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NR 505 Week 2 Paper Refinement of a Nursing Concern
NR 505 Week 2 Paper Refinement of a Nursing Concern
Refinement of a Nursing Concern into an Evidence-based Practice Proposal Sample
Nursing research is defined as the “systematic inquiry designed to develop knowledge about issues of importance, including nursing practice, nursing education, and nursing administration” (Tingen, Burnett, Murchison, & Zhu, 2009). The overall purpose of nursing research is to develop new knowledge or authenticate current knowledge based mostly on theory. “Research is about investigation, exploration, and discovery and it requires an understanding of the philosophy of science” (Conner, 2014).
“Evidence-based practice is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient” (Duke University, 2018). Evidence-based practice (EBP) does not develop new knowledge or authenticate existing knowledge because EBP focuses on translating research evidence into clinical decision-making.
EBP echoes “across nursing practice, education, and science” (Stevens, 2013). EBP has essentially improved the nursing profession by establishing quality improvement (QI) teams that ultimately have transformed more effective, safe, and efficient care.
More importantly, EBP has nurses responding by “launching initiatives that maximize the valuable contributions that nurses have made, can make, and will make, to fully deliver on the promise of EBP” (Stevens, 2013).
EBP’s most significant contribution to professional nursing is the improvement and maintenance of quality healthcare. “Quality healthcare is the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge” (Stevens, 2013 NR 505 Week 2 Paper Refinement of a Nursing Concern).
Identification of MSN Specialty Track
This writer’s MSN Program Specialty Track is healthcare policy within a clinical setting. According to the World Health Organization (2019), health policy refers to decisions, plans, and actions that are undertaken to achieve specific healthcare goals within society. Healthcare policy aims to “outline priorities and the expected roles of different groups; and it builds consensus and informs people” (World Health Organization, 2019 NR 505 Week 2 Paper Refinement of a Nursing Concern).
How Evidence-based Practice Promotes Change in Future Nursing Practice
According to Brownson, Chriqui, & Stamatakis (2009), public health policy profoundly impacts health status. EBP is important to healthcare policy because it encourages nurses to “continue knowledge development that continually improves patient care outcome and quality of care that will expand on the phenomena of the art and science of the nurse and thereby provide an outline for practice within the discipline” (Nurse Journal, 2018).
Healthcare policy is essential to nursing because it defines and integrates the necessary standards under which care should occur (Burke, 2016). Healthcare policies allow nurses to make a difference in nursing practice standards and inevitably lead to an improved quality of care (Burke, 2016). In the nursing profession, nurses need to realize that they have an important in participating in and promoting healthcare policies that promote and advance the lifespan of people.
Selected Nursing Concern
The selected nursing concern is health communication. According to the CDC (2011), health communication is the study and use of communication strategies to inform and influence individual decisions that enhance health. Healthcare communication can occur in various forms; however, the most common forms are written and verbal communication. It is important for communication to be effective so that emotions and intentions are understood behind the information being communicated (Robinson, Segal, & Smith, 2018).
Communication in healthcare facilities is an ongoing issue that spans patient communication, clinician communication, and administration communication. According to Coiera (2006), communication systems and methods receive the least amount of attention within healthcare facilities.
Stakeholders to improve communication in a healthcare facility starts with administration, physicians, nurse managers, patient-care nurses, and patients. Each of the stakeholders is responsible for performing actions that will improve communication within the healthcare facility.
Suppose the stakeholders are not able to promote and perform the actions of effective communication. In that case, there is no leadership and direction given to other members within the healthcare facility and the patients are the ones who will suffer the consequences of ineffective communication.
The biggest barriers to ineffective communication are “lack of consistency from healthcare staff, lack of time to piece together the plan of care, and assumptions of physicians that RNs should be able to do everything” (Cannon, 2013). Ineffective communication carries consequences for patients and us as the medical staff. Two major consequences for patients are major sentinel events and prolonged care due to a lack of communication between medical staff members. NR 505 Week 2 Paper Refinement of a Nursing Concern
A proposed solution to improve communication in healthcare to ensure that it is more effective is to require each employee in the organization to take classes on understanding communication. Within the classes, employees will learn to communicate with one another as well as patients so that effective communication is obtained.
