Category: Evidence based practice

This plan aims to improve the preoperative health status of orthopedic surgical patients to improve surgical outcomes in a hospital setting. The implementation plan will take 2 months as shown in the table below:

A systematic review will be used to guide this implementation plan because it is more informative. After all, it is a summary of existing studies so that only the best evidence is available to guide decision-makers (Smith, Devane, Begley, & Clarke, 2011). This review will target well-designed controlled trials only, regardless of randomization. The target population is the orthopedic surgical population; thus, only studies that have tested the efficacy of the MRSA screening protocol will be included in this review. In addition, the study will entail a comparison of the screened population using the MRSA tool to an unscreened population.

Articles published since 2006 (in the last 10 years) will be included in the study. Only studies that have adapted a controlled trial will be included in this review. A data extraction form will be used to determine the imperative facets of the different studies. Also, a quality appraisal checklist will aid in determining the quality of the studies included in this review. Upon reviewing the methodology, the precision, as well as generalizability of the results, only a certain number of studies will remain. A PRISMA flow diagram will be used to give a pictorial representation of the literature search process.

Two reviewers will be selected and briefed on how to select the studies about the inclusion and exclusion criteria. Differences between the two reviewers will be settled through discussion and consensus (National Heart, Lung, and Blood Institute, 2014). Subsequently, the identified studies will be tabulated, and a test for homogeneity will be carried to determine the need for meta-analysis. Significant results that highlight the need for MRSA screening will guide the rest of the process.

Integration of the significant findings will begin with awareness, where the findings would be communicated to the entire team involved including surgeons, lab personnel, nurses, and the quality improvement committee. Considering the associated barrier of time, the implementation agenda would be introduced to the staff during the routine meetings within the hospital and would entail demonstrations. To avoid poor communication and misinterpretation, a small test would be administered to the staff after discussing what each department would be required to do during the implementation of the MRSA screening protocol.

The library is the basic resource to aid in the gathering of the required articles for the systematic review. Nasal swabs and medication for decolonization are will help to identify MRSA infections and counteract their effects. Subsequently, the healthcare workers involved in the concerted efforts of implementing the solution are important. The location where the solution is to be implemented is in a hospital among orthopedic surgical patients. Time is another important resource that will need proper planning as shown in the table above.

The preoperative assessment procedure, which usually entails an array of activities as discussed by Akhtar, MacFarlane, and Waseem (2013), will change notably. The component of MRSA screening, which is lacking in the standard preoperative assessment process, will be incorporated into the hospitals policy after a pilot to determine the logistics and level of impact on the surgical outcomes.

Orthopedic surgical patients will be divided into two groups. The experimental group will be screened for MRSA and treated for the infection before surgery. The control group will undergo the usual routine that does not have the component of MRSA screening. Once the MRSA infection has cleared, the experimental group will undergo the surgery. Since this implementation plan seeks to determine the prevalence of MRS infections after the surgery, administration of a questionnaire will not be necessary (Mehta et al., 2013).

Nonetheless, two nurses will be used in the identification and decolonization of the MRSA. In addition, the two nurses will determine the occurrence of MRSA after surgery between the two groups for comparison. An independent t-test will be used to compare the means of the two groups as indicated by the University of West England (2016).

The nurses involved in the quasi-experimental study will be asked to uphold privacy about the treatment procedure. Patient information regarding the occurrence of MRSA infections will be noted in the patients files and will be useful for determining the prevalence of these infections. Another type of information required for the study will be kept anonymous and only used by individuals involved in the study and bound by the research code of ethics (Resnik, 2015). The proposed budget for this plan is as follows:

The solution will be extended by scaling it up through a change in the hospitals preoperative assessment policy.

References

Akhtar, A., MacFarlane, R. J., & Waseem, M. (2013). Pre-operative assessment and post-operative care in elective shoulder surgery. The Open Orthopaedics Journal, 7, 316322.

Mehta, S., Hadley, S., Hutzler, L., Slover, J., Phillips, M., & Bosco, J. 3^rd. (2013). Impact of preoperative MRSA screening and decolonization on hospital-acquired MRSA burden. Clinical Orthopaedics and Related Research, 471(7), 2367-2371.

