Tag: Clinical-Nursing

The Evidence Based Practice (EBP) Project: Literature Review and Nursing Implications

Now that you’ve found your evidence, summarized the material, and completed your TOE, it’s time to do your critical literature review and nursing implications sections. Use the data from your TOE to help you.

Submit to the Assignments section the following:

The names of all group members.

Restate your PICO question (in question format only).

Complete the Literature Review section

Include 5-10 paragraphs demonstrating that you have fully read and analyzed all of the evidence. You will likely need to use subheadings to organize your review. Consider questions such as:

What were the common themes throughout the articles?

Were the articles studying the same/different variables?

Were the findings the same/different?

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How do the main objectives/purposes of the researchers affect how the studies were designed/carried out?

Discuss the levels of evidence and how that affects the credibility of the findings.

How did the design of the studies affect the outcomes?

Discuss reliability and validity of findings.
 (Focus heavily on this part. It doesn’t matter what the findings say if they aren’t reliable/valid, so fully evaluate them based on the criteria from the textbook. Discuss the different types of reliability/validity. Be very specific.)

Is the evidence contradictory? If so, why might this be so? (i.e. One study is more reliable than the other.)

Complete the Implications for Nursing Practice section

Include 1-2 paragraphs of implications for nursing practice.

Consider such questions as:

How can/should nursing practice change based on these findings?

How should nurses respond to these findings?

Can current nursing practices be improved with these findings?

Etc.

Note: This is the crux of your entire paper, so make sure to focus on it. Nursing research is only important if you can use it to improve nursing practice. This section doesn’t have to be long, but make it count.

 

Table 1: Group Table of Evidence (TOE) Part 4

 

Citation

(Write citation using APA format, just as you would in a reference list. Put articles in alphabetical order by the first author’s last name)

Purpose Statement (quote directly from the study), Sample, and Setting

Research Question or Hypothesis

(If the study doesn’t list one, write what the implied RQ or Hypothesis is and label as “implied.”)

Variables

(State independent and dependent variables using bullet points.
Note: Participants are not variables)

Design

(Include study design (i.e. meta-analysis, RCT), level of evidence (See the Evidence Hierarchy in Polit & Beck (2014)), other key design features such as use of placebo, blinding, etc.

Outcomes (meaning what the researchers were trying to measure) with Measures and Time Administered (meaning how the data was collected/recorded)

(Do not put the actual data here. That belongs in the Findings column.)

Findings

(Include quantitative data. What are the researchers’ final conclusions based on the outcomes?)

Casiday, R. E., Wright, C. M., Panter-Brick, C., & Parkinson, K. N. (2004). Do early infant feeding patterns relate to breastfeeding continuation and weight gain? Data from a longitudinal cohort study.
European Journal Of Clinical Nutrition, 58(9), 1290-1296
.

 

Purpose:

To describe the first-week feeding patterns for breast- vs. bottle-fed babies, and their association with sustained breastfeeding and infant weight gain at 6 weeks.

 

Sample:

923 full-term mothers of infants that were born at the time of recruitment took part in the study. Out of 54% of the cohort study, the return of the usable diaries was 502.

Setting:

Urban, northeastern community in the United Kingdom

 

 

 

Research Question/Hypothesis:

Do early infant feeding patterns relate to breastfeeding continuation and weight gain?

Independent variable(s):

Early infant feeding patterns

Dependent variable(s):

Breastfeeding continuation and weight gain for infants at 6 weeks. The frequency of breastfeeding for both breastfed and bottle-fed infants was observed and recorded and also weight gain for both.

Study design:

A longitudinal cohort study

Level of evidence:

Level 2

Key design features:

Placebo-controlled study

Outcomes:

Interest was in breastfeeding continuation and weight gain for infants over a period of 6 weeks with regards to the frequency and patterns of breastfeeding. Mother’s midwives collected data through questionnaire dairies and collected it at routine screening visits made to the mothers each week for the 6 week period.

Findings:

