End of Life  

End-of-Life Care (including advanced directives, palliation) Topics to review: Article: Nurses roles and responsibilities Providing care and support at end of life. https://www.nursingworld.org/~4af078/globalassets/docs/ana/ethics /endoflife-positionstatement.pdf

 Choose 1 focal point from each subcategory of practice, education, research and administration and describe how the APRN can provide effective care in end of life management 

Using the American nurses association position statement, recommendations for improvement in end of life management focuses on practice, education, research and administration. Listed below are steps that nurses can take to overcome barriers in healthcare practice.

Practice

1. Strive to attain a standard of primary palliative care so that all health care providers have basic knowledge of palliative nursing to improve the care of patients and families.

2. All nurses will have basic skills in recognizing and managing symptoms, including pain, dyspnea, nausea, constipation, and others.

3. Nurses will be comfortable having discussions about death, and will collaborate with the care teams to ensure that patients and families have current and accurate information about the possibility or probability of a patient’s impending death.

4. Encourage patient and family participation in health care decision-making, including the use of advance directives in which both patient preferences and surrogates are identified.

Education

1. Those who practice in secondary or tertiary palliative care will have specialist education and certification.

2. Institutions and schools of nursing will integrate precepts of primary palliative care into curricula.

3. Basic and specialist End-of-Life Nursing Education Consortium (ELNEC) resources will be available.

4. Advocate for additional education in academic programs and work settings related to palliative care, including symptom management, supported decision-making, and end-of-life care, focusing on patients and families.

Research

1. Increase the integration of evidence-based care across the dimensions of end-of-life care.

2. Develop best practices for quality care across the dimensions of end-of-life care, including the physical, psychological, spiritual, and interpersonal.

3. Support the use of evidence-based and ethical care, and support decision-making for care at the end of life.

4. Develop best practices to measure the quality and effectiveness of the counseling and interdisciplinary care patients and families receive regarding end-of-life decision-making and treatments.

5. Support research that examines the relationship of patient and family satisfaction and their utilization of health care resources in end-of-life care choices.

Administration

1. Promote work environments in which the standards for excellent care extend through the patient’s death and into post-death care for families.

2. Encourage facilities and institutions to support the clinical competence and professional development that will help nurses provide excellent, dignified, and compassionate end-of-life care.

3. Work toward a standard of palliative care available to patients and families from the time of diagnosis of a serious illness or an injury.

4. Support the development and integration of palliative care services for all in- and outpatients and their families.

Thank you

As your EBP skills grow, you may be called upon to share your expertise with others. While EBP practice is often conducted with unique outcomes in mind, EBP practitioners who share their results can both add to the general body of knowledge and serve as an advocate for the application of EBP.

In this Discussion, you will explore strategies for disseminating EBP within your organization, community, or industry. 

To Prepare:

• Review the Resources and reflect on the various strategies presented throughout the course that may be helpful in disseminating effective and widely cited EBP.
  • This may include: unit-level or organizational-level presentations, poster presentations, and podium presentations at organizational, local, regional, state, and national levels, as well as publication in peer-reviewed journals.
• Reflect on which type of dissemination strategy you might use to communicate EBP.

By Day 3 of Week 9

Post at least two dissemination strategies you would be most inclined to use and explain why. Explain which dissemination strategies you would be least inclined to use and explain why. Identify at least two barriers you might encounter when using the dissemination strategies you are most inclined to use. Be specific and provide examples. Explain how you might overcome the barriers you identified.

By Day 6 of Week 9

Respond to at least two of your colleagues on two different days by offering additional ideas to overcome the barriers to strategies suggested by your colleagues and/or by offering additional ideas to facilitate dissemination.

Discussion reply one same requirements (Micheal)

 Given the ubiquitous nature of information available, due to research leading up to information overload following from advancement in technology and the urge to seek new applicable ways of approaching health care and patient safety based on evidence based practices, the need for information dissemination precedes its implementation. Following from the above excerpt, I will like to share on some of the means to information dissemination commonly used either on a professional scale or a semi formal setting.

