Addressing Clinical Challenges

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Addressing Clinical Challenges

(Addressing Clinical Challenges)

Respond to each of the 6 statement

Question description

Please respond with a 150 words per statement. APA format.

Question1: During your practicum, determine what clinical problem or issue the organization is facing. Discuss two implications for nursing.

Statement1:Working in the student health center at a SUNY college, a significant issue we are faced with is the increased number of students who are testing positive for sexually transmitted infections (STI). Despite numerous prevention and treatment efforts, the transmission of STI’s on college campuses continue to be a significant health concern (Williams et al., 2008). Here at the center we offer free condoms and partner up with outside organizations who will test our students for HIV, Chlamydia, Gonorrhea, and Syphilis free of charge. We also treat our students with the appropriate medication regimen if they are tested positive for an STI and will treat their partners as well if they are a student on campus.

Nursing implications include teaching and educating students and encouraging screenings for sexually transmitted infections. Educating our students is a critical component of STI prevention and management. We conduct many different educational programs on topics pertaining to STI’s, sexual health, and safe sex practices. Nurses can offer guidance to individuals about communicating an STI diagnosis to their current or previous partners and can help facilitate treatment (Maria et al., 2017). Encouraging screening for STI’s is also an important nursing implication. We recommend our students to be tested every six month to one year if tested negative in the past. For students who have tested positive, we recommend testing in three months. Students have expressed great gratitude to us for the services that we provide to them.

RESPOND TO THE STATEMENT WITH 175 WORDS APA FORMAT SOURCE IF NECESSARY.(Addressing Clinical Challenges)

STATEMENT 2: I work in a community clinic serving the needs of the underserved in Pinal County Arizona. The clinic provides services in family care, pediatrics, dental, and women’s health. I take a special interest in women’s health as I am the Registered Nurse Team Leader for the OBGYN department. According to the World Health Organization (WHO), 2018 cervical cancer impacts women globally and it is one of the cancers that is the most preventable. I recognized a calling in women’s health because all too often I see how this topic is overlooked and realize that more attention needs to be placed on preventative care of the complex health issues that affect women. Pap smears are a very easy and important tool used in the early detection of cervical cancer. While the Health Resource and Services Administration (HRSA), 2018 underscores that 100 percent of women should complete routine cervical cancer screening they suggest, “an organization can set an appropriate and realistic goal based on the review of comparable data after consideration of the payer mix of the patient population served” (p.10). As an organization we set the benchmark at 75 percent of females in the community ages 21-65 years have routine cervical cancer screening, however the organizations 2017 dashboards indicate they are only at 50 percent. This has many implications to the nursing practice as nurses play a key role in prevention and detection. It is within a nurse’s scope of practice to advocate for screening, provide training and education, and with many nurses in advanced practice roles such as nurse practitioner, they are also performing the screening tests. Greensdale, Fitzgerald, Doyle Barry, and Power-Kean, 2013 stress that women need to be empowered through proper education, take advantage of new technology and electronic medical record (EMR) systems to track and send reminders to patient, and evaluating health behaviors for avoiding routine pap exams. There is absolutely no reason why these screening numbers cannot be turned around and have a positive impact on patient outcomes when we have the resources right at our fingertips.

RESPOND TO THE STATEMENT WITH 175 WORDS APA FORMAT SOURCE IF NECESSARY.(Addressing Clinical Challenges)

STATEMENT 3: Working at a local hospital in the orthopedics department, there is currently an issue regarding readmission to the hospital due to secondary infection in post-operative patients who did not follow their discharge instructions for wound care. Being in a low income region with high rates of diabetes, there are increased risks for health complications after surgery, including improper wound healing (Providence Health Network, 2016). Although there are instructions given to the patients prior to discharge regarding their medications and the physical therapy they need to attend or wound care they need to perform, there is a lack of compliance to the care plan. Many of the patients stated upon readmission that their initial surgery or hospitalization was covered from their insurance but the necessary outpatient therapies or wound care appointments were going to be out of pocket costs, which they could not afford. Because they opted to not follow-up or go to their appointments, they had decreased wound healing and many of them developed staph infections leading to them being readmitted (Providence Health Network, 2016). In order to address this problem, there are several measures being taken both prior to discharge and afterwards in order to reduce these complications and promote proper wound healing and health.

One primary method of reducing these readmission rates is to provide supplies and education for the patients to perform their dressing changes or necessary wound care after being discharged. Public community resources and resources provided from the hospital as donations are given in order to reduce the financial burden on those who cannot afford the follow-up visits to specialty wound care clinics (Providence Health Network, 2016). Prior to discharge the nurses also provide education and demonstration to the patient and their family in order to confirm that they are capable of performing the care needing. In addition, the case managers have created a team of wound care nurses who follow-up with these patients via phone or video chat to ensure they are performing the care.