National Heart, Lung, and Blood Institute. (2014). Quality assessment of systematic reviews and meta-analyses. Web.

Resnik, D. B. (2015). What is ethics in research & why is it important? Web.

Smith, V., Devane, D.,Begley, C. M., & Clarke. M. (2011). Methodology in conducting a systematic review of systematic reviews of healthcare interventions. BMC Medical Research Methodology, 11(15). Web.

University of the West England. (2016). Independent samples t-test. Web.

The study showed that bibliometric analysis of evidence gathered from integrative reviews and analytical studies had substantial implications for nurse-related and evidence based policy changes. Primarily, this is possible through the use of integrative reviews in designing new programs (Benton et al., 2020). The collective database of the synthesized studies as suggested by the authors of the study, can be utilized by nurses to be empowered through evidence-based materials in the formulation of changes in universal health coverage. As such, the applicability of this information has a number of benefits for working nurses, as they will be able to employ concise and trusted resources when advocating or implementing changes to policy. I think that nursing practice can be vastly improved with the use of well-managed databases that employ evidence-based research. This is because such a database will be able to illustrate gaps in knowledge of overarching issues as well as daily medical practices in the sphere of nursing (Houser, 2016). Similarly, it allows for insight into nurse-specific fields such as nurse education, care for the lederly, emergency care, and more.

Currently, accessibility to extensive and complete information that is formed through evidence-based research is limited due to a number of factors. In order to better provide such informative materials among working nurses it is essential to reduce bureaucratic processes and integrate technology into the process. Modern technology allows for low-cost and time-saving methods of information sharing, which will be largely beneficial for nursing. As mentioned prior, evidence-based research has the potential to reveal gaps in information in nurse-specific practices that would otherwise be unseen. I believe it is essential to make such knowledge accesibile and cohesive to promote better nursing care and work quality.

References

Benton, D. C., Watkins, M. J., Beasley, C. J., Ferguson, S. L., & Holloway, A. (2020). Evidence-based policy: nursing now and the importance of research synthesis. International Nursing Review, 67(1), 52-60. Web.

Houser, J. (2016). Nursing research: Reading, using and creating evidence (4th ed.).  Jones & Bartlett Learning

The problem of falling patients in the hospital analyzed in this work requires immediate practical intervention. This issue is the visible result of an overall lack of patient safety in the hospital. The solution to this problem seems to be subservient to each separate employee of the hospital, rather, it requires a plan and an in-depth understanding of the problem. In the process of analysis, the problem of patient security is presented in a historical context and is proven to have its own practical methods of solution. Based on a strategy of evidence-based medicine and drawing theoretical material into action, this sequential problem-solving program will be proposed. In order to establish whether the strategy proposed for implementation is successful, special tests will be offered.

Any practice used in such serious professional fields of activity as medicine and nursing definitely requires a knowledge base as a source of recommendations. Practical medical assistance cannot but be based on a cumulative database, theoretical constructions based on carefully collected statistics. Before prescribing a particular medicine, course of therapy, or the use of medical practices, it is required to focus on the existing evidence of the effectiveness of the decision made. Guided by fundamental ethical principles, such as patient non-harm and patient care, physicians and nurses should be able to use the concept of evidence-based medical practice.

The problem of this issue is obvious since the falls of patients result in injuries of varying degrees of significance and, in general, are a tragic burden of hospitals, especially institutions of the geriatric direction. Touching upon the history of this issue, one cannot fail to note the statistics according to which every hundredth patient falling in the United States dies as a result of this accident (LeLaurin & Shorr, 2017).

Falls are so common that 250,000 people in the United States are injured in this way every year (LeLaurin & Shorr, 2017). Emphasizing the need for its solution, it should be noted that at the moment, in medicine, there is a relatively large gap in the study of falling patients. The calculations and developments that scientists offer are for the most part theoretical and their real effectiveness in real life remains largely unproven.

The evidence-based practice relies on the principle that any independent step of a practicing physician should be based on existing factual material proving the necessity or possibility of a particular practice. It is a scientific direction that is subdivided into a certain number of branches, each of which is associated with a specific type of research. It is important to note that due to each of these subtypes of evidence-based practices, there is a potential opportunity to obtain truly new scientific information (Mackey & Bassendowski, 2017). Evidence-based experimental and semi-experimental practices provide an opportunity to put a particular problem in a new perspective in order to fill a previously unknown gap in practical medicine or nursing.

