M3 A6 Wa Instructions- Clinical Practice Project Part 3

Sample Answer

QSEN Definition Define your QSEN Competency in your own words (paraphrase) using the QSEN.org web site>competencies>graduate KSAS, (example for competency Patient-Centered Care the definition on the web site is Recognize the patient or designee as the source of control and full partner in providing compassionate and coordinated care based on respect for patient’s preferences, values, and needs—take this information then write your definition in your own words (paraphrasing, remember to cite the QSEN site).

The QSEN.org competency that closely relates to my topic is that of safety. The safety competency helps to minimize risk of harm to patients and providers through both system effectiveness and individual performance

(QSEN Institute, 2020).

List two Knowledge/Skills/Attitudes (KSAs)- use two each (Knowledge/skills/attitudes) from the QSEN.org web site which are listed under your chosen competency that you think will help you to meet your selected competency. Then write your KSAS in your own words (paraphrasing/editing related to your specific project—remember to cite the QSEN site).

Knowledge Skills Attitudes

Patient Centered Care- Focusing on the importance of active involvement with families of patients to provide safe and effective quality of care (QSEN Institute, 2020).

Patient Centered Care- Create a list of strategies that will promote and encourage patient and families to be a part of plan of care (QSEN Institute, 2020).

Patient Centered Care- Encourage patients to actively partake in ADLs as well as being able to reiterate education provided about self-care and safety (QSEN Institute, 2020).

Evidence Based Practice – Always provided a plan of care that is based on the patient’s needs. Include patient when creating plan of care. Seek evidence (QSEN Institute, 2020).

Patient Centered Care- Be open minded and encourage patient to provide valuable input on health and symptoms (QSEN Institute, 2020).

Quality Improvement- Always provide continuous quality improvement with every patient (QSEN Institute, 2020).

Discuss Health Care Organization (this is not the facility/organization where you are implementing your project, may be a nursing organization, or any organization which sets standards, conducts research, or publishes evidence based literature in relation to your topic) that will help support your project. Discussion should include the mission/values of the organization (in your own words). Provide citations and references (no direct quotes).

The organization I chose to help support my projects goals and outcomes is the U.S. Department of Health and Human Services’ Agency for Healthcare Research and Quality (AHRQ). The Agency for Healthcare Research and Quality’s mission is to produce evidence to make health care safer, higher quality, more accessible, equitable, and affordable, and to work within the U.S. Department of Health and Human Services and with other partners to make sure that the evidence is understood and used (Mission & Budget, 2020).

The AHRQ will greatly support my project topic due to creating the Nurse Bedside Shift Report Implementation Handbook. This is a twenty-page handbook, which can be located online. This handbook focuses on improving quality of care during nurse shift changes through implementing strategies to ensure the safe handoff of care between nurses by involving the patient and family.

Global Objective the purpose of a global objective is to provide a vision for your overall project-what are you developing and implementing-what is your expected impact on patient outcome? It should be broadly stated-in one sentence. (Do Not Use Any Abbreviations)

My global objective for this project is to educate nurses by April 15, 2021 on the importance of a thorough bedside care handoff between nurses

Project Objectives Project Objectives Now your global objective should be broken down into more focused steps. Be sure your Project Objectives support your Global Objective! How will you achieve your global objective? Be specific. Write 4 Project Objectives…objectives should start with an action verb! (Do Not Use Any Abbreviations) For example; Research on…Develop a tool/guide/protocol/policy/process to…Develop and present education to staff on new tool…Implement new tool on ___number (the number should be adequate to meet your minimum of 1-2 log hours in direct patient contact) of patients to improve (how will your project impact patient outcomes)…

I will reach my global objective by implementing the following five steps

1. Research and provide evidence on the importance of bedside report.
2.  Develop a template that nurses can follow to provide a thorough bedside care handoff. I will develop the template after meeting with my charge nurses and getting ideas on what they believe needs to be included on the template.
3. Educate and teach nurses in the Emergency Department on the importance of bedside care handoff. I will achieve this by providing educational material that shows the importance of bedside care handoff. I will provide the educational materials during shift briefings.
4. I will speak with the Emergency Department Director to see if there is a policy in place that requires bedside care handoff. I will also speak with the director to come up with a plan to monitor for change of shift bedside care handoff compliance.
5. I will follow up with twelve separate patients during the five weeks to determine if the nurses provided bedside care handoff and if the patient was included in the handoff.
   