The frequency of breastfed infants was higher at 2.71 h between feeds as compared to infants that were bottle-fed that was at 3.25 h between feeds and for infants that received both types of breastfeeding it was 3.14 h between feeds (P<0.001) within week 1 of life, but the feed duration was the same for all. For the first week, only maternal education (P=0.004) and breastfeeding (P<0.001) were exclusively related to breastfeeding continuation over the period of 6 weeks. Feeding frequency in the first week was greater which indicated a higher 6-week weight gain for breastfed infants, however for bottle-fed infants no analyzed factors led to the incr4ease in weight gain (Casiday et al., 2004, pp. 1292-1293). Conclusions: First-week feeding patterns of the longitudinal cohort study indicate the significance and infant weight gain and breastfeeding continuation complicated issues, and education accorded to mothers on the feeding implications. At 6 weeks, breastfeeding was discontinued for supplementary bottle feeds. For infants that breastfed, frequent feeding led to higher weight gain during that period. Ferguson, M., & Molfese, P. (2007). Breastfed infants process speech differently from bottle-fed infants: evidence from neuroelectrophysiology. Developmental Neuropsychology, 31(3), 337-347 Purpose: To evaluate whether breastfed infants, process speech differently from bottle-fed infants.   Sample: 12 infants at the age of 6 months were tested Setting: Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY 40292, USA Research Question/Hypothesis: Do infants that have been breast-fed process speech differently as compared to infants that have been bottle-fed. Independent variable(s): Breastfed infants and bottle-fed infants are the independent variables   Dependent variable(s): Speech processing ability is the dependent variable Study design: Retrospective cohort study design Level of evidence: Level 3   Key design features: Placebo-controlled study Outcomes: Interest was in Event-related potential (ERP) wavelength or speech processing measurement and recording of a range of behavioral measures. Data was collected through physical testing of the infants over a specified period.   Findings: The study sought to find out the breastfeeding differential impact against PUFA-enriched formula from a group of 12 infants aged 6 months that were well matched. Recording of data was done on ERP wavelengths and range of behavioral measures. Differences were identified in ERP wavelengths when the comparison was made between PUFA-fed infants and breastfed infants at the age of 6 months. Upon equating cognitive, biological, and perinatal factors, breastfed infants recorded ERPs were seen to change throughout the period of recording at 700 msec when the two groups were evaluated. Their ERPs also showed a difference in all speech sounds, and also recorded scalp recordings generated differences from all regions. Conclusions: In conclusion, differences observed in brain range responses possibly indicate an advantage in terms of later cognitive and linguistic development for infants that were breastfed as compared to infants that were bottle-fed. Kim, T., Lee, H., Park, J., Jang, S., and Kim, M. (2013). Effects of early breastfeeding education on maintenance of breastfeeding practice: A prospective observational study. Open Journal of Nursing , 3 , 209-213.           Purpose: To evaluate the effect of early breastfeeding and prenatal education of breastfeeding in the maintenance of breastfeeding practice after delivery. Sample: 82 pregnant women that were recruited experienced virginal delivery and took part in the study. Setting: Soonchunhyang University Hospital, Department of Obstetrics and Gynecology in Bucheon, South Korea.       Research Question/Hypothesis: Implied It is suggested that new-born infants’ early breastfeeding impacts the postpartum practice of breastfeeding and also related education effects on the practice of breastfeeding. Independent variable(s): Early breastfeeding education is the Independent variable. Dependent variable(s): Breastfeeding practice maintenance is the dependent variable Study design: Observational survey study design Level of evidence: Level 5   Key design features: Placebo-controlled study Outcomes: Interest was in education level and information provision effects on the types and maintenance of feeding. Data was collected through survey questionnaires that detailed information about mother and infant, breastfeeding patterns, and education level of the patient. After birth delivery in weeks 1 and 4, telephone survey interviews were conducted. Analysis of data was done using One-way ANOVA.   Findings: The 82 women sample size were separated into two groups with one having women that breastfed within 2 hours of delivery, and the second one breast-fed in between 2 hours and 24 hours after delivery. Women with degrees from college showed statistical significance in terms of maintaining a higher breastfeeding percentage even after discharge from hospital in the 4 th week (p=0.01). After provision of information, types of feeding (powder, breast milk) indicated differences that were statistically significant in the samples only before the discharge from hospital period by p=0.03. 1 st weeks p-value was 0.97 and 0.83 after the four week period. With this statistical data, it was clear there was no or little statistical significance in the relationship between breastfeeding of infants early and breastfeeding practice maintenance (Kim et al., 2013, pp.210-211) Conclusions: Education of post-partum and antenatal period with regards to breastfeeding is crucial for the maintenance of the breastfeeding practice. Recommended developing educational programs further studies. Singhal, A., Cole, T., Lucas, A., Singhal, A., Cole, T. J., & Lucas, A. (2001). Early nutrition in preterm infants and later blood pressure: two cohorts after randomized trials. Lancet, 357 North American Edition (9254), 413-419.   Purpose: To determine whether early nutrition in preterm infants results in later life lower blood pressure. Sample: 216 (23%) children out of 926 born prematurely and that took part in two randomized trials that were parallel took part in the study in five UK based neonatal units. Setting: Medical Research Council Childhood Nutrition Research Centre, Institute of Child Health, London, UK.   Research Question/Hypothesis: Hypothesis: It is suggested that early diet programmes blood pressure in later life in children randomly assigned different diets at birth. Independent variable(s): Early nutrition is the independent variable Operational definition: Early nutrition refers to early breastfeeding where preterm infants were given dietary interventions such as preterm formula vs. donated banked breast milk and preterm formula vs. standard term formula. Conceptual definition: Early nutrition refers to the process of nourishing or provision of food (in this case breast milk) to infants (preterm) for growth and health. Dependent variable(s): Lower blood pressure is the dependent variable. Operational definition: lower blood pressure in this context refers to the presumed effect brought about by early breastfeeding in infants born prematurely. Conceptual definition: Low blood pressure also referred to as hypotension is a medical condition where the pressure in the arteries is less than 90/60 mmHg which is the measurement used to gauge blood pressure in the arteries. Study design: Randomized controlled study design Level of evidence: Level 1 Key design features: Placebo-controlled design Outcomes:            Interest was in blood pressure measurement. Data was collected from the 216 children aged between 13-16 years that were born prematurely through physical tests by medical practitioners.   Findings: Those children that were followed up at ages between 13 and 16 showed similar characteristics of anthropometry and social class at birth when compared to those that were not followed up. At this age group, 66 children that were given banked breast milk (together with the milk from the mother or alone) showed a lower arterial blood pressure mean as compared to the 64 children that were given preterm formula (mean 81·9 [SD 7·8] versus 86·1 [6·5] mm Hg; 95% CI for difference −6·6 to −1·6; p=0·001). Analysis done in the non-randomized sample showed that the human milk enteral intake proportion in the period of neonatal was related inversely to the arterial pressure later mean (β=−0·3 mm Hg per 10% increase [95% CI −0·5 to −0·1]; p=0·006). No conclusive difference was noticed in comparison of term formula (n=44) and preterm formula (n=42) (Singhal et al., 2001, pp. 416-417). Conclusions: Breast milk consumption was seen to reduce blood pressure in prematurely born children. Data retrieved from the study provides for experimental programming evidence of a risk factor in the cardiovascular through early nutrition and long-term positive breast milk effects were further supported.

