NURS 8114 Week 10: CLARIFYING CONNECTIONS: PRACTICE PROBLEM, EVIDENCE, CHANGING PRACTICE

Walden University NURS 8114 Week 10: CLARIFYING CONNECTIONS: PRACTICE PROBLEM, EVIDENCE, CHANGING PRACTICE– Step-By-Step Guide

This guide will demonstrate how to complete the Walden University NURS 8114 Week 10: CLARIFYING CONNECTIONS: PRACTICE PROBLEM, EVIDENCE, CHANGING PRACTICE assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

How to Research and Prepare for NURS 8114 Week 10: CLARIFYING CONNECTIONS: PRACTICE PROBLEM, EVIDENCE, CHANGING PRACTICE

Whether one passes or fails an academic assignment such as the Walden University NURS 8114 Week 10: CLARIFYING CONNECTIONS: PRACTICE PROBLEM, EVIDENCE, CHANGING PRACTICE depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

How to Write the Introduction for NURS 8114 Week 10: CLARIFYING CONNECTIONS: PRACTICE PROBLEM, EVIDENCE, CHANGING PRACTICE

The introduction for the Walden University NURS 8114 Week 10: CLARIFYING CONNECTIONS: PRACTICE PROBLEM, EVIDENCE, CHANGING PRACTICE is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

How to Write the Body for NURS 8114 Week 10: CLARIFYING CONNECTIONS: PRACTICE PROBLEM, EVIDENCE, CHANGING PRACTICE

After the introduction, move into the main part of the NURS 8114 Week 10: CLARIFYING CONNECTIONS: PRACTICE PROBLEM, EVIDENCE, CHANGING PRACTICE assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

How to Write the Conclusion for NURS 8114 Week 10: CLARIFYING CONNECTIONS: PRACTICE PROBLEM, EVIDENCE, CHANGING PRACTICE

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

How to Format the References List for NURS 8114 Week 10: CLARIFYING CONNECTIONS: PRACTICE PROBLEM, EVIDENCE, CHANGING PRACTICE

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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Sample Answer for NURS 8114 Week 10: CLARIFYING CONNECTIONS: PRACTICE PROBLEM, EVIDENCE, CHANGING PRACTICE

Explanation of Literature Review & Connection to Practice Problem 

For NURS 8114 Week 10: CLARIFYING CONNECTIONS: PRACTICE PROBLEM, EVIDENCE, CHANGING PRACTICE, the PICO framework developed assisted me in developing my critical question (Dang et al., 2021). Many patients within my organization get readmitted with worsening mental and physical health symptoms and often do not follow up with their mental health outpatient appointments. The World Health Organization [WHO] (2023) cites that mental health concerns that go unaddressed have caused a public health crisis, which has led to morbidities and increased financial burdens for healthcare organizations globally. WHO sites that advanced healthcare practitioners are accountable for educating other healthcare clinicians in their roles for improving all aspects of healthcare with inter-collaboration of care. 

 Article I Research: Presentation to Stakeholders and Connection to Practice Problem  

Does Primary Care Fill the Gap in Access to Specialty Mental Health Care? A Mixed Methods Study –completed by Kaynko, Curry, Keene, Sutherland, Naik, and Busch.  

The practice gap issue within this article identifies a lack of trust between patients and their primary care providers regarding providing mental services while they are referred to a mental health specialty provider. As a Doctor of Nursing Practice student, I would address Kyanko et al. study findings as scientific knowledge that identifies patients’ lived experiences are relevant to their level of engagement in mental health specialty outpatient services. Kyanko et al. (2022) study identified subjective findings about patients’ ability to access mental health care and identified that addressing mental health screens within the primary care setting is essential while a patient is waiting to receive follow-up for specialty, such as mental health. Kyanko et al. study also identified that PCP providers minimally meet the mental health needs of patients within this setting. In addition, the study participant’s perceptions significantly influence their willingness to receive specialty services related to their mental health diagnosis.  

Article II Research: Presentation to Stakeholders and Connection to Practice Problem  

Stigma, Occupational Injustice, and Individualization of Systemic Issues: Current Issues Faced By Community-Dwelling Adults With Serious Mental Illness–authors are Solaru and Mendonca.  

This article is categorized as level V, considered a lower evidence level. Solaru and Mendonca (2023) research is relevant for integrative clinical practice for identifying mental health stigmas. As a DNP student, I will present Solaru and Mendonca (2023) integrative reviews as a valuable compilation of studies identifying the importance of strengthening the patient and primary care provider relationship bond. I identified clinicians who understand the lived experiences and providing them with educational resources, allows the patient to make informed decisions despite their medical conditions (Solaru & Mendonca, 2023). Dang et al. (2021) cite that QI projects should consider patients as stakeholders. This integrative review is important for providing knowledge-focused evidence that is patient-centered and aligns with my organization’s mission of providing quality and safe care that adheres to the patient’s right to autonomy during the decision-making process of their care (McEwen & Wills, 2019).  

