...reducing stage 3 and 4 reported pressure ulcers. The Braden scale for predicting pressure sore risk is a universally accepted tool used to help nurses identify patients who are at risk of developing pressure ulcers. The scale evaluates each patient in the following six areas exposure to moisture, sensory perception, activity, and ability to change positions, nutrition, and exposure to shear (Rosenfeld, 2010). The identification of unit specific champions is a key strategy for the continued reduction of the prevalence of pressure ulcers. These leaders on the units serve as the educators for the remaining staff on the unit. These champions would be part of a multidisciplinary team, which reviews all new research, assistive devices, and evidence-based practice concerning the treatment and prevention of pressure ulcers. The multidisciplinary team would focus on key points the help take aggressive action against pressure ulcer prevention, some of the key points are education, documentation, setting benchmarks , and walk rounds. Education would focus on proper assessment, staging and accurate completion of the Braden scale. Consistent and thorough education would be provided to the patient and family. Documentation would be uniform and reduced to a...
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...The article “Facilitating Skin-to-Skin Contact in the Operating Room after Cesarean Birth” was written by Susan Stone, Lyn Prater, and Rebecca Spencer. The purpose of this project was to implement an evidence-based change to provide skin-to-skin contact (SSC) in nonemergent, full-term cesarean births in low-risk healthy mothers and neonates. The three main goals of this project were to develop a protocol for health care professionals’ roles in providing SSC in the OR, implement the protocol, and evaluate the process of implementation of the evidence-based intervention. The project was conducted at an inner-city hospital in the Southwestern United States. The Iowa Model of evidence-based practice to promote quality care and Lewin’s Change...
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...Change in Practice: Preventing Hospital Associated Infections April Shannon Walden University NURS 4000 Section 04, Research and Scholarship for Evidence-Based Practice November 18, 2012 Change in Practice: Preventing Hospital Associated Infections Benjamin Franklin was quoted as saying “an ounce of prevention is worth a pound of cure.” With the increasing costs of healthcare and the emergence of multi-drug resistant organisms this truth still resonates today. Hospital associated infections (HAIs), have been a complication in hospitals for many years. The purpose of this assignment is to address this problem in nursing practice, and discuss evidence on practices that will address this issue. The problem Hospital associated infections (HAIs) can be defined as an infection acquired in hospital by a patient who was admitted for a reason other than that infection. An infection occurring in a patient in a hospital or other healthcare facility in whom the infection was not present or incubating at the time of admission. This includes infections acquired in the hospital but appearing after discharge, and also occupational infections among staff of the facility (central line associated bloodstream infections, catheter associated urinary tract infections, surgical site infections, ventilator associated pneumonia, etc.) (World Health Organization, 2002). HAI’s have become one of the leading caused of hospital related deaths in the United States. However, these infections...
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...Knowledge and Conformance of Delivery Room Staff on Essential Newborn Care Protocol A Thesis Proposal Presented to the Faculty of the Graduate School of University of the Visayas Cebu City, Philippines In Partial Fulfillment of the Requirements for the Degree of Masters of Arts in Nursing Major in Maternal and Child Health Nursing by MAY PRINCES T. ABUCEJO, RN August, 2012 THE PROBLEM AND ITS SCOPE INTRODUCTION Rationale of the Study The Child Survival Strategy published by the Department of Health has emphasized the need to strengthen health services of children throughout the stages. The neonatal period has been identified as one of the most crucial phases in the survival and development of the child. The Millennium Development Goal Number four (4) of reducing under five child mortality can be achieved by the Philippines, however, if the neonatal mortality rates are not addressed from its non-moving trend of decline, MDG 4 might not be achieved (http://www.doh.gov.ph/node/2664). Based on health statistics, the Philippines is one of the 42 countries that account for 90% of under-five mortality worldwide. Eighty two thousand (82,000) Filipino children under five years old die every year. Thirty seven percent (37%) or 40,000 of them are newborn. Majority of them (3/4) die within the first two days of life, mostly from preventable causes. The high mortality and morbidity rates in newborn are directly related to inappropriate hospital and community practices...
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...Abstract An exploration of the importance of Evidenced-Based Practice (EBP), and how it ensures quality healthcare and positive patient outcomes. We will take a look at a simple procedure such as hand washing and show why it is an EBP protocol. Why Is Hand Washing So Important? Everyone in the world is responsible for good hand hygiene. As healthcare providers, it is important to teach our patience the importance of good hand hygiene to prevent spread of infection and or disease. By doing this, you are involving patients in their care and helping the greater cause of disease prevention. All healthcare facilities include hand hygiene protocols. Where I work, the hospital policy is that we wash our hands upon entering a patient’s room, put on gloves, remove gloves, wash hands upon leaving that patient’s room, then wash hand again upon entering the next patient’s room…and continue that routine with each patient. We were allowed to us hand sanitizer up to three times, in place of washing with soap and water, providing the patient is not on contact or any other special precautions. For the most part, most of do this, but I did not see everyone following this protocol, especially doctors. Most of the staff only use the sanitizer all of the time. The only time hand washing protocol seems to be followed fully is when I witness sterile procedures. This is a problem and causes increased occurrence of healthcare associated infections (HAIs), but it is difficult to ensure healthcare...