Employees must be educated about the importance of effective communication and that ineffective communication can lead to serious consequences that can lead to disastrous results (Hicks, 2015). The main purpose of effective health communication is to strengthen relationships between healthcare professionals and patients to improve patient outcomes and safety. With improved patient outcomes and safety comes improved patient satisfaction scores for the facility.
PICO Question and Literature Search Process
The PICOT question for this EBP proposal is as follows: In adult patients (P), how does verbal communication (I) compared to written communication (C) affect patient safety, outcomes, and satisfaction scores (O)? The expected outcome is that effective communication, verbal and written, will lead to improved patient safety, outcomes, and satisfaction scores for the healthcare facility.
This is useful to this writer’s future practice in healthcare policy because it will help this writer formulate policies and procedures for staff members so that effective communication is used to improve patient safety, outcomes, and satisfaction scores. NR 505 Week 2 Paper Refinement of a Nursing Concern
Literature Review
“A literature review is a critical and in-depth evaluation of previous research” (Shuttleworth, 2009). A literature review is done to provide a summary and a synopsis of an area of research, “allowing anybody reading the paper to establish why you are pursuing this particular research” (Shuttleworth, 2009).
The purpose of a literature review is to “establish a theoretical framework for a topic; define key terms, definitions, and terminology; identify studies, models, case studies, etc. that support a topic; and define or establish area of study” (RMIT University, 2005). Conducting literature will help with my research by establishing the theory of the research, establishing the research method, and establishing what is missing from the research so that information can be filled in or obtained.
Steps to Conduct a Literature Review
To perform this writer’s literature review, this writer used the Chamberlain College of Nursing Library and the keywords “effective communication,” “ineffective communication,” and “improving patient outcomes and safety.” Other resources used included additional search terms such as “health communication” and “healthcare policy communication.”
This writer also utilized Google targeting scholarly articles for the identified search terms. Specialty organizations that are relevant to my EBP are the American Nurses Association (ANA), the Centers for Disease Control and Prevention (CDC), and the World Health Organization (WHO).
The steps for a literature review are as follows: “find a working topic; review the literature; focus the topic narrowly and select papers accordingly; read selected articles thoroughly and evaluate them; organize the selected papers by looking for patterns and by developing subtopics; develop a working thesis; organize the paper passed on findings in steps three and four; write the body of the paper; and look at what is written and focus on the analysis, not the description” (University of Guelph, 2018 NR 505 Week 2 Paper Refinement of a Nursing Concern).
Theoretical Framework
“Theories are formulated to explain, predict, and understand phenomena and, in many cases, to challenge and extend existing knowledge within the limits of critical bounding assumptions” (USC Libraries, 2019). “Theoretical framework is a collection of interrelated concepts that guide research, determining what things you will measure, and what statistical relationships you will look for” (Borgatti, 1999 NR 505 Week 2 Paper Refinement of a Nursing Concern).
The theoretical framework that is applicable to my EBP proposal is The Theory of Planned Behavior (TPB). Originally known as the Theory of Reasoned Action, The Theory of Planned Behavior was developed by Icek Ajzen in 1980.
TPB is used to predict an individual’s intention to engage in a behavior at a specific time and place” (Boston University School of Public Health, 2018). TBD relates to communication in healthcare because communication behavior can be observed. Communication behaviors consist of “intentions, attitudes, skills, and barriers of communication” (Rijessen, Schellart, Anema, & van der Beek, 2009).
TPB applies to by EBP proposal since it monitors communication behaviors. Using TPB, clinical staff and patients’ communication behaviors can be observed to ensure they are effective. If appropriate communication behaviors are used, communication can be deemed effective or ineffective. The framework is acceptable if effective communication is obtained using communication behaviors.