Academic Research Essay Outline

Topic: You may choose your topic so long as it specifically relates to law, society, &/or justice.  The only topics you may not write about are abortion, death penalty, or marijuana.

 

Part 1: Outline the Following Preliminary Ideas for Your Essay:

 

Thesis statement
-A one-sentence, overall argument that you assert or your take-away message—a “should”-type statement.

 

A topic sentence for your background information paragraph.  This sentence should convey the overall meaning of the paragraph.

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III.
            A “reason” topic sentence.  A reason provides a “why” or “because” the thesis statement is true.  This sentence states the overall meaning or concept that will be covered in the paragraph.

 

Another “reason” topic sentence.  A reason provides a “why” or “because” the thesis statement is true.  This sentence states the overall meaning or concept that will be covered in the paragraph.

 

Another “reason” topic sentence.  A reason provides a “why” or “because” the thesis statement is true.  This sentence states the overall meaning or concept that will be covered in the paragraph.

Assessing critical business indicators

For your Week 10 Discussion response, you are to be assigned one of the four problems (#9, #10, #11 or #12) on pages 414–415 of the text (eBook) Financial Management of Health Care Organizations: An Introduction to Fundamental Tools, Concepts, and Applications (3rd ed.). 
Please just pick one of these questions for your Week 10 Discussion that makes sense for you. I will not be assigning it as it will be your choice.
Thanks.

Here is the text elink

http://site.ebrary.com/lib/waldenu/docDetail.action?docID=10341702

Zelman, W., McCue, M.,, & Glick, N. (2009).
Financial management of health care organizations: An introduction to fundamental tools, concepts, and applications
(3rd ed.).

Transforming Nursing and Healthcare through Technology Essay

Health Literacy

In order to effectively manage their own health, individuals need to have competencies in two areas—basic literacy and basic health literacy. What is the difference? Basic literacy refers to the ability to read, even simple language. Health literacy is defined as, “the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions” (National Coalition for Literacy, 2009). Unfortunately, according to a Department of Education report on health literacy, only 12% of adults aged 16 and older are considered to have a proficient level of health literacy (U.S. Department of Education, 2006). Acquiring health literacy skills has become more complicated with the explosion of online health information, some credible and some misleading.

In this Discussion, you focus on how to help individuals find credible information on the Internet and develop strategies nurses can use to increase the health literacy of their patients.

To prepare:

· Think about the nurse’s role in improving the health literacy of patients.

· Consider the many ways patients access health information, including blogs, social media, patient portals, websites, etc.

· Reflect on experiences you have had with patients who self-diagnose using online medical sources.

