week 1 -505BSN-16
Power Point Presentation
Area of Interest
By Yahima Montero
During nursing practice, it is essential to identify a personal area of interest with regards to research. A personal area of interest offers a nurse with the impetus and opportunity to identify problems and to seek for plausible solutions and evidence.
This can be achieved through:
Discussion of Evidence-based projects and Models.
Identification and discussion of specialty track.
Discussion of an issue related to the area of Interest.
Recommendations for positive change
Internal and External factors that can influence positive change.
Discussion of AACN essentials and EBP
It is essential for master’s prepared nurses to conduct evidence-based research and projects, which have been found as effective in facilitating realization of positive patient outcomes and achievement of the goals of nursing care and health care organizations. The specialty track of choice that will be discussed in detail in this power point presentation is the executive track, and the AACN Master’s Essentials that address an evidence-based project related to the executive specialty track. Ideally, nurse executives assist health care organizations in the fulfillment of their missions through effective communication and leadership and through promotion of the utilization of EBP in nursing care in addition to helping other nurses advance in their nursing education to provide best possible nursing care. one of the issue that will be discussed with regards to the specialty track of choice is patient safety. This issue is of personal concern since it may impact positively or negatively on patient outcomes and treatment goals. Moreover, the internal and external factors that influence positive change in regard to patient safety will be delineated and discussed. Finally, recommendations for appropriate positive change in the area of patient safety will be offered in this Power Point Presentation.
Evidence-based practice in nursing promotes quality improvement
EBP Informs patients on effective treatment options
Minimizes patient safety issues and nursing care errors
AACN is nurse updated on clinical decision-making
Offers reliable information to nursing care
Designing changes in practice and evaluating validity
Implementation of change, evaluation, modification, or rejection
Master’s Prepared Nurses and EBP
Two of the core competencies of a Master’s prepared nurse is the ability to conduct evidence-based Projects within the health care setting and enhance quality for improved patient outcomes. Essentially, Evidence-based projects involve the use of the best available research evidence, clinical expertise and patient values and preferences (Schub & Walsh, 2017). The process of EBP involves asking a question regarding a particular patient care issue, searching the evidence and applying the evidence to practice after an appraisal. On the other hand, quality improvement involves aspects such as promotion of efficiency and reductions in care variations. In patient care, EBP can influence quality improvement in areas such as prevention of extravasation during chemotherapy. Furthermore, EBP is important for master’s prepared nurses because it allows the nurse to discuss treatment options that align with the values of the patient, which further facilitates culturally sensitive care. EBP facilitates the reduction of safety issues such as falls among the elderly patients or administration of ineffective medication or wrong mediation. Enhanced a patient safety through EBP ensures improved care outcomes because EBP offers reliable information to nursing care. Besides, EBP is important to AACN nurses since it allows the nurses to remain updated on effective clinical decision-making. Master’s prepared nurses may be tasked to design and implement changes related to nursing practice in health care facilities. EBP would be crucial in helping a nurse evaluate the validity and applicability of the given changes in addition to helping the nurse evaluate, modify, or reject the changes.
John Hopkins Nursing EBP Model
The Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model is a powerful and essential problem-solving methodology to clinical decision-making, which utilizes user-friendly tools to guide individual or group use. It is developed to meet specific needs of practicing nurses and is made up of a three step process called PET which is practice, question evidence, and translation (John Hopkins Medicine, n.d.). Evidence leads to adoption of best practices and practice improvements which are clinical, learning, and operational. The main goal of the model is to ensure that current the research findings and best practices are quickly and appropriately incorporated into patient care. the model is easily understood and it is applicable to all practice settings and it entails the interrelationship between theory, practice, research, and continuing education.
5’As of EBP Process
The 5 A’s model outlines the process of EBP which is asking a question related to a given area of clinical practice, acquiring Evidence through conducting a search, carrying out an appraisal of the evidence, application of the evidence to patient care and nursing practice after discussions with the patient and performance evaluation (Schub & Walsh, 2017). EBP is a problem solving method to nursing practice that allows clinicians to review research, clinical guidelines, and other information resources' based on high quality findings and apply the findings into practice. The question related to the clinical issue should serve to guide the nurse to search for the relevant information. The appraisal of the evidence ensures that it is appropriate, applicable to the situation and that it will offer new practice and clinical knowledge for the enhancement of patient outcomes.
Nurse executives a critical role in leadership
Accountable for patient care services in healthcare
Nurse executive involved in health facility management
Works with other nurses for positive outcomes
Creates policies for employees and health facility
Nurse executives are also responsible for budgets
Create and approve care plans for patients
Specialty Track - Executive Nurse
Nursing executives work in positions that integrate leadership and management skills with traditional nursing methods and duties, and promote the use of evidence based practice in nursing care (Joel, 2017). Additionally, working as a nurse executive entails working closely with employees. Nurse executives are managers, responsible for the employees in their area. This includes shift scheduling, employee development and discipline. For instance, an executive nurse working for a hospital might administer a certification test to a nurse to work in the ICU ward or the emergency room of the hospital. Mainly, nursing executives develop new policies used by their employers. This can include both smaller policies that only affect few people or larger policies that affect everyone involved with the organization. Nursing executives have overall financial responsibilities related with to their department or the facility. Moreover, they still work in the best interests of patients in the development and approval of care plans. They also collaborate with other health care workers such as physicians.
