PICOT question and assignment details below, please read entire document.
Description
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Professor and class,
The approved systematic review I decided to go with discharge plans to prevent hospital readmission for acute exacerbation in children with chronic respiratory illness.
Question: How does discharge planning affect children diagnosed with chronic respiratory illness, re hospitalization rates in a 60 day period?
P- Children diagnosed with chronic respiratory illness.
I- Detailed discharge planning upon initial hospitalization period.
C- No discharge teaching during initial hospitalization.
O- Re hospitalization within 60 days period.
T- Time 60 days.
In the past year the home health agency that I’m currently employed was granted permission to start providing services for pediatric patients. Within this population we serve the vast majority suffer from chronic respiratory diseases. The clients diagnosis include tracheostomy, ventilator dependency and oxygen dependency. A trend observed among several patients is re hospitalizations for the same diagnosis within a few months. Even though discharge instructions is provided via paper documentation no formal teaching is completed per parents verbalization during the hospitalization period. My view of the lack of education / teaching is due to the diagnosis being chronic, discharge planners may assume parents are knowledgeable. Tools that I utilize during the teaching period are reinforcement of disease process is certainly required to prevent re hospitalizations of chronic respiratory illness patients. Detail sign and symptoms to monitor on a daily basis along with vital signs parameters as a guide. The importance to report change in condition to MD immediately in order not to delay early intervention preventing hospitalization. Furthermore new and improved treatments can help with managing chronic respiratory diseases at home. Documenting daily activities can assist in assessing when change in condition initially occurred. The RN assessment following hospitalization reveals parents / guardians require detail teaching and reinforcement of caring for children diagnosed with chronic respiratory diseases at home. Adherence to medications, follow up with specialist, infection control methods and precautions are always provided upon my assessment in efforts to prevent re hospitalization.
Research gap is when inadequate data retricts potential to attain a conclusive resolution to proposed evidence based questions. ( Elsevier, 2013). Gap happens between current data and immediate day to day clinical practice.
References:
Chamberlain College of Nursing. (2018). NR-451 Week 2: Characteristics of Nursing Practice [Online Lesson]. Downers Grove, IL.
Elsevier B. V ( 2013). The theory-practice gap and skill acquisition : Collegian, Volume 18, Issue 2, PP 93-98.
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Pauli PROFESSOR’S RESPONSE AND FEEDBACK TO ORIGINAL ASSIGNMENT.
LucilleNice job on your post and exploring the issue of re- admissions as related to children with chronic respiratory disease (Tis the season for wheezing!). Will you be using the Hall systematic review as the basis for your project then? When you progress into the milestones you will want to include the readmission rates on your unit or at your facility as well as how those rates compare to national benchmarks. This data will support the claim that an issue exists. Your nurse manager can provide this information, or obtain this information for you. In such a case, you will use “personal communication” as your APA citation. Here are some additional resources that you may find beneficial for this topic:https://www.ahrq.gov/professionals/systems/hospital/red/toolkit/redtool5.htmlhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3128446/https://www.cms.gov/http://hospitalmedicine.ucsf.edu/downloads/assessing_the_impact_of_nurse_post-discharge_telephone_calls_harrison.pdfhttps://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/Readmissions-Reduction-Program.htmlhttp://www.ihi.org/Topics/Readmissions/Pages/default.aspxhttps://pso.ahrq.gov/Topicshttps://www.medicare.gov/hospitalcompare/readmission-reduction-program.htmlhttps://www.ahrq.gov/sites/default/files/publications/files/medreadmissions.pdfhttps://www.ahcancal.org/quality_improvement/qualityinitiative/Pages/Hospital-Readmissions.aspxhttps://www.healthypeople.gov/Best Regards,Dr. Valerie Pauli ReplyReply to Comment
This is the original question the assignment should be based on, included is the professors response to the question. ADDITIONAL INFORMATION BELOW.
Week 3: Capstone Project: Milestone 1: Practice Issue and Evidence Summary Worksheet (graded)
- Due Sunday by 11:59pm
- Points 175
- Submitting a file upload
Capstone Project Milestone 1: Practice Issue and Evidence Summary Guidelines
Updated 11/14/2017
Purpose
Clear identification of the practice issue is the first step in evidence-based nursing. Next, the evidence is reviewed to determine the best intervention to change practice outcomes. Completion of the milestone will include identification of the practice issue using the ACE Star Model of Knowledge Transformation and a review of the evidence that will support an intervention that will change outcomes. The evidence summary will be conducted through the ‘breaking down’ of a systematic review on your topic for your change project.
