PICOT Paper: Evidence-Based Practice Project

Engaging in evidence-based practice (EBP) projects is among the most practical interventions for addressing health problems. Nurses use nursing interventions founded on research to enhance health outcomes. This paper describes the population, intervention, and expected outcome. It also explains the implementation time and the application of aqnursing science, social determinants of health, and epidemiologic, genomic, and genetic data in supporting the health management of children with obesity.

The wellness of a population’s health using improved patient safety protocols implores healthcare workers (HCWs) especially nurses, to develop evidence-based practice interventions to reduce and prevent occurrence of adverse events like hospital acquired infections (HAIs) and medication administration errors (MAEs) among others. These adverse events lead to poor patient outcomes, increase the overall cost of care and disease burden, and lowers the quality of care delivered by healthcare professionals. Hospital acquired infections are some of the leading healthcare concerns that affect patient safety and quality of care. Many patients suffer from these infections that result into lengthened stays in hospitals, increased cost of care, and in extreme circumstances death.

Population’s Demographics and Health Concerns

The focus population for the EBP project is children usually categorized as preschool-aged children (2-5 years) and school-aged children (6-11 years). Preschool-aged children are usually highly dependent on parents’ choices, including nutritional health, hobbies, and general lifestyle. As they move from pre-

school to school age, children become somewhat dependent on some choices. They start choosing hobbies and establish relationships that influence their daily habits.

Childhood obesity is a serious health concern in the United States whose prevalence is increasing and putting children at risk of poor health. Skinner et al. (2018) found that childhood obesity’s prevalence is still high in the US since 1 in every 5 children has obesity. As the prevalence of obesity increases, children are more exposed to immediate and long term risks of obesity. Vulnerability to heart disease, type 2 diabetes, and cancer is high in children with obesity (Lindberg et al., 2020). Overall, the quality of health declines and children are not productive as desired.

As the populace, government, and health care providers intensify measures to fight obesity, it is disappointing to experience a proportional risk in risk factors. According to Tester et al. (2018), lifestyle changes characterized by low physical activity are continuously exposing children to obesity. Fast foods’ consumption is another risk factor. Pearson et al. (2020) suggested that sedentary living characterized by too much screen time must be addressed to reduce childhood’s obesity prevalence. Gaming, watching television for extended periods, and social interaction through mobile phones can be blamed for the reduced physical activity among children. Regulation is necessary as parents, educators, and health care providers collaborate to encourage physical activity at homes, schools, and communities.

Evidence-Based Intervention

As proposed in the PICOT (Appendix 1), the identified intervention is educating parents and children about the importance of limiting screen time and increasing physical activity. Obesity risk is increased by increased screen time because it is associated with PICOT Paper Evidence-Based Practice Project excessive energy intake and insufficient physical activity (Schwarzfischer et al., 2020). It is expected that educating parents and children will result in positive behavior changes because parents will regulate their children and children will avoid spending too much time on screens because they will understand the consequences. The intervention incorporates health policies and goals that support health equity for children because it focuses on ensuring that children reach their full health potential. When disadvantaged groups are protected from health disparities and assisted in achieving a decent standard of living, health equity is achieved. Preventing childhood obesity is a critical step toward achieving this critical goal.

Also Check Out: Translational Research Graphic Assignment

Click here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS: PICOT Paper: Evidence-Based Practice Project

Intervention Comparison to Previous Research

Previous research confirm that parents are responsible for modeling children’s behaviors by regulating screen time, and awareness to embrace this role is necessary. Pearson et al. (2020) found that shortage of parent- and home-focused interventions to address unhealthy behaviors such as intake of energy-dense snack foods and excessive screen time increases childhood obesity rates. Parental confidence and awareness of the association between screen time and unhealthy behaviors are also recommended. Goncalves et al. (2019) found that parental confidence and self-efficacy to reduce screen time is instrumental in addressing overweight problems among children. With research confirming the central role parents play in regulating screen time, it is essential to encourage them to embrace this critical role and serve as role models of healthy behaviors.

Expected Outcome

Educating parents and children on the implications of too much screen time is expected to be the foundation of behavior change. As a nursing intervention, the education program will improve knowledge on the connection between obesity in children and screen time as a risk factor. Minimizing screen time will lead to a proportional reduction in obesity rates among children, which has become a public health concern since its trend has taken an upward trajectory in the past decade (Skinner et al., 2018). The overall outcome is creating a healthy populace by reducing obesity rates among school-age children.

