Identify a quality improvement opportunity in your organization or practice. In a 1,250-1,500 word paper, describe the problem or issue and propose a quality improvement initiative based on evidence-based practice. Apply “The Road to Evidence-Based Practice” process, illustrated in Chapter 4 of your textbook, to create your proposal.

Include the following:

1. Provide an overview of the problem and the setting in which the problem or issue occurs.
2. Explain why a quality improvement initiative is needed in this area and the expected outcome.
3. Discuss how the results of previous research demonstrate support for the quality improvement initiative and its projected outcomes. Include a minimum of three peer-reviewed sources published within the last 5 years, not included in the course materials or textbook, that establish evidence in support of the quality improvement proposed.
4. Discuss steps necessary to implement the quality improvement initiative. Provide evidence and rationale to support your answer.
5. Explain how the quality improvement initiative will be evaluated to determine whether there was improvement.
6. Support your explanation by identifying the variables, hypothesis test, and statistical test that you would need to prove that the quality improvement initiative succeeded.

Is there a difference between “common practice” and “best practice”?

When you first went to work for your current organization, experienced colleagues may have shared with you details about processes and procedures. Perhaps you even attended an orientation session to brief you on these matters. As a “rookie,” you likely kept the nature of your questions to those with answers that would best help you perform your new role.

Over time and with experience, perhaps you recognized aspects of these processes and procedures that you wanted to question further. This is the realm of clinical inquiry.

Clinical inquiry is the practice of asking questions about clinical practice. To continuously improve patient care, all nurses should consistently use clinical inquiry to question why they are doing something the way they are doing it. Do they know why it is done this way, or is it just because we have always done it this way? Is it a common practice or a best practice?

In this Assignment, you will identify clinical areas of interest and inquiry and practice searching for research in support of maintaining or changing these practices. You will also analyze this research to compare research methodologies employed.

To Prepare:

• Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry. Keep in mind that the clinical issue you identify for your research will stay the same for the entire course. 
• Based on the clinical issue of interest and using keywords related to the clinical issue of interest, search at least four different databases in the Walden Library to identify at least four relevant peer-reviewed articles related to your clinical issue of interest. You should not be using systematic reviews for this assignment, select original research articles.
• Review the results of your peer-reviewed research and reflect on the process of using an unfiltered database to search for peer-reviewed research.
• Reflect on the types of research methodologies contained in the four relevant peer-reviewed articles you selected.

Part 1: Identifying Research Methodologies

After reading each of the four peer-reviewed articles you selected, use the Matrix Worksheet template to analyze the methodologies applied in each of the four peer-reviewed articles. Your analysis should include the following:

• The full citation of each peer-reviewed article in APA format.
• A brief (1-paragraph) statement explaining why you chose this peer-reviewed article and/or how it relates to your clinical issue of interest, including a brief explanation of the ethics of research related to your clinical issue of interest.
• A brief (1-2 paragraph) description of the aims of the research of each peer-reviewed article.
• A brief (1-2 paragraph) description of the research methodology used. Be sure to identify if the methodology used was qualitative, quantitative, or a mixed-methods approach. Be specific.
• A brief (1- to 2-paragraph) description of the strengths of each of the research methodologies used, including reliability and validity of how the methodology was applied in each of the peer-reviewed articles you selected.

Submit your Evidence-Based Project.

Discussion #1:

Title: Community Health Assessment Process: Six Common Phases 

Link: https://www.youtube.com/watch?v=vKNHzb-ww-M&feature=youtu.be

 Video Details: Gayle Shirley, Communications and Systems Improvement Manager for Lewis and Clark Public Health, and St. Peter’s Hospital Director of Marketing and Public Relations Katy Peterson discuss the outcomes of the 2015 Community Health Needs Assessment.

Course required chapter readings for discussion #1:

• Chapter 7:  Process Theory for Program Implementation
• Chapter 8: Monitoring Implementation through Budgets and Information Systems

Directions: 

A) After reading Chapters 7 and 8, and watching the videos, answer the discussion board questions using ONE (1) of the presentation methods below:

• 2-3 pages essay summary (Response to all of the initial discussion board questions below)
• PowerPoint presentation or Prezi (10–15 slides). (Response to all of the initial discussion board questions below)
• Infographic: (Response to all of the initial discussion board questions below)
• Educational/training packet or guide: (Response to all of the initial discussion board questions below)
• Brochure: (Response to all of the initial discussion board questions below)
• 5–7 minute recorded PSA (public service announcement) (Response to all of the initial discussion board questions below)
• Create a thread and respond to all parts of the discussion board questions(s).