     Depending on the type and nature of the information needed to be circulated, information dissemination can take the form of power point presentation, use of informative pamphlets, texting, emailing, use of poster boards and bill boards, use of television or radio announcements and the use of skype or other Internet based platforms like zoom for meetings. Based on the above listed information dissemination techniques, the strategy I would be most inclined to use will be the power point conference presentation style and the use of either skype or zoom for meetings or presentation. “Teams may also want to develop a key driver diagram to assist with initial planning by illustrating the pathway from development of the aim statement to achievement of the outcome.” (Melnyk, 2018, p303)

     My use of power point presentation centers on the need to have a captive audience, who understand the purpose and intent of our meeting and have the urge and desire for new information. “Using the standard templates and themes, you can create something visually appealing, even if you do not have much knowledge of basic graphic design principles.” (Retrieved, 2021). The use of power point presentation style not only presents with slides and picture with a presenter going over the information, this style presents with three variations to presenting the same information; the presenter speaks about the information, the power point slides back up what is been said and the pictures from the power point gives a pictorial perspective of the information disseminated this concept makes it a wining combination for attendees in the conference who learn new information using different dissemination styles. My use of zoom for meetings or presentation will center on the concept of convenience and the ease to reach across a wide global perimeter with the click of a button using an Internet based platform, its simplicity can be useful in moments where physically meeting will rob attendees of the time needed to travel, lodge and set up while the zoom meeting can be done at the comfort of our respective houses or offices without loosing the essence of the information communicated.

     From the aforementioned modes of information dissemination, the style I may not be inclined to use includes but is not limited to the following; emailing this is a form of communication that presents as informal and information tends to get mixed up in the junk mail or Spam folder, texting is another form of disseminating information but also comes across as informal even though it may be a quicker source to get once attention, it is definitely not a preferred platform for disseminating evidence based material.

     Based on my aforementioned intended method of information dissemination; power point presentation and the use of zoom for meetings and or presentations, some of the barriers I may encounter when using these platforms include the following; the problem of microphone not working or the presentation not downloading properly based on how it was formatted or its compatibility with the system, in the case of zoom, distraction could be a big factor since the meeting is done over the Internet at the comfort of each attendees environment, the lack of adequate streaming capacity due to Internet provider could also be a detrimental factor to consider. Some interventions that could help overcome the above mentioned barriers are; making sure the computer and microphone that is intended for use has been checked, tested and information intended for use has been uploaded and tested at least a day prior to the presentation to allow ample time for trouble shooting if the need arise. “In anticipation of the stakeholder kick-off meeting, Carlos and the team discuss the fundamentals of preparing for an important meeting, such as how to set up an agenda, draft key documents, and conduct the meeting. They begin to discuss a time and date for the meeting. Carlos suggests that Rebecca and Chen meet with their nurse manager to update her on the project’s progress and request her help in scheduling the meeting.” (Gallagher, et al., 2011). For the purpose of a hitch free meeting or dissemination over zoom, the organizers need to reach out at least two days prior to the meeting with a list of etiquette that attendees must adhere to alongside any recommendations for trouble shooting should attendees encounter platform emergencies.

                                                                                                              References

Gallagher-Ford, L., Fineout-Overholt, E., Melnyk, B. M., & Stillwell, S. B. (2011). Evidence-based practice, step by step: Implementing an evidence-based practice change. American Journal of Nursing, 111(3), 54–60. doi:10.1097/10.1097/01.NAJ.0000395243.14347.7e. Retrieved from https://journals.lww.com/ajnonline/Fulltext/2011/03000/Evidence_Based_Practice,_Step_by_Step_.31.aspx 

 Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.

Retrieved January 25, 2021, from https://www.sophia.org/tutorials/the-advantages-and-disadvantages-of-powerpoint

Discussion reply one same requirements (Deana)

Main Post

Even though there has been a huge movement in the use of evidence-based research, the research does not extend to clinical practices quickly. Research that would benefit patient outcomes may take years to implement into clinical practice (Melnyk, 2012). When it does penetrate clinical practices, there are several ways to disseminate the information. One way is the poster presentation. The presenter would stand next to the poster to allow for the audience to read it and would be available for any questions in regards to the evidence-based practice. The presenter would have handouts for the audience to take with them since the poster may not include all the information needed (Melnyk, 2018 p559). This is also a way for the presenter to support the evidence and show their excitement for the new practice being put in place.

Another way to disseminate the evidence-based information is through nurse team meetings. This one is facilitated at the hospital I work at. It is a way to reach different groups of people at once. This information is usually done during shift change. Once the information is presented by the charge nurse or nurse manager, there is a sign off sheet that you acknowledge and understand the change that is taking place. After a few weeks, the team leaders will come around and ask how the new practice is working and may even ask you to show them how you implemented the change.

