Nursing Discussion Questions

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Nursing Discussion Questions

Financial, Quality, and, Clinical Aspects to Consider While Developing IBP

             Evidence based health practices help handle different conditions such as falls. The practices entail problem solving approaches that incorporate careful use of recent and quality data in making decisions regarding the care of patients (Vaidya et al., 2017). Evidence based practice is a method comprising of many stages that require huge finances and checks in order to be executed appropriately. A financial manager prepares a comprehensive budget on how the approach can be implemented. Melnyk, Fineout‐Overholt, Giggleman and Choy (2017) suggested that everything must be planned in line with the budget and that every step is carefully undertaken to ensure that the practice works well.

            A key financial aspect that must be considered while developing an evidence based practice for fall prevention in older adults is whether the evidence based solution would assist reduce the costs of healthcare services for older adults. Vaidya et al. (2017) noted that providing affordable but quality healthcare services to older adults is a key objective of nursing practice in the current era. The evidence based practice project discussed herein is expected to lower healthcare costs by lowering fall rates among older adults and reducing treatment costs linked with caring for them and buying drugs.

            Regarding quality consideration, the intervention must help promote the expected patient health outcomes that encompass minimizing mortality rates, improving the quality of life for patients, and lowering fall rates in older adults among other indicators. In light of the EBP project, the evidence based practice intervention would improve the quality of care by minimizing the detrimental impacts of nurse shortage linked to caring for aged adults. Moreover, it would improve patient satisfaction.

             One clinical aspect that must be taken into account while developing evidence based project for fall prevention is the availability of healthcare staffs with required knowledge and expertise to expedite the adoption of the evidence based solution within the inpatient setting. To address fall rates among older adults, the shortage of qualified nurses and other healthcare practitioners within the healthcare system who can care for older adults must be addressed. To achieve this, there is need to consider the skill mix needed for effective implementation of evidence based project solution, its availability, as well as the inferences on the workload of the healthcare practitioners within the health facility.

Proposed Solution to Address Fall Rate

            Falls are becoming a leading public health concern across the world, causing accidental injuries and deaths. A growing pervasiveness of falls among elderly persons both in acute hospitals and those released from health facilities have been revealed in many studies including that by Slade, Carey, Hill and Morris (2017) who noted that falls among older adults is usually linked to considerable burden to patients, physicians, and the entire healthcare system. Besides injury, costs, and death related burden, older adults experiencing falls suffer from increased anxiety, depression, and poor life quality (Powell-Cope et al., 2018). As people continue to age, cases of falls continue to grow and, therefore, successful adoption and implementation of necessary programs to prevent falls is critical in lowering such incidences in the future.

            My proposed solution to deal with fall prevention is to use multifactorial interventions such as conducting multidimensional fall risk assessment, for instance, history of fall situations, assessment of medical conditions and medications, mobility assessment, review of the hearing and vision, as well as, gait and balance screenings (Powell-Cope et al., 2018).  These assessments should be conducted within the clinical setting by a multidisciplinary team so that a comprehensive plan for treatment can be formulated and adopted. Moreover, physical therapists must provide gait and transfer training as well as assistive device training and fitting. At the same time, occupational therapists should train other physicians on how to use assistive devices. Similarly, doctors should review medication regimes, particularly psychotropic drugs, as well as anticoagulants in a bid to minimize the use of medications to prevent falls.

             Slade, Carey, Hill, and Morris (2017) noted that exercise minimizes the risk of falling when incorporated as a critical element of a multifactorial intervention program. Exercise can potentially enhance fall risk factors including poor balance, muscle weakness as well as gait impairment in impaired and healthy elderly. Patients experiencing falls should be encouraged to undertake exercise models such as home exercise programs and group exercise programs among others. Similarly, patients should be informed that while under medication or in unfamiliar environment, or while being tested or being informed about healthcare procedures, they stand high chances of becoming weak or falling. Moreover, they should be informed on when to seek for help.

Internal and External Methods for Disseminating EBP Project Results

             Disseminating results of evidence based practice encompasses targeted transmission of information and interventions to a given public health practice audience (Curtis, Fry, Shaban, & Considine, 2017). The core purpose of disseminating the results is to make evidence based interventions known to improve its application and patient outcomes (Brownson et al., 2018). Many external and internal techniques can be used to disseminate results of evidence based project. Nonetheless, the technique adopted must be effective.

            The internal technique that I would adopt to spread results of the stated EBP project is the hospital board. Normally, hospital boards comprise of workers and health organization including physicians, nurses, as well as, other professionals involved in caring for patients. While circulating the EBP results through the hospital board, the most effective technique to adopt would entail face to face. The technique facilitates interaction and immediate response during the questioning sessions.

