A 23-year-old male patient is admitted with a fracture of C6 and C7 that has resulted in quadriplegia. He was injured during a football game at the university where he is currently a senior. His career as a quarterback had been very promising. At the time of the injury, contract negotiations were in progress with a leading professional football team.

1. Use Roy’s criteria to identify focal and contextual stimuli for each of the four adaptive modes.

2. Consider what adaptations would be necessary in each of the following four adaptive modes: (1) physiological, (2) self-concept, (3) interdependence, and (4) role function.

3. Create a nursing intervention for each of the adaptive modes to promote adaptation.

Reply 1

In healthcare we are constantly searching for ways to find innovative ways with better quality of care for patients for improved outcomes. Research is gathering the evidence-based findings and formulating a plan of action based on fact. Research is developing a hypothesis and collection of data to support a study and able to be applied to general population. The research can be qualitative or quantitative. Qualitative and quantitative research is both ways research can be performed, but it is just two different types of information that is collected. Quantitative used with numbers and numeric variables while quantitative is used with non-numeric variables observation or open-ended questions.

“Quality improvement is a systematic and formal approach to collecting, analyzing, and disseminating data in order to improve services or products that a business renders.” (Helbig, 2018) With quality improvement the Plan-Do-Study-Act is a powerful tool used for quality improvement. QI benefits mainly the process. QI does not implement something new, but improves something already in place.

Difference- we can research ways to improve quality improvement but can not use quality improvement data for research. Another difference is with the quality improvement data is formulated and reported to improve care to patients based on current events while research is based on evidence of past events for new procedures. Another difference is while research requires consent Quality Improvement does not. QI usually occurs in the facility where the problem was found where the research is dependent on what your trying to find. So overall the main difference is based on intent.

In the unit I work there are quantitative data on if a HCG bath was done or soap and water. Which we then monthly gather the qualitative percent of HCG bath vrs soap and water and compare to the infection rate. From this evidence we have mandated that all baths be HCG unless contraindicated and if it is contraindicated the open ended why documented required.

Resources

Agency for Healthcare Research and Quality. (2013). Plan-do-study-act-(PDSA) cycle. Retrieved from https://innovations.ahrq.gov/qualitytools/plan-do-study-act-pdsa-cycle

Helbig, June. (2018) Statistical Analysis. https://lc.gcumedia.com/hlt362v/applied-statistics-for-health-care/v1.1/#/home

Reply 2

According to the National Institutes of Health, research is defined as A systematic, intensive study intended to increase knowledge or understanding of the subject studied, a systematic study specifically directed toward applying new knowledge to meet a recognized need, or a systematic application of knowledge to the production of useful materials, devices, and systems or methods, including design, development, and improvement of prototypes and new processes to meet specific requirements. A research study must be approved by an Institutional Review Board before starting to work on it. An IRB is a committee that applies research ethics to all studies to assure no harm is done to participants (Helbig,2018).

 According to Department of Health and Human services (2011) quality improvement is defined as “systematic and continuous actions that lead to measurable Improvement in health services and the health status of targeted patient groups”. QI project may not be the implementation of something new, but an improvement upon something already in place. Teamwork is essential to produce result of QI project. There is no risk or minimal risk in QI project and even sometimes the participants are unaware that they are being a part of QI project.

 At my workplace, we do quarterly meeting where we do discuss about the number of falls, skin tear, bruises, any kind of incident happened. We track how many incidents happen, time of day, date, age of patient involved, staff present, and other circumstances, which could help to prevent the incident in future. In quantitative research we track number of incidents happens. Qualitative research we track the circumstances related to incident. We take all possible measures like staff and resident teaching, keep call light within reach all the time, proper lighting. We ensure all necessary step are taken to prevent any incidents.

References:

Helbig, J. (2018). Statistical analysis: Applied statistics for health care. Retrieved from https://lc.gcumedia.com/hlt362v/applied-statistics-for-health-care/v1.1/#/chapter/4

 Gregory, K. (2015). Differentiating Between Research and Quality Improvement. Journal of Perinatal and Neonatal Nursing.Retrieved from https://www.nursingcenter.com/pdfjournal?AID=3099809&an=00005237-201504000-00005&Journal_ID=54008&Issue_ID=3099787