...PRACTICE According to a stimulation analysis (Hovmand &Gillespie (2010) adoption and implementation of EBP improved the organizational performance by utilizing highly reliable services and efficient clinical interventions. EBP has been supported by an electronic clinical procedural resource which helps in standardization of care and annual cost savings (Schoville et al., 2014).This electronic reference tool gives you efficient reference in no time and improves bedside patient care and safety. By using updated evidences the clinical experts save time since there is no need for written policies and procedures. An overview of costs and savings analysis explained an apparent savings of $360,899 annually....
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...basis for a systematic approach t o b o t h the writing and evaluation of entrepreneurial business plans. Despite this, the majority of entrepreneurial business plan writing and evaluation is unsystematic—if systematic is taken to mean "based o n empirical evidence and developed theory." T h e vast majority of the a b u n d a n t literature on " h o w to write a successful business p l a n " is n o t research-based (Hindle [1997]). T h e espoused criteria of its authors far o u t weigh the formal application of the k n o w n attributes of successful ventures (Hindle and Mainprize [2002]). This article seeks to articulate a research-based system for assessing the c o n t e n t quality of e n t r e p r e n e u r i a l business plans (EBPs) from t h e p o i n t of v i e w of an investor (more specifically, a venture capitalist investor). As a natural corollary, its fmdings may also serve as a guide to writers of e n t r e preneurial business plans. As the primary source of information for t h e investment screening decision, v e n t u r e capital firms rely almost exclusively...
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...Evidence-based practice (EBP) involves any practice that is effective and based on replicated scientific research following a set of explicit criteria (Buron & Wolfberg, 2013). It is important for educators and professionals to consider the best evidence based practices for individuals with ASD. Simpson (2005) states that “dependence on and uncritical use of miracle cures and unproven methods have encouraged unhealthy, unrealistic and improbable expectations and have, in all too many cases, retarded the progress of students with ASD” (p. 141). Adopting evidence-based practices and using scientific methods are important for educating and supporting individuals with ASD. Effective matching of EBP methods to the particular needs of an individual with ASD is considered best practice. Programs must be correctly applied and evaluated by knowledgeable professionals (Simpson, 2005). Implementation of evidence based-based practices involves a process of actions, multiple decisions and corrections (Fixsen, Naoom, Blase, Friedman & Wallace, 2005). Application to the clinical treatment, education and social intervention of individuals with autism spectrum disorders is influenced by current economic and political trends as well as historical influences. The National Research Council (NRC) issued a report in 2001 that incorporated a thorough analysis of the scientific base for the education of children with autism spectrum disorder (ASD). The review highlighted the aspects of effective...
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...com/viewarticle/771215_print This article sought to find an appropriate model to predict the risk of unplanned heart failure readmissions. The primary outcome from chart reviews also included death of heart failure patients within 30 days of discharge. The study looked at Centers for Medicaid and Medicare Services (CMS) models and the LACE+ index, to mention two of many that looked at prediction ability. The LACE+ index is a model that looks at length of stay, acuity, the Charlson comorbidity score and age, to predict readmissions. They found that no one model was appropriate in predicting the 30-day readmission rates, although using a combination of the models was an improvement to that predictor. The authors are all physicians, PhDs, or have a Master’s degree- helping to establish credibility. The authors also make a statement as to the funding of the project and that they (the authors) were solely responsible for all data collection, design and submission approval writing for the project, also lending credibility to the study. The references used for this study were appropriate in age, of the 28; 13 were within the last five years. Statistical data was gathered by experts and calculations made through third party experts, lending validity to the study. This article does not use the words ‘Evidence-Based Practice’ (EBP), but the CMC model is an EBP model, and many of the newer references make note to EBP. Although this was an interesting article, I may not use this in my final...
