Discussion: Evidence Based Practice Project Solution

Discussion: Evidence Based Practice Project Solution ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON Discussion: Evidence Based Practice Project Solution PICOT Question Among terminally ill patients 65 years and older (P), how does a nurse driven protocol for a hospice consult (I) compared to current practice (C) increase the referrals to hospice to address the goal of care, timely (O) during a 2-hour admission(T)? Discussion: Evidence Based Practice Project Solution Write a paper of 500-750 words (not including the title page and reference page) paper for your proposed evidence-based practice project solution. Address the following criteria: 1-5. Grand Cayon University NUR 699 Week 2 Evidence Based Practice Project Solution Proposed Solution: (a) Describe the proposed solution (or intervention) for the problem and the way(s) in which it is consistent with current evidence. Heavily reference and provide substantial evidence for your solution or intervention. (b) Consider if the intervention may be unrealistic in your setting, too costly, or there is a lack of appropriate training available to deliver the intervention. If the intervention is unrealistic, you may need to go back and make changes to your PICOT before continuing. Organization Culture: Explain the way(s) in which the proposed solution is consistent with the organization or community culture and resources. Expected Outcomes: Explain the expected outcomes of the project. The outcomes should flow from the PICOT. Method to Achieve Outcomes: Develop an outline of how the outcomes will be achieved. List any specific barriers that will need to be assessed and eliminated. Make sure to mention any assumptions or limitations which may need to be addressed. Outcome Impact: Describe the impact the outcomes will have on one or all of the following indicators: quality care improvement, patient-centered quality care, efficiency of processes, environmental changes, and/or professional expertise. Prepare this assignment according to the APA guidelines found in the APA Style Guide, Using 5 citable creditable sources in APA format no older than 5 years. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. Upon receiving feedback from the instructor, refine “Section D: Solution Description” for your final submission. This will be a continuous process throughout the course for each section. Sources: https://www.hhs.gov/ohrp/ Office for Human Research Protections Objectives: Critique measurements for expected outcomes (validity and reliability). Describe the obstacles or barriers to implementing evidence-based practice. Explain why patient values and clinical judgment must be considered before applying the evidence in clinical decision making for an individual patient. attachment_1 attachment_2 attachment_3 attachment_4 attachment_5 Running Heading: Literature Review Literature Review Kellie Swaim 29 June 2020 Literature Review Search Methods A review of the existing literature will assist in determining its applicability to the topic, scientific merit, and strengths and limitations. The PICOT question seeks to evaluate the effectiveness of nurse-led timely referral to hospices for older adults 65 years and above. Therefore, to access peer-reviewed sources on the topic, the worksheet for using practice guidelines by the University of Alberta EBM toolkit was used, and five articles settled upon to help in answering the PICOT question. The search was conducted primarily through Grand Canyon library resources to locate different journal articles in the library. Sage Journals, Elsevier, NCBI, and CINAHL were the primary databases accessed using the university library resources. Inclusion criteria for articles included articles less than five years old, peer-reviewed, and articles handling the topic of referral to hospice centers (Brouwer, Policastri, & Moga, 2015). Articles that fit these criteria could still be excluded if the full text was not accessible. To come up with the relevant articles, keywords used include hospice referral, palliative care, nurse-led hospice, and hospice care. The author of the paper settled on five articles to review for the PICOT question. Summary of the Articles The five articles were determined to be useful in exploring aspects connected to the PICOT question. Riggs et al. (2016) reviewed how a referral to community palliative care influenced admission to hospice centers. The study is a cohort study using logistic regression to achieve the objective. The researchers found that admission to palliative care predicted admission to hospice. The strength of this study is its focus on the correlation between two different end-of-life care systems. Elsewhere, the study does not provide implications for the referral on care. Moreover, Carpenter et al. (2017) evaluate the correlation between timing for referrals to palliative care and hospices to