· Using the Internet, the Walden Library, or other trustworthy sources, identify a resource that you could introduce to patients to help them evaluate the credibility of health information found online.

· What are some strategies you could employ to improve the health literacy of patients?

Required Readings

McGonigle, D., & Mastrian, K. G. (2015).
Nursing informatics and the foundation of knowledge
(3rd ed.). Burlington, MA: Jones and Bartlett Learning.

Chapter      17, “Supporting Consumer Information and Education Needs”

This chapter explores health literacy and e-health. The chapter examines a multitude of technology-based approaches to consumer health education.

Chapter      18, “Using Informatics to Promote Community/Population Health”

In this chapter, the authors supply an overview of community and population health informatics. The authors explore a variety of informatics tools used to promote community and population health.

Chapter      16, “Informatics Tools to Promote Patient Safety and Clinical Outcomes”

The authors of this chapter present strategies for developing a culture of safety using informatics tools. In addition, the chapter analyzes how human factors contribute to errors.

Health literacy: How do your patients rate? (2011).
Urology Times, 39
(9), 32.

The authors of this article define health literacy and emphasize its poor rates in the United States. Additionally, the authors recommend numerous websites that offer patient education materials.

Huff, C. (2011). Does your patient really understand?
H&HN, 85
(10), 34.

This article defines hospital literacy and highlights the barriers that prevent it from increasing. It also emphasizes the difficulties created by language and financial costs.

The Harvard School of Public Health. (2010).
Health literacy studies
. Retrieved from http://www.hsph.harvard.edu/healthliteracy

This website provides information and resources related to health literacy. The site details the field of health literacy and also includes research findings, policy reports and initiatives, and practice strategies and tools.

Office of Disease Prevention and Health Promotion (n.d.).
Health literacy online
. Retrieved June 19, 2012, from http://www.health.gov/healthliteracyonline/

This webpage supplies a guide to writing and designing health websites aimed at increasing health literacy. The guide presents six strategies that should be used when developing health websites.

U.S. Department of Health and Human Services. (n.d.a).
Quick guide to health literacy
. Retrieved June 19, 2012, from http://www.health.gov/communication/literacy/quickguide/Quickguide.pdf

This article contains an overview of key health literacy concepts and techniques for improving health literacy. The article also includes examples of health literacy best practices and suggestions for improving health literacy.

Required Media

Agency for Healthcare Research and Quality (Executive Producer). (2012a).
Interview with Rachelle Toman, M.D. Ph.D.
Rockville, MD: Author. Retrieved from http://www.ahrq.gov/patients-consumers/patient-involvement/ask-your-doctor/videos/clinician06/index.html

In this interview, Dr. Toman discusses the importance of asking patients questions to ensure they have been able to sufficiently communicate their concerns.

Agency for Healthcare Research and Quality (Executive Producer). (2012b).
The waiting room video
. Rockville, MD: Author. Retrieved from http://www.ahrq.gov/patients-consumers/patient-involvement/ask-your-doctor/videos/waitroom/index.html

This video addresses the importance of communication in the patient-health care professional relationship. It highlights the need to ask meaningful questions to the patient to fully understand issues and concerns

Medicare, Medicaid and managed care

MMA was signed by President Bush in 2003. The MMA brought about sweeping changes that increased enrollment and improved access to Medicare Plans. Similarly, the PPACA was signed into law by President Obama in 2010. The law is expected to significantly increase access to Medicaid for the uninsured, low-income families, and individuals. Medicaid managed care has been implemented by most states, mainly because of rising costs, plan quality, access to providers, and the decrease in state revenues and federal matching funding. Medicare has explored managed care for the same reasons: to reduce costs, improve quality and improve access to providers. Using the South University Online Library or the Internet, research the following two topics and write a paper evaluating the impact of these policies on Medicare and Medicaid managed care.

You need to research on the following two topics:

Medicare and managed care

Medicaid and managed care

Based on your research, answer the following questions:

Write a summary for each topic tying together the information learned about that topic.

Analyze the challenges Medicaid faces in terms of improving access to care, quality of care, and reducing the cost of care.

Analyze the challenges Medicare faces in terms of improving access to care, quality of care, and reducing the cost of care.

Draw conclusions about the future of managed care in each program—will it grow or decline? What will be the challenges for success?

Select at least four reputable articles per topic that address the challenges facing Medicare and Medicaid managed care.

Based on your research, summarize your findings on the selected topics and compile your observations in a 5 page Microsoft Word document.

Support your responses with examples.

Cite any sources in APA format

Personal Worldview Essay – Spirituality and pluralism, scientism, and postmodernism

Write an 800-1,000 word essay on your personal worldview. Briefly discuss the various possible meanings of the term “spirituality,” and your understanding of the concepts of pluralism, scientism, and postmodernism. Primarily, address the following seven basic worldview questions:

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What is prime reality?