Conclusion
Research is defined as the “systematic inquiry designed to develop knowledge about issues of importance, including nursing practice, nursing education, and nursing administration” (Tingen, Burnett, Murchison, & Zhu, 2009, para. 5).
“Evidence-based practice is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient” (Duke University, 2018, para. 1). Research is the foundation of EBP to translating research evidence into clinical decision making.
My MSN Program Specialty Track is healthcare policy within a clinical setting. Nurses involved in healthcare policy have the “potential to effect wide-reaching changes in the healthcare system” (National Academy of Sciences, 2019, para. 5). The selected nursing concern is health communication.
According to the Office of Disease Prevention and Health Promotion (2019, para. 2), health communication is essential to healthcare, public health, and the way our society views health. Health communication or communication must be effective so that the message is received and understood by staff members and the information is conveyed to patients effectively.
The proposed solution to improve communication in healthcare settings is to educate staff members on the importance of effective communication as well as educating them on the issues with ineffective communication. This EBP proposal aims to improve communication within healthcare facilities so that patients have more positive outcomes while improving patient safety and patient satisfaction for the healthcare facility.
The PICOT question for this EBP proposal is as follows: In adult patients (P), how does effective communication (I) compared to ineffective communication (C) affect patient safety and outcomes (O)? The expected outcome of this PICO question is that patients will experience more positive outcomes when communicating with medical staff.
Effective communication can lead to improved patient outcomes and improved patient safety. Improved patient outcomes and safety can ultimately lead to improved patient satisfaction scores for healthcare organizations. It is important for healthcare staff members to practice effective communication and to know the difference between effective and ineffective communication.
A literature review is a way to explore previous research on communication and the effects of effective communication and ineffective communication on medical staff as well as patients. A literature review gives a “detailed account of published scientific investigations which are relevant to the project being undertaken” (UNSW Medicine, 2012, para. 1 NR 505 Week 2 Paper Refinement of a Nursing Concern).
A literature is useful in this EBP proposal as it will provide information on previous research done on communication in that healthcare setting and the effects on patients and medical organizations. The Chamberlain College of Nursing Library was utilized to perform literature reviews using the key terms listed earlier in the paper.
Theoretical framework “consists of concepts and, together with their definitions and reference to relevant scholarly literature, existing theory that is used for your particular study” (USC Libraries, 2019, para. 2). The theoretical framework for this EBP proposal is The Theory of Planned Behavior (TPB). TPB is used to “predict an individual’s intention to engage in a behavior at a specific time and place” (Boston University School of Public Health, 2018, para.
The idea is to view the communication behavior of medical staff and patients to evaluate if communication is effective or ineffective. If communication is deemed ineffective, then further evaluation is needed. If communication is deemed effective, then those behaviors should be logged and applied to future education processes. NR 505 Week 2 Paper Refinement of a Nursing Concern
Research is the foundation for EBP. Identifying concerns in nursing and applying them to future nursing practice is a way for nurses to make their place in the future of professional nurses. In nursing, there is no voice that should not be heard, and every nurse should aspire to make a difference in their current and future practice.
Literature reviews help nurses to identify previous research and help them with their current research and possible changes that can be made to improve current methods of doing things. Identifying a PICO or PICOT question gives the nurse a working hypothesis and possible outcome to be proved or disproved. Identifying a theoretical framework allows nurses to identify a way to observe ad analyze their hypothesis in a particular setting and deem the information as valid or invalid for their research.
NR 505 Week 2 Paper Refinement of a Nursing Concern Paper References
Borgatti, S. (1999). Elements of research. Retrieved from
http://analytictech.com/mb313/elements.htm.
Boston University School of Public Health. (2018). The theory of planned behavior. Retrieved from http://sphweb.bumc.bu.edu/otlt/MPH-
Modules/SB/BehavioralChangeTheories/BehavioralChangeTheories3.html.
Brownson, R.C., Chriqui, J.F., & Stamatakis, K.A. (2009). Understanding evidence-based public health policy. American Journal of Public Health, 99(9), 1576-1583. Doi: 10.2105/AJPH.2008.156224. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2724448/.
