow in his room. He has delusions that the CIA is poisoning food and will not eat for multiple days. He has unintentionally hurt his mother after “slapping” food out of her hand, as he did not want her to ingest the “poisoned food.” Symptoms are treated very well with paliperidone, but he struggles to remember to take it.  Med List: paliperidone palmitate, clozapine, lamotrigine