Time for Implementing and Evaluation

Implementation should be immediate. Since the focus population and intervention are known, parents and children’s education on screen time should be done instantly. Doing so will help to achieve the target objective within six months as proposed in the PICOT. Outcome evaluation will be progressive (monthly) and summative (after six months). Progressive evaluation will help to identify areas that need improvement, and summative evaluation will be used to deduce whether the target objectives were achieved.

Applying Nursing Science, SDOH, and Data

Population health management for children applies evidence, tools, and data from different sources. Nursing science helps to develop theories and practical concepts to manage conditions. It provides scientific ways to deliver better health services. Social determinants of health (SDOH) have much to do with living conditions. In this case, health care providers examine how environments where children are born and live, beliefs and socioeconomic status influence obesity and other illnesses and appropriate interventions. Epidemiological data is the basis for determining disease frequency and potential causes. Genomic and genetic data are closely related. Genomic data examines functional information in DNA as genetic data examines the acquired characteristics of children and their influence on health.

In conclusion, children deserve quality health and should be protected from vulnerabilities such as obesity. In response, nurses should use their knowledge and influence to promote quality public health. They should be centrally involved in identifying critical problems that hamper people’s productivity and invent lasting solutions. Addressing childhood obesity by educating parents and children on reducing screen time is an evidence-based lasting solution.

References

Goncalves, W. S. F., Byrne, R., Viana, M. T., & Trost, S. G. (2019). Parental influences on screen time and weight status among preschool children from Brazil: A cross-sectional study. International Journal of Behavioral Nutrition and Physical Activity, 16(1), 1-8. doi: https://dx.doi.org/10.1186%2Fs12966-019-0788-3

Lindberg, L., Danielsson, P., Persson, M., Marcus, C., & Hagman, E. (2020). Association of childhood obesity with risk of early all-cause and cause-specific mortality: A Swedish prospective cohort study. PLoS Medicine, 17(3), e1003078. https://doi.org/10.1371/journal.pmed.1003078

Pearson, N., Biddle, S. J., Griffiths, P., Sherar, L. B., McGeorge, S., & Haycraft, E. (2020). Reducing screen-time and unhealthy snacking in 9–11 year old children: the Kids FIRST pilot randomised controlled trial. BMC Public Health, 20(1), 1-14. doi: 10.1186/s12889-020-8232-9

Benchmark – Evidence-Based Practice Project: PICOT Paper

Refer to the PICOT you developed for your evidence-based practice project proposal. If your PICOT required revision, include those revisions in this assignment. You will use your PICOT paper for all subsequent assignments you develop as part of your evidence-based practice project proposal in this course and in NUR-590, during which you will synthesize all of the sections into a final written paper detailing your evidence-based practice project proposal.

Write a 750-1,000-word paper that describes your PICOT.

Describe the population’s demographics and health concerns.
Describe the proposed evidence-based intervention and explain how your proposed intervention incorporates health policies and goals that support health care equity for the population of focus.
Compare your intervention to previous practice or research.
Explain what the expected outcome is for the intervention.
Describe the time for implementing the intervention and evaluating the outcome.
Explain how nursing science, social determinants of health, and epidemiologic, genomic, and genetic data are applied or synthesized to support population health management for the selected population.
Create an Appendix for your paper and attach the PICOT. Be sure to review feedback from your previous submission and revise your PICOT accordingly.
Complete the “APA Writing Checklist” to ensure that your paper adheres to APA style and formatting criteria and general guidelines for academic writing. Include the completed checklist as the final appendix at the end of your paper.

Refer to the “Evidence-Based Practice Project Proposal – Assignment Overview” document for an overview of the evidence-based practice project proposal assignments.

You are required to cite at least four to six peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

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.

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

Benchmark Information

This benchmark assignment assesses the following programmatic competencies:

MBA-MSN; MSN-Nursing Education; MSN Acute Care Nurse Practitioner-Adult-Gerontology; MSN Family Nurse Practitioner; MSN-Health Informatics; MSN-Health Care Quality and Patient Safety; MSN-Leadership in Health Care Systems; MSN-Public Health Nursing

MS Nursing: Public Health

MS Nursing: Education

MS Nursing: Acute Care Nurse Practitioner

MS Nursing: Family Nurse Practitioner

MS Nursing: Health Care Quality and Patient Safety

4.1: Synthesize nursing science, determinants of health, and epidemiologic, genomic, and genetic data in the management of population health.

