NR 452 W6 RUA Capstone Evidence Based Practice Solved

NR 452 W6 RUA Capstone Evidence-Based Practice Solved

Preparing the assignment: Follow these guidelines when completing this assignment. Speak with your faculty member if you have questions.

You will find important health information regarding minority groups by exploring the following Centers for Disease Control and Prevention (CDC) links:

1. Minority Health: http://www.cdc.gov/minorityhealt/index.html
2. Racial and Ethnic Minority Populations: http://www.cdc.gov/minorityhealt/populations/remp.html

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

Reduction of Risk Potential

Patient safety is one of the central themes that has dominated patient care in the last decades. Therefore, healthcare professionals in hospitals and primary healthcare take part in various initiatives to ensure that patients are offered safe and efficient care. In addition, various nursing organizations that are stakeholders in nurse training, such as the National Council of State Boards of Nursing, ensure that when the trainer nurses are tested after training, the tests cover key areas in patient care (Denman & Cohn, 2022). For example, The National Council Licensure Examination covers four main areas, such as assurance of a safe and effective care environment. One of the priority topics related to the mentioned NCLEX-RN examination blueprint is the reduction of risk potential. These two are related in that when the healthcare professionals reduce the risk potentials among patients, then the patients are assured of safety and hence better outcomes. Therefore, the purpose of this assignment is to explore the importance of reduction of risk potential, healthcare disparities, inequalities, and interventions. In addition, this paper will focus on legal and ethical considerations, potential challenges, participants and interdisciplinary approach, and quality improvement.

The Importance of Reduction of Risk Potential

Risk can take many forms in the hospital and primary health care environments. For example, patients are usually at risk of falls, medication errors, equipment failure, diagnostic errors, errors associated with providers, and indwelling device infections (McGowan et al., 2022). All these risks can lead to adverse events if not well managed and taken care of. Therefore, it is important to come up with effective strategies to manage the risks. Even though risk management can be complex, they are key in helping hospitals and primary health care centers in detecting, assess, mitigating, and preventing risks to patients. The final outcome could be a substantial reduction of risk potential hence better patient outcomes; without a reduction of risk potential, the incidences of patient harm increase hence higher healthcare spending, adverse events, and even death (Redding et al., 2018). Reduction of risk potential is also key to the nursing profession as it reduces the chances of potential litigation due to patient harm in the care environment. Participating in risk reduction also enables the nurses to fulfill their ethical and professional obligation to enhance patient safety. Failure to participate in activities that reduce risk potential may taint the profession’s image and lead to litigations, especially when patients get harmed and die in the care environment.

Healthcare Disparities, Inequality, and Intervention.

As earlier discussed, there are several forms of risk. One of them is medication errors. While any patient can experience medication error, one of the populations which can heavily be affected by the problem if not resolved are individuals with comorbidities hence having to practice polypharmacy. Recent data indicate that these patients have medication error rates of up to 56% (Fernholm et al., 2020). Health care resources can be key in supporting evidence-based professional practice regarding the reduction of risk potential such as medication errors. Among the resources are standards of practice which entail double checks to verify patients, medication names, medication calculations, and routes. Professionals can effectively use these practice guidelines to reduce the risk of medication errors and potential harm occurring.

The reduction of risk potential is also related to healthcare disparities and inequalities. For example, the risks are higher among more vulnerable patients, such as patients with single or multiple chronic conditions. Such patients are more prone to adverse events such as medication errors, patient falls, and hospital-acquired infections. Patients from disadvantaged socio-economic backgrounds are also more prone to risk than those from privileged backgrounds (Fernholm et al., 2020). One of the solutions to medication errors as a risk is the use of bar code scanners. Barcode scanners can be key in matching the patients with the correct medications hence reducing the risk of medication errors.

Various evidence-based interventions have been used to reduce the potential risk of medication errors. Some of the interventions include the use of individual medication supply systems, integrating clinical decision support systems and computerized physician ordering systems, and checking and counterchecking the medication by the nurse prior to dispensing (Billstein-Leber et al., 2018). Among the three, the priority intervention is integrating clinical decision support systems and computerized physician ordering systems. This system is a priority since it has effectively prevented medication risk potential by substantially reducing inappropriate prescriptions, excessive dosage, and adverse drug events. In addition, the use of integrated CDSS and CPOE also results in significant improvement in required dosage and prescriptions (Gohari et al., 2021). Patient education is key when it comes to the reduction of risk potential. For example, in terms of medication errors, the patients should be educated to adhere to medication regimens and promptly report any potential drug events.