It is necessary to draw attention to scientific works devoted to the consideration of various options for filling this gap. In the preceding reports of this study on preventive practices for falling patients, one should name an article that points to a relationship between nursing skills and the incidence of these accidents (Bowden et al., 2018). Other research points to age groups requiring special attention due to the increased risk of falls and injury (LeLaurin & Shorr, 2019). Finally, it is worth mentioning an article that focuses on the implementation of special technical equipment that can reduce the risk of falls and injuries (Dykes et al., 2020). Thus, for the development of an individual methodology in the work, strategies are proposed based on various research experiments using evidence-based practice.

In the analyzed case, it is essential that the research be carried out with minimal risk for the patients. The described problem of patient falls is not about innovation in medicine, testing of a new drug, or a similar problem pertaining to medicine as a biochemical science of treatment. In this case, the direct concern for the safety of patients when moving or in immobility is discussed.

Thus, this is a problem that requires not only immediate practical intervention but also needs a more practically approachable scientific system to develop an adequate methodological apparatus (Horntvedt et al., 2018). In other words, there is no possibility for the hospital to conduct experimental or even semi-experimental research in the context of the fact that this could cause more harm to patients. Rather, in this particular case, hospital administrators are required to come up with a plan and consistently implement their own strategy of action, which, however, will be based on previously obtained scientific and evidence. Thus, an experiment in itself will be considered the introduction of a plan developed on the basis of the past, which will subsequently be statistically evaluated to identify positive dynamics.

The first step in the proposed preventive strategy is to identify risk factors and make decisions to neutralize them. When preparing analytical material for this stage, it is necessary to separate the factors of falling into internal and external factors, for the subsequent elimination of any external ones. Among these factors, are independent of the patient and their health, the training of personnel, as well as modern or, on the contrary, dilapidated equipment and general arrangement of the hospital.

Thus, building on previous developments, and with sufficient funding, it would make sense to equip the hospital with fall prevention systems that have already been proven to be effective. At the same time, the hospital administration should take into account that it is problematic to prevent not only falls but also the possible traumatic consequences of it (Najafpour et al., 2019). One should note the likely need for additional training courses for nurses since research confirms that their professionalism does underestimate the statistics of falls (Bowden et al., 2018). Thus, among the urgently necessary measures, the improvement of the working apparatus is also required, since the coordination of employees can largely prevent the critical harm received from a fall.

A possible hypothetical framework for this work would be the assumption that work on correcting the external causes of patients falls could have a positive effect on fixing this problem. In order to practically confirm the benefits of the implemented solutions, the effectiveness ratio should be calculated using the strategies of previous medical researchers. To do this, it is required to record the number of falls using all of the above practices, also taking into account the falls resulting in injuries, both insignificant and fatal. Comparing these numerical valuables would provide direct evidence of the effectiveness of the strategies. Also, in order to differentiate the effectiveness of strategies, it is required to record how each fall occurred, whether it was prevented and how. Then, using this statistical testing method, it will be possible to improve the most effective applied practices.

References

Bowden, V., Bradas, C., & McNett, M. (2018). Impact of the level of nurse experience on falls in medical surgical units. Journal of Nursing Management, 27(4), 833-839. Web.

Dykes, P. C., Burns, Z., & Adelman, J. (2020). Evaluation of a patient-centered fall-prevention tool kit to reduce falls and injuries: A nonrandomized controlled trial. JAMA Network Open, 3(11). Web.

Horntvedt, M. T., Nordteien, A., Fermann, T., & Severinsson, E. (2018). Strategies for teaching evidence-based practice in nursing education: a thematic literature review. BMC Medical Education, 18, 172. Web.

LeLaurin, J. H., & Shorr, R. I. (2019). Preventing falls in hospitalized patients: State of the science. Clinics in Geriatric Medicine, 35(2), 273-283. Web.

Mackey, A., & Bassendowski, S. (2017). The history of evidence-based practice in nursing education and practice. Journal of Professional Nursing, 33(1), 51-55. Web.