Burke, S. (2016). Influence through policy: Nurses have a unique role. Retrieved from https://www.reflectionsonnursingleadership.org/commentary/more-
commentary/Vol42_2_nurses-have-a-unique-role.
Cannon, C. (2013). Ineffective communication is a barrier to patient care. Retrieved from https://voice.ons.org/news-and-views/ineffective-communication-is-a-barrier-to-patient-
care.
CDC. (2011). What is health communications?. Retrieved from https://www.cdc.gov/healthcommunication/healthbasics/whatishc.html.
Coiera, E. (2006). Communication systems in healthcare. The Clinical Biochemist, 27(2), 89–98. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1579411/.
Conner, B.T. (2014). Differentiating research, evidence-based practice, and quality improvement. American Nurse Today, 9(6). Retrieved from https://www.americannursetoday.com/differentiating-research-evidence-based-practice-
Duke University. (2018). What is evidence-based practice (EBP)? Retrieved from https://guides.mclibrary.duke.edu/c.php?g=158201&p=1036021.
Hicks, J. (2015). Effects of ineffective communication in medical offices. Retrieved from https://www.verywellhealth.com/side-effects-of-ineffective-communication-2317356.
Institute for Healthcare Communication. (2011). Impact of communication in healthcare. Retrieved from https://healthcarecomm.org/about-us/impact-of-communication-in-
National Academy of Sciences. (2019). The future of nursing: Leading change, advancing health. Retrieved from https://www.nap.edu/read/12956/chapter/2.
Nurse Journal. (2018). The practicality of nursing theory in the future. Retrieved from https://nursejournal.org/community/the-practicality-of-nursing-theory-in-the-future/.
Office of Disease Prevention and Health Promotion. (2019). Health communication and health information technology. Retrieved from https://www.healthypeople.gov/2020/topics-
objectives/topic/health-communication-and-health-information-technology.
Rijessen, H.J., Schellart, A.J.M., Anema, J.R., & van der Beek, A.J. (2009). A theoretical framework to describe communication processes during medical disability assessment interviews. BMC Public Health, 9, 375. Retrieved from https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-9-375.
RMIT University. (2005). Purpose of a literature review. Retrieved from https://www.dlsweb.rmit.edu.au/lsu/content/2_AssessmentTasks/assess_tuts/lit_review_L
Robinson, L., Segal, J., & Smith, M. (2018). Effective communication. Retrieved from https://www.helpguide.org/articles/relationships-communication/effective-
Shuttleworth, M. (2009). What is a literature review? Retrieved from https://explorable.com/what-is-a-literature-review.
Stevens, K. (2013). The impact of evidence-based practice in nursing and the next big ideas. The Online Journal of Nursing Issues, 18(2). Retrieved from http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJ
IN/TableofContents/Vol-18-2013/No2-May-2013/Impact-of-Evidence-Based-
Strasner, S. (2016). Claim study: Consequences of poor communication in a clinical setting. Retrieved from https://lhatrustfunds.com/claim-study-consequences-poor-
communication-clinical-setting/.
Tingen, M.S., Burnett, A.H., Murchison, R.B., & Zhu, H. (2009). The importance of nursing research. Journal of Nursing Education, 48(3), 197-170. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3677814/.
University of Guelph. (2018). Writing a literature review. Retrieved from https://www.lib.uoguelph.ca/get-assistance/writing/specific-types-papers/writing-
UNSW Medicine. (2012). SOMS honours. Retrieved from https://medicalsciences.med.unsw.edu.au/students/soms-honours/assessments/literature-
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NR 505 Week 2 Paper Refinement of a Nursing Concern into an Evidence-based Practice Proposal Using the Research Process Instructions
Purpose
This assignment provides the opportunity for the student to continue work on a previously identified area or phenomenon of interest related to their MSN specialty track. Week Two’s assignment builds upon the identified area of interest by developing an overview of the evidence-based practice (EBP) project and the PCIOT/PICo question. This assignment initiates the evidence-based practice proposal that is continued throughout the entire course with each assignment adding components of the research process.
