Literature Review 2025

Literature Review The foundation of the study should suggest some theoretical framework to be explained further in this chapter. The literature review thus describes and analyzes previous research on the topic or a gap in information that your project may fill. This chapter, however, should not merely string together what other researchers have found. Rather, you should discuss and analyze the body of knowledge with the ultimate goal of determining what is known and is not known about the topic. ( The aim of the project is to reduce the patient’s fall rate in the skilled nursing unit at an acute care facility through improving the fall precaution process. The unit consists of 48 bed with a population of stroke, medical, and surgical patients.) This section should contain a discussion of OTHER PEOPLE’s research. This is not the section to include information about your project. Do not include your own opinions or findings from your data. Begin by describing which databases you searched, search terms you used, how you narrowed your search, how you selected those references you will discuss in this section. The Literature Review is what others have written that provide a foundation to the content of your quality improvement activity, an underpinning theory, framework and support for the method you chose for delivery–does that help to expand it? A well-written Literature Review section demonstrates to the reader that you are expert in the problem you examined current, best practice to inform your project. The Literature Review should begin with a paragraph that describes which databases you searched, which search terms you used, which strategies you used, and what you yielded. This shows the extent of your search. Then you describe how you focus on about 35 of the retrieved references and briefly summarize how their content forms the foundation for your project. This section should be about 10 pages and content should be separated with APA first and second level headings. How to perform a Boolean Search Boolean logic is used to search methodically for information about your topic. Boolean operators (named after a mathematician Boole) are simple words (AND, NOT, OR, and AND NOT) that are used as conjunctions to either combine or exclude keywords in a search, which focus results and make them more productive. This will save the writer wasted effort and lost time by focusing on articles that are pertinent to what is being researched. Although search engines and database collections might use them differently, there are certain basic operations that are used in retrieval logic. Proximity Operators (with, near and others) can also help you in searching. AND—requires both terms to be in each item returned. (Narrows the search) OR—either term (or both) will be in the returned document. (Broadens the search) NOT or AND NOT (dependent upon the coding of the database’s search engine)—the first term is searched, then any records containing the term after the operators are subtracted from the results. (Using Parentheses—Using the ( ) to enclose search strategies will customize your results to more accurately reflect your topic. Search engines deal with search statements within the parentheses first, then apply any statements that are not enclosed. Select keywords from your search that are specific to topic and content, as you will use these words under your abstract.

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QI Essay Bloodstream Infection Elimination Or Reduction 2025

Quality Improvement Paper Overview: You will select an opportunity for improvement from within your healthcare organization. To do so, you must have data that supports performance that is not in line with organizational/national benchmark data (ex. Falls, Patient Satisfaction, Infection rates, ED through-put, lengths of stay, etc). You will discuss your idea with someone from the organization to determine priority projects. You will write a Quality Improvement Paper that will be approximately 20 pages, in APA format (double spaced, 12 point font), excluding title, abstract and reference pages. This project will be guided by the FOCUS-PDSA quality improvement framework. To assist you with this process, each week, we will discuss a component of the model and have corresponding assignments that will help you shape your project. MANDATORY PROJECT COMPONENTS The following are requisites for this project: 1. Title Page 2. Abstract 3. Introduction (approx. 1-2 pages), to include: a. Thesis or problem statement b. Background c. Data that is specific to your unit/organization that serves as the basis for a QI initiative. (May include graphs and charts as appendices, if allowed by the organization) 4. Literature Review (approx. 2-3 pages) (This should be set up as if you were submitting a paper for publication. Do an overview of your findings) 5. Definition of Terms (if applicable and necessary for the reader’s understanding of your work) 6. Body – approx.12-15 pages (not including the title page, abstract and references.) a. Evidence-based intervention that is being implemented b. Plan for implementation, including the who, what, when, where and why c. Ethical considerations d. Required resources e. Leadership theory to help guide implementation and sustain it f. Change theory that will facilitate implementation g. Evaluation procedures h. Alternative processes, plan for sustainability i. How will this improve outcomes? Are there any next steps? 7. Conclusion (approx. 0.5-1 page) a. Summary (of what you did and found) b. Discussion (explanation of findings) 8. References – a minimum of ten recent, peer-reviewed sources. Remember, each reference must be cited as an “in-text citation” (within the body of the paper/project).