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...Standardization of Nursing Protocol for Cardiac Arterial Bypass Patients Abstract Evidence-Based Practice (EBP) is an important factor in determining medical courses of action. Nurses have long used tradition rather than evidence in making decisions about beside care; to convince them to switch practice, it is useful to draw a comparison between the efficacy of these disparate routes. Our study designed a research question based on the PICOT model for the cardiac floors and designed procedures using the Kotter and Cohen’s Model of Change. In order to study the effect discussed in our PICOT question, a web search was conducted and the quality of each pertinent study reviewed. Introduction In the nursing staff of an adult Cardiac Surgical Care unit, how does the buy-in from the staff for Evidence-Based Practice (EBP) changes in a new Coronary Arterial Bypass Graft (CABG) pathway affect the decreases in infection rate among this patient population when compared to the old way of delivering patient care through nursing tradition in a six month time frame? The formation of a guideline for practice in nursing is not a new occurrence; books and manuals have been a reality for many years. However, in the past these resources lacked the evidence for standards of care, which traditionally have been based on professional consensus and tradition. The Joint Commission has recognized processes that can be measured regarding patient outcomes and care in order to meet standards for Medicare...
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...Collaborative Communication: Integrating SBAR to Improve Quality/Patient Safety Outcomes Cynthia D. Beckett, Gayle Kipnis Purpose/Evidence-Based Practice Question Collaborative communication and teamwork are essential elements for quality care and patient safety. Adverse patient occurrences are an extremely common outcome of communication failures (Leonard, Graham, & Bonacum, 2004). In 2004, the Joint Commission (formerly the Joint Commission on Accreditation of Healthcare Organizations) analyzed 2,455 sentinel events from hospitals across the United States and reported through root cause analysis over 70% of the events were due to communication failures, and approximately 75% of the patients involved died (Leonard et al., 2004). Although improving communication has been included as a Joint Commission’s National Patient Safety Goal for hospitals since 2003, in 2006, handoff communications were included as a specific communication subset. NPSG 02.05.01 states ‘‘The organization implements a standardized approach to handoff communications, including an opportunity to ask and respond to questions’’ (Joint Commission, 2006). Michael Leonard, MD, from Kaiser Permanente- Denver introduced a collaborative communication tool to support patient safety and outcomes. The structured communication tool is Situation, Background, Assessment, and Recommendation (SBAR) (Haig, Sutton, & Whittington, 2006). The SBAR tool provides a framework for organizing information...
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...ONE OF THE NATION’S LEADING INNOVATORS IN DELIVERING EVIDENCE-BASED SOLUTIONS FOR CRIMINAL JUSTICE AND HUMAN SERVICES TURNING LIVES 1 Yolo County, CA: EBP brings measureable, positive outcomes 2 King County, WA builds new system for Mental Health RX: the PRIME 4 Assessments.com selected to direct $1.2M statewide juvenile project in CA 4 News in Brief 5 Spotlight on ADC staff: Brian Richart is new ADC President 6 EBP – Recent Research: Exploring the Black Box of Community Supervision 8 Upcoming Events Winter 2010 | QUArterLY neWSLetter CURRENT NEWS AND trenDS AROUND supervision, and accurately and objectively identified higher risk juveniles who most need and can most benefit from rehabilitative treatment. Monthly statistics tell the story. In April 2007, the department was managing a caseload of 400 juveniles with a staff of 10 supervising field officers and an outpatient treatment budget of $120,000. Today, the total caseload is down to about 280, as the department has done a better job keeping very low risk youth out of the system altogether. Of those youth who do enter the system, some 150 low risk youth are supervised by 1 1/2 officers with diversion programs and minimal supervision, while the remaining officers are managing the 130 moderate to high risk juveniles (a 38% reduction in individual case load size) and providing individualized treatment through programs such as FFT (Functional Family Therapy) and T4C (Thinking for a Change)– cognitive behavioral programs...
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...Executive Summary This report focuses on the use effective pricing strategies to maximize profits from F1 ticket sales. We believe this to be an important objective for the F1 management given high costs of hosting the F1 race each year. Effective pricing strategies can help to recoup the cost of the race and possibly even generate revenue for the organizers. The first part of this report focuses on the effectiveness of existing price strategies such as perception based pricing, price discrimination, bundling and discount management. Our analysis suggests that the F1 tickets in Singapore are wrongly priced as it fails to capture perceived benefits such as having a city track and being the first ever night race. It is, however, too late to reset the price as the reference point has been established. Next, we argue that while the use of price discrimination has increased the total revenue from ticket sales, the extensive use of early-bird based pricing has reduced the effectiveness of discount pricing. While some bundling strategies currently in place, we believe that more can be done to increase the perceived value and to capture greater market share. We have provided suggests for this in section 7. We further evaluated the use of discount management for quantity purchases and conclude that the use of high discount (≈15%) for greater quantity sale will only be financially justified through high volume sales. Finally, we propose several solutions to increase F1 revenue yield...