Najafpour, Z., Godarzi, Z., Arab, M., & Yaseri, M. (2019). Risk factors for falls in hospital in-patients: A prospective nested case-control study. International Journal of Health Policy and Management, 8(5), 300-306. Web.

Stakeholders play an integral role in dictating the organizational focus through influential force. Examples of stakeholders in the healthcare industry include patients, physicians, investors, insurance companies, and the government. These stakeholders consider meaningful data as one that is factual, organized and up to date. For instance, when discussing a change process like setting up an electronic health recording system, the data must contain a detailed budget capturing all the necessities to achieve this goal. In addition, while presenting data to investors, I would consider descriptive and tabular presentation with current market projections to ensure that information is accurate, organized and comprehensive.

Nursing sensitive indicators determine the quality of structure, processes and outcome of healthcare delivery. Structural indicators such as the supply of nursing staff can either result in a positive or negative outcome. For instance, a high turnover rate in an organization results in staff burnout which can lead to poor work delivery (Oner et al., 2021). Patients are the most affected since they suffer the consequences of medical errors and misdiagnosis when nursing staffs experience burnout due to low staffing. Process indicators such as dissatisfaction in the workplace may hinder motivation and organizational justice, affecting effective patient-physician relationships and leading to poor care delivery (Oner et al., 2021). Additionally, outcome indicators such as hospital falls or infections can affect the quality of care by influencing high readmission or prolonged hospital stay, reducing the quality of care provided.

Effective change processes are methodological and systematic, which requires proper evaluation. Program assessment enhances the management process by enabling the effective projection of risks and opportunities to ensure that the decisions benefit the organization (Oner et al., 2021). Evaluation is also essential since it helps review progress to determine the success level when the change process has not been implemented (Oner et al., 2021). Additionally, evaluation supports continuous strategic planning since it allows adjustments to be made where necessary to avoid mistakes that could cost the organization.

Reference

Oner, B., Zengul, F. D., Oner, N., Ivankova, N. V., Karadag, A., & Patrician, P. A. (2021). Nursingsensitive indicators for nursing care: A systematic review (19972017). Nursing Open, 8(3), 1005-1022. Web.

Introduction

Sedwick, Lance-Smith, Reeder, and Nardis (2012) main apprehension was the increasing rate of Ventilator-Associated Pneumonia (VAP) in critical care patients. Ventilator-associated pneumonia is currently becoming one of the common complications among the Healthcare-Associated Infections (HAI) not only within the United States but also around the world. Therefore, VAP is becoming a significant issue among critical care nurses. The authors of this article argue that there is a need for strategies that would aid in the prevention of VAP. The researchers main purpose was to determine whether strict observance of the ventilator bundles increases the results of the critical care patients. According to the researchers, adherence to the ventilator bundles reduces the rate of VAP by over 9.5%. In addition, the reduced rate also contributes to reasonable savings in the cost of care given to the patients. In essence, the researchers tended to answer the question of whether adherence to the ventilator bundles could lead to a reduced rate of VAP.

Sedwick, Lance-Smith, Reeder, and Nardi (2012) conducted the study for twelve months within the ICUs of one of the main hospitals. In their study, the researchers audited 4709 ventilator days. The study was designed in such a way that the process of reducing the VAP in ICU began in the previous year. The interdisciplinary specialists were trained on the various aspects of the ventilator bundles and the applications. The data was collected and audited by the compliance audits. This study hypothesizes that strict adherence to the ventilator bundles has a direct correlation with improved patient outcomes. Conversely, the null hypothesis is that strict adherence to the ventilator bundles has no direct correlation with improved patient outcomes.

The findings indicate that strict adherence to the ventilator bundles has the capability of reducing the rate of VAP. In other words, the results indicate that strict adherence to the ventilator bundles is one way through which ventilator-associated pneumonia can be prevented and reduced. According to the study, strict adherences that involve increased accountability among the critical care nurses, application of feedback system as well as interdisciplinary collaboration have a direct correlation with the enhanced patient results and end up in remarkable savings in terms of the costs involved in the patient care.