Article III Research: Presentation to Stakeholders and Connection to Practice Problem  

Inter-professional collaboration reduces the burden of caring for patients with mental illnesses in primary healthcare. A realist evaluation study–authors are De Sutter, M., De Sutter A., Sundahl, Declercg, and Decat. 

I identified with De Sutter et al. (2019) research findings that time management and inter-professional collaboration of care reduce healthcare costs. Patients with an SMI are often readmitted to acute inpatient settings with worsening mental health symptoms and related compromised health issues (De Sutter et al., 2019). Frequent readmissions consume the healthcare costs that organizations and patients have to endure (De Sutter et al., 2019). Similar findings of high healthcare costs relevant to poor healthcare delivery of SMI patients were mentioned by Kube et al. (2021). De Sutter et al. research findings are supported by WHO (2023) regarding citations of patients with mental health disorders who are more vulnerable and susceptible to poor health outcomes. De Sutter et al. research mirrors WHO reports that social determinants of health and the lack of inter-collaboration enable the clinician to implement and provide effective treatment plans. 

I would present De Sutter et al. (2019) level of evidence to the stakeholders to assist them in identifying that role clarity and time management are necessary to expedite patients to the next level of community care by using inter-collaboration effectively. Intercollaboration of care is necessary for improving communication and minimizing healthcare errors among patients (De Sutter et al., 2019). Primary care settings are the primary source for providing health care to patients (WHO, n.d., as cited in De Sutter et al., 2019). WHO (2023) acknowledges that integrating mental health services within a primary care setting is imperative to the patient’s mental healthcare. WHO along with De Sutter et al. agrees that patients with SMI should be referred to a specialty mental health provider as evidence shows specialty services are more sensitive and capable of providing the patient’s individualized needs. Stakeholders within my organization would benefit from a guided inter-collaboration approach that will identify post-discharge healthcare resources that provide mental health care within their facility and facilitate community mental health care for the patient’s outpatient needs (De Sutter et al., 2019; WHO, 2023). 

Article IV Research: Presentation to Stakeholders and Connection to Practice Problem  

The Graying of Integrated Health: The Specialized Role of Psychology in Geriatric Primary Care–authors Kube, Harris, and Hicken.  

In multi-disciplinary rounds, there are few discussions regarding targeted groups within the mental health population. Patients with SMI are challenged by social stigmas and medical conditions that impair cognitive functioning (Kube et al., 2021). Although this article does not focus entirely on social stigmas, it is relevant in introducing information to stakeholders regarding an integration model that examines all aspects, inclusive of cognitive awareness challenges that impede patients’ ability to access mental health care (Kube et al., 2021). There are many patients who are challenged with cognitive impairment issues within my facility. 

Also, my hospital organization services many veterans who are shuffled through the system and often get readmitted for the same or worsening mental health conditions. Utilizing an integrative approach with the PACT team will assist VA patients in accessing health care and foster continuity of care while minimizing their symptoms with post-discharge mental health treatments (Kube et al., 2021). I would present to the stakeholders of my organization that improving patients’ ability to access mental health using a collaborative and integrative approach will improve the mental health of patients who have increased barriers to participating in their discharge plans.   

Synthesis of Evidence To Base a Practice Change and Practice Change Initiative 

Synthesizing these four articles has allowed me to identify a gap in practice regarding providers’ understanding of the importance and appropriate interventions in identifying patients who are challenged by social determinants of health and their inability to access mental health services due to these barriers. Specific measures are needed when it comes to integrating social determinants of health screening tools and inter-collaboration of care models (Dang et al., 2021; De Sutter et al., 2019; Kube et al., 2021; Kyanko et al., 2022; Solaru & Mendonca, 2023). Research has revealed that healthcare providers need education on the effectiveness of inter-collaboration practice. My clinical experience has allowed me to identify missing components in the initial psychosocial admission screen and poor communication amongst inter-disciplinary teams will lead to poor health outcomes (De Sutter et al., 2019; Kube et al., 2021; Kyanko et al., 2022; Solaru & Mendonca, 2023). I understand from experience that clinicians will not collect all the necessary information to complete the screen as this process can be ongoing. However, the concern is that the psychosocial screens are not followed-up by the staff nurses. Poor inter-collaboration of practices has been identified in the DNP project’s three purposed practice settings: an outpatient mental health clinic and a private office providing mental health services. 