Legal and Ethical Considerations and Intervention Challenges

One of the ethical implications of addressing risk potential such as medication errors. Among them are impact on the quality of care and trust erosion. When a medication error occurs, the quality of patient care is brought to question, and a patient is highly likely to have trust issues with the provider. However, in efforts to address the risk, the provider must consider non-maleficence and justice principles. One legal implication is that in case a patient is adversely affected by a medication error, then the patient can sue the provider and the hospital (Robertson & Long, 2018). It is important to prevent ethical dilemmas related to the reduction of risk potential. Following the established guidelines can be key in preventing ethical dilemmas. One way of preventing potential legal consequences is using a reporting system such that when an error occurs, the provider reports it without fear of punishment so that the facility can explore the best solutions before the patient decides to sue. Among the challenges of reducing risk potential, such as medication errors, is possible ignorance from the practitioners. Such cases of ignorance largely dent the chances of strategies succeeding. The risk of medication errors should also be resolved. However, one potential challenge is the absence of uniform structures or procedures for resolving such issues, potentially leading to wrongful punishments.

Participants and Interdisciplinary Approach

Interdisciplinary strategies or approaches are important in reducing the risk potential, such as medication errors. Therefore, various professionals can be part of the interdisciplinary team. They include nurses, physicians, pharmacists, patients, and the patient’s families (Robertson & Long, 2018). They all have different roles in implementing the reduction of risk strategies. Nurses ensure that they give the correct medication to the patient as prescribed. The physicians ensure that they have used appropriate tools for accurate diagnosis and prescribe the correct medication. The pharmacist ensures that they give out the correct medications as prescribed by the physicians by counterchecking the prescriptions.

The patients also play a role by using the medication as prescribed. If the patient cannot follow the instructions, their family members come in to ensure that they follow the medication regimen and schedule. Pharmacists and physicians are both outside of nursing. It is important to include them in the implementation of strategies used to reduce the risk potential. For example, the physician ensures that the correct patient diagnosis and prescription are achieved (Billstein-Leber et al., 2018). The pharmacist also ensures that they give the nurses the correct medications and dosages as prescribed by the physician. As such, the two members outside of nursing play a critical role in the whole process of reducing the risk potential.

Quality Improvement

As earlier indicated, the risks within the clinical environment should be minimized as much as possible. Therefore, one benefit in patient outcomes from reducing the risk potential of medication errors is that the patients are safer in the clinical environment hence lower healthcare spending and better outcomes (Billstein-Leber et al., 2018). The nursing profession can also benefit as a result of addressing the concept as a nurse would fulfill their professional obligation of ensuring patient safety in the clinical environment. Resources are important for better solution implementation. One resource which can be used in promoting improved patient outcomes in the clinical environment includes current technology and educating patients using resources such as fliers and videos. Professional nursing knowledge can also be increased to improve clinical professional practice using various resources. One of the resources is evidence-based clinical guidelines formulated by experts. Another resource is nurse training/education resources at the hospitals. Such resources can be key in informing the nurses of the current patient care and professional practice hence better patient outcomes.

Conclusion

It is important to ensure that patients are safe in the environment; as such, the increased evidence-based professional practice should be used to help reduce the risk potential in the clinical environment. Some of the resources identified to support evidence-based professional practice include clinical guidelines and nurse education or training resource at the facilities. Reduction of risk potential such as medication errors is important for patient outcomes and evidence-based practice since it ensures that patients are safe, receive efficient care and the nurses are able to fulfill their professional obligations.

 

References

Billstein-Leber, M., Carrillo, C. J. D., Cassano, A. T., Moline, K., & Robertson, J. J. (2018). ASHP guidelines on preventing medication errors in hospitals. American Journal of Health-System Pharmacy, 75(19), 1493-1517. DOI 10.2146/ajhp170811

Denman, C. L., & Cohn, T. M. (2022). Use of standardized testing to predict NCLEX-RN success for associate degree nursing students in a concept-based curriculum. Teaching and Learning in Nursing. https://doi.org/10.1016/j.teln.2022.05.001

Fernholm, R., Holzmann, M. J., Malm-Willadsen, K., Härenstam, K. P., Carlsson, A. C., Nilsson, G. H., & Wachtler, C. (2020). Patient and provider perspectives on reducing risk of harm in primary health care: a qualitative questionnaire study in Sweden. Scandinavian Journal of Primary Health Care, 38(1), 66-74. https://doi.org/10.1080/02813432.2020.1717095