Research methodology and the critical evaluation of the study

The research design and methodology used to provide the results are not comprehensive. The reviewed literature did not capture the topic to ascertain the claims of the researchers. In essence, the researchers did not give due attention to the importance of secondary information. In any study, secondary data is an important aspect and should not be ignored. The reviewed literature in interrelated studies presents a deeper understanding of the area being studied as well as what other researchers have found on the examined topic. The scrutiny of such literature is helpful in offering novel and comprehensible models that tend to give an explanation of the changes in the area of study, arrange the main concerns, build upon operational explanations and improve on the final research design. On the contrary, the authors of the article provided a briefly reviewed literature of the topic based on a few peer-reviewed articles. Even though the study was designed to be purely quantitative, the qualitative aspect is also critical in determining the study outcomes.

Though the topic being studied is based on the current health issue, it has been studied over time. The reduction of VAP is an area that has been studied for some time. In fact, the ventilator bundles to reduce VAP that the researchers were studying their adherence were established a decade ago. Even though the aspect of the ventilator bundle being studied is novel in this field, currently, it is not one of the pressing issues in the field. However, it is one of the evidence-based practices, which is the major current issue in nursing. In spite of the studys shortcomings, the study is significant in ascertaining the importance of adhering to the ventilator bundles in the reduction of VAP. Further, the findings of the study are also important in helping critical care nurses understand the significance of ventilator bundle adherence.

The researchers applied the quasi-experimental design to establish the correlation between the adherence to the ventilator bundle and the reduction of VAP. In addition, the researchers, to determine the strength of their purported hypothesis, applied the quasi-experimental design. In the study, the variables were qualitative, nevertheless, the researchers came up with ways through which the data can be quantified and tested. Further, the variables were tested through the application of a compliance feedback tool. The compliance audit was applied to provide immediate feedback.

The research design methodology that was purely quantitative, aimed at testing the validity and consistency of significant characteristics of the research in order to determine the existing correlation. The research participants that consisted of the interdisciplinary specialists were chosen through the unsystematic sampling process. In fact, the random sampling procedure that the researchers applied have been proved to be the best method to select the study participants since there is no indication of any business. All through the study, the researchers made sure that they adhere to the rules and guidelines of the study. In addition, they ensured that they tested their research instruments before embarking on the actual survey.

Besides the sample being unbiased, the researchers were certain that the sample chosen was representative. In fact, the sample was drawn majorly from one hospital though the study was conducted over a long period. The sample was also drawn from various specialists involved in the critical care units. As such, the sample captured the practices and the views of the specialists being studied on a wider scale.

Though the study seems to provide a comprehensive conclusion, there is still an existing gap that needs further research. In particular, the studies need to ascertain the results of the study using a greater sample. The study findings do not provide enough information to adapt the results into the critical care nursing practice. Further, similar findings are needed to support the results of the study.

The researchers were clear and consistent in their communication skills which make the article more understandable. However, in some items such as the results, the information has been made complex by some ambiguity of graphs used. Moreover, the information in the discussion and results are ambiguous such that the difference could not be established.

Though the researchers claim that their findings support the application of evidence-based care in the reduction of VAP, more studies need to be conducted in this area. The studies so far conducted have not fully developed the relationship between adherence to evidence-based care and the reduction of the VAP to be applied in critical care nursing. Since the research methodology applied in this study was limited in some areas, further studies need to be conducted using appropriate methodology and larger samples from various hospitals to ascertain the results (Sedwick et al, 2012). Moreover, further studies are needed to establish new items considered important in the VAP bundles. Despite these shortcomings, the study is quite practicable. The reason is that the study provides a confirmation of the applicability of the VAP bundles, particularly where there is strict adherence. In addition, strict adherence to the VAP bundles by critical care nurses will reduce VAP among critical care patients considerably.

The researchers should have included diversified critical care specialists from various hospitals. Moreover, the specialists could have not been conditioned to provide unbiased views. Further, the study could have shown diversity in samples as well as views (Sedwick et al, 2012). Nevertheless, the results indicated a strong correlation between adherence to the ventilator bundles and the reduction of the VAP.