What is the nature of the world around you?

What is a human being?

What happens to a person at death?

Why is it possible to know anything at all?

How do people know what is right or wrong?

What is the meaning of human history?

Prepare this assignment according to the APA guidelines . An abstract is not required.

Contemporary issue in public health policy that has global implications

) Generate a policy brief ( 800 words) which targets a contemporary issue in public health policy that has global implications (e.g., smoking, obesity, infant mortality, etc.).

2) Refer to the  Policy Brief Guide.”

3) While APA format is not required for the body of this assignment, solid academic writing is expected and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

4) This assignment uses a grading rubric. Instructors will be using the rubric to grade the assignment

Healthcare Policy Brief Guide

Legislators seldom have the time to read through all the literature related to a specific health care policy question. To make well-informed decisions, they rely on short, tightly written briefs that quickly and cogently relay the important policy facts, questions, and arguments about an issue.

An effective policy brief will advance a persuasive argument in a concise, clearly organized fashion. A policy brief does not include a lengthy analysis or review of the literature.

Policy Brief Assignment Template

Introduction:

· Begin with a brief overview and state the health care problem.

· Include the history and social context of the public health condition.

Recommendations:

· Clearly state your recommendations for addressing the issue up front.

Background:

· Outline the history or background relevant to the global prevalence of the condition and health disparities related to the condition.

· Describe the population(s) most affected by the conditions.

· Describe the major agencies responsible for enforcement of public health related to this issue along with outlining their roles.

Analysis:

· Constructively criticize arguments, ideologies, and the quality of current actions being taken to address the condition.

· Use evidence from literature and other sources to support your perspectives and advance your recommendations.

Conclusion:

· Conclude with a persuasive argument and summary statement.

· Summarize the major points and provide recommendations for the implementation of specific policies to address the health care issue.

Adapted from the International Society for Technology in Education at
www.iste.org/Libraries/Templates_Starter…/Policy_Brief_Template.sflb.ashx

PICOT Format Evidence-Based Practices & Nursing

Course Project: Part 1—Identifying a Researchable Problem

PICOT format
Evidence-Based Practices & Nursing

Introduction
     Normally, PICOT format is helpful in formulation of questions in an evidenced based clinical practice. PICOT generated questions generally fall under for main categories of clinical practices. These include; therapy, prevention, diagnosis, etiology as well as Prognosis. The essential elements in PICOT questions. The PICOT format is valuable in addressing research questions comprehensively. Five elements are normally addressed including; population, intervention, comparison, outcome and time as well (Riva, Malik, Burnie, Endicott, & Busse, 2012).

Summary of Case Study

        
The ever increasingly high incidence of breast cancer conditions has posed serious challenges in the nursing profession. Provision of appropriate healthcare to the cancer patients has been lacking leading to adverse effects of the proliferation of cancerous cells which further worsen the conditions of the patients. As primary care, clinicians have the responsibility to stressing providing healthcare services within healthcare facilities as well as monitoring treatment in home based facilities to help manage cancer condition. Most cancer patient need clinicians who practice evidence-based clinical practices (Riva, Malik, Burnie, Endicott, & Busse, 2012).

Research Question

  
In cancer patients receiving chemotherapy, will they have better white blood cell count monitoring with a follow-up at home versus follow-up at a health care facility during their treatment?

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PICOT Format

1)
P-Population:
Patients aged 18-60 years-old, breast cancer who have not received chemotherapy in the past six months are subjected to the treatment. Patients with other serious health conditions such as heart diseases were excluded in the study. 30 patients, with 15patients stationed at the healthcare facility while the other 15 patients receiving home-based care, are expected to take part in the study.

2)  
I -Intervention:
The patients will receive dosage based on the age, sex and health general body health as well as the stage of cancer cells proliferation in the body. The patients are required take the prescribed drugs at regular intervals. The subjects will be subjected to treatment under the same during the research study.

3)    
C-Comparison:
All the subject regardless of variations in their level of dose requirement will be subjected to the same treatment for the same duration, 3months. Standardized treatment will be given to subjects with no extreme variations in their level of dose requirement and would be used as an active control group. Using this strategy, it will be possible to minimize the non-specific effects due to a group of the patient receiving treatment within the healthcare.

4
)   O-Outcome:
The response in chemotherapy treatments will be check by examining the numbers of defective cancerous cells in the body tissues. The patients will report to the theatre in order to be examined by an oncologist. The results will be recorded in terms of improved seen in each patient and in the two categories, that those that received home-based care as well as those who received chemotherapy treatment within the healthcare facility (Stevens, 2001).