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...The changes that are occurring in our health care system today require progressively more nurses to take leadership roles. An effective leader is someone who is able to inspire others. Cherry and Jacob state they, “…may not have formal authority granted by their organization but are still able to influence others.” (p.335) With the implementation of the Affordable Care Act (ACA) drawing near, the need for more nurses and health care professionals to take on leadership roles is essential. Having effective leadership is what promotes teams to work at their maximum abilities. An article found in the Annals of Family Medicine states, “the movement to accountable care organizations and patient-centered medical homes will accelerate and increase the emphasis on teams in healthcare.” (Taplin, Foster, & Shortell, 2013) As our health care system enters into a difficult time period facing some of the highest costs and most severe health care professional shortage, we are in dire need of innovative leaders who will help develop plans that will raise patient outcomes. Leadership Defined There are many different definitions of the term leadership. According to Neuman, Newman, and Holder (2000) leadership is defined as “the ability to identify and manipulate factors significant to the successful pursuit of improved healthcare.” (Neuman et al., 2000) A leader within the nursing community has the ability to influence their team members to provide optimal care to their patients. A leader...
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...THE CASE FOR A MODEL OF CARE Contemporary health care systems are constantly challenged to revise traditional methods of health care delivery. These challenges are multifaceted and stem from: 1. novel pharmacological and non-pharmacological treatments; 2. changes in consumer demands and expectations; 3. fiscal and resource constraints; 4. changes in societal demographics in particular the ageing of society; 5. an increasing burden of chronic disease; 6. documentation of limitations in traditional health care delivery; 7. an increasing emphasis on transparency and accountability, 8. evidence based practice (EBP) and clinical governance structures; and 9. the increasing cultural diversity of the community. These challenges provoke discussion of the necessity of developing services around a model of care. What do we mean by a model of care? Ambiguity exists in the literature, with the terms, model of care, nursing model, philosophy, paradigm, framework and theory often used interchangeably, despite referring to diverse, yet parallel concepts (Tierney 1998). In their recent review of the literature, the Queensland Government (Australia) reported that they found no consistent definition of ‘model of care’ (Queensland Health 2000). They concluded that a model of care is a multidimensional concept that defines the way in which health care services are delivered (Queensland Health 2000). More specifically, Davidson and Elliott...
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...evidence based practice in efforts to consistently provide the best care for growing populations. Nurses must be able to utilize research provided and critique this information with a degree of understanding that allows the nurse to interpret the knowledge gained in regards to the studied populations. Furthermore, the credibility and relevance of the study is equally important in the decision to trust its application in current best practice issues. This study states trust and depression are issues that cause difficulties with glycemic control. The purpose of this paper is to critique the quantitative study and offer a critical synopsis of the research presented. PICO (Patient, Intervention, Comparison, and Outcomes) is a type of model used to aid in framing questions for the research study. It helps to define questions that will support the specific population being studied and aids the reviewers in finding relevant information and evidence within the literature (Board of Trustees of the University of Illinois [UIC], 2012). The population studied was uninsured patients with diabetes. In considering the intervention and comparison, the goal of the study was to link health literacy and patient trust factors as predictors of glycemic control. Other factors that were considered were: socioeconomic status, diabetic knowledge, self-care activities, and depression (Mancuso, 2010). The outcome of the study suggests that trust and depression in the patient population was...
