Purpose

This assignment provides the opportunity for the graduate nurse practitioner student to become familiar with research processes which are specific to quality improvement.  The graduate nursing student will develop a State of the Science Evidence-Based Practice Project that is focused on quality improvement.

Note: The process began in Week 2 with the formation of a PICO question. Week 4 was Part 1 of the paper which laid the ground work for the project. Part 2 of the Project in Week 6 adds the following elements:  Abstract, Review of the Literature (State of the Science), strengths and limitations of current evidence, and development of a quality enhancement (improvement) plan that addresses limitations of current practice evidence.

Activity Learning Outcomes

1. Integrate evidence-based practice and research to support advancement of holistic nursing care in diverse healthcare settings (CO1)
2. Integrate knowledge related to evidence-based practice and person-centered care to improve healthcare outcomes (CO2)
3. Develop knowledge related to research and evidence-based practice as a basis for designing and critiquing research studies (CO4)

Due Date: 

• Sunday by 11:59pm MT at the end of WEEK 6
• Part 1 and 2 should be submitted as the final paper

Students are expected to submit assignments by the time they are due. Assignments submitted after the due date and time will receive a deduction of 10% of the total points possible for that assignment for each day the assignment is late. Assignments will be accepted, with penalty as described, up to a maximum of three days late, after which point a zero will be recorded for the assignment. Quizzes and discussions are not considered assignments and are not part of the late assignment policy.

 

Total Points Possible:  200pts

Requirements:

Preparing the Assignment:  Part 2 Criteria for Content

Abstract:

The abstract should be succinct, comprehensive, and follow and include these APA components (accurate, non-evaluative, coherent, readable and concise).

A description of the problem under investigation (one sentence), participants, and essential features of the quality improvement project which include setting, supporting theory, stakeholders and outcome measurements that would be used to determine efficacy of quality improvement project are included.

(See APA 6th ed., for abstract examples and explanation; p. 25-26)

 

State-of-the-Science Review of the Literature (ROL):

See Polit & Beck, 2018, 9th ed., Ch. 7 for description of ROL.

This section will describe the state of the science related to the PICO question and problem statement, purpose of the quality project.

1. A minimum of 6 (six) appropriate research-based scholarly references (articles) must be used.  Required textbook for this course, dictionary and Chamberlain College of Nursing lesson information may be used but will NOT count as scholarly references for this assignment.  For additional assistance regarding scholarly nursing references, please see “What is a scholarly source” from the Chamberlain Library resources.  Be aware that information from .com websites may be incorrect and should be avoided.  References are current if within a 5-year time frame (3 years is best) unless a valid rationale is provided and the instructor has approved them prior to submission of the assignment.
2. The evidence should be critically reviewed and synthesized.
3. The strengths and limitations of the current evidence and current practice are described which provide evidence for practice change clearly supported
4. The identified area of issue or gap in practice is made clear using evidence and is compelling and significant.
5. No more than three (3) direct quotes are used.

Quality Change Plan:

In this section the writer will create an inter-disciplinary quality improvement plan for their future practice area.  The JH Action Planning Tool may be used as a guide but is not required to be submitted along with the project.  This section should be supported by scholarly in-text citations and include the following sections:

1. Feasible plan for implementation: Select a model for use, such as the Plan/Do/Study/Act Model.
2. Identification of key stakeholders with rationale for identification.
3. Identification of appropriate interdisciplinary team members to assemble with rationale.
4. A plan for outcome analysis (this should include independent and dependent variables as well as an overview of a method of statistical analysis (which statistics or outcome measures).
5. Ethical considerations: Protection of Human Subjects.

Criteria for Format and Special Instructions:

1. Page length:  Part 2 of the paper (excluding the title page and reference page) should be 10 pages maximum.
2. Title page, running head, body of paper, and reference page must follow APA guidelines as found in the 6th edition of the manual. This includes the use of headings for each section of the paper except for the introduction where no heading is used.
3. Ideas and information from scholarly, peer reviewed, nursing sources must be cited and referenced correctly.
4. Rules of grammar, spelling, word usage, and punctuation are followed and consistent with formal, scientific, scholarly writing.  First person writing should not be utilized.

Remember:  All sections should have scholarly resources integrated as in-text citations that support the content.  APA current edition is required for all elements of the paper.

Rubric Glossary of Achievement Terms

Comprehensive:  

1. Of Large Scope, Covering or Involving Much; Inclusive
2. Comprehending or thoroughly understanding with one’s mind; having an extensive mental range or grasp of aparticular subject.

Solution:

Abstract

Re-admission for the patients with congestive heart failure(CHF) hs remained a significant problem. The ability to monitor the patients remotely for the deterioration of CHF, therefore, provides an opportunity for implementation of an intervention that can reduce the re-hospitalization rates. the quality improvement project that can address this issue is in-home monitoring using CardioMEMS. the setting of this QI project is a hospital setting. The key participants include nurses from the cardiovascular unit, physicians, cardiologist, CHF patients above the age of 50 years as well as dieticians………

Literature Review

The PICOT question was used to guide the search of the available evidence regarding the effectiveness of in-home monitoring in reducing readmission rates of CHF patients. Owing to the advances in communication technology, monitoring has moved beyond telephone calls as well as requesting patient information. Telemonitoring is being adopted in transferring physiological data such as electrocardiographic signals, oxygen saturation as well as blood pressure among others. In light of this, a myriad of studies was gathered for this project to guide the implementation of this project.

In their retrospective chart review, Assaad, Sarsam, Naqvi, and Zughaib (2019) explored the impact of in-home monitoring precisely CardioMEMS device in reducing the readmission rate in CHF patients. 27 patients were included in the study the results showed that the total number of readmission before the monitoring device was used was 46 in comparison to 9 post-implementation. The study, therefore, deduced that in-home monitoring reduced CHD related readmission by 80.4%. Consistent with these findings, a study by Adamson et al. ( 2016) explored the impact of CardioMEMS in 550 patients who were implanted with the monitoring device and followed the patients for 515 days. The study found a reduction of 30 days of……Click link below to purchase full tutorial at $10

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