Gohari, S. H., Bahaadinbeigy, K., Tajoddini, S., & Kalhori, S. R. N. (2021). Effect of Computerized Physician Order Entry and Clinical Decision Support System on Adverse Drug Events Prevention in the Emergency Department: A Systematic Review. The Journal of Pharmacy Technology: jPT: Official Publication of the Association of Pharmacy Technicians, 37(1), 53. https://doi.org/10.1177%2F8755122520958160

McGowan, J., Wojahn, A., & Nicolini, J. R. (2022). Risk management event evaluation and responsibilities. In StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK559326/

Robertson, J. J., & Long, B. (2018). Suffering in silence: medical error and its impact on health care providers. The Journal of Emergency Medicine, 54(4), 402-409. https://doi.org/10.1016/j.jemermed.2017.12.001

Redding, M., Hoornbeek, J., Zeigler, B. P., Kelly, M., Redding, S., Falletta, L., … & Bruckman, D. (2019). Risk reduction research initiative: a national community–academic framework to improve health and social outcomes. Population Health Management, 22(4), 289-291. https://doi.org/10.1089/pop.2018.0099

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.

In this paper the student will provide a detailed description of the relationship between the category from the NCLEX-RN examination blueprint, the priority concept (topic) selected based on assessment performance, and professional practice.

• Write a 4-6 page paper (not including the title page or reference page) using APA format
• Include the following sections:
  1. Introduction- 20 points/8%
• Offer a detailed description of the purpose statement for the
• Identify the priority concept (topic) from the Individual Student Comprehensive Assessment Trends: Longitudinal Performance Table drawn from one (1) of the four (4) main categories of the NCLEX-RN examination blueprint:
• Assurance of a safe and effective care environment
• Health promotion and maintenance of health
• Preservation of the patient population’s psychosocial integrity
• Preservation of the patient population’s physiological integrity
• Provide a detailed description of the relationship between the category from the NCLEX-RN examination blueprint and the priority concept (topic).
  1. Importance – 20 points/8%
• Describe the importance of the priority concept (topic) to professional practice.
• Describe the importance of the priority concept (topic) to the health status of a patient population.
• Include the potential negative effect(s) to professional practice if the priority concept (topic) is unresolved.
• Include the potential negative effect(s) to the patient population if the priority concept (topic) is unresolved.
  1. Healthcare Disparities, Inequalities, and Interventions- 70 points/28%
     • Identify patient populations that may be negatively influenced by the priority concept (topic) if unresolved.
     • Identify healthcare resources to support evidence-based professional practice related to the priority concept (topic).
     • Summarize potential priority concept (topic) healthcare disparities and inequalities related to diverse populations.

       

     • Propose an evidence-based solution for the priority concept (topic) related to healthcare disparities.
     • Identify three (3) evidence-based practice interventions.
     • Prioritize the identified evidence-based practice interventions and provide rationale.
     • Discuss two (2) patient education considerations related to the priority concept (topic).
  2. Legal & Ethical Considerations and Intervention Challenges- 40 points/16%
     • Identify at least one (1) ethical and one (1) legal implication for addressing the priority concept (topic) in professional practice.
     • Discuss at least one (1) strategy in prevention of an ethical dilemma related to the priority concept (topic) in professional practice.
     • Discuss at least one (1) strategy in prevention of legal consequences related to the priority concept (topic) in professional practice.
     • Identify one (1) anticipated challenge to the success of preventing the priority concept (topic) in professional practice.
     • Identify one (1) anticipated challenge to the success of resolving the priority concept (topic) in professional practice.
  3. Participants and Interdisciplinary Approach – 20 points/8%
     • Identify all the parties who will be involved in the implementation of the priority concept (topic) interventions.
     • Discuss the role of each member in the intervention implementation for the priority concept (topic).
     • Identify a minimum of two (2) members of a discipline outside of nursing.
     • Discuss the benefit of including the identified interdisciplinary members from disciplines outside nursing to promote evidence-based professional practice.
  4. Quality Improvement– 20 points/8%
     • Provide at least one (1) benefit in patient outcomes from addressing the priority concept (topic) within the clinical environment.
     • Provide at least one (1) benefit to the nursing profession that will result from addressing this priority concept (topic) in clinical professional practice.
     • Discuss at least one (1) resource utilized to promote improved patient outcomes in the clinical environment.
     • Discuss at least one (1) resource utilized to increase professional nurse knowledge promoting improved clinical professional practice.
  5. Conclusion – 20 points/8%
     • Provide a thorough recap of the purpose to promote increased evidence-based professional practice knowledge related to the priority concept (topic) deficiency.
     • Summarize resources identified to support improved evidence-based professional practice related to the priority concept (topic).
     • Include a complete statement describing why addressing the priority concept (topic) matters for patient outcomes and evidence-based professional practice.