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9 2025

You will collaborate with two of your classmates to share ideas and offer feedback and suggestions to one another in an informal setting. This collaboration within your group will assist you in further developing your Change Proposal to be submitted for feedback from your instructor next week. Peers submission attached below.. please provide feedback and suggestions individually!! Peer 1: Victoria Lyons posted IV. Implementation Plan Assess the factors that are likely to affect the implementation of your recommended activities Many stroke patients require rehabilitation after their hospitalization and many patients get readmitted from post-acute care facilities, educating these facilities could decrease the readmission rate however rehabilitation facilities are often short-staffed and may not have money for education amongst the staff Identify evidence-based rationales to propose how you will address them, incorporating your identified change theory. Your plan should encompass the following with evidence to support your rationale: Technological challenges Stroke patients require adequate follow-up care with their health provider team, tele-health is a great way to provide these follow-up appointments however stroke patients may not be able to navigate computers to be able to do these appointments as they frequently have deficits. Stroke health care providers would have to learn how to use tele-health and there may be push back to using it due to health care providers typically using hands on assessment skills, they may not find assessing patients this way adequate. Finding a group of health care providers that are willing to start treating patients this way is the first step. Institutional structures Changes in hospitals do not happen overnight. At my state run hospital it seems to take forever to get any changes made. Implementing education regarding how to reduce stroke readmissions would require research and then approval from many different committees to even be approved for implementation. Once approved then it has to be sent all to all hospital staff involved. Examples of committees that a hospital will have and that any changes would have to go through are finance, safety and quality, strategic planning, and audit and compliance committee (Price, 2018). Strategies for building buy-in-among different stakeholders, including nursing Doctors, nurse practitioners, physician assistants, physical therapists, social workers, and case managers will need to be on board with the change process. Historically nurses have a hard time with change. Financial trends and anticipation of the availability of human resource and project funding Implementing tele-health and training to decrease stroke readmission, mostly education and new ways to check that everything a patient needs, will cost money which the institution will have to be prepared to put into their budget. Institutions get penalized financially for readmissions so increasing efforts to decrease these would be a financial benefit (Kripalani, Theobald, Anctil, & Vasilevskis, 2015). Hospital or governmental policy constraints It may be tricky for patients that have strokes that are on Medicaid or Medicare and working around their insurance policies. Within hospitals it takes time to get a policy set into place. Regulatory requirements Some regulatory acts that would have to be taken into consideration would be The Health Information Technology for Economic and Clinical Health Act (HITECH) (Maryville University, 2020) and the Medicare Access and CHIP Reauthorization Act of 2015 (Maryville University, 2020). The MARCA works with a payment model for quality of care, reducing readmissions would help with reimbursements (Maryville University, 2020). Patient diversity Educating patients on ways to decrease their admission will have many different considerations. Reading levels, language spoken, family support, use of technology, what disability they have after their stroke. Understanding why groups of people tend to get readmitted over others is an important way to decrease admissions. Individuals less than 80 years of age had a less chance of being readmitted over individuals over 80, this was related to statin use (Poston, 2018). References Kripalani, S., Theobald, C., Anctil, B., & Vasilevskis, E. (2015). Reducing Hospital Readmission: Current Strategies and Future Directions. Annu Rev Med, 1-18. Maryville University. (2020). 5 Important Regulations In United States Healthcare. Retrieved from Maryville University: https://online.maryville.edu/blog/5-important-regulations-in-united-states-healthcare/ Poston, K. (2018). Reducing readmissions in stroke patients. American Nurse Today, 9-15. Price, N. (2018, August 24). Board Structure of a Healthcare Institution. Retrieved from Board Effect: https://www.boardeffect.com/blog/board-structure-healthcare-institution/ Peer 2: Zachary Erickson posted Victoria and Lisa, My apologies for late submission this week. I know it doesn’t leave you much time for feedback and I will try to be more prompt in the future. My implementation plan is coming together but I look forward to your thoughts on what to add and what to clarify. Let me know what you think. -Zak Change Proposal: Work-Related Bullying Implementation Plan Utilizing Lippitt’s Phases of Change, (Mitchell, 2013) Raising Awareness of The Need for Change Create buy-in for the change process by appealing to direct and indirect victims of WRB. Build enthusiasm by drawing attention to commonalities and shared experiences. Multimedia approach incorporating; Visual printed media to spark collaboration and create a dialogue Initial email surveys to gain baseline data and identify areas of greatest need Opening anonymous reporting channels to increase communication and involvement Overcome technological hurdles is essential during this phase. Identifying and utilizing existing resources within the organization starts by reaching out to internal research, quality management, and information technology departments to secure support and time commitments for the development of infrastructure changes that facilitate reporting and data collection. This ties into the next phase of change. Building a Relationship with The System Presentation of a completed Change Proposal to nursing leadership and members of administration. Clearly stating the evidence-supported physical, psychological, and financial costs to patients, staff members, and the organization at large Accurately estimating the time and resource commitment necessary for program development and ongoing success Building buy-in on an administrative level Reaching out to unit managers to identify their perception of WRB and its prevalence on their individual work environments Involvement of employee health/occupational medicine staff as partners in the reduction of workplace stressors through larger behavioral changes. Further promotion of the WRB reduction initiative among staff members and identification of staff champions passionate about these changes. Defining the Problem What does WRB look like? Where is WRB occurring in this work environment? What is the direct impact to staff members? How does WRB impact our patients? What are the long-term ramifications of allowing WRB to go unaddressed? Are there policies in place that address WRB? If so, do they need to be modified? Setting Goals and Action Planning Time sensitive goals create milestones and improve evaluation of program success. Program phases will be rolled out quarterly, with the relationship building and collaborative planning happening in the first quarter after program approval, followed by the initial campaign to raise awareness in the second quarter, and full program implementation on select units slotted for six months after approval. Evaluation of successful change will occur quarterly thereafter to measure program effectiveness, make changes, and incorporate new work areas. Action planning should be interdisciplinary and tailored to the needs of individual work environments. Buy-in and early adoption of the program is essential to the success of this phase. Implementation The operational model will be relationship-based and involve several components Psychodynamic education based on cognitive behavioral models Cognitive rehearsal training, i.e. role-play, universal anti-bullying phrases, resilience training Policy enforcement training: building awareness and support for new or changed policies Coaching: using the established reporting system to identify WRB trends and address areas of highest incidence  (Balevre, Balevre & Chesire, 2018) Weekly program updates with core program supporters and monthly meetings with staff champions will identify areas of success and areas in need of reevaluation. Stabilization/Acceptance Change program success depends on acceptance and sustainability This means consistent administrative support through the enforcement of zero-tolerance policies that directly address WRB events in a timely and supportive fashion. Ongoing evaluation of staff awareness and involvement in initiative. Monthly review of staff feedback and yearly retraining as part of core safety measures. Maintaining program flexibility and changing delivery of training and monitoring strategies to best suit each work environment. Redefine the Role of the Change Agent Once the change process is initiated, the change agent works to keep others on track with program support and involvement. Coordinate the feedback review efforts and continue to recruit interested staff members to act as program champions. Liaise with administration members and continue to “bridge the gap” between program results and the impact on staff and patients. Share program successes both within the organization and with the community. References Balevre, S., Balevre, P., & Chesire, D. (2018). Nursing professional development anti-bullying project. Journal for Nurses in Professional Development, 34(5), 277-282. doi: 10.1097/nnd.0000000000000470 Mitchell, G. (2013). Selecting the best theory to implement planned change. Nursing Management, 20(1), 32-37. doi: 10.7748/nm2013.04.20.1.32.e1013

