Change the FONT to red to highlight your revisions from the module one template.
Student Name
Date:
Vanessa Rocks
October 11, 2020
Project Topic:
QSEN Competency: (example, Patient-centered Care)
Creation of a patient safety tool to prevent pressure ulcers.
Teamwork and Collaboration
QSEN Definition: Define your QSEN Competency in your own words (paraphrase) using the QSEN.org web site>competencies>graduate KSAS, (example: for competency Patient-Centered Care the definition on the web site is Recognize the patient or designee as the source of control and full partner in providing compassionate and coordinated care based on respect for patient’s preferences, values, and needs—take this information then write your definition in your own words (paraphrasing, remember to cite the QSEN site).
The ability to function within nursing and other inter-professional teams, encouraging open ended communication, appreciation and respect for those within your workplace in order to achieve the highest level of patient centered care. (QSEN Institute, 2020).
List two Knowledge/Skills/Attitudes (KSAs)- use two each (Knowledge/skills/attitudes) from the QSEN.org web site which are listed under your chosen competency that you think will help you to meet your selected competency. Then write your KSAS in your own words (paraphrasing/editing related to your specific project—remember to cite the QSEN site).
Knowledge
Skills
Attitudes
Evaluate one’s own personal assets and liabilities and how they contribute to a team environment (QSEN Institute, 2020). Make clear all roles of team members and expectations of each role (QSEN Institute, 2020).
Illustrate one’s own assets as well as struggles through demonstration and how they affect a team (QSEN Institute, 2020). The ability to conform to different roles within the team as a particular situation calls for (QSEN Institute, 2020).
Belief that patients and family members are an integral part of any health care team (QSEN Institute, 2020). Appreciation for other members of your team that approach communication differently then you (QSEN Institute, 2020).
Discuss Health Care Organization (this is not the facility/organization where you are implementing your project, may be a nursing organization, or any organization which sets standards, conducts research, or publishes evidence based literature in relation to your topic) that will help support your project. Discussion should include the mission/values of the organization (in your own words). Provide citations and references (no direct quotes).
The National Pressure Injury Advisory Panel (NPIAP) is a non-profit organization that is dedicated to the prevention and treatment of pressure injuries. The mission of the NPIAP is to provided leadership in the field of pressure injury prevention and treatment using education, policy and research (National Pressure Injury Advisory Panel 2020). In the U.S today due to the large population of older adults with an extremely high rate of chronic disease there are more people than ever before who are suffering from chronic wounds secondary to these conditions (Torres, 2020).
Global Objective: the purpose of a global objective is to provide a vision for your overall project-what are you developing and implementing-what is your expected impact on patient outcome? It should be broadly stated-in one sentence. (Do Not Use Any Abbreviations)
The global objective for my topic will be to implement an in room repositioning schedule for staff to be used with any patient who is at moderate to high risk for prevention and worsening of pressure ulcers. The incidence of pressure ulcers or prevention thereof is often a good indicator of overall good nursing care, patient health and satisfaction (Etafa et al., 2018)
Project Objectives: Project Objectives: Now your global objective should be broken down into more focused steps. Be sure your Project Objectives support your Global Objective! How will you achieve your global objective? Be specific. Write 4 Project Objectives…objectives should start with an action verb! (Do Not Use Any Abbreviations) For example; Research on…Develop a tool/guide/protocol/policy/process to…Develop and present education to staff on new tool…Implement new tool on ___number (the number should be adequate to meet your minimum of 1-2 log hours in direct patient contact) of patients to improve (how will your project impact patient outcomes)…
Work with staff to get feedback on what would work best for repositioning toolDevelop repositioning tool Educate staff on new repositioning tool and policyImplement new tool on 2 patients to determine success and improvements needed.
