...following account is a self-reflection of my experience in the application of analytical methods course. Over that past eight weeks of the application of analytical methods course, we dealt with different topics, assignments, and discussions that range from PICOT question development to DNP project dissemination. I learnt the importance of evidence-based practices (EBPs) and their relevance to my current job as a nurse practitioner, and most importantly to my upcoming DNP project. My learning experiences during this eight weeks course section has been quite versed. In the first week, the class objective was to formulate a PICOT that will be used for an EBP intervention. I vividly could remember how I struggled to put a one-sentence PICOT question for high blood pressure education for African American adults. Later, I was able to come up with a better PICOT question at the end of the sixth week of class with the help of the class instructor. Similarly, I learnt about EBP models for practice. Examples of such models are: the ACE star (2004); IOWA (1994); Stetler and Marram (1976); Rosswurm and Larrabee models (1990); Alice Magaw (1902)….. Although these models have been in existence for quite a bit, I found them relatively new. In the class discussions, we discussed at length on how EBs and models affect individual practices, various misconceptions about EBP, and how to appraise research articles. These topics have enriched my ability to explore various data base to search for relevant...
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...The PICOT question format is a consistent "formula" for developing answerable, researchable questions. Writing these questions is deceptively simple! When you write a good one though it makes the rest of the process of finding and evaluating evidence much more straightforward. As strange as it sounds deciding what you are looking for related to your outcome can be one of the hardest parts! When you determine the outcome it helps you hone the process of searching for evidence. Remember evidence is not just what you want the outcome to be... it is evaluating the evidence supporting or refuting what influences the outcome. If you are interested in getting to the heart of the effect of testing Foley balloons on the rates of UTIs then you need to find evidence on the pros and cons of testing the balloon! Question Templates for Asking PICOT Questions: P: Population/disease (i.e. age, gender, ethnicity, with a certain disorder) I: Intervention or Variable of Interest (exposure to a disease, risk behavior, prognostic factor) C: Comparison: (could be a placebo or "business as usual" as in no disease, absence of risk factor, Prognostic factor B) O: Outcome: (risk of disease, accuracy of a diagnosis, rate of occurrence of adverse outcome) T: Time: The time it takes to demonstrate an outcome (e.g. the time it takes for the intervention to achieve an outcome or how long participants are observed). Note: Not every question will have an intervention (as in a meaning question)...
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...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 qualification. These standards...
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...Clinical question My clinical question is “how is nursing residency program beneficial to new graduate registered nurses? Nursing residency program is a program designed to increase retention and provide essential tools to promote graduate nurse success and productivity. (Welding, 2011). Nurse Residency program gives the nurse who is a novice the learning base and expertise set required to move to clinical nursing practice competence while giving the skills required to meet the mission and objectives of the organization, the program gives nurses the administration abilities to work cooperatively within a multidisciplinary team. The nurse residency program bridges the gap between...
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...Personal Philosophy of Nursing Jessica Pons NUR/391 January 28, 2013 Sharon Thompson Personal Philosophy of Nursing To formulate my personal philosophy of nursing, I had to look at what my core values were. I am a kind, compassionate, honest, and caring. I chose nursing as my profession because nursing is something that always has been in my blood. I believe human life is precious and is to be valued. Not only do I consider my patient’s wellbeing, but I also look at the wellbeing of the families. Families take care of the patient when they are discharged. I also look at my fellow health care workers. Without being able to work alongside them, I could not take care of the patient properly. Lastly, I consider my own health. An unhealthy nurse cannot properly do their job. Caring for patients and their families, working well with coworkers, and taking care of your own health is what makes a difference because no matter how small the task, little things add up to big things. That is why I believe the world will get better one small step at a time. My Patients My patients are human beings. They are people with feelings and souls, and they are to be treated with just as much respect as everyone does. It does not matter if they are on their deathbed or just coming in because they have a cough. Being a positive role model is an important philosophy. I was raised watching my mother be a nurse and always enjoyed going to work with her and helping with small things such as...
