NU300M3: Competency Assessment Evidence-Based Practice: Innovation and Change Worksheet Introduction Many innovations in healthcare offer the promise of improved patient outcomes. Healthcare...

NU300M3: Competency Assessment
Evidence-Based Practice: Innovation and Change Worksheet
Introduction
Many innovations in healthcare offer the promise of improved patient outcomes. Healthcare innovations can be prompted by nursing research that provides new supporting evidence for practice. Evidence-based practice innovations require a vision for what is possible and a willingness to em
ace change.
Directions
Complete Parts A, B, and C on the following worksheet. All responses should be written in complete sentences. Provide a citation and reference for any supporting resource utilized.
Part A: Cu
ent Applications of Nursing Research
1. Review the research studies designated in the Course Resources.
2. Choose one (1) study to discuss in the box below.
· Describe the issue/problem addressed in this study and its significance.
· Which research approach method was utilized to study this topic?
· See pp XXXXXXXXXXof your textbook (Blais & Hayes, 2016).
· Explain how the findings from this study can improve patient outcomes.
· APA in text citation and reference are required.
    Problem and Significance
    
    Research Approach Method
    
    Improving Patient Outcomes
    
Part B: Future Applications of Evidence-Based Practice
1. Reflect on problems you have observed in the healthcare setting that have a direct effect on patient outcomes. Think about how some of these problems could be addressed through new/original nursing research.
2. Choose one (1) such problem to discuss in the box below.
· Describe the problem and its significance.
· Explain how new/original nursing research might be used to address this problem and improve patient outcomes.
· Which research approach method should be utilized to study this problem? Why? See pp XXXXXXXXXXof your textbook (Blais & Hayes, 2016).
    Problem and Significance
    
    Addressing the Problem: Improving Outcomes
    
    Research Approach Method
    
Part C: Navigating Change
1. The implementation of any innovation in evidence-based practice requires change. Reflect on your experiences with practice changes in the healthcare setting. Think about the people and processes that were involved in the change.
2. Choose two (2) common/motivating forces associated with practice changes you have experienced in the healthcare setting. See p. 290 of your textbook (Blais & Hayes, 2016).

· Describe the motivating force.
· Give an example of how the motivating force manifested itself in the healthcare setting.
· How did the motivating force facilitate or accelerate the implementation of new practices in the healthcare setting?
    Motivating Force #1: Description, Example, Effect
    
    Motivating Force #2: Description, Example, Effect
    
3. Choose two (2) restraining forces associated with practice changes you have experienced in the healthcare setting. See p. 290 of your textbook (Blais & Hayes, 2016).

· Describe the restraining force.
· Give an example of how the restraining force manifested itself in the healthcare setting.
· How did the restraining force impede or block the implementation of practice changes in the healthcare setting?
    Restraining Force #1: Description, Example, Effect
    
    Restraining Force #2: Description, Example, Effect
    
References:
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NU300
M3
:
Competency Assessment

Evidence
-
Based Practice:
Innovation and Change

Worksheet

Introduction
Many innovations in healthcare offer the promise of improved patient outcomes.
Healthcare
i
nnovation
s

can be prompted by nursing research that provides new supporting evidence

for
practice
.
E
vidence
-
ased
practice
innovations require a vision for what is p
ossible and a
willingness to em
ace change.
Directions
Complete
Parts A, B, and C on
the following worksheet
. All responses should be written in
complete sentences.

Provide a citation and reference for any supporting resource utilized.
Part A:
Cu
ent Applications of
Nursing Research
1.

Re
view the research studies designated in the
Course Resources
.
2.

Choose
one

(
1
)

study
to discuss in the box below.
·

Describe the
issue
problem
addressed in this study
and its significance
.
·

Which research approach method was utilized to study this topic?
o

See pp. 196
-

197

of your textbook (Blais & Hayes, 2016).
·

Explain
how the findings from this study can improve patient outcomes.
·

APA in text citation and reference are required.
Problem and Significance
Research Approach Method
Improving Patient Outcomes

Page 1 of 2

NU300M3: Competency Assessment
Evidence-Based Practice: Innovation and Change Worksheet
Introduction

Many innovations in healthcare offer the promise of improved patient outcomes. Healthcare
innovations can be prompted by nursing research that provides new supporting evidence for
practice. Evidence-based practice innovations require a vision for what is possible and a
willingness to em
ace change.

Directions
Complete Parts A, B, and C on the following worksheet. All responses should be written in
complete sentences. Provide a citation and reference for any supporting resource utilized.