Possible Steps to Assist Me in Completing My Project: List at least 4 steps in your project (Do Not Use Any Abbreviations)
Week I hope to accomplish by: Provide hopeful completion date
Research repositioning tools Create unit specific repositioning toolMeet with unit manager once tool has been drafted for approval/suggestionsEducate staff on use of new tool and what patients will be used on
Complete by 10/6/20Complete by 10/13/20Complete by10/16/20Complete by 10/20/20
Direct patient engagement: Describe in a one or two sentences how you will provide direct patient engagement (contact) in your clinical practice project and describe how this will impact patient outcomes. (keep in mind you are not required to actually measure your outcomes, but you will need to describe your potential/projected improved patient outcomes) Be specific.
Education will be provided to each of the two patients about the repositioning tool that will be placed in their rooms in order to help staff keep track of their repositioning schedule. Involving the patients in the education about the new tool will help make them aware of the time we are putting into their care and ultimately preventing or worsening pressure injuries.
What are the scope, duration and history of the problem? Write 3-4 paragraphs related to your selected problem. Provide supportive details using in text citations. Give supportive data from facility, community, state, or national data to explain why you feel this is an issue. Your paragraphs should be professionally written, single spaced with APA formatted citations and references (there is a reference textbox at the end of this form. Use it for your references). (Supportive data requires paraphrased citations from your research, not direct quotes)
Pressure injuries are preventable in most cases, however the incidence of pressure ulcers continues to rise posing a major burden to the healthcare system. Pressure injuries affect ≤3 million adults each year just in the United States (Mervis & Phillips, 2019). While there are plenty of resources and foundations dedicated to this cause the rate and severity of pressure injuries remains mostly unaffected (Mervis & Phillips, 2019) Personally, I can say that I am not all that surprised at that statistic. Working in a hospital which is often understaffed and underfunded the staff does the best that they can to check on high risk patients however the ideal repositioning schedule of two hours is often a difficult goal to be maintained. Repositioning is a vital part of caring for, preventing and healting pressure ulcers. According to Avsar et al., there is a 25% reduction in accuriqung pressure ulcers with a more frequent repositioning schedule (2020).
Who does your problem affect? Write 1-2 paragraphs discussing individuals, communities, etc. that are affected by this problem. Remember to include all parties that are affected. Your paragraph(s) should be professionally written, single spaced with APA formatted citations and references (there is a reference textbox at the end of this form. Use it for your references).
Pressure injuries are a rising issue among patients in both the acute and long term care settings and especially patients in critical care. There are many contributing factors that can make a patient even more at risk for developing pressure ulcers. Critical care patients at even higher risk of developing pressure injuries include age, length of admission, diabetes, heart disease, hypotension, prolonged ventilation and vasopressor agents (Cox, 2017).
Your selected organization: (remember this is not the facility/organization where you are implementing your project, may be a nursing organization, or any organization which sets standards, conducts research, or publishes evidence based literature in relation to your topic) How does this organization support your topic? Some things to consider when researching…Have they advocated? Do they support financially? Are they involved in research to support your topic? Do they use it as part of accreditation requirements? Write 1-2 paragraphs. Your paragraph(s) should be professionally written, single spaced with APA formatted citations and references (there is a reference textbox at the end of this form. Use it for your references.)
The organization that I have selected to model my project after, The National Pressure Injury Prevention Panel (NPIAP) is one that works strongly in pressure injury prevention in several different modalities. They are present in education, public policy and research. T The NPIAP is a non-profit organization which is made up of experts from many different health care disciplines, bringing a wide range of knowledge and expertise to provide the best possible knowledge into the community and help stop the spread of pressure injuries. They are financially assisted by several corporations and organizations and have gain international recognition as a leader in this subject matter. There are several other regions, Europe and Japan for example who have modeled their organizations based off of the work that NPIAP does. They present several yearly educational symposiums along with webinars and virtual learning throughout the year.
What are the implications of the problem? What will happen or not happen if the problem is not resolved? Write 1-2 paragraphs discussing the implications with supporting details (information from your selected organization and/or health care facility would be important here). Your paragraph(s) should be professionally written, single spaced with APA formatted citations and references (there is a reference textbox at the end of this form. Use it for your references).