Many authors argue that the ethical issues confronting translational research are similar to those encountered in basic clinical research, but they are diverse and complex (Mandal et al., 2017). The various stages of the process present various ethical challenges. Informed consent, animal bioethics, conflicts of interest, social injustice, and risk analysis are all part of the research process, just as they are in biomedical research. Data transfer can suffer ethical issues with confidentiality during gaps. Resources and funding can also raise ethical concerns, particularly during the research’s preapproval phase. Due to patent issues, financial connections between research scientists and fund supporters can act as cofounders, resulting in issues such as nondisclosure risk information to participants and negative results in publications. While research by resource-rich countries on resource-poor countries is common, it causes social injustice and disparity, especially when the results are not expected to benefit the resource-poor country.

One example is disease research that results in inventions or products that are too expensive for developing countries to implement. Funding allocations favor research processes that have a higher chance of success and commercialization over those that have a greater impact on public health but have fewer chances of success or are difficult to conduct. Although translational research ethics is not a new field of biomedical ethics, issues must be addressed in order to identify and prevent unethical practices (Mandal et al., 2017). The well-being of research participants and society should take precedence over the advancement of knowledge.

Healthcare providers, including nurses, have a professional and social responsibility to ensure fairness and equity to patients, families, and communities in the face of rapidly evolving technology (Badzek et al., 2013). As it relates to healthcare provider obligations, nurses should be aware of and understand basic ethical principles and laws concerning human rights and the duty to warn.

Support for Population Health Management for Selected Population (C 4.1) 10.0% Explanation of how nursing science; social determinants of health; and epidemiologic, genomic, and genetic data are applied or synthesized to support population health management for the selected population is omitted. Explanation of how nursing science; social determinants of health; and epidemiologic, genomic, and genetic data are applied or synthesized to support population health management for the selected population is incomplete. There are major inaccuracies. Explanation of how nursing science; social determinants of health; and epidemiologic, genomic, and genetic data are applied or synthesized to support population health management for the selected population is summarized. More information and support are needed. Explanation of how nursing science; social determinants of health; and epidemiologic, genomic, and genetic data are applied or synthesized to support population health management for the selected population is adequate. Some detail is needed for accuracy or clarity. Explanation of how nursing science; social determinants of health; and epidemiologic, genomic, and genetic data are applied or synthesized to support population health management for the selected population is thorough. The narrative is insightful and demonstrates an understanding of how the various aspects contribute to population health management for selected populations.

Appendix 5.0% The appendix and required resources are omitted. The APA Writing Checklist and PICOT are attached, but an appendix has not been created. The paper does not reflect the use of the APA Writing Checklist during development. The APA Writing Checklist and PICOT are attached in the appendix. The APA Writing Checklist was generally used in development of the paper, but some aspects are inconsistent with the paper format or quality. The APA Writing Checklist and PICOT are attached in the appendix. It is apparent that the APA Writing Checklist was used in development of the paper. The APA Writing Checklist and PICOT are attached in the appendix. It is clearly evident by the quality of the paper that the APA Writing Checklist was used in development.

Organization and Effectiveness 20.0%
Thesis Development and Purpose 7.0% Paper lacks any discernible overall purpose or organizing claim. Thesis is insufficiently developed or vague. Purpose is not clear. Thesis is apparent and appropriate to purpose. Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose. Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.

Argument Logic and Construction 8.0% Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources. Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility. Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis. Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative. Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.

Mechanics of Writing (includes spelling, punctuation, grammar, language use) 5.0% Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used. Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied. Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed. Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech. Writer is clearly in command of standard, written, academic English.

Format 10.0%
Paper Format (Use of appropriate style for the major and assignment) 5.0% Template is not used appropriately or documentation format is rarely followed correctly. Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent. Template is used, and formatting is correct, although some minor errors may be present. Template is fully used; There are virtually no errors in formatting style. All format elements are correct.

Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style) 5.0% Sources are not documented. Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors. Sources are documented, as appropriate to assignment and style, although some formatting errors may be present. Sources are documented, as appropriate to assignment and style, and format is mostly correct. Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.