5)  
T-Time:
The outcome would be measured after 2 weeks for 3months. The results will be recorded at an interval of two weeks from the onset of the study throughout the 3months

In evidenced-based clinical practice, it is imperative to standardize treatments in order to avoid skewing expected treatment outcomes. Teaching the subjects, the importance of chemotherapy treatment should be part and parcel of the planning process of the patient recruitment into the research study. More importantly, standardizing instruction to study subjects is also important in ensuring no additional interventions are inadvertently introduced during the study period. Additional intervention can be by way of extra pieces of advice to the study subjects (Stevens, 2001).

Evidence-based clinical practices, clinicians are encouraged to not only provide available cancer care choices but also undertake to provide information on quality care. In addressing challenges and complication associated with breast cancer, clinicians should provide timely, accurate information (Morley, 2009).

Keywords in Literature Review

The keywords to look for in literature review include; breast net weight, breast biopsies related history, hyperplasia prior to biopsy, radiation of the chest, breastfeeding, obesity, excessive use of alcohol, sedentary lifestyles, and chemotherapy as well as exogenous hormones. These items show the mode of progression of cancerous cells and influence the type of healthcare to be provided to patients in evidence-based clinical practices (Stevens, 2001).

 

Reference

Morley, P. T. (2009). Evidence evaluation worksheets: the systematic reviews for the evidence evaluation process for the 2010 International Consensus on Resuscitation Science.
Resuscitation, 80
(7), 719-721.

Riva, J. J., Malik, K. M., Burnie, S. J., Endicott, A. R., & Busse, J. W. (2012). What is your research question? An introduction to the PICOT format for clinicians.
The Journal of the Canadian Chiropractic Association, 56
(3), 167.

Stevens, K. R. (2001). Systematic reviews: The heart of evidence-based practice.
AACN Clinical Issues, 12
(4), 529–538.

Week 4:

Course Project: Part 2—Literature Review

Application: Using the Data/Information/Knowledge/Wisdom Continuum

 

Introduction

Nursing informatics is a field that integrates the nursing science with the process of managing data, collecting information, applying information as well as applying the knowledge to make decisions. The healthcare field requires the making of intelligent decisions that are founded on a proper analysis of data, information and knowing how best to apply this information to make the decisions. It is imperative to note that there are terabytes of soft copy data and information as well as tons of hard copy of the same and thus making the role of nursing informatics to narrow down to the most relevant information. Science cannot account and satisfy all the decisions that can be made by healthcare practitioners, some decisions require ethical, social and economic considerations. This is where nursing informatics chips in to provide relevant data, information, and knowledge that when used in the appropriate way can be embraced as wisdom (Makar, 2012).

Pediatric nursing is no exception in the above-discussed phenomena and this is why pediatrics have to be complemented by informatics techniques in their day to day encounters. Today the world is faced with a major dilemma regarding the use of vaccines. Is vaccination a solution to health hazards or does it expose children to more risks? The same research question has been elevated to include adults and it has been on the debate for so long since the olden days of vaccination. It all starts with the small pox vaccine that is faced with a lot of controversies when the diseased matter is introduced into a healthy body for the purposes of preparing the body by manipulating the immune system to get ready for a similar instance. Jenner’s methods to introduce cowpox infected fluid work pretty well in the process of conferring the immune system but his methods later set fear in the community (Maldonado, 2002).

The above-discussed research question spans across many nursing principles as the healthcare is ethically and professionally challenged to determine the safety and legitimacy of vaccines and inoculation programs. The Walden Library offers researchers and nursing practitioners with the resources and databases for the probing of the inoculation concern. The library has a number of databases some of which are business, computing and general knowledge oriented. It is imperative to choose a relevant database source as well that harbors most healthcare related articles as well as other research by scholar-practitioners too. After going through the databases, the Cochrane library database repository makes one of the finest databases relevant to the subject of concern. The search terms used include, “Does vaccine and inoculation programs prevent health hazards in children?” (“Databases by Name – Academic Guides at Walden University,” n.d.).

On the other hand, a similar search follows but with a converse statement to the prevention and protection against diseases. It follows in the structure, “Does vaccine and inoculation programs increase health risks in children?” The database throws up hundreds of articles, e-books and newspaper articles published by medical and critics revolving around the inoculation concern. A process to select the relevant articles is necessary thanks to the database search criteria that takes care of the necessity. There are a number of ways that one can narrow down his/her search to the most relevant and up to date articles that provide data and information about the research question. A good article is one which is peer reviewed and has references as well as having its full publication in the repository. Peer reviewed articles have already been compared to existing knowledge against a topic of concern and thus very vital when it comes identifying a relevant and satisfactory source (Gassert, 2000).

