Complete a 250-350-word reflection of what you have learned during this topic. Include the following in your reflection:

1. Think about an experience you’ve encountered when viewing or completing the particular assessment.
2. Discuss difficulties that could potentially arise or specific questions related to completing this type of assessment.
3. Include illustrative examples of potential strategies used to overcome the difficulties encountered when completing (the particular) assessment.
4. Describe how the Christian worldview and compassion for all plays a role in this type of assessment.

 Solid academic writing is expected.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

CASE STUDY

You are caring for an 82-year-old woman who has been hospitalized for several weeks for burns that she sustained on her lower legs during a cooking accident. Before the time of her admission, she lived alone in a small apartment. The patient reported on admission that she has no surviving family. Her support system appears to be other elders who live in her neighborhood. Because of transportation difficulties, most of them are unable to visit frequently. One of her neighbors has reported that she is caring for the patient’s dog, a Yorkshire terrier. As you care for this woman, she begs you to let her friend bring her dog to the hospital. She says that none of the other nurses have listened to her about such a visit. As she asks you about this, she begins to cry and tells you that they have never been separated. You recall that the staff discussed their concern about this woman’s well-being during report that morning. They said that she has been eating very little and seems to be depressed.

1. Based on Nightingale’s work, identify specific interventions that you would provide in caring for this patient.

2. Describe what action, if any, you would take regarding the patient’s request to see her dog. Discuss the theoretical basis of your decision and action based on your understanding of Nightingale’s work.

3. Describe and discuss what nursing diagnoses you would make and what interventions you would initiate to address the patient’s nutritional status and emotional well-being.

4. As the patient’s primary nurse, identify and discuss the planning you would undertake regarding her discharge from the hospital. Identify members of the discharge team and their roles in this process. Describe how you would advocate for the patient based on Nightingale’s observations and descriptions of the role of the nurse.

 

Prior to beginning work on this assignment review Chapters 21, 24, 25 and 27 of Health Informatics: An Interprofessional Approach.

Select two of the case studies located in the course textbook at the end of Chapters 21, 24, 25, or 27, and answer the questions associated with those case studies in a cohesive, APA-formatted paper.

Chapter 21:

• Recommend where would you start to improve the user experience.
• Pharmacists are asking for your help due to struggles with non-integrated systems. What methods would you use to examine this issue?
• Describe how usability should be incorporated as part of the purchasing process for this institution.

Chapter 24:

• Assuming that you are the clinical content manager leading reporting efforts, recommend the approach you would take to address the reporting problem.
• Describe how the effort of changing preadmission testing data collection from paper to the Electronic Health Record System (EHR) can be approached.
• Using Patient Safety and Quality Research Design (PSQRD) methodology, identifying area of quality improvement in the hospital setting, recommend a process plan and identify the expected outcomes.

Chapter 25:

• Discuss whether the proposed course of action would be permissible under current fraud and abuse regulations.
• Explain common issues related to the use of EHR and healthcare fraud.
• Discuss how the proposed EHR could potentially facilitate healthcare fraud.

Chapter 27:

• Describe the timeline of the program and its potential financial impact on the individual healthcare providers who are involved in meaningful use.
• Explain the process that providers must complete to avoid payment penalties.
• Explain the timeframe for the provider to achieve modified stage two and stage three measures.

The Week 4 Case Studies Papers

• Must be three to four double-spaced pages in length (not including title and references pages) and formatted according to APA style as outlined in the Ashford Writing Center (Links to an external site.)’s APA Style (Links to an external site.) resource for each case study.
• Must include a separate title page for each case study with the following:
  • Title of paper including the chapter number and case study title
  • Student’s name
  • Course name and number
  • Instructor’s name
  • Date submitted

For further assistance with the formatting and the title page, refer to APA Formatting for Word 2013 (Links to an external site.).

• Must utilize academic voice. See the Academic Voice (Links to an external site.) resource for additional guidance.
• Must include an introduction and conclusion paragraph. Your introduction paragraph needs to end with a clear thesis statement that indicates the purpose of your paper.

For assistance on writing Introductions & Conclusions (Links to an external site.) as well as Writing a Thesis Statement (Links to an external site.), refer to the Ashford Writing Center resources.

• Must use at least two scholarly or credible sources in addition to the course text.
  • The Scholarly, Peer-Reviewed, and Other Credible Sources (Links to an external site.) table offers additional guidance on appropriate source types. If you have questions about whether a specific source is appropriate for this assignment, please contact your instructor. Your instructor has the final say about the appropriateness of a specific source for a particular assignment.
  • To assist you in completing the research required for this assignment, view this Ashford University Library Quick ‘n’ Dirty (Links to an external site.) tutorial, which introduces the Ashford University Library and the research process, and provides some library search tips.
• Must document any information used from sources in APA style as outlined in the Ashford Writing Center’s Citing Within Your Paper (Links to an external site.)
• Must include a separate reference page that is formatted according to APA style as outlined in the Ashford Writing Center. See the Formatting Your References List (Links to an external site.) resource in the Ashford Writing Center for specifications.

Carefully review the Grading Rubric (Links to an external site.) for the criteria that will be used to evaluate your assignment.

Assignment: Evidence-Based Project, Part 4: Critical Appraisal of Research

Realtors rely on detailed property appraisals—conducted using appraisal tools—to assign market values to houses and other properties. These values are then presented to buyers and sellers to set prices and initiate offers.

Research appraisal is not that different. The critical appraisal process utilizes formal appraisal tools to assess the results of research to determine value to the context at hand. Evidence-based practitioners often present these findings to make the case for specific courses of action.