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...EMORY UNIVERSITY NELL HODGSON WOODRUFF SCHOOL OF NURSING TITLE: NRSG 507: Theory and Research Applications CREDIT ALLOCATION: 3 Semester hours PLACEMENT: Tuesdays 1:00 – 3:50 PM Rm. 201 FACULTY: Catherine Vena, PhD, RN | Eun Seok (Julie) Cha, PhD, RN | Clinical Associate Professor | Assistant Professor | Room 224 | Room 234 | cvena@emory.edu | echa5@emory.edu | 404-727-8430 | 404-712-9578 | Office Hours: By appointment | Office Hours: By appointment | COURSE DESCRIPTION: This course is an introduction to the theoretical and research foundations of advanced nursing practice. Key content to be covered includes the philosophical basis of science and knowledge, the structure and development of theory, qualitative and quantitative research methods, theory and research critique, and the application of theory and research in advanced nursing practice. It delineates research competencies for advanced practice nurses. The course encompasses critique of studies, application of research findings to practice (research utilization) and evaluation of outcomes attributable to advanced practice nursing. Ethical considerations related to research are integrated throughout the course. COURSE OBJECTIVES/OUTCOMES: 1. Understand the relationship between theory, research, and practice. 2. Critique and evaluate theoretical perspectives and research methods used to address clinical problems. 3. Understand...
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...Cases Chapter 3 Systems Analysis and Design in a Changing World 6th Ed Satzinger, Jackson & Burd Chapter 3 Outline Use Cases and User Goals Use Cases and Event Decomposition Use Cases and CRUD Use Cases in the RMO Business Case User Case Diagrams Systems Analysis and Design in a Changing World, 6th Edition 2 Learning Objectives Explain why identifying use cases is the key to defining functional requirements Describe the two techniques for identifying use cases i.e. user goal technique and event decomposition technique to identify use cases Apply the CRUD technique to validate and refine the list of use cases Describe the notation and purpose for the use case diagram Draw use case diagrams by actor and by subsystem Overview Chapter 2 provided an overview of systems analysis activities, functional and non-functional requirements, modelling, and information gathering techniques This Chapter focuses on identifying and modelling the key aspect of functional requirements – Use Cases In the RMO Tradeshow System from Chapter 1, some use cases are Look up supplier, Enter/update product information, Enter/Update contact information This chapter’s opening case Waiters on Call, examples of use cases are Record an order, Record delivery, Update an order, Sign in driver, Reconcile driver receipts, Produce end of day deposit slip, and Produce weekly sales reports Systems Analysis and Design in a Changing World, 6th Edition 4 Systems Analysis and Design in a Changing...
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...Western Governors University XTT Task 1 January 2, 2015 CURRENT NURSING PRACTICE In the United States there are approximately 5% of sterile surgical operations that will become infected each year. The number one nosocomial infections regarding surgical patients are infections at the surgical site (Kalb, Lefevre, Dididze, & Levi, 2013). For reductions of infections on any surgical site, this skin will need to be cleaned (or prepped) and covered with a sterile towel or drape. The site of the incision is prepped so that bacteria or microbes that cause the infection are found on the skin surface. Due to these microbes, prepping a patient’s skin will be the most important step prior to any surgery. Different hospitals throughout the United States use many different products for the cleaning or prepping stage. At the hospital of my place of employment, there are three different agents that can be used. This list includes Chlorhexidine gluconate, chlorhexidine alcohol, and povidone iodine. Any type of infection involving the incision site can cause complications that could be long term for any patient to deal with and may have financial consequences to any hospital. This particular hospital is considering a change to standardize the prepping solution and needs to determine the cost factor if it were to change to a new product or to add premixed applicators of particular type of surgical prep solution. At this hospital, the current standard is using a surgical prep cleanse...
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...Professional Development: Critiquing Research The ability to critique (critically analyse and evaluate) research from both the qualitative and quantitative paradigms is an essential skill for occupational therapists. It is this skill, integrated with expertise gained from clinical practice that underpins evidence based practice (EBP). Although there are many definitions of EBP, Muir Gray (1997) defines it as “an approach to decision making in which the clinician uses the best evidence available, in consultation with the patient, to decide upon the option which suits the patient best." The purpose of this assignment is to enable the development of skills in critical analysis by critiquing a research article, which will contribute to further development of knowledge and skills in using EBP in clinical settings. A framework developed by Hek and Moule (2006) (see pages 3- ) has been used to guide the critique of a research article. A framework was used as Caldwell et al (2010 pg e1) argue that “ frameworks assist the novice healthcare practitioner with learning about approaches to research by giving consideration to aspects of the similarities and differences between the qualitative and quantitative research paradigms.” This framework was chosen as it is comprehensive and covers points/questions raised during the critiquing process, although it is important to remember that it is not a definitive checklist and other...
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