Another way they are working to correct this issue is to provide diabetes education to patients that already have diabetes or who are at risk for developing diabetes. Because many patients come in and are unaware that they are at risk or have diabetes, they also present a higher risk for complications. Teaching them about proper nutrition and glucose monitoring, as well as checking their feet are all ways the nurses are able to increase knowledge of diabetes. By making them aware of the risk for impaired tissued integrity or decreased wound healing, it will help encourage them to be more diligent in their post-operative care upon discharge (providence Health Network, 2016). Making sure they are educated regarding the effects of diabetes is a priority for all patients, but increasingly so in the patients with a higher risk for complication because of the comorbidity.

RESPOND TO THE STATEMENT WITH 175 WORDS APA FORMAT SOURCE IF NECESSARY.

QUESTION 2 What is the main issue for your organization in addressing a solution to evidence-based nursing practice? Discuss what might be the first step in addressing and resolving this issue.

STATEMENT 3(Addressing Clinical Challenges)

As the nursing profession continues to evolve, the educational focus is also changing. One of the most significant emerging needs in healthcare today is evidence-based practice. Key elements in the successful implementation of evidence-based practice in nursing include: (University of Texas Arlington, 2012)

  • Reviewing research and studies that examine the best practices in clinical nursing (University of Texas Arlington, 2012).
  • Interactive decision-making regarding care and treatment planning which integrates care team members, as well as the opinion of the patient and his or her family (University of Texas Arlington, 2012).
  • Ongoing professional development education of nurses, including pursuit of advanced degree programs when available (University of Texas Arlington, 2012).
  • Addressing clinical issues and critically examining possible practice changes (University of Texas Arlington, 2012).
  • Strong emphasis on problem-solving skills, clinical judgment and the use of sound evidence to support clinical decisions based on research, experience and the environment (University of Texas Arlington, 2012).

There are many ways to help address, and resolve the need for more EBP in health care settings. It starts, with support from management, and across the board education.

  • Confirm management support (Agency for Healthcare Research and Quality, 2018).S
  • Expressed support for the initiative (Agency for Healthcare Research and Quality, 2018).
  • Additional months for Implementation Team to work (Agency for Healthcare Research and Quality, 2018).
  • Training resources and release time for unit staff involved in prevention (Agency for Healthcare Research and Quality, 2018).
  • Resources for equipment and supplies (Agency for Healthcare Research and Quality, 2018).
  • Policies and procedures in place (Agency for Healthcare Research and Quality, 2018).
  • Develop a process for monitoring implementation closely and making midcourse corrections as needed (Agency for Healthcare Research and Quality, 2018).
  • Carry out your strategies so that you successfully implement the new practices (Agency for Healthcare Research and Quality, 2018)

RESPOND TO THE STATEMENT WITH 175 WORDS APA FORMAT SOURCE IF NECESSARY.

STATEMENT 5

Evidence based practice (EBP) involves clinical decision making based on current best research evidence, clinical expertise, and patient preferences (Stokke et al., 2014). Research has revealed that patient outcomes significantly improve when nurses utilize evidence based practice. EBP has been shown to increase patient safety, improve clinical outcomes, and reduce healthcare costs. One of the main issues we are faced with in addressing a solution to evidence-based nursing practice in my organization is lack of support and resistance from senior staff to use and conduct research. Without support and engagement from senior staff, it is nearly impossible for our facility to sustain a culture of evidence based practice. Due to this issue, we are also currently one of the few SUNY colleges who have not yet implemented electronic health records into our facility.

The first step to addressing and resolving this issue is to stress the importance of implementing evidence based practice into our facility. Communication and collaboration is imperative in resolving this issue. Many of the senior staff are afraid of technology and simply refuse to embrace it. A few of them lack support because they feel they lack knowledge and competency. Conducting a meeting with all staff involved and explaining the significant benefits that ebp can bring to our facility is imperative. Explaining how evidence based practice is used in similar facility settings would also be beneficial. The hardest step in this process is to get everyone in agreeance that implementing evidence based practice in our facility is a necessity.

RESPOND TO THE STATEMENT WITH 175 WORDS APA FORMAT SOURCE IF NECESSARY.

STATEMENT 6(Addressing Clinical Challenges)

Evidence-based nursing practice is an approach used in nursing practice that allows nurses to use up to date research that has been proven and tested by professionals in improving patient outcomes. This practice involves the ability to access, summarize, and apply information from literature to everyday clinical problems (University Libraries, 2018). According to the Journal of Clinical Nursing, evidence-based nursing is an ongoing process by which evidence, nursing theory and the practitioners’ clinical expertise are critically evaluated and considered, in conjunction with patient involvement, to provide delivery of optimum nursing care for the individual (as cited in, University of Libraries, 2018).

One of the main issues in addressing a solution to evidence-based nursing practice in our organization is the everchanging policies and procedures. The constant changing of policies and procedures makes it almost impossible to keep up with. When we do have time to research a certain topic we are not sure if we are looking at the correct one. Sometimes the policies have not been updated in our system and we can only go by what was said during our quarterly meetings. A way to address this issue is to promptly update our policies before they are introduced in our meetings. This way we have a formal written policy we have access to for reinforcement and guidance. Another step in resolving this issue is to keep staff updated and reminded of these changes via emails, posters, meetings, and end of shift reports.

 
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