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Family Health Assessment Part I 2025

Understanding family structure and style is essential to patient and family care. Conducting a family interview and needs assessment gathers information to identify strengths, as well as potential barriers to health. This information ultimately helps develop family-centered strategies for support and guidance. This family health assessment is a two-part assignment. The information you gather in this initial assignment will be utilized for the second assignment in Topic 3. Develop an interview questionnaire to be used in a family-focused functional assessment. The questionnaire must include three open-ended, family-focused questions to assess functional health patterns for each of the following: Values/Health Perception Nutrition Sleep/Rest Elimination Activity/Exercise Cognitive Sensory-Perception Self-Perception Role Relationship Sexuality Coping Select a family, other than your own, and seek permission from the family to conduct an interview. Utilize the interview questions complied in your interview questionnaire to conduct a family-focused functional assessment. Document the responses as you conduct the interview. Upon completion of the interview, write a 750-1,000-word paper. Analyze your assessment findings. Submit your questionnaire as an appendix with your assignment. Include the following in your paper: Describe the family structure. Include individuals and any relevant attributes defining the family composition, race/ethnicity, social class, spirituality, and environment. Summarize the overall health behaviors of the family. Describe the current health of the family. Based on your findings, describe at least two of the functional health pattern strengths noted in the findings. Discuss three areas in which health problems or barriers to health were identified. Describe how family systems theory can be applied to solicit changes in family members that, in turn, initiate positive changes to the overall family functions over time. Cite at least three peer-reviewed or scholarly sources to complete this assignment. Sources should be published within the last 5 years and appropriate for the assignment criteria. Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.

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