In this Assignment, you will use an appraisal tool to conduct a critical appraisal of published research. You will then present the results of your efforts.

To Prepare:

• Reflect on the four peer-reviewed articles you selected in Module 2 and the four systematic reviews (or other filtered high- level evidence) you selected in Module 3.
• Reflect on the four peer-reviewed articles you selected in Module 2 and analyzed in Module 3.
• Review and download the Critical Appraisal Tool Worksheet Template provided in the Resources.

The Assignment (Evidence-Based Project)

Part 4A: Critical Appraisal of Research

Conduct a critical appraisal of the four peer-reviewed articles you selected by completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template. Choose a total of four peer- reviewed articles that you selected related to your clinical topic of interest in Module 2 and Module 3.

Note: You can choose any combination of articles from Modules 2 and 3 for your Critical Appraisal. For example, you may choose two unfiltered research articles from Module 2 and two filtered research articles (systematic reviews) from Module 3 or one article from Module 2 and three articles from Module 3. You can choose any combination of articles from the prior Module Assignments as long as both modules and types of studies are represented.

Part 4B: Critical Appraisal of Research

Based on your appraisal, in a 1-2-page critical appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with APA citations of the research.

By Day 7 of Week 7

Submit Part 4A and 4B of your Evidence-Based Project.

Learning Resources

Note: To access this module’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.
Chapter 5, “Critically Appraising Quantitative Evidence for Clinical Decision Making” (pp. 124–188)
Chapter 6, “Critically Appraising Qualitative Evidence for Clinical Decision Making” (pp. 189–218)

Fineout-Overholt, E., Melnyk, B. M., Stillwell, S. B., & Williamson, K. M. (2010a). Evidence-based practice step by step: Critical appraisal of the evidence: Part I. American Journal of Nursing, 110(7), 47–52. doi:10.1097/01.NAJ.0000383935.22721.9c
Note: You will access this article from the Walden Library databases.

Fineout-Overholt, E., Melnyk, B. M., Stillwell, S. B., & Williamson, K. M. (2010b). Evidence-based practice, step by step: Critical appraisal of the evidence: Part II: Digging deeper—examining the “keeper” studies. American Journal of Nursing, 110(9), 41–48. doi:10.1097/01.NAJ.0000388264.49427.f9
Note: You will access this article from the Walden Library databases.

Fineout-Overholt, E., Melnyk, B. M., Stillwell, S. B., & Williamson, K. M. (2010c). Evidence-based practice, step by step: Critical appraisal of the evidence: Part III: The process of synthesis: Seeing similarities and differences across the body of evidence. American Journal of Nursing, 110(11), 43–51. doi: 10.1097/01.NAJ.0000390523.99066.b5
Note: You will access this article from the Walden Library databases.

Williamson, K. M. (2009). Evidence-based practice: Critical appraisal of qualitative evidence. Journal of the American Psychiatric Nurses Association, 15(3), 202–207. doi:10.1177/1078390309338733
Note: You will access this article from the Walden Library databases.

Document: Critical Appraisal Tool Worksheet Template (Word document)

Required Media

Laureate Education (Producer). (2018). Appraising the Research [Video file]. Baltimore, MD: Author.
Accessible player –Downloads–Download Video w/CCDownload AudioDownload Transcript

Laureate Education (Producer). (2018). Interpreting Statistics [Video file]. Baltimore, MD: Author.
Accessible player –Downloads–Download Video w/CCDownload AudioDownload Transcript

Laureate Education (Producer). (2018). Review of research: Hierarchy of evidence pyramid [Mutlimedia file]. Baltimore, MD: Author.

Schulich Library McGill. (2017, June 6). Types of reviews [Video file]. Retrieved from https://youtu.be/5Rv9z7Mp4kg

  

Case Study, Learning Unit 4: Quality Improvement

The nursing director has asked you to form a team for quality control that addresses the issue of extended stay of patients who have been noncompliant with their diabetic protocol. These patients are staying an extra 72 hours in the acute care facility and usually have repeated admissions.

Related question #1

Based on what you know about the need for continuous quality control, who would you select to be part of this team?

Related question #2

What data should you ask your team to collect?

Related question #3

What could your team member produce that would assist in assessing the situation? 

  

Unfolding Case Study, Learning Unit 4: Quality Improvement

(Based on case in Module 4.1)

Part I

Sylvia has recently received complaints from her nursing staff that cancer patients are waiting up to 2 hours to begin their chemotherapy IV regime. Some of the oncologists often leave out important details when ordering the chemotherapy agents, and therefore, the pharmacy must contact the oncologists to get further instructions. If the order is incomplete, oftentimes it is not brought to the nurses’ attention until the patient has been waiting. At times, the oncologist cannot be contacted or located, which is adding to the frustration of the staff and patients.

Related question #1

What can Sylvia do to improve this process?

Part II

Sylvia asks the pharmacy and oncologist to appoint a team member that would serve on the task force to develop a process that would decrease the delay in chemotherapy treatments. The team meets and creates a sample checklist. The checklist is approved by all team members, and Sylvia decides it is time to incorporate the checklist in the process.

Related question #2

What steps should Sylvia take to assess the effectiveness of the new protocol?

Part III

Sylvia writes a report summarizing her findings of the audit she conducted on patient satisfaction, waiting time, and time of filling orders to time of administration of the chemotherapy.

Related question #3

According to quality improvement guidelines, what is the logical next step for Sylvia?