Assignment: Clinical Guideline & Implementation

Assignment: Clinical Guideline & Implementation

Assignment: Clinical Guideline & Implementation

Question Description
Write RESEARCH SYNTHESIS, THE CLINICAL PROTOCOL

USES RUBRIC AND MUST FOLLOW INSTRUCTIONS

APA 6.0 REQUIRED

Refer to the “CLC Assignment: Evidence-Based Project (EBP) Student Guide” for additional guidance. (attached)

RESEARCH SYNTHESIS

ACCURATELY REPORTS INFORMATION FROM THE SOURCES USING DIFFERENT PHRASES AND SENTENCES

ORGANIZED IN SUCH A WAY THAT READERS CAN IMMEDIATELY SEE WHERE THE INFORMATION FROM THE SOURCES OVERLAP

CLARIFIES SOURCES AND HELPS THE READER UNDERSTAND THEM IN RELATION TO EACH OTHER

CLINICAL PROTOCOL

“THERE ARE VARIETY OF WAYS TO COMPLETE THE CLINICAL PROTOCOL AND IMPLEMENTATION, FOR EXAMPLE YOU COULD USE EXISTING MODELS SUCH AS THE IOWA MODEL OF EVIDENCE BASED PRACTICE ALONG WITH KOTTER’S 8 STEP CHANGE MODEL AS THE ROADMAP FOR THESE SECTIONS. REMEMBER THIS SHOULD BE A HIGH-LEVEL OVERVIEW OF THE PROTOCOL AND IMPLEMENTATION PLAN.”

ARTICLE WE WORKED ON SO FAR, YOU HAVE TO ADD RESEARCH SYNTHESIS, THE CLINICAL PROTOCOL TO THIS

Evidence based practice (EBP) has made a huge impact in nursing throughout history. Nurses have the ability to change their practice and improve outcomes for their patients first hand. It has become an interdisciplinary approach within clinical practice that has paved the way health care professionals safely and ethically practice medicine. The idea of EBP incorporates individual experience with evidence-based research to create the most clinical sound practices and guidelines. The following paper will discuss and identify a clinical question that will be followed with a problem statement regarding an evidence-based practice that could enhance the care of end of life patients.

Foreground Question

The authors of the paper have collectively crafted four relatable foreground questions that will shape the content of the evidence-based practice project.According to Polit and Beck (2016), a foreground question can be answered by up-to-date research evidence. EBP assists in diagnosis, treatment, and prognosis in the healthcare field.

How can healthcare providers optimize pain control in end of life and hospice patients?
Are there alternatives to pain medicine that would be an adjunct to therapy; such as a
holistic approach?

Do healthcare providers adequately address the pain and suffering of end-of-life and hospice patients experience?
In a dilemma, should practitioners choose patients to have a quality of life or quantity of life?
Problem Statement

Nurses, as well as physicians, working with hospice often face more ethical dilemmas than those assisting patients of any other age group. Euthanasia is forbidden as such in the United States and is only applicable in some states under particular circumstances. Addressing this issue with the patients is probably one of the most challenging ethical dilemmas faced by geriatric nurses. The nurse has a greater opportunity than the physician to create a relationship, so it will generally be the geriatric nurse that will inform the patient about his/her right to file a non-resuscitation order. While doing so, it is necessary that the nurse explains the patient the relevance of such non-resuscitation order, as it will prevent physicians and nurses from resuscitating him if he needs it if he has filed such order. (Rainer et al., 2018).