After finding the relevant articles from the repository, an informatics nursing practitioner needs to extract relevant information from the numerous sources selected. It is important to note that not every single word contributes to the main topic of study or rather the research question under consideration. Thus this makes it a necessity to employ keyword search criteria by the use of assistive software that can scan through electronic documents and highlight all the keywords or phrases of consideration. Information is obtained following a structure that guides a researcher in staying and keeping in the research goal and objective frame (Gassert, 2000).

More important after extracting relevant data and information is the process of structuring the information and process the data into information too. Information can be organized into cells that are object specific and data mining techniques are employed to identify patterns and trends that are unseen without organizing information. The process of data mining and data analytics is the process of gaining knowledge as the information is subjected to real life phenomena to give insights on what the healthcare field is missing. The information is synthesized to speak more about itself in relevance to the research question under consideration and this gives way for knowledge in the health care field (Makar, 2012).

Conclusion

It is worth noting that once knowledge is gained, another process of making rational and intelligent decisions commences and this is what concludes the process of nursing informatics. The application of knowledge to make calculated decisions that are in most cases right and effective is termed as wisdom. In this discussion, Wisdom can be gained from the process of informatics as contributed by the role of making effective decisions by application of knowledge gained. However, gaining wisdom takes time and experience as practitioners apply knowledge in diverse fields (Makar, 2012).

References

Databases by Name – Academic Guides at Walden University. (n.d.). Retrieved from
http://academicguides.waldenu.edu/az.php

Gassert, C. A. (2000). Academic Preparation in Nursing Informatics.
Health Informatics
, 15-32. doi:10.1007/978-1-4757-3252-8_2

Makar, E. V. (2012). The Alliance for Nursing Informatics Emerging Leaders Program.
CIN: Computers, Informatics, Nursing
,
30
(4), 179-182. doi:10.1097/nxn.0b013e318255c114

Maldonado, Y. A. (2002). Current Controversies in Vaccination.
JAMA
,
288
(24), 3155. doi:10.1001/jama.288.24.3155

Prymula, R. (2013). Controversies in Vaccination.
European Review
,
21
(S1), S56-S61. doi:10.1017/s1062798713000227

 

 

 

Course Project: Part 3—Translating Evidence Into Practice

 

Translating Evidence into Practice

The PICOT question arising from this research is: When do cancer patients on chemotherapy, receive better white blood cell count monitoring; with a follow-up at home or with follow-up at a health care facility during their treatment? Answering this question has a lot of significance in the nursing practice. First, chemotherapy is among the cancer treatments that cause damage to the white blood cells, the cells responsible for fighting infections in our bodies. As such, when chemotherapy damages some of the white blood cells, it leads to neutropenia, a condition that increases the risks of getting infected (“Blood Cell Counts | Breastcancer.org,” 2017). For people with any cancer, and who may be undergoing chemotherapy, such infections are very severe and usually require treatment with antibiotics. Hence, nurses need to closely monitor the white blood cells count in their patients for effective prediction of potential severe neutropenia, ahead of time. The PICOT question, therefore, regarding the best setting to follow-up white blood cells count, is important towards assisting patients with breast cancer (“Low White Blood Cell Count: A Side Effect of Treatment,” 2017).

In my literature review, I deduced that besides breast cancer is the main challenge in healthcare; there are inadequate treatments for patients suffering from this type of cancer. According to Polit, & Beck, (2017), people living with breast cancer experience the worst of health conditions, yet their number is increasing at an alarming rate. Among the most surprising factors attributed to breast cancer is that screening for the condition using the modern technology may lead to acquiring cancer itself. Hence, the number of patients with the breast cancer is expected to continue rising. Lifestyle changes are among the major attributes of the rise in breast cancer cases. For instance, as women seek leisure activities, the engage in alcohol consumption, which is a major contributor to breast cancer. As well, consumption of fast foods is attributed to excessive weight, another risk factor for breast cancer.

Hoffman et al., (2014), attributes hormone replacement therapy (HRT) as another risk factor for breast cancer. Recent research by Hoffman et al, (2014), has proven that the more a woman uses HRT, the more she is predisposed to breast cancer. As well, studies have found that women who give birth in their late ages of life are at higher risks of acquiring breast cancer as compared to their counterparts who sire children at early ages. Then research explains why women in developing countries tend to have higher risks of getting breast cancer as compared to those in developing countries.