Course Outcomes
This assignment enables the student to meet the following course outcomes:
- CO4: Develops and outlines a scientific, systematic decision-making process to integrate critical thinking with clinical judgment to assure safe and effective outcomes. (PO4)
- CO8: Selects evidence for best practice when planning professional nursing care for individuals, families, aggregates, and communities. (PO8)
Due Dates
Milestone 1 consists of the completion of ONE form with two worksheets called the Practice Issue and Evidence Summary Worksheets. (Links to an external site.) Complete both worksheets and submit the form by Sunday, 11:59 p.m. MT at the end of Week 3.
Points
Milestone 1 is worth 175 points (75 points for the Practice Issue and 100 points for the Evidence Summary).
Practice Issue Worksheet Directions
- A tutorial with tips for completing this assignment may be viewed at https://atge.webex.com/atge/ldr.php?RCID=4905b26a67572323c11b839e3251c96a (Links to an external site.) (Links to an external site.)
- Choose the ONE systematic review topic that is of most interest to you, or most relevant to your practice situation, from the List of Approved Systematic Reviews (Links to an external site.).
- Follow the grading criteria below to formulate your practice issue, which must be based on the topic of the systematic review you have selected. THE ONE I SELECTED IS ABOVE.
- Use the worksheet to document the practice issue presented and approved by your instructor in the Week 2 Discussions.
- Your practice issue will be the same for all three Milestone assignments in this course.
- Please type your answers directly into the worksheet.
Evidence Summary Worksheet Directions
- Develop an evidence summary by following the grading criteria below.
- Document this on the evidence summary portion of the worksheet.
- You will use this worksheet to incorporate your evidence summary into your Week 4 Milestone 2 assignment.
- Please type your answers directly into the worksheet.
**Academic Integrity Reminder**
Chamberlain College of Nursing values honesty and integrity. All students should be aware of the Academic Integrity policy and follow it in all discussions and assignments.
By submitting this assignment, I pledge on my honor that all content contained is my own original work except as quoted and cited appropriately. I have not received any unauthorized assistance on this assignment.
Please see the grading criteria and rubrics on this page.
NOTE: Please use your browser’s File setting to save or print this page.
Rubric
NR451_Milestone1
| Criteria | Ratings | Pts | |||||
|---|---|---|---|---|---|---|---|
|
This criterion is linked to a Learning OutcomePractice issue statement, scope of practice, practice areaIdentifies a Practice issue statement that is an independent nursing decision, and is relevant to the systematic review topic chosen from among the list provided in the course. Describes the scope of practice issues. Example: The number of falls in your facility has been increasing, especially during shift change. What do you believe may be causing this? Are there any new interventions that could be put into place that would lessen or eliminate the falls? This is where you begin your initial search into the problem or practice issue identified. Identifies the practice area. |
|
20.0 pts |
|||||
|
This criterion is linked to a Learning OutcomePractice issue identification, rationale for selectionsIdentifies how rationale behind how the practice issue was selected as a practice issue/problem Documents the practice issue in a logical manner. |
|
35.0 pts |
|||||
|
This criterion is linked to a Learning OutcomeTypes of evidence to gather, rationale for selectionsIdentifies and documents types of evidence that must be gathered for review of the Practice Issue. Describes rationale for each type of evidence that is selected. |
|
20.0 pts |
|||||
|
This criterion is linked to a Learning OutcomePractice problemStates practice problem in own words, with reference to the population, setting, and magnitude and in measurable terms. Describes practice setting in measureable terms. Example: Consider the example given in the evidence summary above. The setting is the long term care facility where falls have been increasing and a trend has been identified that it seems to occur mainly during shift change. What do you believe may be causing this? What can be done to lessen or eliminate the falls? How does this number of falls relate to other months that have been tracked? |
|
10.0 pts |
|||||
|