Possible Steps to Assist Me in Completing My Project List at least 4 steps in your project
(Do Not Use Any Abbreviations) Week I hope to accomplish by Provide hopeful completion date

Eight possible steps to help me reach my global objective are:

1. Meet with my preceptor Shelby San Miguel to discuss my Clinical Practice Project idea as well as how to implement it in the emergency department. I will keep her updated and informed the whole five weeks as well as value the input she has.
2. Meet with the assistant nurse night managers and charge nurses to get approval for the implementation of my Clinical Practice Project.
3. I will research and provide data from multiple organizations including the U.S. Department of Health and Human Services’ Agency for Healthcare Research and Quality (AHRQ) on the importance of bedside care handoff between nurses.
4. I will speak to charge nurses and peers for input on what to put on the bedside care handoff template.
5. I will research and print out educational material on bedside care handoff and give this information during both day and night shift briefings.
6. I will create an easy template nurses can follow to provide thorough bedside care handoff. This template will be printed out and copies will be left in the break room as well as each nursing station in the emergency department.
7. After meeting with the Emergency Department Director and getting approval, I will monitor for compliance of using the template during bedside care handoff.
8. I will follow up with patients and nurses who have agreed to be a part of this project for their inputs and recommendations.

• Completed on 4/1/2021
• Complete by 4/6/2021
• Completed on 4/1/2021
• Complete by 04/10/2021
• Complete by 4/15/2021
• Complete by 4/10/21
• Complete by 4/25/2021
• Complete by 4/25/2021

Direct patient engagement Describe in a one or two sentences how you will provide direct patient engagement (contact) in your clinical practice project and describe how this will impact patient outcomes. (keep in mind you are not required to actually measure your outcomes, but you will need to describe your potential/projected improved patient outcomes) Be specific.

I will provide direct patient engagement in my CPP by asking five-night shift nurses to utilize the template I provide on two different patients. I myself will also utilize the template on two patients. A total of twelve patients will be involved in the bedside care handoff. Patients will be asked if they would like to participate and be questioned.

Patients will be encouraged to be involved in bedside care handoff by asking questions and seeking clarification. Patient satisfaction will increase due to better communication between healthcare provider and patient, as well as allowing the patient to be more involved in their care and treatment plan. By creating a thorough template for bedside care handoff, it will lead to an increase in patient safety, quality of care, and communication.

What are the scope, duration and history of the problem? Write 3-4 paragraphs related to your selected problem. Provide supportive details using in text citations. Give supportive data from facility, community, state, or national data to explain why you feel this is an issue. Your paragraphs should be professionally written, single spaced with APA formatted citations and references (there is a reference textbox at the end of this form. Use it for your references). (Supportive data requires paraphrased citations from your research, not direct quotes)

Previous research processes indicate that bedside care is critical in enhance the delivery of quality care and the general management of the patients. Patients who receive bedside care handoff often experience effective patient outcomes. Bedside care handoff is always common among the patients with different complex complications.

For instance, patients undergoing complex treatment processes such as surgical operations often require bedside care to enhance their recovery processes (Sagherian et al. 2017). Statistics show that bedside care handoff often leads to high quality healthcare outcomes. With bedside care handoff, there is always a significant reduction in the number of mortalities among patients.

Center for Disease Control and Prevention (CDC) indicates that over two million patients receiving beside care often obtain quality healthcare outcomes. Bedside care handoff often leads to the increased patient involvement as well as understanding of care being undertaken (Sagherian et al. 2017). Also, from the research processes, bedside care handoff often leads to the decreased patient and family anxiety and the reduced feeling of abandonment. Bedside care handoff is also applied in determining the increased accountability of nurses, increase in teamwork as well as the relationship among nurses and patients.

Bedside care handoff is an effective treatment process that should be introduced in healthcare processes. In other words, it is a procedure that should be introduced to manage all inpatients in the healthcare settings. Bedside care handoff can help in eliminating some of the practices that leads to adverse health outcomes. Also, bedside care is important in understanding patients and their needs (Choe et al., 2019). Finally, bedside care can enhance the determination of the best treatment processes to be applied in ensuring effective patient outcomes.

