Acquiring Previous Data

During rounds, Charles encounters a rare condition he personally has never seen and only vaguely remembers hearing about in nursing school. He takes a few moments to prepare himself by searching the internet. That evening, he researches further to learn how to treat, administer, and assess the patient safely. The sources he researches include online clinical databases and his own school textbooks. Most of the information seems consistent, yet some factors vary. Charles wants to provide the highest quality in patient safety. He wonders which resources are best.

What should Charles do when he encounters direct contradictions in information from two sources?

Charles should consider whether the websites he is researching are evidence-based and whether these websites are legitimately registered with HONcode.   

Which resources are the most trusted, and how do you determine this?

"The HONcode certification is an ethical standard aimed at offering quality health information" (HONcode, 2015) However HONcode cannot assure at any given time that the sites provide quality evidence-based information on their sites.  Websites that have the HONcode demonstrate their willingness to participate in legitimate and ethical programs.

Which resources are the most accurate, and how do you determine this?

The most accurate are the sites that are peer reviewed, and offer evidence-based research.  Government source websites are also a very valuable resource to research medical data. 

What criteria should Charles use to identify credible resources to enhance his clinical practice?

The criteria that Charles should use to identify credible resources to enhance his clinical practice would be to determine the level of study design used in the research.  Study designs are developed to reduce or eradicate bias. In order to ensure that Charles is gathering the highest quality information for his patients and himself, he should consider the level of evidence used in the research of data resources.

" Evidence Based Practice (EBP) can be defined as the conscientious integration of best research evidence with clinical expertise, patient values and needs in the delivery of high-quality, cost effective health care. Assessment tools are used on a regular basis by clinicians in clinical practice, and during research to ultimately improve patient care" (Ingham-Broomfield, 2015).

References:

http://www.hon.ch/HONcode/Patients/Visitor/visitor.html

 Ingham-Broomfield, R. (. (2015). A nurses’ guide to Qualitative Research. Australian Journal Of Advanced Nursing, 32(3), 34-40 7p.

Teaching Strategies for Educating Staff on Not using Shoe Covers in the OR

"The use of shoe covers has never been shown to decrease surgical site infection risk or decrease bacteria counts on the operating theatre floor.  However, it may protect team members from exposure to blood and other body fluids during an operation and is thus recommended" (Demir, 2009).

1.  Set Clear Lesson Goals

Provide staff with literature that supports the objective that you want to meet.  Once staff can identify with research that supports the change in practice, implement policies that to ensure change in practice.

2.  Question to Check for Understanding

Provide questions in open forum or by questionnaires to assess learning of staff.  Provide surveys to understanding and rationale of new clinical practice.

3.   Allow flexibility for Change of Practice

Reinforce policy supporting change in practice.  Ensure proper attire is being met in OR.  Follow up with staff on the change in practice. 

"Implementing a policy for surgical attire is one example of working together with a multidisciplinary team to make the perioperative environment safer for patients and providers.  A strategy based on a collaborative review of the evidence and acknowledgement of preference among provider groups will add to the success of the implementation" (Graling, 2013).

References:

Demir, F. (2009). A survey on prevention of surgical infections in operating theaters. Worldviews On Evidence-Based Nursing, 6(2), 102-113 12p. doi:10.1111/j.1741-6787.2009.00152.x

Graling, P. (2013). Surgical Attire Compliance for Safe Patients and Practitioners. AORN Journal, 97(4), 475-478e4 1p. doi:10.1016/j.aorn.2013.01.009

Identify two ways evidence-based practice is used in your institution.

Two ways that evidence-based practice is used in my current institution is through the implementation of new policies and procedures that impact clinical practices.  Another way that evidence-based practice is in the implementation of the electronic health record. 

Does Using the Pilot program and Phased Approach processes through information technology impact the use of EBP.

The application of evidence-based practices into information technology through a pilot program and phased approach increases the quality of patient care by providing reliable clinical research that promotes optimal health care outcomes.  The nurse will have the ability to exercise the most efficient clinical care to patients through the guided efforts of evidence-based practice that is incorporated into the patients plan of care through technology.   

What are two implications of using technology? How can it be improved?