Advance health practitioners face dilemmas whether to advocate for patients for a decent quality of life or a quantity of life (Buppert, 2017). According to the most recent statistics, 1.63 million Medicare beneficiaries were enrolled in hospice for one day or longer in 2016 (National Hospice and Palliative Care Organization, 2018).While hospice facilities can provide a variety of support, most patients and their families utilize this service for end-of-life care (National Hospice and Palliative Care Organization, 2018).Moreover, although patients enter hospice with a range of principle diagnoses, one issue that is a common thread for these patients is pain management at end-of-life and during the dying process.However, Dr. Susan Glod reported in an article for the New England Journal of Medicine that due to the opioid epidemic in recent years, hospice patients could be “victims” of the changes to opioid prescribing policies in the past few years (Glod, 2017). One recent study revealed the significance of nursing home patients enlisted in hospice care with pain at 60% (Hunnicut, Tjia, & Lapane, 2017).Though nurses are now in a difficult position concerning their approach to hospice patients with chronic pain, they still must address this aspect of care.The American Nurses’ Association (2018), position statement regarding the nurse’s duties for end-of-life care states the following:

“Decisions about care at the end of a person’s life often involve quality-of-life considerations. Nurses are obligated to provide care that includes the promotion of comfort, relief of pain and other symptoms, and support for patients, families, and others close to the patient.” (para. 3).

Given this information along with the literature reviewed at this time, it is essential to closely examine the relationship between the presence of pain and treatment of pain in end-of-life patients and hospice patients.

References

American Nurses Association. (2018). Nurses’ roles and responsibilities in providing care and support at the end of life. Retrieved from https://www.nursingworld.org/practice-policy/nursi…

Coyne, P., Mulvenon, C., & Paice, J. A. (2018). American society for pain management nursing and hospice and palliative nurses association position statement: Pain management at the end of life. Pain Management Nursing, 19(1), 3-7. doi:10.1016/j.pmn.2017.10.019

Glod, S. (2017). The other victims of the opioid epidemic. New England Journal of Medicine, 376, 2101-2102. DOI: 10.1056/NEJMp1702188

Harrison, K. L., & Connor, S. R. (2016). First Medicare demonstration of concurrent provision of curative and hospice services for end-of-life care. The American Journal of Public Health, 106(8), 1405. Retrieved from http://eds.b.ebscohost.com.lopes.idm.oclc.org/eds/…

Hunnicutt, J. N., Tjia, J., & Lapane, K. L. (2017). Hospice use and pain management in elderly nursing home residents with cancer. Journal of Pain and Symptom Management, 53(3). 561-570. doi:10.1016/j.jpainsymman.2016.10.369

Kirby, E. G. (2018). Patient centered care and turnover in hospice care organizations. Journal of Health & Human Services Administration, 41(1), 26. Retrieved from http://eds.b.ebscohost.com.lopes.idm.oclc.org/eds/…

National Hospice and Palliative Care Organization. (2018). NHPCO facts and figures: Hospice care in America. Retrieved from https://www.nhpco.org/hospice-statistics-research-…

Polit, D. F., & Beck, C. T. (2016). Nursing research: Generating and assessing evidence for

nursing practice (10th ed.). Retrieved from http://gcumedia.com

Reddy, A., Yennurajalingam, S., & Bruera, E. (n.d). “Whatever my mother wants”: Barriers to

adequate pain management. Journal of Palliative Medicine, 16(6), 709-712. doi:10.1089/jpm.2012.0189

Reynolds, J., Drew, D., & Dunwoody, C. (2013). American society for pain management nursing position statement: Pain management at the end of life. Pain Management Nursing, 14(3), 172. Doi:10.1016/j.pmn.2013.07.002

Sanders, S., Herr, K. A., Fine, P. G., Fiala, C., Tang, X., & Forcucci, C. (2013). An examination of adherence to pain medication plans in older cancer patients in hospice care. Journal of Pain and Symptom Management, 45(1), 43. Doi:10.1016/j.jpainsymman.2012.01.007

Assignment: Clinical Guideline & Implementation

RUBRIC

CLC – EBP Develop Clinical Guideline and Implementation Plan

1
Not submitted
0.00%

2
Unsatisfactory
75.00%

3
Less Than Satisfactory
80.00%

4
Satisfactory
88.00%

5
Good
92.00%

6
Excellent
100.00%

70.0 %Content

35.0 %Clinical Guideline

None

Clinical guideline is unclear or not present.