Conclusion

Though the study had various shortcomings, the results indicate the expected outcomes. The results are in line with the study hypothesis that strict adherence to the ventilator bundles has a direct correlation with improved patient outcomes. The research results are in line with the predictions of the previous empirical and theoretical studies. According to the study, through the application of evidence-based practices, patient morbidity, mortality as well as the cost of healthcare is improved. Moreover, the study indicates that the improved accountability by the critical care nurses on their daily patient care is significant in the improvement of the patient results.

Reference

Sedwick, M. B., Lance-Smith, M., Reeder, S. J. & Nardi, J. (2012). Using Evidence-Based Practice to Prevent Ventilator-Associated Pneumonia. Critical Care Nurse, 32(4), 41-52.

The research methodology that would be most suitable for the evidence-based practice project is quantitative quasi-experimental. Quasi-experimental designs characteristically enable the researcher to align the project with the treatment situation while employing another criterion apart from the random assignment (Heinen, Mackett, van Wee, Ogilvie, & Panter, 2018). Because the project will be carried out in an outpatient facility, the researcher will use self-reports where respondents will record falls, near falls, and the date of occurrence instead of using random perspectives.

The project is aligned with the clinical question as it seeks to understand the best approach to decreasing falls. It supports the data collection method as the rate of falls or possible falls will be recorded for every 100 patients. Gathering such data is what makes it possible for the researcher to employ a quantitative technique of analysis, which permits a broader study, engages a high number of participants, and facilitates results generalization. Since the project will concentrate on the prevention of falls among elderly patients above 65 years and who live alone, data analysis will create room for improved impartiality and accuracy of findings.

Qualitative research techniques with the help of convenience sampling may be employed in evidence-based practice projects to study people and understand their behavior, ideas, themes, and incentives (Salvador, 2016). A good example would be a situation where a designer is establishing ideas for a new product or logo. The researcher will seek to understand peoples inclinations and preferences to ensure that the introduced change is commercially practicable.

Focus groups establish qualitative information regarding respondents views about the product or logo. The researcher may find that participants like or dislike the new product or logo. A qualitative study will enable comprehension of feelings, emotions, and discernments that trigger and influence activities (Rosenthal, 2016). It will also allow the researcher to proceed deeper into existing concerns and discover refinements associated with the issue.

References

Heinen, E., Mackett, R., van Wee, B., Ogilvie, D., & Panter, J. (2018). Residential self-selection in quasi-experimental and natural experimental studies. Journal of Transport and Land Use, 11(1), 939-959. Web.

Rosenthal, M. (2016). Qualitative research methods: Why, when, and how to conduct interviews and focus groups in pharmacy research. Currents in Pharmacy Teaching and Learning, 8(4), 509-516. Web.

Salvador, J. T. (2016). Exploring quantitative and qualitative methodologies: A guide to novice nursing researchers. European Scientific Journal, 12(18), 1-8. Web.

Background

Evidence-based practice means to heighten the effectiveness of the nurse practicing. By gathering and analyzing evidence, an RN is enabled to define a customized care plan. Horntvedt emphasizes the idea in question, stating that EBP redesigns medical care to minimize possible risks. If RNs are allowed to access and analyze current medical reports, they will enhance and customize a care plan.

What does research suggest?

The researcher further stresses that despite the importance of the practice, it faces significant hardships in implementation. Horntvedt has researched RNs awareness of EBP and their readiness to put the method into practice (2018). The analysis has made it evident that currently, RNs possess limited awareness of EBP, as they lack a proper introduction and further education on the method (Horntvedt, 2018). For EBP implementation into nursing practice, the education system must be accordingly reshaped.

How Will I Encourage the Method Myself?

As a future RN, I set the following plan for myself:

1. I have to gather as much evidence as possible and evaluate it while increasing my awareness of the current care reports and the development of the practice.
2. I have to converse with my patient to identify their needs actively.

Implementing EBP even in personal practice may face obstacles, as it is impossible in some cases, slight evidence may be provided, especially nowadays. As Weissman rightfully observes, during the pandemic, health institutions cannot deliver some clinical services (2020). Thus, a lack of digital servicing may pose a significant obstacle to introducing EBP. The psychological state of patients may alter the course as well, as they may be reluctant to cooperate or provide unbiased narration of their physical conditions. Still, I find these obstacles minor compared to the significance of EBP and its practical value.