Who does your problem affect? Write 1-2 paragraphs discussing individuals, communities, etc. that are affected by this problem. Remember to include all parties that are affected. Your paragraph(s) should be professionally written, single spaced with APA formatted citations and references (there is a reference textbox at the end of this form. Use it for your references).

Bedside care handoff impacts general treatment processes and the patient outcomes. In the healthcare system, bedside care handoff impacts different people, communities and other groups of people. They often get to be engaged in the treatment process, a scenario that often leads to their safety in the treatment process.

Also, healthcare professionals are affected by the bedside care because they get to know the kinds of treatment that ought to be adopted and the support they can give. Also, the patient’s family members may be affected by the bedside care (Zhao et al., 2018). With the bedside care, family members can be engaged in the treatment processes and understand the care process.

Your selected organization (remember this is not the facility/organization where you are implementing your project, may be a nursing organization, or any organization which sets standards, conducts research, or publishes evidence based literature in relation to your topic) How does this organization support your topic? Some things to consider when researching…Have they advocated? Do they support financially? Are they involved in research to support your topic? Do they use it as part of accreditation requirements? Write 1-2 paragraphs. Your paragraph(s) should be professionally written, single spaced with APA formatted citations and references (there is a reference textbox at the end of this form. Use it for your references.)

United States’ Center for Disease Control and Prevention is one of the organizations involved in the research processes of different healthcare issues. The organization often undertake different research processes geared towards improving healthcare processes. CDC undertake research processes whose outcomes are used to set standards and enhance healthcare delivery processes (Stone et al., 2020).

Most organizations rely on the research processes undertaken by CDC to facilitate treatment processes and manage general care. There are different punished research about bedside care by CDC that can be applied in enhancing the research processes. The organization also provides statistics that can be applied to support the ideas that can be applied in the research process. The organization is always involved in the research processes to support the topic under consideration.

What are the implications of the problem? What will happen or not happen if the problem is not resolved? Write 1-2 paragraphs discussing the implications with supporting details (information from your selected organization and/or health care facility would be important here). Your paragraph(s) should be professionally written, single spaced with APA formatted citations and references (there is a reference textbox at the end of this form. Use it for your references).

Bedside care handoff has implications in the general healthcare processes. With bedside care handoff, there is always an increase in the quality healthcare delivery to the patients. Also, bedside care handoff often enhances medical delivery processes to the patients; in other words, bedside care usually led to the understanding between the patient and the healthcare providers, a scenario that allow healthcare professionals to adhere to the treatment standards. Generally, healthcare institutions that adhere to the bedside care often record increased efficiency in the general healthcare delivery (Zhao et al., 2018).

Plan of Action In the space below outline your plan of Action. Remember your plan of action should assist you in meeting your global and project objectives; therefore, they must be linked. Your plan of action can include your action steps from week one or they may have changed. In either case, list your action steps (that you have already completed and planned steps) and provide a one paragraph (per action step) explanation supporting this action.

You should have a minimum of four action steps (no more than five), this means you should have a minimum of four paragraphs and no more than five. Your actions steps should have supportive details (references). Your paragraphs should be professionally written, single spaced with APA formatted citations and references (there is a reference textbox at the end of this form. Use it for your references).

Action plans refer to the procedures that can be undertaken to enhance achievement of effective outcomes in the research processes. To successfully undertaken and complete the research process, there is the need to adhere to plan and steps that have been previously formulated. These steps include:

• Undertaking visibility study as well as reviewing existing restorative care programs.
• Creating restorative educational tools that can be applied in the bedside management of the patients, the tools should always highlight the interventions as well as suitable methods of enhancing bedside management (Henskens et al., 2017).
• Creation of a robust environment as well as educational processes that can enhance bedside managements of patients
• Testing the program through considering few cases and their general outcomes.

Proposed Solution Write 2-3 sentences describing your proposed solution to your problem. Remember that your solution should be linked to your global and project objectives. Your proposed solutions should have supportive details (references), professionally written, single spaced with APA formatted citations and references (there is a reference textbox at the end of this form.

Use it for your references).