The social workers at my hospital are responsible for completing the behavioral health psychosocial screen and rely on the assistance of other healthcare clinicians to add to areas that they did not capture in their assessment. The nurse who provides direct care often does not document other components of social determinants of health information during the patient’s stay. For example, families and significant others have visited over the weekend when the social workers are not present. This is the time to capture patient-to-family interactions and document the feedback from these encounters. Relevant information regarding the patients’ social needs can go missing with incomplete social determinants of health screens, which can impose barriers to accessing mental health care for the patient post-discharge (De Sutter et al., 2019; Kube et al., 2021; Kyanko et al., 2022; Solaru & Mendonca, 2023). 

I attest that when I come to work on Mondays, I ask the charge nurse about the patient-family visits. The nurses provide a lot of information that is not reflected in the patient’s chart. Social interactions of patients and their families are significant for utilization review purposes, which reflects identifying the patient’s support system before discharge. Studies have shown that patients with poor social interaction and no community support often fail their discharge plan and get readmitted to the inpatient psychiatric facility with worse symptoms (De Sutter et al., 2019; Kube et al., 2021; Kyanko et al., 2022; Solaru & Mendonca, 2023). I would utilize the relevant research evidence to educate staff or influence stakeholders with policy changes that produce change initiatives for psychosocial screening initiatives relevant to the best healthcare delivery approaches for mental health patients. Integrative practices for inter-collaboration of care are contingent on all disciplines providing as much relevant information as possible regarding the best course of treatment during the patient’s stay and discharge needs. There is a global need to close the practice gaps that enable mental health patients from living optimal and functional lives (WHO, 2023).

References  

Dang, D., Dearholt, S. L., Bissett, K., Ascenzi, J., & Walen, M. (Eds.). (2021). Johns Hopkins nursing evidence-based practice: Model and guidelines (4th ed.). Sigma Theta Tau International.    

De Sutter, M., De Sutter, A., Sundahl, N., Declercq, T., and Decat. P., (2019). “Inter-Professional collaboration reduces the burden of caring for patients with mental illnesses in primary Healthcare. A Realist Evaluation Study.” European Journal of General Practice 25 (4): 236–42. doi:10.1080/13814788.2019.1640209.   

Kube, E., Harris, G., & Hicken, B. (2021). The graying of integrated health: the specialized role of psychology in geriatric primary care. Aging & Mental Health, 25(10), 1941–1949. https://doi.org/10.1080/13607863.2020.1768215Links to an external site.   

Kyanko, K. A., A Curry, L., E Keene, D., Sutherland, R., Naik, K., & Busch, S. H. (2022). Does primary care fill the gap in access to specialty mental health care? A mixed methods study. Journal of General Internal Medicine, 37(7), 1641–1647. https://doi.org/10.1007/s11606-021-07260-zLinks to an external site.  

McEwen, M., & Wills, E. M. (2019). Theoretical basis for nursing (5th ed.). Wolters Kluwer.  

Solaru, A. A., & Mendonca, R. J. (2023). Stigma, occupational injustice, and individualization of systemic issues: current issues faced by community dwelling adults with serious mental illnesses. Disability & Society, 38(6), 1076–1083. https://doi.org/10.1080/09687599.2022.2164706Links to an external site.   

World Health Organization. (2023). Mental Health. https://www.who.int/health-topics/mental-health#tab=tab_1

Sample Answer 2 for NURS 8114 Week 10: CLARIFYING CONNECTIONS: PRACTICE PROBLEM, EVIDENCE, CHANGING PRACTICE

The practice problem I have been conducting a literature review on is Nurse Burnout. Specifically, a literature review was conducted in search of evidence-based interventions to reduce nurse burnout.

Burnout affects nurses in the US and across the globe (Adams et al, 2019; Chiao et al, 2021; Xie et al, 2020). Nursing burnout impacts the nurse both professionally and personally (Adams et al, 2019; Xie et al, 2020). Nurse burnout is linked to a negative work environment with inadequate staffing, increased turnover rates and high-nurse patient ratios and decreased quality of care (Adams et al, 2019, Copeland, 2020; Etingen et al, 2020; Xie et al, 2020).  Turnovers are costly and can cost as much as $80,000 per vacancy to rehire and retrain (Adams et al, 2019).

A positive work environment has been found to decrease feelings of nurse burnout (Adams et al, 2019; Copeland 2020; Etingen et al, 2020; Xie et al, 2020). Adams et al (2019) found nursing burnout decreased with increased leadership involvement and implementation of a culture tool kit including “kudos” board, a thank-you cards, a nursing practice suggestion box. Luo et al (2019) found focusing on 3 good things at least two times per week and documenting the findings in an application reduced feelings of nursing burnout. Bianchini & Copeland (2021) found that mind-based interventions decreased stress and feelings of burnout. Etingen et al (2020) found animal assisted therapy decreased stress levels.

