Research Assignment PP

profilecindyrod14
Module5Assignment.ppt
Home>Nursing homework help>Research Assignment PP


Theoretical Framework to Support Evidence-Based Practice

TRIAGE IN EMERGENCY AND CRITICAL SETTINGS

Introduction

  • The provision of nursing care requires a commitment to the adoption of evidence-based practice.
  • Evidence-based practice is a problem-solving approach to the delivery of care that integrates the experience of nursing professionals with the preferences and values of patients (Andrea & Eve, 2018). .
  • Evidence-based healthcare leads to better outcomes in the provision of care.
  • Evidence-based practice plays an important role in not only improving treatment outcomes, but also reducing the cost of care.

Evidence-based practice relies on a collaborative approach between caregivers and patients. In addition, it requires an appreciation of the unique preferences of patients, their concerns, social support and expectations in determining the most appropriate treatment model (Nilsen, 2015). Furthermore, this combines the knowledge gained from the provision of care and the insights outlined in peer-reviewed articles.

*

Advanced Practice nursing area

  • The provision of emergency and critical care settings is an important advanced practice area due to the increasing demand.
  • The quality of nursing care provided at these settings have a consequential effect on the patient experience and recovery outcomes.
  • The aging population is also increasing the demand for emergency and critical care.
  • Nurses are required to meet the gaps left by the shortage of nurses.

The increasing autonomy of nurses in emergency and critical care settings highlight the need for effective intervention measures that would enhance their impact. Furthermore, advanced practice nurses are required to contribute towards the improvement of treatment outcomes.

*

Impact of emergency and critical settings on healthcare outcomes

  • Patients in emergency and critical settings are in a sensitive healthcare state.
  • The quality of care provided in this setting determines the recovery rates of patients from difficult conditions (Woo, Lee & Tam, 2017).
  • Nurses often face challenges in emergency triage.
  • The difficulties in the conduct of emergency triage are particularly evident during a public health crisis such as the COVID-19 one.

The triage decisions that are made in an emergency and critical setting have a consequential effect on treatment outcomes. Consequently, the application of the Lowa model can play a crucial role in improving triage decisions. The implementation of the model would provide a framework for an evidence-based process improvement strategy.

*

Implications of the Lowa model on emergency and critical settings

  • The Lowa-model links practice changes within the existing system.
  • The model provides an effective framework for the implementation of pilots changes that form the basis of broader change initiatives.
  • The application-oriented model is effective in supporting continuous process improvement initiatives (Melnyk & Fineout-Overholt, 2011).
  • Furthermore, it can enable nurses to use the insights gained from asking questions to implement systemic approaches to the provision of care.

The Lowa model provides an effective framework for implementing change in a busy and sensitive care environment. The adoption of this model would allow nursing staff to implement effective process improvement strategies.

*

Evidence-based practice

EBP

Best Research Evidence

Patient Values & Preferences

Clinical Expertise

The components of EBP comprise of research evidence and clinical expertise. Nursing professionals are expected to demonstrate good judgment in drawing on appropriate sources of knowledge in their work. Furthermore, the patient values and circumstances have a consequential effect on their needs, expectations and preferences.

*

The LOWA Model

  • Efforts to utilize research evidence to improve nursing outcomes are often done in a group.
  • The LOWA Model is predicated on the belief that evidence-based practice is triggered by an impetus that sets the stage for the implementation of effective change (Craig & Dowding, 2019).
  • This trigger can be gained from an analysis of available knowledge on the subject or the experience of a caregiver in the provision of care.

In this regard, this model will be the most effective in enabling nurses in a emergency care or critical setting to provide high quality care. Furthermore, this requires the nursing staff to engage on a research as a team. The approach will enhance stakeholder engagement and ownership of process outcomes.

*

The LOWA Model of Evidence-based Practice to Promote Quality Care

Problem-Focused Triggers

Knowledge Focused Triggers

Priority for Organization

Consider other triggers

Develop Team

The model outlines three key decision-points which determine the quality of care provided to a patient. The decision points have a consequential effect on the quality of care provided to patients. The points to entry are knowledge-based and problem focused errors.