Topic 3 DQ 2

Discuss the role of the Institutional Review Board. Discuss ethical research considerations specific to population health. How are respect for the persons, potential benefits and burdens of the research, and justice kept in balance? Provide an example.

Re: Topic 3 DQ 2

The Institutional Review Board (IRB) is responsible for approving, rejecting, or requiring changes in a research study in order to gain approval from the Federal Drug Administration (FDA) (Parker, 2016). The primary goal of the IRB is to protect the rights, welfare, and security of research subjects. As a result, all research studies involving human subjects must first obtain IRB approval before proceeding, though there are exceptions to this policy. Failure to obtain IRB approval will result in disapproval, and the results and data will be barred from publication in a peer-reviewed journal (Parker, 2016).

Because genetic, biological, environmental, and lifestyle factors all influence disease development in certain populations, it is critical that research is conducted to investigate causes and find solutions. Furthermore, the research must be consistent and transparent throughout all phases, while adhering to regulatory standards. Because some populations (elderly, minorities, disabled, etc.) are deemed vulnerable or disadvantaged in population health research, it is critical that additional safeguards are implemented to protect their rights and safety (Al Tajir, 2018).

Clinical researchers are required to follow the ethical principles outlined in the Belmont Report (Al Tajir, 2018). Informed consent, the evaluation of risks and benefits in research, and the selection of research participants are all guided by the principles of beneficence, nonmaleficence, respect, and justice (Al Tajir, 2018). Furthermore, because of the complexities involved, such as in natural disasters and disease outbreaks, there are additional ethical considerations in population health (Al Tajir, 2018). A risk-benefit analysis must be performed to protect study participants (Al Tajir, 2018). A risk-benefit analysis compares potential risks to the benefits to participants and the community (Al Tajir, 2018). When recruiting subjects for research, keep in mind that the health and welfare of all eligible participants is equally important, and they should not be denied participation in research because of their age, gender, or race (Al Tajir, 2016). This provision, however, may not apply in all circumstances. For example, I participated in a clinical study with participants who were classified as overweight or obese based on their BMI (BMI). Because the research drug was being studied for its efficacy in the treatment of obesity, the recruitment was fair and nondiscriminatory. As a result, people who were not considered obese were excluded from the study because they would not benefit directly from it.

References

Al Tajir, G. K. (2018). Ethical treatment of participants in public health research. Journal of Public Health and Emergency, 2, 2-2. https://doi.org/10.21037/jphe.2017.12.04

Parker G. E. (2016). A framework for navigating institutional review board (IRB) oversight in the complicated zone of research. Cureus, 8(10), e844. https://doi.org/10.7759/cureus.844