Nurse navigator role guides patients in decision-making
Advocates for adherence to treatment protocols
Coordinates care and treatment across care continuum
Provides education, resources and support to patients
Involved in cancer conferences at multidisciplinary levels
Reduce access barriers and provides psychosocial care
Participates in community outreach for cancer awareness
Nurse Navigator Role and Rationale
I am enrolled in the Executive Leadership specialty track. The rationale for choice of this track is I have been in a leadership position for eight years, I and foresee my growth in leadership. I have a passion for leading a team that is engaged. The area of interest within the nurse executive specialty track is the nurse navigator role. Navigators follow the patients and ensure adherence to treatment, in addition to provision of support and signposting to available community resources. They essentially "navigate" the patients through their treatment (Joel, 2017). Navigation services enhance patient outcomes and they ensure the patients receive the proper diagnostic tests between treatment, follow the patients during their visits with the oncologist, and they visit the patient while they are receiving treatment. This continuation of care with the patient contributes to better compliance from the patient. The nurse navigator plays an important role in the outpatient oncology setting. I have selected the nurse navigator as an area of interest. The nurse navigator role is essential to promoting better patient outcomes, minimizing costs and increased reimbursements. Navigation begins with community outreach to raise awareness about the value of prevention and early detection in underserved communities. Another key navigator role, from a patient-driven care perspective, is to ensure that the entire team knows the patient’s life goals and incorporates these goals into the treatment planning process, so that survivorship care begins at time of diagnosis; knowing their life goals and hopes also applies to patients with metastatic disease.
Executive nurses ensure patient safety during care
Advocates for use of EBP to improve quality of care
Ensures reduction of HAIs, falls, and antibiotic resistance
Diagnostic errors are costly safety concerns
Personal protective clothing and equipment protocol
Regular hand washing as a safety measure
Recommendation for change include work division
During nursing care, an executive nurse ensures patient safety to prevent negative health outcomes such as untimely mortalities or hospital acquired infections. HAIs have long plagued healthcare facilities, both clinically and financially. Protocol, including hand hygiene and antimicrobial stewardship play directly into the rate and prevalence of HAIs, and all three are continuously deemed as patient safety concerns (Morello, Lowthian, Barker, McGinnes, Dunt & Brand, 2013). The nurse executive should also advocate for safe antibiotic use to prevent antibiotic resistance for both patients and health care workers such as nurses. The first line of defense against infections remains one of the least-used tactics. A nurse executive ensures safety of the workforce and in the workplace which is a prerequisite for patient safety. A nurse executive may divide work into three categories to create reliable team interactions, ensuring reliably designed processes, and promoting the value of a safety culture.
Culture of Safety
Developing safety small workgroups
Training staff on local safety issues
Standards of Safety
Educating staff on safety standards and measures
Ensuring adhering to the set safety standards
Internal Factors for Positive Change
Developing safety work groups at the department or microsystem level and training nurses and health care workers for local safety projects enhances safety within a health care facility. Although some projects need to be implemented across the entire hospital, much of the work should be done at the microsystem, that is at the clinical unit level. As the frontline teams understand the need for safety improvement on their particular units and are given the tools to make effective systems changes, they begin to carry out safety projects on the local level without waiting for the central safety team (Morello, Lowthian, Barker, McGinnes, Dunt & Brand, 2013). Nurse executives are tasked to advocate for adherence to safety standards within care for delivery of positive patient outcomes. Therefore, it is important to periodically conduct training and education on safety standards to ensure compliance.
Bench marking with other health care organizations
Carrying out external safety assessments
External Factors for Positive Change
One of the external factors that may influence positive change in the area of safety within the health facility is policy regulations. Benchmarking with other health care organizations is a critical policy requirement that allows hospitals to assess their performance against the performance and standards of similar organizations. Benchmarking is a comparison and measurement of a healthcare organization's services against other national healthcare organizations. It provides leaders with insight to help them understand how their organization compares with similar organizations that provide the same services (Morello, Lowthian, Barker, McGinnes, Dunt & Brand, 2013). Besides, it allows for the sharing of best practices and evidence-based practice (EBP) clinical research outcomes between healthcare facilities at a national level. Benchmarks can be tailored to specific areas of nursing, such as acute- and long-term care hospitals. The four core principles of clinical practice benchmarking are maintaining quality, improving customer satisfaction, enhancing patient safety, and continuous improvement. Eternal safety assessments allow an external team to evaluate the performance of a hospital in terms of safety. The advantage fo an external team is they offer an honest, and balanced results of the real safety picture within the health care facility. Legislations can affect the decisions carried out by a nurse executive within the health facility since the decisions should comply with the local state and federal legislations to avoid breach of law.