Two implication of information technology in nursing practice is safety and quality in health care.  "Technologies used by nurses offer the means for preventing errors and adverse events (e.g., medication errors, miscommunications, delays in treatment, and adverse events—such as failure to rescue, nosocomial infections, pressure ulcers, falls, and complications of immobility" (NIH, 2015).

"Evidence-based nursing care is informed by research findings, clinical expertise, and patients’ values, and its use can improve patients’ outcomes. Use of research evidence in clinical practice is an expected standard of practice for nurses and health care organizations, but numerous barriers exist that create a gap between new knowledge and implementation of that knowledge to improve patient care" (Peterson et al., 2014).

References:

Peterson, M. H., Barnason, S., Donnelly, B., Hill, K., Miley, H., Riggs, L., & Whiteman, K. (2014). Choosing the Best Evidence to Guide Clinical Practice: Application of AACN Levels of Evidence. Critical Care Nurse, 34(2), 58-68 11p. doi:10.4037/ccn2014411

http://www.ncbi.nlm.nih.gov/books/NBK2686/

Unit 6 Blog Part I - Consumer Research Technology

Today consumers carry out their own independent medical research and health based education through the internet.  This has become an all too familiar resource for consumers who no longer wait for appointments with their physicians as personal healthcare has become more accessible through the internet.  Consumers also use the internet to perform self diagnosis of medical symptoms with little to no medical expertise.  This new wave of medical information through technology has even gone as far as creating avenues where independent sources have now designed their own blogs or websites that disseminate information that is not supported by any evidenced based practice or reliable research.  While this continues to be a problem in internet technology, there are many accredited sites that are quality based through reliable research that is provided by actual medical practitioners.  In order for the consumer to determine which sites are accredited and qualified to provide accurate up to date medical information one can verify whether the site is certified by the HONcode, which is an ethical standard aimed at offering quality health information.  "The HONcode can be found on The Health on the Net Foundation (HON) website which is a non-governmental site that founded to encourage the dissemination of quality health information for patients and professionals and the general public, and to facilitate access to the latest and most relevant medical data through the use of the internet" (HON, 2015).  Most recently, a colleague of mines went on a quest researching medical information on the web regarding  Gastroesophageal Reflux Disease (GERD).  His reasoning behind this was because he had just been diagnosed with GERD upon having a esophagogastroduodenoscopy (EGD) test.  He asked me what my educated opinion was about the reliability and validity of Wikipedia, WebMD, and cdc.gov.  I gave him an oversight about how important it is to be aware of the unreliable medical web resources that are available and how to check for HONcode certifications, and well as fact checking web sources based on evidenced based practices and reliable research.  I informed him that the Wikipedia was a web source that provided information that was not necessarily supported by qualified research and that was predominantly based on consumers medical expertise and experiences.  WebMD is an accredited site and has four medical doctors permanently on its content board and has won many awards in the American medical community.  "WebMD itself has also been accredited by the Utilization Review and Accreditation Commission -- a non-profit organization dedicated to promoting quality healthcare and health information in the U.S. -- for every year since 2001" (WebMD Reliable, 2015).  However, the site is at times under scrutiny over questions of being too commercial.   The cdc.gov site is one of the highest in quality research and measurability of accurate medical information.  "CDC.gov is CDC's primary online communication channel. Annually, there are close to 500 million page views to the site, averaging 41 million page views per month. CDC.gov provides users with credible, reliable health information" (cdc.gov, 2015).

References:

Our commitment to reliable health and medical information. (n.d.). Retrieved October 6, 2015.

Is WebMD Reliable? - Learn for free at Techboomers. (n.d.). Retrieved October 6, 2015.

(2014, May 7). cdc.gov Retrieved October 7, 2015.

Unit 6 Blog Part II - SurveyMonkey Results

Upon reviewing the surveymonkey results, I was able to see that the survey tool was effective in describing the effectiveness of the presentation in terms of meeting the specific objectives that were intended to communicate to the audience.  I think that I could have implemented more visual and interactivity into the presentation.  I believe that I would try to implement more animation into my next presentation or graphics. 

Below is the analysis of my surveymonkey.  Let me know what you think…

https://www.surveymonkey.com/results/SM-VRHTDLG2/