Clinical guideline lacks important information or had inaccurate information. No Introduction to assist staff to implement. Expected patient outcomes are not described or not justified by the clinical plan.

Clinical guideline incorporates most of the required information for use. Introduction not present and/or not helpful. Expected outcomes of the clinical change are identified, but are vague or not realistic.

Clinical guideline is clear, comprehensive, and justified by evidence. Introduction to guideline not fully persuasive. Expected outcomes of the clinical change are defined.

Clinical guideline is clear, comprehensive, and justified by evidence. Guideline is introduced to help users understand the purpose as well as the process. Expected patient outcomes to be used for evaluation are identified and realistic.

35.0 %Implementation Plan

None

Implementation plan is not present.

Assignment: Clinical Guideline & Implementation

Implementation is not well defined or is unrealistic.

There is a plan for implementation, but it is not realistic or lacks detail needed for implementation. Change issues not identified.

Plan for implementation (including timeline and criteria for evaluating outcomes) is clear and feasible, but lacks some detail. Barriers to change are Identified and addressed.

Plan for implementation (including timeline and criteria for evaluating outcomes) is detailed, clear, and feasible. Barriers and drivers for change are identified and addressed in implementation plan.

5.0 %Organization and Effectiveness

5.0 %Mechanics of Writing (includes spelling, punctuation, grammar, language use)

None

Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice and/or sentence construction are employed.

Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) and/or word choice are present.

Some mechanical errors or typos are present, but are not overly distracting to the reader. Audience-appropriate language is employed.

Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of sentence structures and effective figures of speech.

The writer is clearly in command of standard, written academic English.

25.0 %Format

5.0 %Research Citations (in-text citations for paraphrasing and direct quotes, and references page listing and formatting, as appropriate to assignment and style)

Assignment: Clinical Guideline & Implementation

None

No references page and no citations are included.

References page is present, but citations are inconsistently used.

References page is included. Sources are appropriately documented, although some errors may be present.

References page is present and fully inclusive of all cited sources. Documentation is appropriate and citation style is usually correct.

In-text citations and a references page are complete. The documentation of cited sources is free of errors.

20.0 %Participation

None

Participation is not evident.

Posts do not encourage further discussion and dialogue with other students in the class. Posts are critical, argumentative, or confrontational. Individual group contributions are submitted extremely late, affecting the group’s ability to accomplish a successful task. Cooperative teamwork is not evident.

Most posts encourage further discussion and dialogue with other students in the class. Posts are professional and exhibit a positive attitude that is respectful of others. Individual contributions are submitted but not on time. Cooperative teamwork is exhibited but limited.

All posts encourage further discussion and dialogue with other students in the class. Posts are professional and exhibit a positive attitude that is respectful of others. Individual contributions are provided by the designated timeline. Cooperative teamwork is exhibited but not consistently.

All posts encourage further discussion and extensive dialogue with other students in the class. Posts demonstrate a critical analysis of classmates’ postings and provide relevant and constructive feedback. Individual contributions are provided before the designated timeline. Cooperative teamwork is exhibited in order to complete the project.

100 %Total Weightage

Assignment: Clinical Guideline & Implementation

You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.

ADDITIONAL INSTRUCTIONS FOR THE CLASS

Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.
Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.
One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.
I encourage you to incorporate the readings from the week (as applicable) into your responses.
Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately.
In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).
Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.
APA Format and Writing Quality

Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).
Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
I highly recommend using the APA Publication Manual, 6th edition.
Use of Direct Quotes

I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.
As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.
It is best to paraphrase content and cite your source.
LopesWrite Policy

For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.
Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.
Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?
Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.
Late Policy

The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.
If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.
I do not accept assignments that are two or more weeks late unless we have worked out an extension.
As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.
Communication

Communication is so very important. There are multiple ways to communicate with me:
Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.