Nurse Executive is an interprofessional team member
Offers insightful EBP input about patient care
Communicates, collaborates, and consults with team members
Nurse is part of the bedside rounding team
Nurse leader is Involved in team simulations
Health promotion for individuals/populations across lifespan
Involved in health promotion and disease prevention
AACN Master’s Essentials Essential VII: Interprofessional Collaboration for Improving Patient and Population Health Outcomes
Through implementation of interprofessional collaboration and learning to work together and respecting one another's perspectives in healthcare, multiple disciplines can work effectively as a team to help improve patient outcomes. This essential critically addresses Evidence-based preventive measures, with the nurse at the fore front of carrying out health promotions for individuals and populations for disease prevention and maintenance of health (Woten, 2016). Healthcare is dependent on many different disciplines working together to address patient needs. Health promotion, disease, and injury prevention across the lifespan are essential elements of baccalaureate nursing practice at the individual and population levels. These concepts are necessary to improve population health. Notably, nursing leaders are part of this collaborative interprofessional teams in a health care settings. The nurse offers valuable insight on patient care and advocates for the rights of the patient within the inter professional team. Moreover, nurses are critical in team simulation which ensures that training is collaborative and designed to meet a common goal. Epidemiologic studies show that lifestyle, environmental, and genetic factors are major determinants of population health in areas of health, illness, disease, disability, and mortality. Hence, acute care and disease based episodic interventions alone are inadequate for improving health. Nursing health promotion along with disease and injury prevention are important throughout the lifespan and include assisting individuals, families, groups, communities, and populations to prepare for and minimize health consequences of emergencies, including mass casualty disasters.
Quality and organizational leadership essential to patient safety
Also critical in high quality nursing practice
Essential II as a nursing leadership framework
Offers EBP understanding of practice management
Also centered on strategies for care evaluation
Useful in interdisciplinary nursing leadership roles
Facilitates understanding of EBP and best practices
Meeting Essential II Organizational Systems And Leadership
As a nurse executive, essential II is important in helping initiate an EBP quality improvement on value-based purchasing within the health care organization. This aspect links provider payments to improved care performance and holds health care providers responsible and accountable for the quality of care provided (Joel, 2017). Value-based programs are important because they stimulate the utilization of EBP for the achievement of optimal patient outcomes and health care goals. Leadership is essential in nursing. Hence, Essential II offers nurses a model for ascension into leadership roles, especially for nurse executives who are tasked to offer refined leadership for health care organizations and to other nurses.
Evidence-based projects are an important aspect of nursing and clinical practice
Research is an essential part of nursing care
The JHNEBP model is a vital problem solving tool
Nurse executive role offers leadership in health care
Meeting essential VII for interprofessional collaboration
Meeting essential II for organizational leadership
Nurse executive is an integral patient advocate
The presentation outlined the importance of EBP in nursing. It is essential for master’s prepared nurses to conduct evidence-based research and projects, which have been found as effective in facilitating realization of positive patient outcomes and achievement of the goals of nursing care and health care organizations. In this presentation, the Johns Hopkins Nursing Evidence-Based Model was discussed as an important problem solving tool. Furthermore, the specialty track of choice which is the nurse executive, is critical in provision of leadership within health facilities. The nurse navigator role which is an area of nurse executive that I am interested in helps patients to navigate through their cancer treatments and provides support to these patients. Meeting Essential VII for interprofesional collaboration is one of the essentials of nursing that allows nurses to work collaboratively within a multidisciplinary team. Additionally, meeting Essential II is an important aspect that can offer a nurse with an EBP model for ascension to a leadership role and it facilitates enhancement of organization leadership systems using EBP.
Joel, L. A. (2017). Advanced practice nursing: Essentials for role development. Philadelphia, PA: FA Davis.
John Hopkins Medicine. (n.d.). John Hopkins Nursing Evidence-Based Practice Model. Retrieved from http://www.hopkinsmedicine.org/evidence-based-practice/jhn_ebp.html
Morello, R. T., Lowthian, J. A., Barker, A. L., McGinnes, R., Dunt, D., & Brand, C. (2013). Strategies for improving patient safety culture in hospitals: A systematic review. BMJ Quality & Safety, 22(1), 11-18.
Schub, E. B., & Walsh, K. C. (2017). Evidence-based nursing practice: Implementing. Plos One, 12(10), e0184594. doi:10.1371/journal.pone.0184594
Woten, M. B. (2016). Collaboration, interprofessional: Nurse-physician relations. CINAHL Nursing Guide, 13(14). doi:10.1016/j.nurpra.2016.05.014