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Physiological Adaptation

Physiological adaptation is the identified topic from the Individual Student Comprehensive Assessment Trends. On

the longitudinal performance table, I scored 70%, and this was the least performed. The physiological adaptation category accounted for 14% of the whole percentage, and it includes managing and providing care for patients with acute, chronic, and life-threatening physical conditions goals (National Council of State Boards of Nursing, 2018). The related content includes alterations in body systems, medical emergencies, fluid and electrolyte imbalances, pathophysiology, unanticipated response to therapies, and hemodynamics (Silvestri & Silvestri, 2019; Brussow& Dunham, 2018). The purpose of this paper is to discuss physiological adaptation in the aspects of its importance, healthcare disparities and interventions, legal and ethical considerations, interdisciplinary approach, and quality improvement.

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Importance

Patients often require some level of physiological adaptation to maintain and maximize physiological integrity. Physiological adaptation is significant to professional practice because providers must understand that a client’s body goes through various alterations when responding to a disease process, illness, medical, and surgery intervention (Wang et al., 2020). Thus, acknowledging the alterations enable providers to provide appropriate care to help the patient return to a near-normal state of health. The concept is also significant to the health status of a patient population because it determines a patient’s ability to cope with their health state and adapt to an impaired physical state. If physiological adaptation is unresolved, health providers may face prolonged hospitalization rates, high readmission rates, and increased workload (Wang et al., 2020). Besides, patients may suffer from increased complications, high morbidity rates, increased healthcare costs.

Healthcare Disparities, Inequalities, and Interventions

All patient populations across the lifespan may be negatively affected by physiological adaptation if it goes unresolved. For instance, pregnant women, fetuses, and newborns may be negatively affected if potential prenatal complications are not identified promptly and appropriate interventions are implemented, resulting in complications during pregnancy, labor, and delivery (Silvestri & Silvestri, 2019). Besides, pediatric and adults patients may develop hypothermia and hyperthermia if the underlying disorders causing the symptoms are not corrected. Critically ill patients on ventilators may also develop complications if physiological adaptation to respiration is not resolved (Wang et al., 2020). The potential complications include alveolar over-distension, oxygen toxicity, cardiac complications, hypo/hyperventilation, and respiratory infections. In addition, post-op patients are at risk of postoperative complications, such as bleeding, pain, surgical site infection, due to a lack of appropriate interventions to promote optimal physiological adaptation and failure to monitor and intervene appropriately.

Healthcare resources to support evidence-based professional practice with regard to physiological adaptation include clinical trials, peer-reviewed journal articles, randomized clinical trials, treatment guidelines, practice guidelines, and best practices. The healthcare disparities can be addressed by incorporating health education into patient care to empower patients to progress toward their health goals (Escoffery et al., 2018). Health education should consider the intrinsic and extrinsic factors that can facilitate or deter the patient’s progress. Intrinsic factors include underlying conditions such as hypertension and obesity, whereas extrinsic factors include a patient’s social support system. Besides, health education should focus on improving patients’ safe care interventions and helping them modify their lifestyle to healthier lifestyle practices (Escoffery et al., 2018). In addition, health education should focus on empowering patients to maximize their areas of strength and improve on their weaknesses.

Legal & Ethical Considerations and Intervention Challenges

Ethical and legal implications arise in relation to physiological adaptation. Ethical issues surrounding the issue include beneficence, the moral duty to do good. Health providers are required to evaluate interventions and implement those that will provide the best possible outcomes while causing the least harm to the patient (AbuAbah et al., 2019). Legal implications arise with regards to privacy and confidentiality. Providers may face legal consequences if they fail to uphold the confidentiality of a patient’s health information without their consent or if there is a breach of privacy (AbuAbah et al., 2019).

Ethical dilemmas can be prevented by using the ethical decision-making model, which is a framework for resolving ethical dilemmas. The nurse should consider the ethical principles involved, individuals who will be affected, and the consequences of each decision. Legal consequences can be avoided by always seeking informed consent before assessing patients, initiating treatment, or sharing patient information (AbuAbah et al., 2019). Potential challenges to preventing failures in physiological adaptation include unhealthy lifestyle practices that lead to chronic illnesses such as sedentary lifestyle, high caloric intake, smoking, and excessive alcohol consumption. Potential challenges to resolving physiological adaptation include factors like antibiotic resistance, which may hinder successful recovery from bacterial infections.