There are also dissemination strategies that I would be least inclined to use and that would be through email. Emails can become overwhelming at work. The dissemination of the evidence-based information could be looked over or even deleted before even being read. Even though you can reach many people at once, this is not an effective way to promote evidence-based changes. Another dissemination strategy that I would not use is brochures. Brochures are just handouts without the proper support to answer questions. Many brochures would end up in bags or the garbage and then the information in the brochure would not be used to promote best practices for the patients.

When using the dissemination strategies, there may be barriers encountered. One of those barriers is the behavior of nurses who do not think there needs to be a change. For example, nurses who believe that the way things are done work just fine and do not want change. Another barrier is not enough education on EBP. Staff may not understand EBP or how to implement it. There are ways to overcome these barriers. One of the ways to break these barriers is through research and on the job learning. This should be the culture of the facility. Supporting this type of culture allows for nurses to use EBP and incorporate it into their daily practices as nurses. This becomes natural for them and patients benefit because they are receiving the best evidence-based practices (Mick,2017).

References

Melnyk, B. M. (2012). Achieving a high-reliability organization through implementation of the ARCC model for systemwide sustainability of evidence-based practice. Nursing Administration Quarterly, 36(2), 127–135. doi:10.1097/NAQ.0b013e318249fb6a

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.

Mick, J. (2017). Funneling evidence into practice. Nursing Management, 48(7), 27–34. https://doi-org.ezp.waldenulibrary.org/10.1097/01.NUMA.0000520719.70926.79

Students maintained and submitted weekly reflective narratives throughout the course to explore the personal knowledge and skills gained throughout this course. This assignment combines those entries into one course-long reflective journal that integrates leadership and inquiry into current practice as it applies to the Professional Capstone and Practicum course.

This final submission should also outline what students have discovered about their professional practice, personal strengths and weaknesses that surfaced during the process, additional resources and abilities that could be introduced to a given situation to influence optimal outcomes, and, finally, how the student met the competencies aligned to this course.

The final journal should address a variable combination of the following, while incorporating your specific clinical practice experiences:

1. New practice approaches
2. Interprofessional collaboration
3. Health care delivery and clinical systems
4. Ethical considerations in health care
5. Practices of culturally sensitive care
6. Ensuring the integrity of human dignity in the care of all patients
7. Population health concerns
8. The role of technology in improving health care outcomes
9. Health policy
10. Leadership and economic models
11. Health disparities

While APA style 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.

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. Refer to the LopesWrite Technical Support articles for assistance.

Benchmark Information

This benchmark assignment assesses the following programmatic competencies:

RN to BSN

2.3:     Understand and value the processes of critical thinking, ethical reasoning, and decision making.

4.1:     Utilize patient care technology and information management systems.

4.3:     Promote interprofessional collaborative communication with health care teams to provide safe and effective care.

5.3:     Provide culturally sensitive care.

5.4:     Preserve the integrity and human dignity in the care of all patients.

answer question #10  ——> Leadership and economic models

Infographics are visual representations of information. They can include numbers, text, images, or any combination of the three. Just as in traditional writing assignments, an infographic can take on any of the various rhetorical modes — informative, instructive, descriptive, persuasive, etc. Infographics provide quick way to convey a lot of information. For example, this infographic on Integrating Virtual Clinics conveys interesting data much more concisely than another paragraph inserted here could have:

Students will create an Infographic on the topic of Telehealth. Students should create an infographic that is easily understood by the lay public or general population. The infographic should provide information useful to communicating the “What, Why, When and How” of Telehealth. Students may choose to focus on one or more the following suggested topic areas, however, students may choose their own relevant telehealth topic areas of:

• Telehealth Versus Telemedicine
• Environments or Systems
• Population Health
• Health Promotion and Illness Prevention
• Integrative Health
• Technologies and Innovation
• Provider Access
• Patient Access
• Policy Implications
• Legal Implications
• Clinical Practice Issues
• Education/Training Needs
• Research Implications
• Quality of Care
• Outcome Management

Directions:

1. Students will select a platform (tool) for building their infographic. There are a number of great infographic platforms available online. Many are free, but most require that you do set up an account. Check out Infogr.am, Easelly, Piktochart, and Visme.
2. Create the Infographic using one of the above platforms.
3. Post completed infographic in PDF format to the D2L week four assignment link.