A DNP prepared graduate is equipped with leadership abilities and skills to engage nurses and transform the work environment (AACN, 2006). Reducing nurse burnout can be achieved through leadership engagement and involvement with cost-effective and time efficient activities which promote a positive work environment (Adams et al, 2019; Copeland, 2020; Etingen, 2020; Wei et al, 2017). Nurse burnout is too costly not to make the necessary changes to promote a positive work environment.

References

Adams, A., Hollingsworth, A., & Osman, A. (2019). The Implementation of a Cultural Change Toolkit to Reduce Nursing Burnout and Mitigate Nurse Turnover in the Emergency Department. Journal of Emergency Nursing, 45(4), 452–456. https://doi-org.ezp.waldenulibrary.org/10.1016/j.jen.2019.03.004

American Association of Colleges of Nursing. (2006). The essentials of doctoral education for advanced nursing practice. https://www.aacnnursing.org/Portals/42/Publications/DNPEssentials.pdf

Bianchini, C., & Copeland, D. (2021). The Use of Mindfulness-Based Interventions to Mitigate Stress and Burnout in Nurses. Journal for Nurses in Professional Development, 37(2), 101–106. https://doi-org.ezp.waldenulibrary.org/10.1097/NND.0000000000000708

Chiao, L.-H., Wu, C.-F., Tzeng, I.-S., Teng, A.-N., Liao, R.-W., Yu, L. Y., Huang, C. M., Pan, W.-H., Chen, C.-Y., & Su, T.-T. (2021). Exploring factors influencing the retention of nurses in a religious hospital in Taiwan: a cross-sectional quantitative study. BMC Nursing, 20(1), 1–8. https://doi-org.ezp.waldenulibrary.org/10.1186/s12912-021-00558-7

Copeland, D. (2021). Brief Workplace Interventions Addressing Burnout, Compassion Fatigue, and Teamwork: A Pilot Study. Western Journal of Nursing Research, 43(2), 130–137. https://doi-org.ezp.waldenulibrary.org/10.1177/0193945920938048

Etingen, B., Martinez, R. N., Smith, B. M., Hogan, T. P., Miller, L., Saban, K. L., Irvin, D., Jankowski, B., & Weaver, F. M. (2020). Developing an animal-assisted support program for healthcare employees. BMC Health Services Research, 20(1), 1–9. https://doi-org.ezp.waldenulibrary.org/10.1186/s12913-020-05586-8

Luo, Y., Li, H., Plummer, V., Cross, W. M., Lam, L., Guo, Y., Yin, Y., & Zhang, J. (2019). An evaluation of a positive psychological intervention to reduce burnout among nurses. Archives of Psychiatric Nursing, 33(6), 186–191. https://doi-org.ezp.waldenulibrary.org/10.1016/j.apnu.2019.08.004

Xie, C., Zeng, Y., Lv, Y., Li, X., Xiao, J., & Hu, X. (2020). Educational intervention versus mindfulness-based intervention for ICU nurses with occupational burnout: A parallel, controlled trial. Complementary Therapies in Medicine, 52. https://doi-org.ezp.waldenulibrary.org/10.1016/j.ctim.2020.102485

Sample Answer 3 for NURS 8114 Week 10: CLARIFYING CONNECTIONS: PRACTICE PROBLEM, EVIDENCE, CHANGING PRACTICE

My topic focused on the potential of effective nursing plans to promote medication adherence in elderly patients with chronic diseases. Patient education emerged as a core strategy that can improve the welfare of older patients suffering from chronic conditions. Face-to-face meetings are more influential since there is a greater understanding of the patient’s needs and a review of the factors affecting medication adherence. Older patients with chronic conditions tend to abandon medication when they feel that their issues have been ameliorated (Punnapurath et al., 2021). Providing adequate patient education to reveal the progression of a condition and the efforts of the medication can improve adherence to prescriptions.

Nursing strategies such as collaboration and follow-up are also integral in enabling quality improvement through medication adherence. An understanding of the influences and situations that limit medication adherence can ensure that healthcare providers can adequately address them (Punnapurath et al., 2021). Collaboration allows a closer review of a client’s condition and the progression of the disease. Older people are more reluctant to seek medical aid. A careful and holistic assessment of their healthcare needs can ensure that any concern can be addressed effectively. Follow-up care is also crucial given the age of the patients to ensure an understanding of any complications due to medication that can limit adherence (Tolley et al., 2023).

Reference

Punnapurath, S., Vijayakumar, P., Platty, P. L., Krishna, S., & Thomas, T. (2021). A study of medication compliance in geriatric patients with chronic illness. Journal of Family Medicine and Primary Care, 10(4), 1644.

Tolley, A., Hassan, R., Sanghera, R., Grewal, K., Kong, R., Sodhi, B., & Basu, S. (2023). Interventions to promote medication adherence for chronic diseases in India: A systematic review. Frontiers in Public Health, 11, 1194919.