Participants and Interdisciplinary Approach

The interdisciplinary team involved in addressing physiological adaptation will include physicians, registered nurses (RNs), nutritionists, renal nurses, respiratory therapists, and physical therapists. The physician’s roles include patient assessment, performing invasive procedures, prescribing treatment, and evaluating treatment plans. The RNs will monitor vital signs, perform wound care, and provide patient education (Rosen et al., 2018). Besides, the nutritionist will assess patients’ nutritional requirements, plan daily diet, and provide nutritional support. The renal nurse will monitor patients before, during, and after dialysis. The respiratory therapist will be involved in setting the ventilator and monitoring patients on the ventilator (Rosen et al., 2018). Lastly, the physical therapist will be tasked with providing physical therapy to improve patients’ mobility, restore function, and prevent disability.

The importance of including non-nursing professionals such as nutritionists and therapists is that they will offer input on best managing patients’ nutrition and functional movement since they have specialized knowledge and skills (Rosen et al., 2018). The interdisciplinary approach can enhance patient outcomes, clinical practices, and patient satisfaction. It can also help decrease the length of stay and avoid duplication of services, promoting a comprehensive and holistic approach to care.

Quality Improvement

Addressing physiological adaptation is associated with benefits to both the patients and the nursing profession. It will help prevent disease complications and associated morbidities, thus promoting better patient outcomes. Reduced health complications and better patient outcomes result in reduced hospital stays and readmission rates, which lower nurses’ workload (Escoffery et al., 2018). Therefore, the nursing profession will benefit from a reduced workload and burnout levels, which will ensure they have adequate time to attend to other critical patient care issues.

Resources used to promote improved patient outcomes in the clinical environment include technological advancements such as automated IV pumps and Electronic health records, which promote safe administration of IV fluids and drugs and safe storage of patient information. Resources used to improve professional nurse knowledge include professional development courses (Mlambo et al., 2021). They aim at increasing nurses’ knowledge and skills in areas such as Medical Emergencies and managing alterations in Body Systems, fluid and electrolyte Imbalances, and hemodynamic instability.

Conclusion

Physiological adaptation aligns with the NCLEX text plan on preserving the patient population’s physiological integrity. This is because the nurse has a major role in promoting physical health and wellness by providing care and comfort, minimizing the potential risk to patients, and managing alterations in health. Health providers must understand alteration in physiological adaptation to identify abnormalities in patients and provide appropriate care interventions to help them return to a near-normal state of health. Therefore, an interdisciplinary approach is recommended since members from different professions can share ideas on evidence-based interventions to promote better patient outcomes. Resources that promote evidence-based practice include clinical trials, treatment and practice guidelines, and best practices.

References

AbuAbah, F., Alwan, A., Al-Jahdali, Y., Al Shaikh, A., Alharbi, A., & Al-Jahdali, H. (2019). Common medical ethical issues faced by healthcare professionals in KSA. Journal of Taibah University Medical Sciences, 14(5), 412–417. https://doi.org/10.1016/j.jtumed.2019.09.001

Brussow, J. A, & Dunham, M. (2018). Students’ mid-program content area performance as a predictor of end-of-program NCLEX readiness. Nurse educator, 43(5), 238–241.

Escoffery, C., Lebow-Skelley, E., Haardoerfer, R., Boing, E., Udelson, H., Wood, R., … & Mullen, P. D. (2018). A systematic review of adaptations of evidence-based public health interventions globally. Implementation Science, 13(1), 1-21. https://doi.org/10.1186/s13012-018-0815-9

Mlambo, M., Silén, C., & McGrath, C. (2021). Lifelong learning and nurses’ continuing professional development, a meta-synthesis of the literature. BMC nursing, 20(1), 1-13. https://doi.org/10.1186/s12912-021-00579-2

National Council of State Boards of Nursing. (2018). 2019 NCLEX-RN Test Plan. Chicago:

Rosen, M. A., DiazGranados, D., Dietz, A. S., Benishek, L. E., Thompson, D., Pronovost, P. J., & Weaver, S. J. (2018). Teamwork in healthcare: Key discoveries enabling safer, high-quality care. The American psychologist, 73(4), 433–450. https://doi.org/10.1037/amp0000298

Silvestri, L. A., & Silvestri, A. E. (2019). Saunders Comprehensive Review for the NCLEX-RN® Examination-E-Book.

Wang, X., Shao, J., & Ye, Z. (2020). Understanding and Measuring Adaptation Level Among Community-Dwelling Patients with Metabolic Syndrome: A Cross-Sectional Survey. Patient preference and adherence, 14, 939–947. https://doi.org/10.2147/PPA.S248126