The implications of this problem range far and wide. The most severe implication being death resulting from pressure injuries that won’t heal. Another major repercussion of pressure injuries lies with the health care institutions. I think it is commonly known that when hospitals or health care facilities alike have a high rate of pressure injuries the likelihood of reimbursement decreases drastically. However there are arguments that pressure injury prevention is cost effective as long as hospitals are invested in nursing compliance and prevention standards (Padula et al., 2018)
Plan of Action: In the space below outline your plan of Action. Remember your plan of action should assist you in meeting your global and project objectives; therefore, they must be linked. Your plan of action can include your action steps from week one or they may have changed. In either case, list your action steps (that you have already completed and planned steps) and provide a one paragraph (per action step) explanation supporting this action. You should have a minimum of four action steps (no more than five), this means you should have a minimum of four paragraphs and no more than five. Your actions steps should have supportive details (references). Your paragraphs should be professionally written, single spaced with APA formatted citations and references (there is a reference textbox at the end of this form. Use it for your references).
My plan of action began when I first began researching established repositioning tools. Each week I find new and more detailed information of the subject of pressure injuries and measures taken toward prevention. Last week I began developing my repositioning tool modeled after a combination of tools that I discovered during my research. While it was just a start, I plan to edit each week based on the feedback received from my mentor and patients. I plan to meet with the unit manager in the next week to get his thoughts on the tool that I drafted. Once I get his approval and or edits I will then finish my final draft. After my final draft is completed and approved by both my mentor and the unit manager I will educate staff on the implementation of the new tool. I will educate each of my two patients with a different staff member present in each room. These staff members can continue to teach the use of the tool to the rest of the unit once I have finished my project.
Proposed Solution: Write 2-3 sentences describing your proposed solution to your problem. Remember that your solution should be linked to your global and project objectives. Your proposed solutions should have supportive details (references), professionally written, single spaced with APA formatted citations and references (there is a reference textbox at the end of this form. Use it for your references).
The only problem I foresee is the compliance and understanding by patients. In order for this tool to work, the patients or family members need to play an active part in their healthcare. My proposed solution would be to make sure that each patient is properly educated on how they are to participate and leave no questions unanswered. In a case where the patient is cognitively impaired and incapable or participating the nurses will need to team up to participate and be one another’s buddy to make sure that repositioning care is carried out.
Work with Mentor this week: In 2-3 paragraphs discuss activities with your Mentor (Preceptor) for this project so far. Include positive and negative thoughts, what was helpful and what information or activity would have been helpful. No citations or references are needed; it should still be professionally written.
In this weeks meeting we first looked over the repositioning tool that I had designed. She gave me her feedback on the positive points as well as constructive criticism and recommendations. We then discussed my approach with a patient who she would let me speak with today. She recommended introducing myself and that I was a student. She recommended showing him the tool that I had designed and asking him from patient’s perspective if the tool would be helpful. I feel that this meeting was extremely productive and that I really made some headway in developing my project.
Practice Log update: Begin typing documentation on your Clinical Log, provide here a brief explanation of time you have completed this week – you will need to document on your clinical log in addition to the templates, this update does NOT take the place of completing your required log. This is a non-graded item. — Do not include: Orientation off the Unit, Observation, writing or researching papers/assignments, Lunch or Break time. — Do include: A total over the course includes a Minimum of 3 hours with preceptor, Maximum of 6 hours on research of topic, a minimum of 1-2 hours in direct patient contact and the remainder– 10-11 hours in implementation of your project, Total of 21 true hours.
Type
Date
Time (ex: 1:00pm-2:00pm)
Total Time Spent (ex: 1 hour)
Description (describe specifically what you did in one or two sentences)
Preceptor (a minimum of 3 hours is required for the course)
10/5/20
10:00am-11:00am
1 hour
I showed her the draft of the tool that I had made so far and she offered her suggestions as well as discussing some of the research that I discovered. She then allowed me to interview and educate one of her patients on the tool I had designed so far.
Research on topic (a maximum of 6 hours is allowed for the course)
10/5/20
9:00am-10:00am
1 hour
Researched to see if there were any repositioning tools available to compare to what I had come up with.
