Respond to this post with a positive response :

Ask a probing question, substantiated with additional background information, evidence or research.

Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional research.

Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

Use  references

                                                     Initial Post

                                                 Improving Quality

The IOM recommends that policy makers, health care leaders, clinicians, regulators, purchasers, and others are urged to adopt a shared vision for health care that focuses on closing the quality gap between what we know to be good health care and the health care that people actually receive. The report recommends a redesign of the American health care system by providing six “Aims for Improvement”:   Of the six aims, Drug diversion is best categorized by the “aims” is safety and is defined by avoiding injuries to patients from the care that is intended to help them. Drug diversion is defined by the use of prescription medications that are acquired or ingested illegally.  In recent years, the problem of opioid addiction has reached epidemic proportions and has been one of the largest contributors to the rise in diversion incidents.  Diversion involving healthcare providers can result in a various types of patient harm. Diversion poses substantial risk not only to the individual who is diverting the drugs but also to patients, co-workers, and employers. The president of Pharmaceutical Diversion Education estimates that there are approximately 37,000 incidents of drug diversion throughout the heath care system and can result in several types of patient harm including; substandard care due to having an impaired provider, tampering with medication administration – especially, those for pain, and increased risk of infection. The CDC, state, and local health departments have combined efforts to investigate the incidents of infection stemming from drug diversion activities that involved healthcare providers who tampered with injectable drugs.  The findings showed Nearly 30,000 patients were potentially exposed to bloodborne pathogens and were referred for testing. However, no data is available that precisely defines the extent of every type of drug diversion in the health care workplace. Patient safety and professional safety all demand effective, reliable safeguards to maintain the integrity of prescription drugs and controlled substances. Improvements are needed in drug monitoring systems. Greater awareness and specialized training in the area of addiction can help to ameliorate drug diversion. There are many actions health care providers can take to ensure the safety of drug administration. One strategy being developed by the pharmaceutical industry is to reformulate frequently abused drugs into abuse-deterrent preparations. Additionally, The National Pharmaceutical Drug Misuse Framework for Action established a plan aimed at improving the quality use of medicines and reduce the potential for misuse. A goal of the Foundation, is to provide a medication monitoring system for prescribers and pharmacists with real-time access to information on prescriptions for controlled substances.  As nurses, educators, managers and co-workers, we can be more vigilant in our efforts to prevent, detect, and report any suspected diversion. Several key areas such as improved systems for medication management, greater support for prescribers and pharmacists, education and improvement of health literacy, harm reduction and improved regulation are all a part of the solution.

Reference 

Australian Government National Drug Strategy. National Pharmaceutical Drug Misuse Framework for Action (2012-2015). Canberra: NDS; 2013. www.nationaldrugstrategy.gov.au/internet/drugstrategy/Publishing.nsf/content/drug-mu-frm-action [cited 2015 Sep 7]

 

CDC (2013). Risks of Healthcare-associated Infections from Drug Diversion. Retrieved from https://www.cdc.gov/injectionsafety/drugdiversion/index.html

Committee on Quality of Health Care in America, Institute of Medicine. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: National

Inciardi JA, Surratt HL, Kurtz SP, Burke JJ. The diversion of prescription drugs by health care workers in Cincinnati, Ohio. Subst Use Misuse 2006;41:255-64. [PubMed]

Knickman, J. R., & Kovner, A. R. (Eds.). (2015). Health care delivery in the united states (11th ed.). New York, NY: Springer Publishing.

 McGregor C, Gately N, Fleming J. Prescription drug use among detainees: Prevalence, sources and links to crime. Trends and issues in crime and criminal justice. No. 423. Canberra: Australian Institute of Criminology; 2011 Aug.

Pilgrim JL, Yafistham SP, Gaya S, Saar E, Drummer OH. An update on oxycodone: lessons for death investigators in Australia. Forensic Sci Med Pathol 2015;11:3-12. [PubMed]

 

                        Respond to this post with a positive response :

Ask a probing question, substantiated with additional background information, evidence or research.

Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional research.

Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

Use  references

                                                  Main Post 

Throughout my years as an ICU nurse, critical thinking has become a skill that I utilize on a daily basis in my clinical practice. Not only are critical thinking skills a part of my daily practice, but I also observe my colleagues putting their critical thinking skills to use in their every day clinical practice. One example of critical thinking skills being used in ICU clinical practice is when multiple drips are being titrated on a patient that is extremely ill. As an ICU nurse, it is essential and vital that you utilize critical thinking skills when choosing which drip to titrate up or down or which drip to start or stop. Another instance where I have observed critical thinking skills being used in the ICU is when I would attend a rapid response on one of the medical floors. As the critical care nurse, I must use my critical thinking skills to choose the right lab tests to run, determine what might be going on with the patient that is in distress, and choose the right treatment pathway.

 

I try to improve my clinical competence in every way I can, especially by employing my critical thinking strategies. Some of the strategies I use most often include listening, continuing to learn every chance I get, and explaining to my colleagues why I came to a specific conclusion. I use the strategy of listening to improve my clinical competence because it helps me find new solutions to everyday problems that I might face in the ICU. Learning helps improve my clinical competence because it makes me a better ICU nurse. The more I learn, the more proficient I can become. I like to explain my rationale for the conclusion I came to because another colleague might have something important to add that would aid in solving the problem at hand. 

 

Clinical scholarship is defined as an approach that enables evidence-based nursing and the development of best practices to meet the needs of clients efficiently and effectively (Stanley et al., 1999). 

Critical thinking is defined as the objective analysis and evaluation of an issue in order to form a judgment (Benner, Hughes, & Stuphen, 2008, p. [Page 120]). 

Clinical practice is defined as either the field of principal professional clinical activity (Wilkes, Mannix, & Jackson, 2013).

 

After reviewing the definitions of clinical scholarship, critical thinking, and clinical practice I was able to see how each term is interconnected. In order to have a clinical scholarship like approach in clinical practice, it is essential that critical thinking tools be utilized. The development of the best practices in clinical nursing practice will not occur if there is no critical thinking involved in the process (Wilkes, Mannix, & Jackson, 2013).

These three terms should be looked at as a single unit; one cannot exist without the other. 

 

 

 

Benner, P., Hughes, R. G., & Stuphen, M. (2008). Patient Safety and Quality: An 

 

               Evidence-Based Handbook for Nurses.Rockville, MD. 

 

Stanley, J., PhD, Keating, S. B., EdD, Edwardson, S., PhD, Easley, C. E., PhD, Alichnie, 

 

               C., PhD, & Edwards, J., PhD. (1999, March 15). Defining Scholarship for the 

               

               Discipline of Nursing. Retrieved December 31, 2018, from

 

               https://www.aacnnursing.org/News-Information/Position-Statements-White-

 

               Papers/Defining-Scholarship 

 

Wilkes, L., Mannix, J., & Jackson, D. (2013). Practicing nurses perspectives of clinical 

 

scholarship: a qualitative study. BMC nursing, 12(1), 21. doi:10.1186/1472-6955-

 

 

Review the evidence-based practice project ideas you described in Topic 5 DQ 1. Based on your initial ideas, what types of scholarly nursing research (such as quantitative or qualitative research, peer-reviewed resources, etc.) would be required to further investigate the issue? Identify the criteria you would use to evaluate the appropriateness of the research. Why is it important to select research that meets these criteria?  250 words

Describe and provide rationale for which design you plan to use in   your DPI project. Be sure to describe how your methodology is in line   with your project questions. 1 page, APA

 This project will use the quantitative methodology with a descriptive research design.

Topic:  Use of Advanced Practice Providers in triage in improving waiting times in Emergency departments? 

  

Holloway, I., & Galvin, K. (2016). Qualitative research in nursing and healthcare. John Wiley & Sons.