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...In teenage patients with exercise induced bronchospasm (P), how beneficial is albuterol treatment before exercise (I), compared to albuterol treatment after exercise (C) in preventing the asthma attacks (O) in school settings during physical education (T) Key words: exercise induced asthma, albuterol, teenage, school setting, and physical education Assignment Questions Guidelines What two guidelines were used? (AHRQ, n.d.) “Pathogenesis, prevalence, diagnosis, and management of exercise-induced bronchoconstriction: a practice parameter.” (John M. Weiler, September 26, 2010) “Evidence-based care guideline for management of acute exacerbation of asthma in children aged 0 to 18 years.” (Acute Asthma Guideline, Cincinnati Children's Hospital...
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...based on research, and to provide the most skilled, advanced, and expert care. Nurses should know where to find research to support evidence-based care decisions. According to Ciliska, Haynes, and Marks (2013), a nurse could review textbooks, online data bases, journal articles, and the internet. One should consider that both consolidated and distilled information resources are available, and remember that distilled information resources do not always provide the most accurate and up to date information. The consolidate resources can be plentiful and one may have some difficulty choosing which research documents to review when searching for a specific topic. Chitty (2010) suggested using the PICO tool, which is also referred to as the PICOT tool (Langara College, 2015). This tool is a five step process for “streamlining” the process of selecting appropriate research. It includes consideration of Population (describes a group of patients similar to yours, Intervention...
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...Benchmark Assignment The Death Penalty Picot pg. 1 Keith e picot 3/28/2012 Criminal Procedure Benchmark assignment Mr. Jessie Torres The Death Penalty in America An unreasonable and Inhumane Deterrent The Death penalty has been a staple in U.S. justice system since its inception in 1608, when Captain George Kendall, in the Jamestown Colony of Virginia was ‘executed by firing squad for treason’. Even though controversial this punishment has no place in America. Death Penalty is unreasonable and inhumane deterrent for crime and should be abolished. First of all. data shows a racial bias towards black crimes against white victims. In addition, it is less expensive to house inmates than to execute them. Finally many countries have abolished the Death Penalty deeming it merciless I am a person that does not believe in the death penalty. The main thing we Question is, what purpose it serves for us to put another person on death row. By killing another human being it wont bring back that victim they murder. People against this method realize capital punishment does not stop criminals from killing or stop them from their mischief act. Many states that are against this method argue that the death penalty is both cruel and unnecessary that the dignity of human life must never be taken away, even in the case of someone who done great evil. Prosecutor need to take time out to make sure that...
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...The Effect of Telemonitoring in CHF patients Evidence Based Practice Project Sacred Heart University The Effect of Telemonitoring in CHF Patients Evidence Based Practice Project Question (PICOT) Question: In elderly individuals over the age of 65, does the use of a mobile phone-based medication adherence application, compared to a mobile phone texting reminder, increase medication compliance by 25%, within 12 weeks of implementing the program? Evidence Appraisal Matrix Source (APA) | Type of Study design (RCT, phenomenology, etc.)/Purpose | Level of Evidence(According toMelnyk & Fineout-Overholt) | Sample, settingInclusion/ExclusionCriteria | Methods, instruments, data analysis | Findings/Implications | Inglis, S. C. (2011). Structured telephone support or telemonitoring programmes for patients with chronic heart failure. Cochrane Database Of Systematic Reviews, (6), doi:10.1002/14651858.CD007228.pub2 | Systematic Review | Level I | Twenty-five studies and five published abstracts were included. 16 evaluated structured telephone support, 11 evaluated telemonitoring, and two tested both interventions. Inclusion criteria:only peer reviewed, published RCTs comparing structured telephone support or telemonitoring to usual care of CHF patients were included. | Various search engines such as: MEDLINE, EMBASE, CINAHL, and AMED were searched from 2006 to November 2008.Relevant studies and systematic reviews and abstract conference proceedings were hand searched. No...
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...Individuals are protected against discriminatory acts in the above areas regardless of whether or not the acts were intended to cause them harm. Thus, Canada Human Right Act distinguishes between two broad types of racial discrimination. Disparate treatment occurs when individuals are deliberately treated differently because of their race. Examples include offering ethnic minorities lower starting salaries, posing different interview questions to White and ethnic minority applicants, or refusing to hire applicants of color. Disparate impact, also referred to as adverse impact, occurs when facially neutral workplace practices have an unnecessary and negative effect on members of a protected class (e.g., people of color), thereby limiting the opportunities of that group. Race-related examples of disparate impact can include a wide array of activities, including recruitment and hiring practices or unnecessary requirements for one’s appearance...