Effective management of bedside care handoff processes require elaborate planning on the procedures of implementation processes (Choe et al., 2019). My proposed solution would be to create a template all nurses must use and sign off on during bedside care handoff.

My objective is to educate nurses on the importance of a thorough bedside care handoff. I will use data that I have researched to demonstrate how bedside care handoff decreases patient complaints, increases patient/family satisfaction as well as increases patient safety.

What are the gaps in the existing data? Write 1-2 paragraphs related to your selected problem. Your paragraph(s) should be professionally written, single spaced with APA formatted citations and references (there is a reference textbox at the end of this form. Use it for your references). You may need to look back at your Evidence-based Nursing Textbook for some help.

There are gaps in the existing data about the impact of bedside shift on patient safety. The data provided is not specific on the impact of bedside shift on a nursing department rather a generalization to the entire healthcare system. There is need to have adequate research focused on impact of bedside nurse shift on specific departments like emergency department and provide relevant data that will be crucial in handling the challenges associated with emergency department.

Additionally, the data provided on the research topic is more quantitative than qualitative. The qualitative data is crucial as it is based on the observational attributes. This involves intricate communication skills between the three stakeholders involved at the bedside shift that is; incoming nurse, outgoing nurse and the patient (Forde et al., 2020).

What types of additional research might be useful? Write 1-2 paragraphs discussing additional research that describes individuals, communities, other issues etc. that are affected by your topic. Your paragraph(s) should be professionally written, single spaced with APA formatted citations and references (there is a reference textbox at the end of this form. Use it for your references). Be sure the research relates to your problem.

Additional research on bedside shift reporting and impact to patient care should be done on specific departments of healthcare systems so as to provide specific data on areas or departments in nursing that require special attention. This will help the nurse leaders and managers to be specific in their targeted training and educative programs aimed at promoting better bedside shift practice and patient’s safety.

There is also need to increase the sample size in the research and use a direct approach in measuring on the impact of this practice on patient safety (Dorvil, 2018). The process of carrying out the EBP on better bedside shift reporting requires collaboration and inclusion of all the stakeholders involved in the process so that the report is accepted and implemented by all.

Adoption of good bedside shift reporting is long and demands a thorough analysis of the healthcare organizational culture and environment.
Identify Stakeholders Write 1-2 paragraphs identifying the key stakeholders to your problem with supporting examples.

Individuals or groups that are directly or indirectly influenced by the problem or solution are the stakeholders. In some cases the stakeholders are obvious; however in some cases stakeholders can be developed. Your paragraph(s) should be professionally written, single spaced with APA formatted citations and references (there is a reference textbox at the end of this form.

Use it for your references).

Nurses, nurse leaders and patients are the key stakeholders in the bedside shift nurse reporting. There is need to have effective communication between all the stakeholders to guarantee safe transition. Example at the bedside shift, there is the outgoing nurse, the incoming nurse and the patient. These three stakeholders are directly involved in the shift process and they have to communicate effectively and efficiently to minimize the chances of nursing or clinical errors.

Nurse leaders and managers have the responsibility of promoting additional training and educational programs that will equip the nurses with relevant skills and knowledge on how to effectively manage the bedside shift reporting (Larsson & Sahlsten, 2016).

List needed resources A successful change agent will identify all available resources. Resources include money, time, connections, and those resources which help you to meet your objectives. You may list your resources, but explain why the resource is needed and how these resources will help support your change.

Successful implementation of the change project on bedside shift reporting requires

• human resources
• financial resources.

The human resource required are adequate number of the nursing staff to make the shift regular and manageable by all the nurses. The nurses require adequate training on the best practices at the time of shift. This is where the nurse leaders and managers come in handy to help the new nurses attain adequate skills and train them on effective communication and engagement with the patients during the shift.

Achievement of the successful implementation of the change process requires financial support to be able to facilitate the training on the nurses on good practices at the bedside shift. Additionally, the financial resources are required in conducting research on how well and which areas to focus on during the active implementation of this change process (Center & Estrella, n.d.).

Project Update Write 2-3 paragraphs discussing your project progress. Include in your discussion how your QSEN competency and KSAs are supporting your project and if your global and project objectives are close to being met. You do not need citations or references; however, this should be professionally written.