            Similarly, the external technique that I would use to disseminate the information is presentation during conferences of professional organizations such as American Nurses Association. The professional organization can offer the most appropriate platform to improve circulation of project results to many nurses. Face to face is the most suitable technique I would adopt in the conference to enhance consultation and deliberations with other nursing practitioners. Principally, the communication approaches used would differ considerably in external and internal forums. For instance, the hospital board is composed of workmates, and this means that there would be less formation communication but more interactive as compared to presenting the same information to American Nurses Association conference.

            Disseminating the results of my EBP project to the stated groups helps facilitate spread and sharing of information and knowledge within the nursing fraternity. This, according to Brownson et al. (2018), would improve the ability to make decisions among the members of the group involved in nursing practice, thus improving patient outcomes. In addition, reporting EBP results to the stated groups would improve productive criticism of the findings thus providing a good opportunity to check on what to be improved before implementation.

Evaluating Whether the EBP Project Made a Difference in Practice

             The core purpose of adopting EBP in healthcare is to bring the needed change in the targeted health facility. Within the healthcare setting, the aim of introducing evidence based solutions is to enhance quality care delivered to patients and improve treatment outcomes (Louch, O'Hara, & Mohammed, 2017). Further, reducing healthcare costs is becoming a critical factor to consider when adopting EBP in healthcare environment. Evaluation helps establish whether the organization has effectively implemented the required changes in its operations (Soheilipour & Farajzadeh, 2016). As such, there is need to use evaluation method that can help determine the expected changes within the healthcare setting.

             The aim of my evidence based project is to implement multifactorial intervention programs to reduce fall rates and harmful health outcomes linked to the condition among older adults. To determine the effectiveness of the adopted intervention, a comprehensive evaluation plan that explained and pointed out the expected variables and outcomes of the intervention was established.

            The major expected outcome for my EBP project was the adoption of multifactorial intervention programs to prevent falls among older adults. It entailed informing patients on the right time to seek help. The next measure of the effectiveness of the EBP was on the outcome of the patients regarding lowering cases of falls in acute settings together with associated health challenges.

            Summative evaluation is one of the techniques that would help determine the effectiveness of the evidence based practice. It is a systematic approach that allows gathering and analysis of information regarding the impacts or consequences of intervention, output and results during implementation (Elhami, Ban Mousaviasl, & Zahedi, 2018). Therefore, summative evaluation would assist in measuring and establishing the efficacy, success, and cost implications of my EBP projects within the healthcare organization.

Independent and Dependent Variables to be Collected

             An independent variable, as stated by Flannelly, Flannelly, and Jankowski (2014), refers to the variable usually controlled or changed during scientific experiment to establish the impacts of the dependent variable while a dependent variable refers to a variable being measured or tested during a scientific trial. For the already described EBP project on fall prevention within the hospital setting, the independent variables would encompass patients put in the fall prevention programs and preventing patients from hanging on the edge of the bed. Given that the aim of the project is to change the fall prevention strategies within the hospital, all the stated factors are considered independent variables.

            Similarly, the dependent variables for this EBP project would entail fall rate for the period of July, as well as the expertise and knowledge of the staff regarding fall prevention. This EBP measures falls rates and knowledge gained because the two variables depend on the new strategies implemented. Paying attention to independent and dependent variables is important because it ensures that the variables are realistic and achievable (Flannelly, Flannelly, & Jankowski, 2014). Moreover, understanding the results would help the researcher to establish the effectiveness of his or her solutions.

Differences between Clinical and Statistical Significance

             To adopt EBP effectively, there is need to understand and interpret clinical results. As such, there is need to understand the difference between clinical significance and statistical significance. Statistically significant outcome means a difference or relationship between variables not caused by a single chance (Schober, Bossers, & Schwarte, 2018). In light of this, as a parameter in EBP, statistical significance indicates the possibility of the findings from the research is correct and does not occur accidently (Schober et al., 2018).

            The probability value (P-value) shows the possibility of the randomness of a certain result happening but not the real variance between the variables being experimented. In research analysis, results are considered statistically significant when the value of the probability obtained during the analysis is far much less than the certainty level that the researcher requires. Heavey (2015) noted that research studies such as EBP, researchers often set the values of probability as 0.05 and this implies that there is 5% chance that the findings of the study were not brought about by the probability, and 95% certainty that the variables analyzed in the study have a strong relationship (Heavey, 2015).

            Clinical significance implies a subjective understanding of the research findings as valuable for patients who need the care and thus can shape the behavior of healthcare professionals and providers (Schober et al., 2018). Principally, a significant result is achieved when medical professionals strongly believe that the result is sufficient to be medically essential and thus should be used as a guide to deliver healthcare to patients.

            In EBP, the researcher must first determine statistical significance before clinical significance. Nonetheless, clinical significance is often a subjective assessment and cannot be determined using an exclusive experiential test. In the proposed EBP project, clinical significance can be used to support positive outcomes of the project by making sure that the findings are statistically significant. The reasoning is that most of the statistically significant results often have clinical significance