Translational Research Graphic Organizer State the nursing practice problem for your evidence-based practice project. If your nursing problem has not yet been approved, make any required changes or revisions to your nursing practice problem prior to starting the assignment. Using your proposed topic, conduct a literature search and complete the tables below. Nursing Practice Problem: The problem that this project seeks to address is the incomprehensive hand-off during nurse change-overs. Roslan & Lim (2017) characterized the problem as the communication breakdown that happens during nurse-to-nurse change-overs. The problem arises because nurses use ineffective handover practices that increase the risks of miscommunication. For example, nurses practice bedside handovers whereby information is verbally shared between off-shift and incoming nurses (Fealy et al, 2018). There is also no structured procedure, framework, and/or checklist used to conduct handovers (Fealy et al, 2018). As a result, inaccurate, incomplete, and misleading information is transferred. This is a significant problem because it increases the risks of medical errors thus compromising patient safety. Comparison 1: Translational Research vs. Qualitative Research Criter ia Peer-Reviewed Translational Peer-Reviewed Traditional Article and Article and Permalink/Working Permalink/Working Link: Link: Fealy, G., Donelly, S., Doyle, G., Brenner, M., Patterson, A., McIntire, E., Hughes, M, Mylotte, E.,…Ziki, M. (2018). Beecroft, N., Happ, M, MoffatClinical handover practices among healthcare Bruce, S. (2019).Nursing practitioners in acute care services: A qualitative Handovers in Critical Care: A study. Journal of Clinical Nursing, 28(2), 1-9. Retrospective Analysis of https://www.researchgate.net/profile/MaryInformation Content and HughesFunction. Proceedings of the 12/publication/326954892_Clinical_handover_pr International Symposium on © 2021. Grand Canyon University. All Rights Reserved. Observations (Similarities/Differences) Human Factors and Ergonomics in Health Care 8(1), 4-8. actices_among_healthcare_practitioners_in_acute _care_services_A_qualitative_study/links/5bed4a 174585150b2bb7a768/Clinical-handoverpractices-among-healthcare-practitioners-inacute-care-services-A-qualitative-study.pdf https://www.researchgate.net/prof ile/Emily-Patterson15/publication/335838980_Nursi ng_Handovers_in_Critical_Care_ Traditional Qualitative Research Type: A_Retrospective_Analysis_of_Inf Descriptive study. ormation_Content_and_Function/ links/5da123cc299bf116fe9ed67f/ Nursing-Handovers-in-CriticalCare-A-Retrospective-Analysisof-Information-Content-andFunction.pdf Translational Research Type: Descriptive study. Metho The study adopted a descriptive dology design. Qualitative data obtained from previously conducted experiments were subjected to emergent theme analysis (Patterson et al, 2019). The study adopted a qualitative-descriptive design The two studies are similar in the (Fealy et al, 2018). Qualitative data were used to sense that they employed describe existing handover practices. The content qualitative data and techniques. analysis method was used to analyze research data. Both of them also employ a descriptive approach. © 2021. Grand Canyon University. All Rights Reserved. Goals The goal is to establish the right contents for inclusion in electronic handover reports (Patterson et al, 2019). The goal is also to establish the most effective format and designs for electronic handover reports. To assess nursing handover practices (Fealy et al, Goals are similar in the sense that 2018). The goal is also to determine the factors they both address the effectiveness that influence the effectiveness of handover of handover practices. practices. The translational study, however, has a more pragmatic goal. It addresses a practical question/problem, that is, how to present handover information appropriately. For traditional research, the goal addresses a theoretical problem. Data Collec tion Data were collected from 20 reports on previous experimental studies. Handover information relating to 20 patients was used to establish the most important contents of a handover report. Data about the current handover practices were collected using focused group discussions and interviews. Data were obtained from 116 practitioners working in rural and urban hospitals (Fealy et al, 2018). © 2021. Grand Canyon University. All Rights Reserved. While the traditional research article relied on primary data sources, the translational research article utilized secondary data. The other difference is that the translational study incorporated data about patients while the traditional research article relied exclusively on expert information from nurse practitioners. Comparison 2: Translational Research vs. Quantitative Research Criteri a Peer-Reviewed Translational Article and Permalink/Working Link: Lee, S., Atrkinson, E., Minaerd, G., Obrien, A. (2018). Electronic tool helps anesthesia trainee handovers. The Clinical Teacher, 15, 1-6. https://booksc.org/book/ 68537697/f393a5 Peer-Reviewed Traditional Article and Permalink/Working Link: Observations (Similarities/Differences) Delardes, B., McLeod, L., & Chakraborty, S. (2020). What is the effect of electronic clinical handovers on patient outcomes: A systematic review. Health Informatics Journal, 1-12. https://journals.sagepub.com/doi/fu ll/10.1177/1460458220905162 Translational Research Type: Applied Research Traditional Quantitative Research Type: Basic research Methodology An experimental design was adopted. Trainee nurses were observed giving intraoperative handovers with a checklist and then without a checklist (Lee et al, 2018). The study adopted a quantitative approach. Numerical data from previous experimental studies were subjected to quantitative analysis to establish the impacts of electronic handover. Both adopted a quantitative approach. The difference is that translational research used an experimental design while traditional research relied on data obtained from past experimental studies. © 2021. Grand Canyon University. All Rights Reserved. Goals Data Collection The goal is to develop a standardized electronic handover (Lee et al, 2018). This would help overcome the