*

Clinical Decision Points

Decide if the problem is of sufficient priority for the organization to explore potential changes.

Determine if there is sufficient research base for the implementation of evidence-based practice.

Decide if the change is appropriate for the practice.

If the problem is sufficient enough to warrant the intervention of a healthcare organization, then a team is formed to proceed with the project. If it does not meet this criteria, then a new trigger is sought. Similarly, the innovation is piloted at the practice area only if there is adequate research to support its implementation. In the event of an absence of sufficient research, new evidence is sought. In addition, a change is instituted if it is determined that it would yield positive outcomes in the provision of care. In contrast, the team is required to continue looking for evidence if it is found that it is inappropriate.

*

Triggers

  • Problem-focused triggers are caused by frequently encountered problems, risk management and quality improvement data collected by the team. Moreover, total quality improvement practices are also important considerations.
  • Knowledge-focused triggers includes new information from reputable institutions and scholars.
  • The identification of a trigger is followed by the assembling, critiquing and evaluation of relevant research.

The progression of this model is determined by the availability of relevant research. According to White and Spruce (2015), changes are initiated if there is sufficient information that supports their adoption. The reliance on scientific principles ensures that every initiative is supported by robust evidence.

*

Change strategy

  • The model relies on a process of planned change.
  • The staff need to be empowered to implement appropriate change.
  • Moreover, they need the knowledge and resources that are necessary for the implementation of change.

The Lowa model pushes for the active engagement of nursing staff in the process. In addition, it requires the empowerment of the nursing team through training and information-sharing. As such, this model emphasizes stakeholder engagement and support during the implementation of evidence-based practice.

*

Monitoring

  • The Lowa model requires the monitoring of patient outcomes by nursing staff after the implementation of the change.
  • The monitoring enables the staff to get feedback on the implementation of the evidence-based practice.
  • Outcome measurements focus on the consideration of the effects on fiscal performance of the institution, the staff and the patient.
  • As such, it advocates for a holistic monitoring paradigm.

The Lowa model adopts an outcome-based monitoring approach. The holistic model requires an analysis of the financial implications of the intervention and the treatment experience. Moreover, it also involves a consideration of the effect it has on the staff.

*

Conclusion

  • Evidence-based practice plays an integral role in enabling nurses to optimize the provision of care in emergency and critical care settings.
  • The practice ensures that nurses are able to act on deficiencies in this care environment.
  • The Lowa-model places nurses at the center of process improvement initiatives.

The Lowa model requires nursing staff to act on both their knowledge and complaints by patients and their family members to implement effective change initiatives.

*

References

  • Andrea P & Eve B. (2018). What’s in a Name: Performance Improvement, Evidence-Based Practice, and Research?. Nursing & Health Sciences Research Journal, 1(1), 40-45.
  • Craig, J. V., & Dowding, D. (2019). Evidence-based practice in nursing. Amsterdam : Elsevier.
  • Melnyk, B. M., & Fineout-Overholt, E. (2011). Evidence-based practice in nursing & healthcare: A guide to best practice. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins.
  • Nilsen P. (2015). Making sense of implementation theories, models and frameworks. Implementation science : IS, 10, (53), 1-13.
  • Tam, H L., Chung, S F & Lou, C K. (2018). A review of triage accuracy and future direction. BMC Emergency Medicine, 18(58), 1-7.
  • White, S., & Spruce, L. (2015). Perioperative nursing leaders implement clinical practice guidelines using the Iowa Model of evidence-based practice. AORN Journal, 102(1), 51-56.
  • Woo, BFY., Lee, JXY & Tam, WWS. (2017). The impact of the advanced practice nursing role on quality of care, clinical outcomes, patient satisfaction, and cost in the emergency and critical care settings: a systematic review. Human Resources for Health, 15(63), 1-22.