References

Horntvedt MT, Nordsteien A, Fermann T, Severinsson E. (2018). Strategies for teaching evidence-based practice in nursing education: a thematic literature review. BMC Med Educ., 18(1), 172. doi: 10.1186/s12909-018-1278-z.

Weissman RS, Bauer S, Thomas JJ (2020). Access to evidence-based care for eating disorders during the COVID-19 crisis. Int J Eat Disord, 53(5), 369  376. doi: 10.1002/eat.23279.

Literature Review

Breastfeeding is a crucial process that allows infants to receive the nutrients needed in the future for developing immunity to specific diseases, as well as maintaining good health, in general. However, numerous mothers prefer to use a formula instead of breastfeeding, thus abstaining from it (Shepherd, Walbey, & Lovell, 2017). Studies show that the specified choice makes infants especially susceptible to health-related risks, including the risk of developing serious conditions in the future (Fewtrell, 2019).

Therefore, strategies for promoting exclusive breastfeeding t the mothers of newborn children have to be created. Due to the opportunity to cement the standard routine for exclusive breastfeeding, roleplaying and scripting should be used as the main strategies in educating mothers of infants and promoting exclusive breastfeeding to women.

Studies show that roleplaying has a vast significance for encouraging patients to shape their behaviors. For instance, Toback and Clark (2017) mention that roleplaying allows patients to accept the behaviors that they would not have considered otherwise, thus helping them to adjust to the new roles and perform new tasks with due responsibility. In turn, scripting helps to cement the specified roles and responsibilities, as the study by Britton et al. (2019) assures.

With the help of scripting, mothers of infants will be able to memorize the necessary routine actions that they will have to perform in order to get used to exclusive breastfeeding and avoid resorting to using the formula. Specifically, aaa mentions the importance of scripting in teaching patients specific behavior patterns and introducing them to healthy attitudes. However, there is currently a gap in the evaluation of the impact of scripting and role-playing on breastfeeding. Nevertheless, research indicates that the application of scripting leads to better learning and an increase in patients self-esteem and sense of certainty (Shepherd et al., 2017). Therefore, the adoption of the proposed techniques can lead to improvements in the rates of exclusive breastfeeding.

Evidence-Based Practice

The project in question is based on studying the outcomes of role-playing and scripting as interventions on the levels of exclusive breastfeeding in the mothers of infants. It is believed that the evidence-based practice (EBP) performed in a local healthcare facility will prove the importance of role-playing and scripting on the promotion of exclusive breastfeeding in young mothers of newborn children. The EBP process will consist of introducing mothers to the concept of exclusive breastfeeding with the help of roleplaying and scripting, as well as the following assessment of changes in the rates of exclusive breastfeeding among the target population.

The EBP process is expected to prove that the application of role-playing and scripting affects pregnant womens ability to memorize instructions and follow them accurately. The EBP process will take place in a local healthcare facility for pregnant women. Specifically, the practice will involve the education of pregnant women by using role-playing and scripting. The application of scripting will imply learning the key scenarios and actions that women will have to take in order to provide their children with exclusive breastfeeding. Namely, correct breastfeeding practices will be learned in the process, while typical errors will be avoided.

In turn, role-playing will help women to develop the learned behaviors that will allow them to apply breastfeeding as a habitual action. As a result, breastfeeding is expected to become an important part of womens routine, allowing them to develop the skills and knowledge needed to sustain the quality of nutrition for their children at a decent level.

References

Britton, B., Baker, A. L., Wolfenden, L., Wratten, C., Bauer, J., Beck, A. K.,& Oldmeadow, C. (2019). Eating as treatment (EAT): A stepped-wedge, randomized controlled trial of a health behavior change intervention provided by dietitians to improve nutrition in patients with head and neck cancer undergoing radiation therapy (TROG 12.03). International Journal of Radiation Oncology* Biology* Physics, 103(2), 353-362.

Fewtrell, M. S. (2019). Promoting and protecting breast-feeding: The importance of good quality data. Journal of Pediatric Gastroenterology and Nutrition, 68(3), pp. 296-297.