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...proposal, implementation, and final demo or paper. * Students will be grouped into teams for the sake of presentations at the end of the semester. Marks allocated for each individual piece of the project are as follows: a) Proposal – 10% b) Project write-up – 22% c) Presentation – 8% Projects include but are not limited to: * Research Paper * You can work on original research problems. The outcome should be a paper with original technical contribution. Your grade on this will be judged on originality, soundness of the approach, and quality of presentation. * Example Topics: * Vulnerability Analysis * Wireless Security * Intrusion Detection * Authentication * Access Control * Authorization * DNS Security * Digital Watermarking * New Attacks * Survey Paper * You can write a paper that surveys a particular field on information security. The outcome should be a paper that summarizes the trend in the field you have chosen. Your grade will be judged on the completeness of the survey, the quality of the trend analysis, and the quality of presentation. * Example topics: * Vulnerability Analysis * Wireless Security * Intrusion Detection * Authentication * Access Control * Authorization * DNS Security * Digital Watermarking * Implementation ...
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... Regular and ongoing evaluations will help ensure that the change policy is effective after implementation (Stevens, 2013). In order to evaluate the change plan, regular “checks” will be conducted to determine how effectively the staff members are adhering to the new protocols. In addition, the patients will be monitored and their records will be evaluated regularly to determine the impact of the change policy on overall patient health in facility. In this way, the staff is held accountable for adhering to the new policy, and the implementation can be tracked for effectiveness using evidence from patient files. The outcomes should be evaluated by examining patient records regularly. During the first quarter after implementation, patient records should be evaluated every two weeks, and staff checks should occur at least once each month. Following the first quarter, patient records should be evaluated monthly, and staff checks should occur at least once each quarter. In addition, staff should be offered retraining if it is determined they are not adhering to the new policy following implementation. This retraining can be aligned with new employee training. The process by which the change policy is implemented is as important as the policy change itself (AHRQ, 2014). The implementation of the change policy should be focused on four specific phases: education, training, implementation, and follow-up. First, the staff will be educated about the policy change and the justification...
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...are supposed to make nurses aware that something is wrong with the patient and prevent sentinel events have resulted in sentinel events. Some research has been done to show that alarms that were ignored is what led to the sentinel event occurring. I chose to research this area as I have witnessed this in the workplace over the years. I am reluctant to see what the outcomes of research on this subject will lead to and what protocol implementations will occur to meet the 2016 JCAHO deadline for this problem to be addressed. #1 Database (or collection) (30 possible points): Title of source: Association for the Advancement of Medical Instrumentation (AAMI) Location of source (URL): http://www.aami.org/htsi/alarms/library.html Owner or publisher: Healthcare Technology Safety Institute (HTSI) Describe (in your own words) the research database or collection of research including the purpose and the subject matter it covers: AAMI, the Association for the Advancement of Medical Instrumentation, is a nonprofit organization that provides evidence based practices to healthcare professionals, biomedical engineering, nurses, physicians, and hospital administrators. AAMI is a leading resource in regards to...
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...At the start of the project, the team did not address the risk associated with the assumption that a satisfactory software implementation based on a modification of the UDP protocol was feasible. The team did not discuss this risk with the client and thereby missed the opportunity to set the client's expectation for how the project should proceed if the planned solution was found not to be feasible. Initially, the team thought that it would have flexibility in determining the solution, and the client expressed a similar expectation. But the client's expectations changed as the project progressed because the client did not see evidence of a software implementation as quickly as he expected. The team became aware of the client's expectations...
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...Standardization of Nursing Protocol for Cardiac Arterial Bypass Patients Abstract Evidence-Based Practice (EBP) is an important factor in determining medical courses of action. Nurses have long used tradition rather than evidence in making decisions about beside care; to convince them to switch practice, it is useful to draw a comparison between the efficacy of these disparate routes. Our study designed a research question based on the PICOT model for the cardiac floors and designed procedures using the Kotter and Cohen’s Model of Change. In order to study the effect discussed in our PICOT question, a web search was conducted and the quality of each pertinent study reviewed. Introduction In the nursing staff of an adult Cardiac Surgical Care unit, how does the buy-in from the staff for Evidence-Based Practice (EBP) changes in a new Coronary Arterial Bypass Graft (CABG) pathway affect the decreases in infection rate among this patient population when compared to the old way of delivering patient care through nursing tradition in a six month time frame? The formation of a guideline for practice in nursing is not a new occurrence; books and manuals have been a reality for many years. However, in the past these resources lacked the evidence for standards of care, which traditionally have been based on professional consensus and tradition. The Joint Commission has recognized processes that can be measured regarding patient outcomes and care in order to meet standards for Medicare...