Discussion Board Questions:

Address ALL the following questions below:

For the first (1st) question below, please pick one of the following health issues identifies as salient in Bowe County’s most recent community health needs assessment: vaccination, adolescents’ pregnancy, gunshot wounds, or type 2 diabetes.

1.  (Refer to Chapter 7): Draft a logic model for the program (health needs assessment of choice): See example picture below.  

A logic model is a graphic depiction (road map) that presents the shared relationships among the resources, activities, outputs, and outcomes/impacts for your program. It depicts the relationship between your program’s activities and its intended effects, in an implicit ‘if-then’ relationship among the program elements — if I do this activity, then I expect this outcome. Among other things, a logic model helps clarify the boundary between ‘what’ the program is doing and ‘so what’—the changes that are intended to result from strong implementation of the “what.”

Logic Models often include 5 core components of the program action:

INPUTS: resources, contributions, investments that go into the program

OUTPUTS: activities, services, events, and products that reach people who participate or who are targeted

OUTCOMES: results or changes for individuals, groups, communities, organizations, communities, or systems

Assumptions: the beliefs we have about the program, the people involved, and the context and the way we think the program will work

External Factors: the environment in which the program exists includes a variety of external factors that interact with and influence the program’s action.

1. (Refer to Chapter 8): Imagine that your healthcare organization is starting a health program for chronic illness prevention (i.e., diabetes, obesity, asthma, etc.). You have been charged with leading a team to address the health information technology issues related to that program. What steps would you take? What would be your top three (3) concerns? 
2. Choose one article pertaining to your topic that you submitted for assignment #1 

Prepare an annotated bibliography of one source you will use in developing your proposed program. In this way, each of you will have a few key citations related to program planning that may be useful for future reference. You MUST one article about evidence-based successful programs that are as similar to the one you will design. No exceptions are allowed. 

REQUIRED COMPONENTS for Annotated Bibliography: Specifically prepare an annotated bibliography, which is a list of citations in appropriate APA format with 2-4 sentences that summarize the main idea(s) of the item and 1-2 sentences that relate the material to your topic. They must be articles from scholarly/peer-reviewed journals.

See example:

ANNOTATED BIBLIOGRAPHY 

AuBuchon, J. P. (2005). Meeting transfusion safety expectations. Annals of Internal Medicine, 143(7), 537-8. Retrieved from: Pro Quest (Links to an external site.)

This journal argues the steps needed to understand the risks associated with virologic transmission in our blood supply, and the importance of meeting blood transfusion safety for the public and the health care industry needs to constantly reexamine its procedures. AuBuchon (2005) makes a good case for those in the public health care services, to be aware of the impacts on transfusion recipients’ morbidity and mortality; and gives us examples in which we have to change the way we handle blood and blood products. With the appearance of West Nile virus in 2002, there has been a rapid adaptation of nucleic acid testing systems in order to maintain the safety of our blood, but at what cost, and how can we improve the quality when the donors’ health history statements have turned out to be unreliable. James P. AuBuchon MD is affiliated with Dartmouth-Hitchcock Medical Center, in Lebanon, NH.

4. A minimum of one reference is required to support your response to the discussion question. You may cite the course required textbook and or other sources from which you have used content. Make sure your references are in APA format.

 

Cover Letter

A significant part of a registered nurse’s job involves communicating with patients and providing emotional support. A successful cover letter should emphasize examples of your bedside manner and empathy as well as your emotional stability and composure in difficult situations.

 Follow these steps to create your customized entry-level, registered nurse cover letter:

You are applying for a job at Kindred Hospital in South Florida. Research the unique needs, characteristics, and culture of the hospital. 
1. Specify how you’re a good fit for the position. (10 points)
2. Highlight your specialties and skills which set you apart from other nurses, paying particular attention to those that required additional training. (10 points)
3. Don’t neglect soft skills that are highly relevant to a position as a registered nurse, such as problem solving, teamwork, communication, and leadership. (5 points)
4. Carefully proofread your cover letter before submitting to make sure all contact information is correct and that there are no misspellings.(5 points)