challenge of incomplete handover information during shift change-overs. The goal of the study is to compare different electronic handover methods in terms of their effectiveness (Delardes, McLeod & Chakraborty, 2020). Both studies aim at improving the effectiveness of handover practices. Data for the study was collected using the observation method. The trainee nurses were observed while experimenting with handover checklists. Data about the impact of electronic handover methods on outcomes such as risks of adverse events, time to procedure, and handover completeness were obtained from reputable electronic databases from which the reviewed articles were obtained include Embase, MEDLINE, and Scopus. The main difference is that the translational research article relied on primary data while secondary data was relied upon in the traditional research article. The difference is that the translational study aimed at producing a tangible solution in the form of a useful handover checklist that can be used in a nursing environment. On the other hand, the traditional research article intends to create theoretical knowledge on effective handover practices. © 2021. Grand Canyon University. All Rights Reserved. © 2021. Grand Canyon University. All Rights Reserved. References Delardes, B., McLeod, L., & Chakraborty, S. (2020). What is the effect of electronic clinical handovers on patient outcomes: A systematic review. Health Informatics Journal, 1-12. Fealy, G., Donelly, S., Doyle, G., Brenner, M., Hughes, M, Mylotte, E.,…Ziki, M. (2018). Clinical handover practices among healthcare practitioners in acute care services: A qualitative study. Journal of Clinical Nursing, 28(2), 1-9. Lee, S., Atrkinson, E., Minaerd, G., Obrien, A. (2018). Electronic tool helps anesthesia trainee handovers. The Clinical Teacher, 15, 16. https://booksc.org/book/68537697/f393a5 Patterson, A., McIntire, E., Beecroft, N., Happ, M, Moffat-Bruce, S. (2019).Nursing Handovers in Critical Care: A Retrospective Analysis of Information Content and Function. Proceedings of the International Symposium on Human Factors and Ergonomics in Health Care, 8(1), 4-8. Roslan, B., & Lim, L. (2017). Nurses’ perceptions of bedside clinical handover in a medical-surgical unit: An interpretive descriptive study. Proceedings of Singapore Healthcare, 26(3), 150–157. © 2021. Grand Canyon University. All Rights Reserved. PICOT Draft Name__Wendy Fernandez __ Part 1: Propose a relevant nursing practice problem for an evidence-based practice project. Explain why you selected this topic and how it is relevant to advance nursing practice. Include one research article that demonstrates support for the nursing practice problem. Incomprehensive handing off is one of the major nursing practice problems in the U. S. According to Roslan & Lim (2017), incomprehensive handoff implies communication breakdown during nurse-to-nurse shift change. This topic is chosen because it significantly impacts patients’ safety. It accounts for more than 70% of adverse medical events, and in-hospital deaths (Shahid & Thoman, 2018). The topic is relevant since inaccurate reporting of patient information can lead to medical errors, delay in treatment, and/or the formulation of inappropriate patients’ treatment plans. Part II: In the table below, describe the population and the intervention. (You will continue drafting the PICOT, completing the shaded areas in Topic 3.) PICOT Question P I C Population Can the use of electronic handovers and structured communication tools reduce in-hospital mortality, within one year, for the population of inpatientn individuals diagnosed with heart disease? Patients admitted to hospitals with heart disease are the population of focus for this evidencebased project. Heart disease accounts for the highest number of hospital admissions, and deaths in the U. S. According to Heron (2021), heart disease accounts for 24% of all the deaths in the U. S. Deaths due to heart disease are also highest among non-Hispanic whites and non-Hispanic blacks (Heron, 2021). These findings seek to show that incomprehensive handoff affects heart disease patients the most. The proposed intervention is to introduce electronic handovers, and structured communication tools as mandatory requirements in clinical environments. A study by Delardes, McLeod & Chakraborty (2020) established that electronic handovers have the potential of improving the accuracy of nurse-to-nurse communications, and reducing delays in the Intervention provision of critical care. A structured communication tool would ensure that detailed, and complete patient information is shared between nurses, thus reducing the occurrence of medical errors, and/or the formulation of ineffective treatment plans. Comparison © 2021. Grand Canyon University. All Rights Reserved. O Outcome T Timeframe PICOT Problem Statement © 2021. Grand Canyon University. All Rights Reserved. References Delardes, B., McLeod, L., & Chakraborty, S. (2020). What is the effect of electronic clinical handovers on patient outcomes: A systematic review. Health Informatics Journal, 1-12. Heron, M. (2021). Deaths: Leading Causes for 2018. National Vital Statistics Reports, 70 (4), 1-65, Roslan, B., & Lim, L. (2017). Nurses’ perceptions of bedside clinical handover in a medical-surgical unit: An interpretive descriptive study. Proceedings of Singapore Healthcare, 26(3), 150–157. Shahid, S., & Thomas, S. (2018). Situation, Background, Assessment, Recommendation (SBAR) Communication Tool for Handoff in Health Care – A Narrative Review. Saf Health, 4, 7. © 2021. Grand Canyon University. All Rights Reserved. PICOT Draft Name_____________________________________ Part 1: Propose a relevant nursing practice problem for an evidence-based practice project. Explain why you selected this topic and how it is relevant to advance nursing practice. Include one research article that demonstrates support for the nursing practice problem. Part II: In the table below, describe the population and the intervention. (You will continue drafting the PICOT, completing the shaded areas in Topic 3.) PICOT Question P Population I Intervention C Comparison O Outcome T Timeframe PICOT Problem Statement © 2021. Grand Canyon University. All Rights Reserved.

