Instructions

Developing a Care Plan—Continued

In a Microsoft Word document of 4-5 pages formatted in APA style, you will submit your final comprehensive care plan for the aggregate based on the health risks faced by the aggregate, incorporating feedback from your instructor on your Week 5 paper and your continued work.

In your paper, address the following:

• Propose two (2) priority-nursing diagnoses based on the major health risks identified during the risk assessment for the aggregate .
  • Include strategies to address the nursing diagnoses and identified risks of aggregate.
  • Support your strategies with at least two journal articles.
• Develop a disaster management plan with the following components:
  • List of disasters that might affect your aggregate (take into consideration the geographical location of the aggregate, past history, etc.).
  • Strategies for handling at least two disasters from the list.
  • Recommendations for a disaster supplies kit.

On a separate references page, cite all sources using APA format. Please note that the title and reference pages should not be included in the total page count of your paper.

• Use this APA Citation Helper as a convenient reference for properly citing resources.
• This handout will provide you the details of formatting your essay using APA style.
• You may create your essay in this APA-formatted template.

 

• Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry.
• Develop a PICO(T) question to address the clinical issue of interest you identified in Module 2 for the Assignment. This PICOT question will remain the same for the entire course.
• Use the key words from the PICO(T) question you developed and search at least four different databases in the Walden Library. Identify at least four relevant systematic reviews or other filtered high-level evidence, which includes meta-analyses, critically-appraised topics (evidence syntheses), critically-appraised individual articles (article synopses). The evidence will not necessarily address all the elements of your PICO(T) question, so select the most important concepts to search and find the best evidence available.
• Reflect on the process of creating a PICO(T) question and searching for peer-reviewed research.

The Assignment (Evidence-Based Project)

Part 3: Advanced Levels of Clinical Inquiry and Systematic Reviews

Create a 6- to 7-slide PowerPoint presentation in which you do the following:

• Identify and briefly describe your chosen clinical issue of interest.
• Describe how you developed a PICO(T) question focused on your chosen clinical issue of interest.
• Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected.
• Provide APA citations of the four relevant peer-reviewed articles at the systematic-reviews level related to your research question. If there are no systematic review level articles or meta-analysis on your topic, then use the highest level of evidence peer reviewed article.
• Describe the levels of evidence in each of the four peer-reviewed articles you selected, including an explanation of the strengths of using systematic reviews for clinical research. Be specific and provide examples.

Job burnout is a state of physical or emotional exhaustion that also involves a sense of reduced accomplishment and loss of personal identity (Mayo Clinic Staff, 2018).  Nursing burnout/turnover is negatively impacting healthcare at a national level. With recent reports of pervasive “burnout” and depression among healthcare professionals and the pressure that many influential healthcare organizations exert on clinicians to deliver high-quality, safe care under increasingly heavy patient loads, the use and teaching of EBP may be key not only to providing outstanding care to patients and saving healthcare dollars, but also to reducing the escalating turnover rate in certain healthcare professions (Melnyk & Fineout-Overholt, 2018). This is devastating, yet important, due to the impact this has on patient care and safety.  This being said, my topic of nurse burnout/turnover formed into a PICO(T) question is:

P: Registered Nurse’s in the ED

I: Nurse burnout and turnover rate

C: Other areas of nursing

O: Patient safety and satisfaction

Question: Does Registered Nurse burnout/turnover in the ED impact patient safety and satisfaction?

Databases and Results

When searching for this topic the databases used were MEDLINE, PubMed, and EBSCO through the Walden Library.  The search terms used for MEDLINE and PubMed were nurse burnout narrowing the search to 5 years, humans, journal article, English, and full text.  That generated approximately 813 articles.  After incorporating the Boolean terms AND nurse turnover, it then narrowed the search articles to 402.  Through the Walden Library, the search terms nurse burnout in the ED were used, narrowing to peer-reviewed only and full text.  This generated 8 articles.  To improve these results strategies such as incorporating more Boolean terms, using more specific search terms, and trialing more databases could benefit in a more efficient and effective search.

Conclusion

Clinicians with burnout may have impaired attention, memory, and executive function that decrease their recall and attention to detail placing them and their patients at higher risk for errors and safety (Heath, 2018).  Happy and healthy employees promote happy and healthy patients.  This topic is in need of clinical inquiry at a national level, but also where this nurse is employed.  The turnover rate has been significantly increased where this nurse is employed, leading to short staffing, thus increased workload and unhappy patients.  This kind of work environment is unsafe and warrants change not only for the healthcare professionals sake, but more importantly the patients sake.

References

Heath, S. (2018, September 5). How does provider burnout impact patient care quality, care access? Retrieved from https://patientengagementhit.com/news/how-does-provider-burnout-impact-patient-care-quality-care-access

Mayo Clinic Staff. (2018, November 21). Know the signs of job burnout. Retrieved from https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/burnout/art-20046642

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

Edit question’s body

 Write a paper of 500-750 words (not including the title page and reference page) on your proposed problem description for your EBP project. The paper should address the following:

Describe the background of the problem. Tell the story of the issue and why it deserves attention.
Identify the stakeholders/change agents. Who, or what organizations, are concerned, may benefit from, or are affected by this proposal. List the interested parties, patients, students, agencies, Joint Commission, etc.
Use the feedback from the Topic 2 main forum post and refine your PICOT question. Make sure that the question fits with your graduate degree specialization.
State the purpose and project objectives in specific, realistic, and measurable terms. The objective should address what is to be gained. This is a restatement of the question, providing focus. Measurements need to be taken before and after the evidence-based practice is introduced to identify the expected changes.
5) Provide supportive rationale that the problem or issue is an important one for nursing to resolve using relevant professional literature sources.
Develop an initial reference list to assure that there is adequate literature to support your evidence-based practice project. Follow the “Steps to an Efficient Search to Answer a Clinical Question” box in chapter 3 of the textbook. Use “NUR-699 Search Method Example” to assist you.
7) The majority of references should be research articles. However, national sources such as Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), Department of Health and Human Resources (HHS), or the Agency for Healthcare Research and Quality (AHRQ) and others may be used when you are gathering statistics to provide the rationale for the problem.
Once you get into the literature, you may find there is very little research to support your topic and you will have to start all over again. Remember, in order for this to be an evidence-based project, you must have enough evidence to introduce this as a practice change. If you find that you do not have enough supporting evidence to change a practice, then further research would need to be conducted. 

-Each student shall submit in the appropriate assignment folder 2 short narratives, complete APA Style citations, references and links for 2 “authoritative external sources” (as defined in the guidelines). The sources are required to discuss criminal assault and battery in medical settings.

 Proper APA Style is required for in-text citations and references for each of the two sources. 2.4 A link is required for each source after the complete APA Style reference for each source. The link provided must lead to the full article referenced.

“External Authoritative Sources” for purposes of this course shall mean: books, peer reviewed journal articles, education and government sites as well as non-partisan national or international organizations (such as WHO, UNICEF, UNAIDS etc) provided, the foregoing source/material article selected has in text citations and references to support statements made therein. Under no circumstances are newspapers (e.g., the Wall Street Journal), blogs (regardless of source), editorials, panel discussions and “dot com” sites be used. The foregoing are not considered authoritative for this course.