Week 5: Project Planning and Preparation

Comment by Karen Kidder: Please have a page number in the upper right-hand corner of each page. Thank you for this paper, and for trying to keep our young people safe. You explained your subject well, although the first paragraph needs more emphasis on the problem of STDs and why it is important. There are some APA issues with capitalization in the references. Article titles only have the first word of the title and any secondary titles, and proper nouns, capitalized. Journal names have all major words capitalized and in italics. Please see the attached paper with comments. This is interesting, and I look forward to reading more about it as we progress through the course. Respectfully, Professor.

Organizational Needs Assessment

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NR711- Fiscal Analysis and Project Management

March 2022

Organizational Needs Assessment

A DNP-prepared nurse is not only a healthcare provider but also an advocate for better health in society. I am collaborating with an STDs clinic to create awareness in the community about STDs prevention and treatment. I met with the stakeholders and the decision-maker to identify and assess the facility’s needs. The main issue is that despite the efforts done by the staff in prevention, appointments coordination, patient education about the plan of care, and disease process, some patients continue having high-risk sexual behavior, with inconsistent use of a condom with sexual partners of unknown STDs status, missing appointments, compromising the patient outcomes. This paper identifies the practice problem, informs how I plan to address it, and places the stakeholders that will influence organizational change. Comment by Karen Kidder: Please use 3rd person in scholarly writing.

Identification of the Practice Problem or Need

The practice problem is Sexually Transmitted Diseases, and my focus is to enhance educative prevention programs that increase condom use and protection among vulnerable populations such as young adults with high-risk sexual behavior. Despite efforts to address the problem, the rate of new infections is still high in Miami, indicating a gap between evidence and practice (Newmann et al., 2021). I analyzed and determined the practice problem by reading multiple articles and journals about the prevalence of STDs in Miami, Florida. I also reviewed the STDs clinic’s internal data, which revealed a high prevalence of the issue. I interviewed vital stakeholders who confirmed the need to address this practice problem to maximum results.

Evidence in Literature Comment by Karen Kidder: Level 2 headings are not in italics.

Recent CDC reports show that the rate of new STDs infections continues high; 4 of the 25 cities that top the list of infection rates are in Florida; Miami spiked upward and is currently ranked among the top 25 towns mostly affected (Butame et al., 2021). Studies also reveal that the annual cases of STDs in the USA continue to rise, reaching an all-time high for the eighth year. The most common reported STDs are chlamydia, syphilis, and gonorrhea. There was a nearly 30% increase in STDs between 2015 and 2019 (Gebrezgi et al., 2021). These rates are alarming, considering that the rates were lower less than 20 years ago. For example, gonorrhea was at historic lows, and syphilis was close to elimination (Trepka et al., 2021). The drastic changes show a need to prioritize efforts and regain control of the grounds to minimize the spread of STDs.

The diversion of efforts and resources to curb covid 19 led to worse health outcomes regarding the prevention and treatment of STDs, increasing the overall burden of STDs across vulnerable populations such as young adults with high-risk sexual behavior. Most recent studies also show that staying at home increases the risk of new infections among vulnerable people (Pinto et al., 2021).

Sources of Internal Evidence

The clinical provider’s reports recorded high levels of new patients that report high-risk sexual behavior and inconsistent use of condoms, challenging the facility. Internal reports of incidence at the practicum site reveal that STDs infection rates at the facility continue to be significantly high. There are office form records of the multiple phone call done from the staff in the patient's chart to encourage patient follow-up, but there is a challenge with sustaining these efforts, leading to poor health outcomes. The rate of chlamydia infection and reinfection is the highest, but the rate of syphilis is recorded as the slowest.

Stakeholders

The main stakeholders in the project outcomes are the clinical case manager, administrator, patient coordinators, medical practitioners, and the local community. The stakeholders who are more likely to support his change are the members of the local community and the medical practitioners. The clinical manager and the administrator would be aligned to ensure the facility has a good reputation in healthcare. Still, they are concerned about profit, are unwilling to spend money on new ideas, and are afraid of getting out of their comfort zone to implement this change.

The local community and service providers will have the most impact. Members of the community are the target population, and how their willingness to embrace change will positively or negatively affect the project's outcomes. Since change is a collective responsibility, the other stakeholders' dedication and commitment will also determine the results.