NR 505 Week 2 Paper Refinement of a Nursing Concern Course Outcomes
This assignment enables the student to meet the following course outcomes:
- CO#1 Integrate evidence-based practice and research to support advancement of holistic nursing care in diverse healthcare settings. PO 1
- CO#2 Integrate knowledge related to evidence-based practice and person-centered care to improve healthcare outcomes. PO 2, 5
- CO#4 Develop knowledge related to research and evidence-based practice as a basis for designing and critiquing research studies. PO 1, 2, 3, 5
Due Date: Sunday 11:59 PM MT at the end of Week Two
Total Points Possible: 150 points
NR 505 Week 2 Paper Refinement of a Nursing Concern Requirements
Description of the Assignment
This assignment builds on the identification of a nursing concern from NR 500 and the application of a nursing theory to the selected concern from NR 501. For this course, the selected concern and nursing theory then serve as a foundation to the identification of PICOT/PICo. Identification of the literature search strategy is also required. NR505 All Papers – Week 2+Week 5 and Week 7
Criteria for Content
Overview of Selected Evidenced-based Practice Project: This section provides a foundation to the MSN EBP scholarly project. It should contain the following elements:
- Explain the relationship between research and evidenced-based practice (EBP)
- Distinguish how EBP is different from research
- Explain the contribution of EBP to professional nursing
- Identify your MSN Program Specialty Track and practice focus
- Explain how EBP promotes change within your future practice setting
Identification of the Nursing Concern to be Improved: This section provides a comprehensive discussion of the selected nursing concern. It should contain the following elements:
- Explain the selected nursing concern in detail
- Identify how frequently the selected concern occurs within your specialty track setting
- Identify the stakeholders impacted by the concern
- Identify the consequences of the selected concern
- Identify your proposed solution to the selected concern
- Identify a purpose statement for this EBP proposal
PICOT/PICo question and Literature Search Process: This section identifies the PICOT/PICo question that will used for this EBP proposal. The literature search parameters will also be identified. It should contain the following elements:
- Identify the question in correct format with all required elements
- PICOT for quantitative research approach
- PICo for qualitative research approach
- Identify how the expected outcome will be useful to your future practice setting
- Discuss the purpose of conducting a literature review and the contribution it will provide to this EBP proposal
- Identify the steps used to conduct a literature review for this EBP proposal by including:
- The specific library databases used
- The key search terms and phrases used
- The minor (additional) search terms and phrases used
- Identify any specialty organization that is relevant to this EBP proposal
Theoretical Framework: This section presents the theoretical framework that will used in this EBP project. It should contain the following section:
- Explain the theoretical framework to be used in this EBP proposal
- Describe how the identified theoretical framework is applied to this EBP proposal. NR505 All Papers – Week 2+Week 5 and Week 7
Preparing the NR 505 Week 2 Paper Refinement of a Nursing Concern Assignment
Criteria for Format and Special Instructions
- The paper (excluding the title page and reference page) should be at least 5, but no more than 8 pages. Points will be lost for not meeting these length requirements.
- Title page, running head, body of paper, and reference page must follow APA guidelines as found in the 6th edition of the manual. This includes the use of headings for each section of the paper except for the introduction where no heading is used.
- A minimum of 6 (six) appropriate research-based scholarly references must be used. Required textbook for this course, dictionary and Chamberlain College of Nursing lesson information may NOT be used as scholarly references for this assignment. For additional assistance regarding scholarly nursing references, please see “What is a scholarly source” located in the Course Resources tab. Be aware that information from .com websites may be incorrect and should be avoided. References are current – within a 5-year time frame unless a valid rationale is provided and the instructor has approved them prior to submission of the assignment.
- Ideas and information from scholarly, peer reviewed, nursing sources must be cited and referenced correctly. NR 505 Week 2 Paper Refinement of a Nursing Concern
- Rules of grammar, spelling, word usage, and punctuation are followed and consistent with formal, scientific writing.