APA Writing Checklist

Use this document as a checklist for each paper you will write throughout your GCU graduate program. Follow specific instructions indicated in the assignment and use this checklist to help ensure correct grammar and APA formatting. Refer to the APA resources available in the GCU Library and Student Success Center.

☐ APA paper template (located in the Student Success Center/Writing Center) is utilized for the correct format of the paper. APA style is applied, and format is correct throughout.

☐ The title page is present. APA format is applied correctly. There are no errors.

☐ The introduction is present. APA format is applied correctly. There are no errors.

☐ Topic is well defined.

☐ Strong thesis statement is included in the introduction of the paper.

☐ The thesis statement is consistently threaded throughout the paper and included in the conclusion.

☐ Paragraph development: Each paragraph has an introductory statement, two or three sentences as the body of the paragraph, and a transition sentence to facilitate the flow of information. The sections of the main body are organized to reflect the main points of the author. APA format is applied correctly. There are no errors.

☐ All sources are cited. APA style and format are correctly applied and are free from error.

☐ Sources are completely and correctly documented on a References page, as appropriate to assignment and APA style, and format is free of error.

Scholarly Resources: Scholarly resources are written with a focus on a specific subject discipline and usually written by an expert in the same subject field. Scholarly resources are written for an academic audience.

Examples of Scholarly Resources include: Academic journals, books written by experts in a field, and formally published encyclopedias and dictionaries.

Peer-Reviewed Journals: Peer-reviewed journals are evaluated prior to publication by experts in the journal’s subject discipline. This process ensures that the articles published within the journal are academically rigorous and meet the required expectations of an article in that subject discipline.

Empirical Journal Article: This type of scholarly resource is a subset of scholarly articles that reports the original finding of an observational or experimental research study. Common aspects found within an empirical article include: literature review, methodology, results, and discussion.

Adapted from “Evaluating Resources: Defining Scholarly Resources,” located in Research Guides in the GCU Library.

☐ The writer is clearly in command of standard, written, academic English. Utilize writing resources such as Grammarly, LopesWrite report, and ThinkingStorm to check your writing.

Trauma occurs when individuals are overwhelmed by circumstances or events and counters them with extreme horror, fear, and helplessness. Excessive stress overwhelms an individual’s coping capacity. Trauma can stem from exposure to abuse, discrimination, neglect, violence, and accidents (Shalaby & Agyapong, 2020). This paper seeks to describe populations with traumatic experiences and an intervention to address the concern and discuss factors that influence health management.

Population’s Demographics and Health Concerns

According to the National Council for Behavioral Health (NCBH), 70% of adults in the U.S. have experienced a traumatic event at least once. Almost all children who observe a parental homicide or sexual assault will develop Post Traumatic Stress Disorder (PTSD). Likewise, 90% of sexually abused children, 77% who school shootings, and 35% of youths exposed to community violence develop PTSD (NCBH, 2020). Trauma is associated with adverse effects on physical and mental health as well as social and occupational functioning. Physical effects include headaches, excessive sweating, palpitations, altered bowel patterns, and being easily startled. Mental impact includes fear, anxiety, depression, emotional swings, increased alcohol and drug use, and sleeping difficulties (Mikhail et al., 2018). Furthermore, individuals socially isolate themselves due and have diminished interest in activities.

Proposed Evidence-Based Intervention

The proposed intervention incorporates peer support in trauma-informed care to accelerate the recovery process. Peer support involves having persons from diverse backgrounds sharing common trauma experiences (Shalaby & Agyapong, 2020). The intervention uses peer support workers, individuals with lived trauma experiences, and who have received special training to be part of the care team. Based on their similar experiences and the shared understanding, patients may trust their peer support worker and be more willing to engage in treatment.