Patient Engagement Time (a minimum of 1-2 hours, Specify number of patients)
10/5/20
11:00am-11:30am
0.5 hour
I introduced myself to one patient and asked him if I would be able to speak with him about my school project. I showed him the tool I had designed and asked him if it was easy to understand from a patient’s point of view.
Implementation (the remainder should be spent in implementation, 10-11 hours)
10/4/20
2:00pm-5:00pm
3 hours
Designing patient safety tool on computer.
Total Time spent this week (by the end of the course you should spend at least 21 true hours)
Total for this week = 5.5 hours
References (double-space and use correct 7th ed. APA format) This should include references from Module 1
Avsar, P., Moore, Z., Patton, D., O’connor, T., Budri, A. M., & Nuget, L. (2020). Repositioning for preventing pressure ulcers: a systematic review and meta-analysis. Journal of Wound Care, 29(9), 496–508. https://doi.org/10.12968/jowc.2020.29.9.496 Cox, J. (2017). Pressure injury risk factors in adult critical care patients: a review of the Literature. Wound Management & Prevention, 63(11). https://doi.org/10.3912/OJIN.Vol21No02Man04 Etafa, W., Argaw, Z., Gemechu, E., & Melese, B. (2018). Nurses’ attitude and perceived barriers to pressure ulcer prevention. BMC Nursing, 17(1). https://doi.org/10.1186/s12912-018-0282-2 Mervis, J., & Phillips, T. (2019). Pressure ulcers: Pathophysiology, epidemiology, risk factors, and presentation. Journal of the American Academy of Dermatology, 81(4). https://doi.org/10.1016/j.jaad.2018.12.069 National Pressure Injury Advisory Panel. https://npiap.com/. Padula, W. V., Pronovost, P. J., Makic, M. B. F., Wald, H. L., Moran, D., Mishra, M. K., & Meltzer, D. O. (2018). Value of hospital resources for effective pressure injury prevention: a cost-effectiveness analysis. BMJ Quality & Safety, 28(2), 132–141. https://doi.org/10.1136/bmjqs-2017-007505 QSEN Institute. (2020). Graduate QSEN competencies. https://qsen.org/competencies/graduate-ksas/ Torres, Z. (2020). Wound care education for primary care providers at a regional medical center. Scholarship Repository. https://repository.usfca.edu/dnp/198/.
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You selected a problem that was professionally or personally important to you, researched the problem, and developed a plan of action that included strategies for success, stakeholders and resources by linking a QSEN competency. Now it is time to put it all together. You may use the information from your weeks 1-3 templates – but do not just copy and paste – synthesize all of your information. For this assignment you will write a minimum of a 4-5 page paper (no more than 5 pages, not including the title page, abstract, or reference page) connecting all of your links. Your paper should be in strict APA (7th edition) format including citations and references, and an abstract is required for this paper. You may use first person, but limited use. My project was implementation of a repositioning tool to prevent and lessen prevent pressure injuries in the acute care setting. I used the QSEN competency of Teamwork and Collaboration. Your paper should include:An abstract.An introduction.The frame of your problem. Remember to include your framing information! I’ve attached template with all the information that I gathered over the last few weeks.Supportive organization. I used The National Pressure Injury Advisory Panel https://npiap.com/A second solution to your problem (see explanation below). You can add your own take on this.An implementation and evaluation plan for your second solution including a discussion related to your stakeholders and resources.An overall evaluation of your CPP.Preceptor (mentor) experience.A conclusion. The Second Solution:The paper includes a discussion of a hypothetical second solution, implementation, and evaluation. (numbers 5 and 6 above). A good nurse always has a back-up plan – or what are your next steps now that you implemented your CPP. This is where your second solution comes into play. Also, are there stakeholders or resources that might be available if there were a different solution? Is there a short term solution and a long term solution? Do you need to adjust your plan due to time or money constraints?ReferencesMinimum of eight (8) total references: one (1) reference from required course materials and seven (7) peer-reviewed references – you may use the ones from your templates in weeks 1-3. All references must be no older than five years (unless making a specific point using a seminal piece of information)Peer-reviewed references include references from professional data bases such as PubMed or CINHAL applicable to population and practice area, along with evidence based clinical practice guidelines. 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