Johns Hopkins Nursing Evidence-Based Practice Discussion Paper

Johns Hopkins Nursing Evidence-Based Practice Discussion Paper

The project purpose and project outcome have been identified and stated. The project’s purpose is “Improve staff knowledge about patient falls and prevention”. Staff education increases the knowledge and skills of the nursing staff on the topic of interest. The project outcome is, “Improvement in knowledge after attending education”. It is expected that nurses†attendance to the in-service classes on fall education will increase their understanding of risks, causes, prevention and management of falls at the emergency department.
Education can play a critical role in molding the structure of the emergency department. Nurses will acquire knowledge and skills of reducing the risk of falls. It is feasible to accomplish staff education in the identified facility. Pre and post knowledge assessment will be conducted to determine if knowledge increases after attending the classes on fall education. The collaborative culture of the organization is supportive of the idea and the site leader and project mentor are ready to back the project implementation. Johns Hopkins Nursing Evidence-Based Practice Discussion Paper
The implications of staff education on falls will increase knowledge and skills in handling patients during hospitalization. Nurses will acquire knowledge of preventing patients from falling, providing quality care and meeting unique patient needs. Patients will benefit because an increase in knowledge will imply fewer hospital stays and reduced medical costs. The community will enjoy quality services and reduced incidents of physical disability resulting from falls. With knowledgeable nurses in place, the organization will gain a good reputation and increased patient satisfaction scores. Patients will be satisfied with the fall services and as a result, more referrals will be expected.

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Confidentiality and privacy will be enhanced by ensuring personally identifiable or organizational identifiable data are protected. The scholarly voice of the project will be general and use a third persona, “It” to ensure privacy is protected. No specific or exact name of the organization will be revealed to ensure that it remains confidential.
I need 2 things done:
1. A work breakdown structure (WBS)
2. Checklist, which has been uploaded

The step I action file is just a reference. phase 2 started on 11/28/22, and the project is ending on 2/5/22. Everything will be completed by 2/5/22.

Staff Education Program Checklist

The Doctor of Nursing Practice (DNP) student is responsible for complying with the site’s policies and requirements regarding the DNP project. The DNP student must follow the steps in the 2021 DNP Project Process Guide for students following the 2021 DNP Program of Study while working on the DNP project. The resources for the DNP project are located on the Office of Research and Doctoral Studies DNP Doctoral Study page. Johns Hopkins Nursing Evidence-Based Practice Discussion Paper

The DNP student must be actively enrolled in the doctoral mentoring study course shell (NURS 8702 or 8703) to participate in any activities related to the project.

Staff Education Projects

• Staff education projects must align with the purpose of the project and project outcome identified on the Staff Education Site Approval Form.
• The project must follow the steps in the DNP Project Process Guide.
• Staff education may include nurse residencies, orientation, in-service education, and continuing education of professional staff. Programs may be multidisciplinary in nature, meaning that other professional healthcare clinicians may attend and benefit from the content. Staff education is usually developed to meet a need identified by a site or clinical practice setting to improve patient care, achieve standards of practice, or to meet regulatory guidelines.
• For the DNP nurse, staff education is often used to help inform and improve knowledge and skills using current evidence-based practices to facilitate improvement in healthcare and nursing practice to affect positive social change.
• The project management action plan should include milestones and tasks for the ADDIE phases of analysis, design, development, implementation, and evaluation for the staff education project (https://educationaltechnology.net/the-addie-model-instructional-design/). Johns Hopkins Nursing Evidence-Based Practice Discussion Paper
• Evaluation should be formative and summative. Formative evaluation should be conducted during the development of the program while summative evaluation occurs after implementation to assess the outcome of the education program. If a student is developing a comprehensive program that will be conducted over several months and needs organization approval prior to implementation, the student may develop the program and complete a formative evaluation with stakeholders. Examples of these types of programs include a critical care education program or a nurse residency program.
• DNP students may not develop scholarly projects that involve patients, families, or pre-professional students as their target population.
• The evaluation should identify the program’s impact on social change as an outcome.

Ethical Requirements for Staff Education Doctoral Projects

In the doctoral project documents, the doctoral student must change the name of any partner sites and generalize the location(s) so that the site(s) is not identifiable. The student must redact any information that will lead a reader to identify the site. The site must decide if the project should be publicized.  The doctoral student is required to change the name of the site in all materials (including drafts shared with peers and faculty members) to protect the site’s identity. In some cases, the doctoral student will need to maintain confidentiality by removing key pieces of evidence and/or data that might give away the site’s identity. Johns Hopkins Nursing Evidence-Based Practice Discussion Paper

The DNP student

• may not collect any type of data from patients or patients’ family members for this type of project;
• is responsible for ensuring that no proprietary, sensitive, or confidential information is disclosed in the doctoral project document; and
• is responsible for complying with all of the site’s poli This includes, but is not limited to, site QI policies and site resource use policies (pertaining to copying/printing materials, etc.).