In my change project process, on promoting bedside shift reporting, I have made steps in line with meeting my objectives and goals. The QSEN competency and KSAs has helped me carry out extensive literature review on a number of reputable articles about bedside shift reporting practices among the nurses. This review is crucial in providing me with information that I need in my change project on the topic.

Furthermore, I have already conducted the research on at least 12 patients to follow up on their experiences at bedside shift reporting. It has helped me identify the glaring gaps that do exist in communication between the nurses and patients. Approximately six out of the twelve patient I interviewed opened up to me that hey have never been involved in the bedside shift conversation during the handover session at change of shift.

I have not yet finalized on the educational program and training that should be done by the nurses to help them realize the need of a modernized bedside shift reporting that actively engages all the stakeholders. I believe that the promotion of effective strategy and general improvement of patient care and experiences is based on having nurses that are well trained and have proper inter and intra personal relationships.

References (double-space and use correct 7th ed. APA format)

This should include references from Module 1

McAllen, E.R., Stephens, K., Swanson-Biearman, B., Kerr, K., Whiteman, K (April 9, 2018) “Moving Shift

Report to the Bedside An Evidence-Based Quality Improvement Project” OJIN The Online Journal of

Issues in Nursing Vol. 23, No. 2. DOI 10.3912/OJIN.Vol23No02PPT22

Mission and Budget. (2020). Agency for Healthcare Research and Quality, Rockville, MD.

https //www.ahrq.gov/cpi/about/mission/index.html

QSEN Institute. (2020). Graduate QSEN competencies. http //qsen.org/competencies/graduate-ksas/

White-Trevino, K., & Dearmon, V. (2018). Transitioning Nurse Handoff to the Bedside Engaging Staff and

Patients. Nursing Administration Quarterly, 42(3), 261–268.

Sagherian, K., Clinton, M. E., Abu-Saad Huijer, H., & Geiger-Brown, J. (2017). Fatigue, work schedules, and perceived performance in bedside care nurses. Workplace health & safety, 65(7), 304-312. https //journals.sagepub.com/doi/full/10.1177/2165079916665398
Choe, K., Kim, Y., & Yang, Y. (2019). Pediatric nurses’ ethical difficulties in the bedside care of children. Nursing ethics, 26(2), 541-552. https //journals.sagepub.com/doi/abs/10.1177/0969733017708330
Zhao, W., Wu, Q., Reinthal, A., & Zhang, N. (2018). Design, implementation, and field testing of a privacy-aware compliance tracking system for bedside care in nursing homes. Applied System Innovation, 1(1), 3. https //www.mdpi.com/2571-5577/1/1/3
Stone, P. W., Larson, E., Saint, S., Wright, M. O., Slavish, S., Murphy, C., … & Olmsted, R. (2020). Moving evidence from the literature to the bedside Report from the APIC Research Task Force. American journal of infection control, 38(10), 770-777. https //www.sciencedirect.com/science/article/abs/pii/S0196655310008461
Henskens, M., Nauta, I. M., Scherder, E. J., Oosterveld, F. G., & Vrijkotte, S. (2017). Implementation and effects of Movement-oriented Restorative Care in a nursing home–a quasi-experimental study. BMC geriatrics, 17(1), 1-11. https //bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-017-0642-x
Forde, M. F., Coffey, A., & Hegarty, J. (2020). Bedside handover at the change of nursing shift a mixed methods study. Journal of Clinical Nursing, 29(19-20). https //doi.org/10.1111/jocn.15403
Dorvil, B. (2018). The secrets to successful nurse bedside shift report implementation and sustainability. Nursing Management (Springhouse), 49(6), 20–25. https //doi.org/10.1097/01.numa.0000533770.12758.44
Larsson, I. E., & Sahlsten, M. J. M. (2016, December 4). The Staff Nurse Clinical Leader at the Bedside Swedish Registered Nurses’ Perceptions. Nursing Research and Practice. https //www.hindawi.com/journals/nrp/2016/1797014/
Center, G., & Estrella, F. (n.d.). Master’s Projects and Capstones Theses, Dissertations, Capstones and Projects Fall. Retrieved July 9, 2019, from https //repository.usfca.edu/cgi/viewcontent.cgi?article=1435&context=capstone