Topic Prioritization

The criteria determined to be of high quality is that the primary decision-maker identified the problem and supported my decision to address the issue. The requirement specified to be of low priority is that the problem aligns with the organizational mission and vision. After assessing the determinants, I found out that the practice problem is a significant area because of its potential implications in terms of safety, reducing economic burden, and increasing the quality of life. External and internal data also show that the problem should be addressed soon.

Gap Analysis Template Comment by Karen Kidder: Charts and graphs do not need to be double spaced.

What is happening at the practicum site?	What should be happening based on evidence?	What is your practice gap?	Why is there a practice gap?	What factors are contributing to the practice gap?	What evidence do you have to demonstrate the practice gap?
There is a need to enhance educative prevention programs to promote condom use among populations with high-risk sexual behavior.	New guidelines for evidence-based education initiatives need to be implemented to engage patients in STDs prevention.	A significant community population has been diagnosed with STDs. Yet, there are no guidelines to implement prevention education and strategies that grant follow-ups, which increases the risks of new infections.	There is a likelihood of a lack of knowledge. Lack of dedication and commitment.	There is a perception that prevention education and follow-ups require much time and money. There are gaps in staff training to engage patients in preventing and treating STDs.	Stakeholders state STDs prevalence goes up despite prevention efforts. Clinical reports show limited patient sexual behavior modifications and a lack of prevention commitment.

Conclusion

Sexually Transmitted Diseases (STDs) are a significant practice problem, and their prevalence affects society. After assessing the organization, the main issue was that some patients continue having high-risk sexual behavior, inconsistent use of a condom with sexual partners of unknown STDs status, missing appointments, and the lack of follow-up leading to the ineffectiveness of intervention strategies. To stop the spread of STDs, actions to gain control of the grounds must be emphasized. As a DNP-prepared nurse, I must enhance the quality of care in the community, and this project will positively impact the community regarding safety, quality, and reducing burden. I have support for the project from critical stakeholders who I believe will play a significant role in making positive project outcomes. Comment by Karen Kidder: Not sure what this means?

References

Butame, S. A., Idalski Carcone, A., Coyle, K., & Naar, S. (2021). Implementation of eEvidence-bBased pPractices to rReduce yYouth HIV tTransmission and iImprove sSelf-mManagement: A sSurvey of kKey sStakeholder perspectivesPerspectives. AIDS Ppatient Ccare and STDs, 35(10), 385-391.

https://doi.org/10.1089/apc.2021.0071

Gebrezgi, M. T., Fennie, K. P., Sheehan, D. M., Ibrahimou, B., Jones, S. G., Brock, P., ... & Trepka, M. J. (2021). Predictors of chlamydia or gonorrhea among people with HIV in Miami-Dade County Ryan White Program in 2017. AIDS Ccare, 1-6. Comment by Karen Kidder: There are only 8 authors so all should be listed. APA has us list up to 20 authors.

https://doi.org/10.1080/09540121.2021.1883510

Lim, A. C., Venkatesh, M., Lewald, D. L., Emmanuel, P. J., & Sanders, L. (2021). Changes in the time of COVID-19: Aa quality improvement initiative to maintain services at a youth sexual health clinic. Sexually Ttransmitted infectionsInfections.

http://dx.doi.org/10.1136/sextrans-2021-055265

Newman, D. R., Matthias, J., Rahman, M. M., Brantley, A., & Peterman, T. A. (2021). Repeat Syphilis aAmong HIV-iInfected mMen in Florida and Louisiana 2000–2018: Implications for sScreening rRecommendations. AIDS Ppatient Ccare and STDs, 35(11), 435-440.

https://doi.org/10.1089/apc.2021.0081

Pinto, C. N., Niles, J. K., Kaufman, H. W., Marlowe, E. M., Alagia, D. P., Chi, G., & Van Der Pol, B. (2021). Impact of the COVID-19 pPandemic on Chlamydia and Gonorrhea sScreening in the US. American Jjournal of Ppreventive Mmedicine, 61(3), 386-393.

https://doi.org/10.1016/j.amepre.2021.03.009

Trepka, M. J., Dawit, R., Fernandez, S. B., Sheehan, D. M., Degree, A., Li, T., ... & Spencer, E. C. (2021). Social disorganization and new HIV diagnoses, 2013‐2017, Florida: Rural‐urban differences. The Journal of Rural Health, 2021. 1-10.. Comment by Karen Kidder: again, list all authors as there are only eight.

https://doi.org/10.1111/jrh.12636