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...Conflict in the Middle East is largely caused by the Sykes-Picot agreement or Asia Minor Agreement of 1916 that allowed for Britain and France to seize control of most of the Middle East after defeating the Ottoman Empire in order to build an oil pipeline for their use. Jerusalem was left as an unagreed territory in terms of ownership, which caused conflict because it was the Holy Land that Christians, Jews and Muslims had been fighting over for a millennium. This only created more conflict in the Middle East and has turned the Middle East into a theocratic anarchy now known as ISIS. With this sort of conflict, thousands are hungry and...
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...World War I was caused by competitions for power and resources by the empires, and the conclusion of the war resulted in the destruction of the empires, particularly the Ottoman Empire and Austria-Hungary Empire. The dissolution of the Ottoman Empire allowed many Middle East countries to be self-governed, while the West such as Great Britain and France had more interest in Europe than in the Middle East enabled the former to play a dominant role of colonization in the region. This seeded confrontation between two different civilizations, resulting in chaos later and to a large extent helping shape the Middle East in today's world. This paper attempts to examine this history arguing how the Ottoman Empire declined and eventually dissolved at the end of WWI. It shows that the internal problems of the Empire, such as its backward political and economic system, failed to compete with the increasing influence of the Western European countries, whose government was more efficient and more industrialized than the former, in the Middle East. The paper starts with a discussion of the contemporary situation in the Empire, and then deals with the problems that led to the conflicts between the Ottoman Empire and the European powers over the Middle East during WWI. It finally analyzes how the defeat of the Ottomans and the increasing British and French dominance in the Middle East laid the ground for today's conflicts in the region between the Arabic states and the Jewish nation, which...
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...NP ltd | Policy Brief | Canadian Immigration Reform: Macroeconomic Impacts | | | 7/28/2014 | | Table of Contents 1.0 Executive summary 2.0 Distribution List 3.0 Introduction 4.1 History 4.2 Policy 4.3 Federal Skilled Worker Program 4.4 Temporary Foreign Worker Program 4.0 Policy Outcomes 5.5 Labour Supply 5.6 Keynesian Theory – Aggregate Supply and Demand 5.7 Demands for Goods and Service 5.8 ADI/IA – Aggregate Demand and Inflation 5.9 Aggregate Supply 5.10 Multiplier effect 5.11 Money market 5.12 Short Term/Long Term Immigration Impacts on GDP 5.0 Policy Recommendations 1.0 Executive Summary The World Bank (2014) identifies Canada as having the 11th largest economy in the world with a gross domestic product (GDP) of $1.82 trillion in 2013 with a population of 35 million (Canada 2013). Immigration has been a crucial element of the development and generation of revenue for the country. Skilled workers play a vital role in the growth of the Canadian economy and range from general skilled workers, professionals as well as business immigrants and foreign investors. There is evidence demonstrating that immigrants do experience some challenges assimilating and this does cause some fiscal burden as more social support is required. Delays integrating into the social system impact numerous social resources...
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...Contemporary Issues in Business, Management and Education 2013 Virtual teams: opportunities and challenges for e-leaders Snellman Carita Liliana* a Metropolia University of Applied Sciences, Business, Leiritie 1, Vantaa 01600, Finland Abstract In the globalized world with crucial technological changes, leaders are facing unforeseen opportunities as well as challenges while striving to reach their objectives. Such changes have led to organizational restructurings and implied rethinking of leadership functions and practices. Changing organizational structures, from traditional hierarchical towards lower and more flexible ones, have made leaders organize work in new ways. Teams account for one new way of organizing work and reaching organizational goals. Likewise, globalized markets have made leaders search for new solutions to meet the needs of customers. In consequence, organizations strive for competitive advantages through downsizing, subcontracting, joint ventures, strategic alliances, and other collaborative and network-based alternatives which are typically facilitated by virtual teams. Virtual teams are geographically and organizationally dispersed teams that function over time zones. Due to such dispersion, physical contact in virtual teams is reduced or lacking altogether which means that collaboration is enabled by IT-solutions such as computerbased communication. This kind of electronically facilitated team work is known to imply opportunities as well as challenges...
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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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