the qualitative evaluation of care. The study utilized a cross-sectional approach to understanding palliative care consultations and connection to the satisfaction of bereaved families. The researchers based their study on the hospice system at Veteran Affairs. They utilized this sample to specify their research to veterans. They found that consultations are starting 91 days to 180 days before death was more effective as compared to those performed within a week (Carpenter et al., 2017). The study presents a strong correlation between timing and family satisfaction. However, it is limited to Veteran Affairs and hence cannot be generalized. Buss, Rock, & McCarthy (2017) present a discussion with primary care providers to determine the effects of hospice and palliative care on the wellbeing of patients. The qualitative design of this study is a review of current approaches and primary care opinions on palliative and hospice care. The main weakness of the study is that it is not empirical and hence relies on the expert opinions of practitioners. On the other hand, it presents the views of practitioners on the topic of hospice and palliative care. The outcome of the article is to define palliative care and hospices and their benefits to patients. Mulville, Widick, & Makani (2019) present a review of the effects of timely hospice care referrals for oncology patients. Thus, this was a retrospective study hence relying on patients’ families and practitioners’ experiences inappropriate referrals. Although they found that many cancer patients were in hospice for a few days, the researchers concluded that timely referrals affected patients’ and families’ satisfaction. Therefore, the article guides practitioners to implement appropriate assessments and referrals to hospice care. Lastly, Gelfman et al. (2018) looked at predictors of hospice placement for patients with advanced heart failure. The study employed a cross-sectional study of the current admissions to hospice for the defined group. The authors used a propensity score-match sample using Medicare records. The characteristics of patients did not affect hospice enrollment. However, those who enrolled in hospice early were survived longer, lived a more fulfilling life, and were less likely to die in the hospital. The advantage of this research is that it utilizes credible sources: Medicare records. On the downside, it does not include characteristics of the hospice in affecting outcomes. Research Support Discussion: Evidence Based Practice Project Solution. The five research articles present strong support to the PICOT question advanced in the introduction. Primarily, the articles portray the importance of timely referral to hospice for older adults with chronic illnesses. The research articles thus support a nurse-led referral program that initiates early consultations with hospice centers for referral purposes. The research is valid since it is located in credible, peer-reviewed journals; therefore, external research is valid and credible (Brouwer, Policastri, & Moga, 2015). The articles also contain references to the PICOT question issue of the hospice referral, and hence they are valid in addressing the question. Overall, the literature supports the PICOT question. Grand Cayon University NUR 699 Week 2 Evidence Based Practice Project Solution References Brouwer, E. S., Policastri, A., & Moga, D. C. (2015). Using administrative data for your research project: 10 considerations before you begin. American Journal of Health-System Pharmacy , 72 (3), 184–187. https://doi-org.lopes.idm.oclc.org/10.2146/ajhp140348 Buss, M. K., Rock, L. K., & McCarthy, E. P. (2017, February). Understanding palliative care and hospice: a review for primary care providers. In Mayo Clinic Proceedings (Vol. 92, No. 2, pp. 280-286). Elsevier. Carpenter, J. G., McDarby, M., Smith, D., Johnson, M., Thorpe, J., & Ersek, M. (2017). Associations between timing of palliative care consults and family evaluation of care for veterans who die in a hospice/palliative care unit. Journal of Palliative Medicine , 20 (7), 745-751. Gelfman, L. P., Barrón, Y., Moore, S., Murtaugh, C. M., Lala, A., Aldridge, M. D., & Goldstein, N. E. (2018). Predictors of hospice enrollment for patients with advanced heart failure and effects on health care use. JACC: Heart Failure , 6 (9), 780-789. Mulville, A. K., Widick, N. N., & Makani, N. S. (2019). Timely referral to hospice care for oncology patients: a retrospective review. American Journal of Hospice and Palliative Medicine® , 36 (6), 466-471. Riggs, A., Breuer, B., Dhingra, L., Chen, J., Hiney, B., McCarthy, M., … & Knotkova, H. (2016). Hospice enrollment after referral to community-based, specialist-level palliative care: incidence, timing, and predictors. Journal of Pain and Symptom Management , 52 (2), 170-177. Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10

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