Incorporating peer support supports Healthy People 2020 goal of improving mental health through prevention and ensuring access to appropriate, quality mental health services. The intervention will improve the mental health outcomes of persons with trauma experiences. It will help prevent mental health issues such as anxiety, PTSD, depression, and alcohol and substance use disorders.

Comparison of the Intervention to Previous Practice or Research

Previous practice in trauma-informed care entailed using behavioral health counselors. Crisanti et al. (2019) compared cognitive behavioral therapy intervention groups guided by certified peer support workers with groups led by behavioral health counselors for trauma survivors with PTSD. At six months after baseline, persons in the peer-led sessions had a higher therapeutic alliance and stronger connection than those in the counselor-led sessions. The study shows that peer support can increase patient engagement and ultimately accelerate the recovery process.

Expected Outcome for the Intervention

Incorporating peer support is expected to increase patients’ engagement in treatment and thus accelerating their recovery. Since patients will share their trauma experiences with peer support workers who have experienced similar experiences, it will promote a shared understanding and increase patients’ trust (Shalaby & Agyapong, 2020). Peer support is expected to help patients overcome social isolation caused by trust issues by creating trust between patients and the peer workers.

Time for Implementation and Evaluation of the Outcome

The intervention will be implemented within six months. Patients will be randomly assigned to an intervention or a control group. The intervention group will be assigned to a peer support worker, while the control group will be provided the usual trauma-informed care without peer support. Evaluation will be conducted six months after the implementation of the peer support care. The recovery scores of patients in the intervention group will be compared to those of the control group to evaluate the difference in recovery and outcomes.

Synthesis of Nursing Science, Determinants of Health, and Epidemiologic, Genomic, and Genetic Data in the Management of Population Health

Nursing science is applied to support patients with trauma experiences in line with the principles of safety, respect, and trust. Nursing science is also applied in delivering patient-centered care to improve patient engagement and the quality of trauma-informed care (Fleishman et al., 2019). Social determinants such as living in under-resourced or racially segregated neighborhoods and experiencing food insecurity can result in toxic stress. Social determinants that should be considered in trauma screening include poverty, neighborhood crime and violence, and racism (Mikhail et al., 2018). Health providers should increase protective factors to mitigate exposure to trauma and environmental factors that contribute to it.

Trauma mainly affects minority racial groups, children, adolescents, and older adults. The data can be applied in trauma-informed care by emphasizing screening for trauma experiences among high-risk populations. Youssef et al. (2018) found that trauma exposure can be passed to offspring transgenerationally via the epigenetic inheritance mechanism of DNA methylation alterations. The genetic data can be synthesized in trauma-informed care by emphasizing trauma screening to persons whose close relatives were exposed to trauma.

Conclusion

More than 70% of the U.S population has encountered traumatic events such as homicide, sexual assault, shooting, and community violence. Trauma is associated with adverse effects on physical and mental health and impairments in social and occupational functioning. My proposed intervention is to incorporate peer support in trauma-informed care. Peers work together with patients to create relationships where they share their strengths and support each other’s healing. Peer support is expected to increase patient engagement and accelerate recovery. The intervention will be implemented over six months using an intervention and control group.

References

Crisanti, A., Murray-Krezan, C., & Reno, J. (2019). Are treatment groups led by peers as effective as groups led by counselors for treating posttraumatic stress disorder and substance use disorder? https://doi.org/10.25302/5.2019.ce.12114484

Fleishman, J., Kamsky, H., & Sundborg, S. (2019). Trauma-informed nursing practice. OJIN: The Online Journal of Issues in Nursing, 24(2). https://doi.org/10.3912/OJIN.Vol24No02Man03

Mikhail, J. N., Nemeth, L. S., Mueller, M., Pope, C., & NeSmith, E. G. (2018). The social determinants of trauma: a trauma disparities scoping review and framework. Journal of Trauma Nursing| JTN, 25(5), 266-281.

National Council for Behavioral Health. (2020, July 17). Trauma Infographic. National Council. https://www.thenationalcouncil.org/

Shalaby, R., & Agyapong, V. (2020). Peer support in mental health: Literature review. JMIR mental health, 7(6), e15572. https://doi.org/10.2196/15572

Youssef, N. A., Lockwood, L., Su, S., Hao, G., & Rutten, B. (2018). The Effects of Trauma, with or without PTSD, on the Transgenerational DNA Methylation Alterations in Human Offsprings. Brain sciences, 8(5), 83. https://doi.org/10.3390/brainsci8050083