DNP Action Planning Tool

• Using this checklist, identify critical milestones and tasks on the Action Planning Tool. All milestones and tasks must be written as SMART objectives. Review the chapters below for assistance with developing milestones and tasks. This checklist should be submitted into MyDR with the Action Planning Tool.
• Resources
  • Dang, D., Dearholt, S., Bissett, K., Ascenzi, J., &Whalen, M. (2022). Johns Hopkins evidence-based practice: Model and guidelines (4th ed.). Sigma.
  • Sipes, C. (2020). Project management for the advanced practice nurse (2nd ed.) Springer.
  • White, K., Dudley-Brown, S., & Terhaar, M. (2021). Translation of evidence into nursing and healthcare (3rd ed.) Springer. Johns Hopkins Nursing Evidence-Based Practice Discussion Paper

The healthcare sector is one of the areas that has received significant changes over the years most of which are geared towards improving quality, fostering patient safety as well as the implementation of evidence based practices. Some of the projects that have been implemented in healthcare include the implementation of technology such as electronic health records, remote monitoring, artificial intelligence and robots (Hathaliya, Tanwar & Evans, 2020). These changes and trends have significantly aided in the provision of quality, safe and timely healthcare services among patients and the general population.

According to Dang et al., (2022), the Johns Hopkins Nursing Evidence-Based Practice model is a powerful problem-solving approach to clinical decision-making and is accompanied by user-friendly tools to guide individual or group use. The tool is especially useful among practicing nurses who use it for guidance in their day to day activities. The tool also helps to ensure that evidence based practices are incorporated into patient care to promote efficiency and appropriate patient outcomes.

Current healthcare issue

The current healthcare issue of interest is patient falls. Patient falls refers to the unplanned descending to the floor of a patient that ends with or without an injury. Patient falls can lead to internal bleeding, external and internal fractures or even lacerations that worsens the health of an individual. According to LeLaurin & Shorr, (2019), patient falls are the most common adverse events that are reported in hospitals with an annual figure of 700,000 to 1 million cases reported in the United States.  Further, it is estimated that at least one in four falls results in injury and about 10 percent sustain serious injuries. Cases of inpatient falls results in significant burden to the patient as well as the healthcare facilities as they increase chances of sustaining injuries as well as death. Further, falls can increase the length of stay among patients leading to congestion and litigation, both of which are adverse effects on the healthcare facilities. Also, falls reduce workflow among healthcare providers due to an increase in emergencies that require the attention of healthcare providers thereby increases the workload for the already overburdened healthcare providers.  The Centers for Medicare & Medicaid Services (CMS) stopped reimbursing hospitals for fall-related injuries thereby; healthcare facilities have increased their efforts in fall prevention among hospitalized patients.

There are a number of risk factors that predispose one to an increased risk of fall and they include weak muscles especially those in the legs that easily lose balance and leads to uncertain falls. Poor balance is another risk factor that can predispose one to falls and it is caused by issues with the gait such as a weak back born. Johns Hopkins Nursing Evidence-Based Practice Discussion Paper

Relevancy of the problem in healthcare

Falls represent a major cause of preventable injury in healthcare and a commonly reported serious adverse event among patients. Hospitalized patients are at an increase risk of fall than outpatients and this can lead to serious injuries such as subdural hematomas, fracture or even death. Further, one aspect that makes fall prevention in healthcare a topic of concern is the fact that several strategies have been shown to help prevent falls in hospitals therefore, the need to evaluate and implement these strategies to improve patient outcomes. According to King et al., (2018), patient falls has a multifactor etiology that consists of three causes; the first one is environmental hazards; the second factor is physiological unanticipated factors such as fainting and the last one is physiological anticipated such as gait and fall history.

With the increase in awareness and research on patient falls, several evidence based interventions have been established that can help prevent patient falls in healthcare facilities. The first prevention intervention is familiarizing the patient with the hospital environment. Most patients fall because they are not familiar with some hazards that exist within the hospital environment. In addition, keeping the patient’s possessions within a safe reach is another preventive measure against falls. As a fact, some patients fall while looking for some of their essential items and this at times may lead to falls among frail and weak patients who cannot control themselves while in bed. Also, another evidence based fall prevention measure is the installation of sturdy handrails in hallways and bathrooms to offer support to patients while walking on when in the washrooms. Lastly another fall prevention measure is the installation and maintenance of the bedside alarms within the reach of patients to enable them signal when they are in need.

Staff education on patient falls

In nursing staff education is a critical ingredient in professional development as well as in enhancing competencies among healthcare providers. Staff education is the act of teaching healthcare providers or helping them to gain important skills, attitudes, knowledge and values that helps in making them more competent with current healthcare trends. Fall prevention training in particular helps healthcare staff to assess the risk factors as well as highlight appropriate measures to help minimize the occurrence of risks. In addition, staff education should as well encompass what steps and procedures to follow during a patient fall event. Fall prevention education helps empower individual healthcare providers, teams and the healthcare facility at large. Johns Hopkins Nursing Evidence-Based Practice Discussion Paper

At the facility level, education helps to increase staff awareness on their responsibilities in identifying, reporting and preventing potential hazards that are within the facility that are fall risk factors. Further education can help train on appropriate use of safety and fall prevention facilities and equipment such as handrails and bedside alarms for patients. Further education helps the facility in identifying and providing the necessary assistance to patients with high risks. Lastly, education programs help the facility enhance surveillance for hazards such as poor lighting and spills.

At the level of healthcare team, staff education should help the healthcare providers acknowledge the importance of fall prevention as well as how to identify risk factors and conditions that can lead to falls. Further, they can learn to take the most appropriate action after as fall incidence.

At an individual level, staff education helps providers learn how to use the risk awareness tools as well as assessing patients prior to admission to establish the fall risk index. In addition, individual healthcare providers can learn to help patients in using available devices as well as seek for help when the effort of one caregiver is not enough. Johns Hopkins Nursing Evidence-Based Practice Discussion Paper

Appendix I Action Planning Tool

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