Part A: Cu
ent Applications of Nursing Research

1. Review the research studies designated in the Course Resources.

2. Choose one (1) study to discuss in the box below.
 Describe the issue/problem addressed in this study and its significance.
 Which research approach method was utilized to study this topic?
o See pp XXXXXXXXXXof your textbook (Blais & Hayes, 2016).
 Explain how the findings from this study can improve patient outcomes.
 APA in text citation and reference are required.

Problem and Significance











Research Approach Method




Improving Patient Outcomes






Learning about Turning: Report o f a
Mailed Survey o f Nurses' Work to
Reposition Patients
De
a R. Hanna, Ann Marie Paraszczuk,
Margaret M. Duffy, Lawrence A. DiFiore
Repositioning a patient every 2 hours remains the gold standard of
nursing care to prevent pressure ulcers. Findings from this study
showed silent factors are clinical realities that can increase nurses'
work to reposition patients. Silent factors also can affect how nurs­
es prioritize their work.
R epositioning patients every 2 hours to prevent pressure ulcers became the gold stan­
dard of nursing care in an era when
the nation's healthcare system was
very different: the 1950s-1980s
(Lyder, XXXXXXXXXXIn contrast, cu
ent
acute care patients live longer, are
more physiologically frail, weigh
more, and often have several coexist­
ing conditions. These patients thus
have more risk for developing pres­
sure ulcers than patients in the past.
In 2008, hospital-acquired pres­
sure ulcers (HAPUs) were placed on
the list of never events by the
Centers for Medicare & Medicaid
Services (CMS). According to Wat­
son (2010), the list of never events
contained 28 items in six different
categories. Stage 3 and Stage 4
HAPUs were listed as care manage­
ment events. CMS will not pay any
costs associated with patient care
that results from never events. The
main effect of this policy on clinical
nurses has been the burden they
feel to ensure patients do not sus­
tain HAPUs. However, it is unclear if
staffing levels or nurses' work
processes have been redesigned
suitably to meet increased patient
care demands (Myny et al., 2012).
With contemporary mattresses
now able to reduce pressure effec­
tively, the need to maintain the tra­
ditional standard for repositioning
patients has been questioned. Yet,
epositioning a patient every 2
hours remains the gold standard of
nursing care to prevent pressure
ulcers (Makic, Rauen, Watson, &
Poteet, 2014).
Significance of Research
In preparation for this study, 15-
year trends from XXXXXXXXXXfor cer­
tain patient conditions were exam­
ined in 2010 using the public access
path to the Health Care Utilization
Project database (HCUPnet). This
analysis established trends of
increased cases for mo
id obesity,
mechanical ventilation, and Clostri­
dium difficile (C. difficile), examined
with z-statistic testing (significant at
p= XXXXXXXXXXBetween 1993 and
2008, cases of mo
id obesity
increased 29-fold, mechanical ven­
tilation cases nearly doubled, cases
of C. difficile increased four-fold,
and fecal incontinence tripled.
These findings were used to develop
the investigator-designed survey
ooklet. Findings also supported
the pre-study hypothesis that nurs­
es' work related to repositioning
patients to prevent pressure ulcers
might have increased in ways that
are unrecognized within staffing
models.
De
a R. Hanna, PhD, RN, is Associate Professor, Division of Nursing, Molloy College,
Rockville Centre, NY.
Ann Marie Paraszczuk, EdD, RN, is Associate Professor, Division of Nursing, Molloy College,
Rockville Centre, NY.
Margaret M. Duffy, PhD, RN, is Senior Administrative Director, Northwell Health, Manhasset,
NY.
Lawrence A. DiFiore, PhD, is Assistant Professor, Department of Mathematics, Molloy College,
Rockville Centre, NY.
Acknowledgments: The authors thank Jacqueline Dienemann, PhD, RN, FAAN, NEA-BC,
Professor Emeritus, School of Nursing, UNC Charlotte, who provided valuable feedback for writ­
ing the research grant proposals; Paul Puccio, New York State Nurses Association, for assisting
with the first random sample; and nurses from NYSNA who responded to the survey; Academy
of Medical-Surgical Nurses for providing access to their list of nurses and AMSN nurses who
esponded to the survey. The authors also thank the graduate research assistants who were
assigned by Molloy College to assist during this study: Denise Dilena (Fall, 2012); Claudia
Mayorga (Summer, 2013); Susana Chavez XXXXXXXXXX).
Note: This study was funded with two Molloy College Faculty Scholarship grants and with a
esearch grant from the principal investigator’s alumni association, the original Columbia
University-Presbyterian Hospital School of Nursing Alumni Association, Inc.
MEDSURG nursxno July-August 2016 • Vol. 25/No. 4 219
Research for Practice
Purpose
The purpose of the cu
ent study
was to examine nurses' work and
work environments in relation to
epositioning patients to prevent
pressure ulcers. The study examined
four previously unrecognized