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...Introduction This paper explain the Accountability of a nursing professional based on an evidence report from Agency for Healthcare Research and Quality Assessment(AHRQ) , the report is " Closing the Quality Gap: A Critical Analysis of Quality Improvement Strategies (Vol. 6: Prevention of Healthcare–Associated Infections)" under the head Quality Improvement and Patient Safety What is Accountability? In Fundamentals of Nursing it says “The ability and willingness to assume responsibility for ones’ actions and accepting the consequences of one's behavior.” Accountability of nursing professional is a legal obligation; for a professional nurse it is relating to ethics and moral responsibility. Within the kingdom of professional accountability, there are many factors. The American Nursing Association (ANA) states in its code that the nurse will assume accountability for nursing judgment and actions. A professional nurse has the responsibility to take decisions and practice within the scope of care, calling upon his/her information and skills to make judgments in favor of the patient. A professional nurse is accountable to their profession, their patients, employer, and other health care team members and to themselves. Nurses are accountable to provide safest care for their patient based on evidence based practice and safe nursing interventions. Nursing profession as a whole is build up on accountability, unselfishness, integrity and social justice. A professional...
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...Evidence Based Practice & Pressure Ulcers Matthew Slawter Chamberlain College of Nursing NR451 RN Capstone Course November 2014 Evidence Based Practice & Pressure Ulcers Evidence based practice (EBP) gives nurses a method to use critical appraised data and scientific evidence that is proven to confirm the delivery of quality health care to a patient population. Pressure ulcer prevention continues to be a major and growing concern among todays patients and healthcare providers. This problem is a concern because prevention of pressure ulcers can be accomplished through good skincare techniques and increased education of nurses. The field of nursing along with the healthcare industry can benefit from simply decreased the occurrence of pressure ulcers. The general purpose of this proposal is to determine if the value nurses place on skincare and pressure ulcer prevention can decrease the incidence pressure ulcers. Change Model Overview The John Hopkins Nursing Evidence-Based Practice Process is simply related to the complex challenges organizations and nurses face with the implementation of evidence-based practice and translation. Furthermore, this process provides guidelines for managing the process, structure, and evidence translation among various healthcare settings and outcomes of EBP projects. Nurses should use this process as a guide to facilitate change as it suggest leadership and planning for EBP measurement, identification, evaluation and monitoring...
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...fetus. Prior to initiating oxytocin, the patient should be counseled about the indications for the use of oxytocin, the methods of administration to be employed, and the risks of failure, cesarean delivery, or fetal compromise. A physician capable of performing cesarean section should be readily available during the induction or augmentation of labor (2). UNIT STRUCTURE Each hospital’s department of obstetrics should develop a standardized, single, universal written protocol for the use of oxytocin for labor induction or augmentation. Standardization of an oxytocin infusion protocol is recommended to reduce medication dosing error and improve patient assessment. Elements of a protocol should include (2): Indications for the use of oxytocin for labor induction and augmentation. Methods for preparation and administration of oxytocin. Qualifications of staff authorized to administer oxytocin and monitor patients. The level of the initial dose and subsequent doses, The timing interval of changes in doses A protocol for patient assessment, including definitions of normal and abnormal...
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...infection is defined as having a positive blood culture while central venous access is in place without any further evidence of infection related to the patient’s comorbidities (Smith, et al., p. 1038). Organisms that are known to cause these infections include staphylococcus aureus and enterobacteriaceal (Curry, Honeycutt, Goins & Gilliam, 2009, p.151). It is concluded that one in ten patients experience an adverse event such as a central line bloodstream infection during their stay at the hospital (McPeake, Cantwell, Malcolm & Malcolm, 2012, p. 123). Furthermore, it has also been researched that over fifty percent of those cases could have been avoided if there were increased patient safety processes that were followed strictly and routinely evaluated for effectiveness (McPeake, et al., p. 123). Recent changes in government and insurance reimbursement suggests the elimination of payment for central line bloodstream infections especially when proven to be obtained during their hospital stay (Duane, Brown, Borchers, Wolfe, Malhotra, Aboutanos & Ivatury, 2009, p.1166). Hospital charges for central line infections increase the cost of stay nearly threefold (Duane, et al, p. 1166). The invasive nature of the catheters insertion predisposes patients to infection and it is healthcare professional’s responsibility to search out and implement evidence based practice that could prevent additional harm (Duane, et al., p. 1168). The general community has become more aware...
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...1 Carter, N. M., Reitmeier, L., & Goodloe, L. R. (2014). An Evidence-Based Approach To the Prevention of Catheter-Associated Urinary Tract Infections. Urologic Nursing, 34(5), 238-245 8p. doi:10.7257/1053-816X.2014.34.5.238 An Evidence-Based Approach To the Prevention of Catheter-Associated Urinary Tract Infections. Urinary tract infections account for at least 35% of all hospital acquired infections with 80% of them being associated to indwelling catheter. Each day an indwelling catheter is in situ increase pose a 3% tom 10% risk of developing an infection. Early discontinuation of the catheter reduce the risk of acquiring infection and in this study, infection rate drop from 4 cases in second quarter to none in the fourth quarter in the protocol implementation (Carter, N. M., Reitmeier, L., & Goodloe, L. R. 2014). 2...
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