Shepherd, L., Walbey, C., & Lovell, B. (2017). The role of social-cognitive and emotional factors on exclusive breastfeeding duration. Journal of Human Lactation, 33(3), pp. 606-613.

Toback, M., & Clark, N. (2017). Strategies to improve self-management in heart failure patients. Contemporary Nurse, 53(1), 105-120. Web.

Evidence-based practice relies on the increasing amount of previous research that provides a substantial database of expertise, which can be used in other cases. In general, this approach to treatment is considered to be one of the primary competencies a healthcare specialist should acquire. It implies that the decision-making process is shaped by best research evidence, clinical expertise, and patient values (Institute of Medicine, 2003, p. 56). When evidence-based medicine was first introduced, it focused on the previously published literature in search of better practices that had facts supporting their effectiveness (Djulbegovic & Guyatt, 2017). The rapid development of modern technologies allows for a broader implementation of evidence-based practices, as computers and the Internet have made data sharing easier. Therefore, the 21st century demonstrates excellent opportunities for evidence-based medicine implementation on a comprehensive level.

The approach in question encompasses all the aspects of healthcare and comprises a set of strategies that are presently used. Kingbeil and Gibson (2018) state that the teach-back program is an effective evidence-based approach that serves to ensure proper communication between healthcare professionals and their patients. This strategy dictates that nurses and other members of the team should work on improving their patients self-management following the discharge procedures. The evidence of its effectiveness is based on a practical study, which included three hundred interdisciplinary teams. The research revealed that nurses and other practitioners, who used the strategy, reported a higher rate of misunderstanding correction and an overall better quality of communication. As for me, I find this evidence-based practice useful and plan on implementing it throughout my professional career. Indeed, many patients may refrain from clarifying some points, while some nurses and doctors might not consider a thorough explanation necessary. Accordingly, post-discharge management can be significantly improved by clear communication.

References

Djulbegovic, B., & Guyatt, G. H. (2017). Progress in evidence-based medicine: a quarter century on. The Lancet, 390(10092), 415-423.

Institute of Medicine. (2003). Health professions education: A bridge to quality. National Academies Press.

Kingbeil, C., & Gibson, C. (2018). The teach back project: A system-wide evidence based practice implementation. Journal of Pediatric Nursing, 42, 81-85.

Over the past several years, there has been a growth in evidenced-base (EB) policy and practice in the public health arena. Is there a need for this type of policy making? What are the limitations of EB policy and practice? Be sure to use the readings to support your response.

The increase of evidence-based policy and practice in the public health arena has both positive and negative effects, however, such policymaking is really useful and important. Ham, Hunter, and Robinson (1995) state that it must go without saying that policy making in health care is relied on specific evidence. The main arguments which can explain the positive effect of evidenced-base policy and practice in public health are as follows. To make a powerful decision, health professionals have to rely on valid information considered after the practical experiments and strong conclusions. Findings researched by scholars can be used for treating individuals and even creating specific treating programs (Haines & Donald, 1998).

Nevertheless, there are a number of negative effects caused by using evidence-based policy and practice. Lack of necessary information, bad quality, the inability to measure the outcomes, and a restricted number of adequate tests may have negative effect on policymaking. Furthermore, evidence-based recommendations may be too broad, without specification and, therefore, useless (Briss, et al., 2000). There are many cases when policies are made on the basis of incomplete evidence that causes numerous problems. However, the presence of limitations in the evidence-based policy and practice does not point to the uselessness of the method in policymaking. It is important to weight evidence before making a policy, as well as it is important to weigh each policy while making a decision in the public health arena (Anderson, L. M., et al.).

Reference List

Anderson, L. M., et al. (2005). Evidence-based public health policy and practice: promises and limits. American Journal of Preventive Medicine, 25(5S), 226-230.

Briss, P.A., Zaza, S., Pappaioanou, M., et al. (2000). Developing an evidence-based guide to community preventive servicesmethods. Journal of Preventive Medicine, 18, 35-43.

Haines, A. & Donald, A. (1998). Getting research findings into practice  making better use of research findings. British Medical Journal, 317(7150), 72-75.

Ham, C., Hunter, D.J. & Robinson, R. (1995). Evidence-based policy-making. British Medical Journal, 310(6972), 71-72.