This criterion is linked to a Learning OutcomeSource of evidenceIdentifies a source of evidence that is a nursing topic that is the subject of a systematic review article. Provides a complete reference for the systematic review article that was chosen from the list provided. |
|
20.0 pts |
|||||
|
This criterion is linked to a Learning OutcomeObjectives of the article/Statement of questionsIdentifies the objectives of the article. Identifies questions being addressed by author/s. Explains relationship to the chosen practice issue |
|
20.0 pts |
|||||
|
This criterion is linked to a Learning OutcomeInterventions/Main findings summarySummarizes, in own words, suggested interventions by the author/s to improve patient outcomes. Summarizes main findings of the author/s including strength of evidence for each main outcome. Describes the relevance to the Milestone 2 paper. |
|
30.0 pts |
|||||
|
This criterion is linked to a Learning OutcomeEvidence-based solutions and limitationOutlines evidence-based solutions to consider for the capstone project. Discusses any limitations to the studies included in the systematic review that he/she believes may impact use of the evidence provided in their project |
|
20.0 pts |
|||||
|
Total Points: 175.0 |
|||||||
References:
Nursing Standards
Nursing and Midwifery Board of Australia. (2018). Code of conduct for midwives. https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards.aspx
Clinical Guidelines
Guideline Adaption Committee. (2016). Clinical practice guidelines and principles of care for people with dementia. NHMRC Partnership Centre for Dealing with Cognitive and Related Function Decline in Older People. https://cdpc.sydney.edu.au/wp-content/uploads/2019/06/CDPC-Dementia-Guidelines_WEB.pdf
Living Guideline
Stroke Foundation. (2022). Australian and New Zealand living clinical guidelines for stroke management – chapter 1 of 8: Pre-hospital care. https://app.magicapp.org/#/guideline/NnV76E
Evidence-based practice
BMJ Best Practice
Goldfarb, S., & Josephson, M. (2020). Cystic fibrosis. BMJ Best Practice. https://bestpractice.bmj.com/
Schub, T., & Cabrera, G. (2018). Bites: Head lice [Evidence-based care sheet]. Cinahl Information Systems. https://www.ebscohost.com
Beyea, S. C., & Slattery, M. J. (2006). Evidence-based practice in nursing: A guide to successful implementation. http://www.hcmarketplace.com/supplemental/3737_browse.pdf
JBI: Evidence summary
Swe, K. K. (2022). Blood glucose levels: Self-monitoring [Evidence summary]. JBI EBP Database. https://jbi.global
JBI: Best practice information sheet
Bellman, S. (2022). Experiences of living with juvenile idiopathic arthritis [Best practice information sheet]. JBI EBP Database, 24(1), 1-4.
Cochrane Database of Systematic Reviews
Srijithesh, P. R., Aghoram, R., Goel, A., & Dhanya, J. (2019). Positional therapy for obstructive sleep apnoea. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD010990.pub2
Drug Information
Codeine. (2023, January). In Australian medicines handbook. Retrieved February 2, 2023, from https://amhonline.amh.net.au
Colorado State University. (2011). Why assign WID tasks? http://wac.colostate.edu/intro/com6a1.cfm
Dartmouth Writing Program. (2005). Writing in the social sciences. http://www.dartmouth.edu/~writing/materials/student/soc_sciences/write.shtml
Rutherford, M. (2008). Standardized nursing language: What does it mean for nursing practice? [Abstract]. Online Journal of Issues in Nursing, 13(1). http://ojin.nursingworld.org/MainMenuCategories/ThePracticeofProfessionalNursing/Health-IT/StandardizedNursingLanguage.html
Wagner, D. (n.d.). Why writing matters in nursing. https://www.svsu.edu/nursing/programs/bsn/programrequirements/whywritingmatters/
Writing in nursing: Examples. (n.d.). http://www.technorhetoric.net/7.2/sectionone/inman/examples.html
Perth Children’s Hospital. (2022, April). Appendicitis [Emergency Department Guidelines]. Child and Adolescent Health Service. https://www.pch.health.wa.gov.au/For-health-professionals/Emergency-Department-Guidelines/Appendicitis
Department of Health. (n.d.). Who is being active in Western Australia? https://ww2.health.wa.gov.au/Articles/U_Z/Who-is-being-active-in-Western-Australia
Donaldson, L. (Ed.). (2017, May 1). Healthier, fairer, safer: The global health journey 2007-2017. World Health Organisation. https://www.who.int/publications/i/item/9789241512367
NCBI Bookshelf
Rodriguez Ziccardi, M., Goyal, G., & Maani, C. V. (2020, August 10). Atrial flutter. In Statpearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK540985/
Royal Perth Hospital. (2016). Procedural management: Pre and post (24-48 hours) NPS. Canvas. https://courses.ecu.edu.au
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