Further, LoBiondo-Wood, & Haber, (2017) point out that the real causes of cancer have caused a lot of contradictions as well as inconsistencies. For instance, the real cause of breast cancer has not been identified, but there exist several predisposing factors that increase the risks of women acquiring breast cancer. Some scientists have attributed breast cancer to genetic inheritance, environmental pollution, infection, and oral contraceptives, but epidemiological research has disapproved all of these claims, showing that the causes of breast cancer are sporadic. However, although breast implants were dismissed as leading to the common type of breast cancer, they have been connected with increasing the risks of lymphoma, a rare form of breast cancer. LoBiondo-Wood, & Haber, (2017) profess that although dietary fats are not the only predisposing factors for breast cancer, they play a significant role towards the development of the condition.

This literature review reveals that treatment of breast cancer needs increased health strategies. On the other hand, health practitioners should come up with mechanisms that prevent breast cancer patients from getting exposed to radiation on a regular basis. In conclusion, the review is proof that there are no adequate measures put in place to prevent the prevalence of breast cancer. Hence such measures need to be formulated so that the increase in breast cancer cases can be halted.

The evidence-based nursing practice in this context involves standardization of treatments to avoid twisting the expected treatment outcomes. For example, Polit, & Beck, (2017), have associated screening as a predisposing factor for breast cancer due to exposure to radiation. Therefore, breast screening is not a standardized strategy for approaching breast cancer. Instead, nurses should result to chemotherapy, which should be done alongside regular monitoring of white blood cells count. If the evidence-based practice is not applied, the patient could experience additional complications such as increased risks of being infected. As well, other treatment strategies may worsen the situation by facilitating the spread of cancer cells, for instance, exposure to radiation.

More importantly, standardizing instruction to study subjects is critical as well in ensuring no additional interventions are inadvertently introduced during the study period. The strategy management skill that I would use is educating staff on skills and principles about breast cancer. The education program would be aimed at all my colleagues, including those in pre-service training as well as those in in-service training (Stevens, 2001).

Through the use of manuals as well as user-friendly guidelines, I would educate staff members on the newly acquired knowledge. The manuals would incorporate recent research-based data, which would foster the development of innovative practices. For the implementation of the evidence-based practice, I would use the current research-based data to come up with strategies for handling the involved problem. (McCormack et al., 2017) The evidence-based practice would assist towards better decision-making process as we decide on the best setting to carry out the monitoring process. Additional intervention can be by way of extra pieces of advice to the study subject (“Implementing the Evidence-Based Practice (EBP) Competencies in Healthcare: A Practical Guide for Improving Quality, Safety, and Outcomes,” 2017).

 

References

Blood Cell Counts | Breastcancer.org
. (2017). 
Breastcancer.org
. Retrieved 9 October 2017, from
http://www.breastcancer.org/symptoms/testing/types/blood_counts

Hoffman, A. J., Robinson, C. B., & Weisbrod, B. L. (2014). Putting evidence into practice: an update of evidence-based interventions for cancer-related fatigue during and following treatment. 
Clinical journal of oncology nursing
, 
18
(6), 38.

Implementing the Evidence-Based Practice (EBP) Competencies in Healthcare: A Practical Guide for Improving Quality, Safety, and Outcomes
. (2017). 
Nursingknowledge.org
. Retrieved 9 October 2017, from
https://www.nursingknowledge.org/implementing-the-evidence-based-practice-ebp-competencies-in-healthcare-a-practical-guide-for-improving-quality-safety-and-outcomes.html

LoBiondo-Wood, G., & Haber, J. (2017). 
Nursing Research-E-Book: Methods and Critical Appraisal for Evidence-Based Practice
. Elsevier Health Sciences.

Low White Blood Cell Count: A Side Effect of Treatment
. (2017). 
Breastcancer.org
. Retrieved 9 October 2017, from
http://www.breastcancer.org/treatment/side_effects/low_white_blood_cell

McCormack, L., Sheridan, S., Lewis, M., Boudewyns, V., Melvin, C., & Kistler, C. et al. (2017). 
Communication and Dissemination Strategies to Facilitate the Use of Health-Related Evidence
. 
Ncbi.nlm.nih.gov
. Retrieved 9 October 2017, from
https://www.ncbi.nlm.nih.gov/books/NBK179104/

Polit, D. F., & Beck, C. T. (2017). 
Nursing research: Generating and assessing evidence for nursing practice
 (10th ed.). Philadelphia, PA: Wolters Kluwer. Chapter 8, “Planning a Nursing Study”This chapter focuses on the necessary steps for planning a research study. It describes different research designs and their key features and discusses how to plan for data collection.

Stevens, K. R. (2001). Systematic reviews: The heart of evidence-based practice.
AACN Clinical Issues, 12
(4), 529–538.

Design an intervention plan to improve the quality of outcomes for an exercise education program. The following topics should be addressed: Intervention Plan Components; theoretical foundations; Stakeholders, Policy, and Regulations, Ethical and Legal Implications.

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