NURS 8114 Week 7: FRAMING A PRACTICE PROBLEM AS A CRITICAL QUESTION WITH MEASURABLE OUTCOMES

Walden University NURS 8114 Week 7: FRAMING A PRACTICE PROBLEM AS A CRITICAL QUESTION WITH MEASURABLE OUTCOMES– Step-By-Step Guide

This guide will demonstrate how to complete the Walden University NURS 8114 Week 7: FRAMING A PRACTICE PROBLEM AS A CRITICAL QUESTION WITH MEASURABLE OUTCOMES 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 7: FRAMING A PRACTICE PROBLEM AS A CRITICAL QUESTION WITH MEASURABLE OUTCOMES

Whether one passes or fails an academic assignment such as the Walden University NURS 8114 Week 7: FRAMING A PRACTICE PROBLEM AS A CRITICAL QUESTION WITH MEASURABLE OUTCOMES 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 7: FRAMING A PRACTICE PROBLEM AS A CRITICAL QUESTION WITH MEASURABLE OUTCOMES

The introduction for the Walden University NURS 8114 Week 7: FRAMING A PRACTICE PROBLEM AS A CRITICAL QUESTION WITH MEASURABLE OUTCOMES 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 7: FRAMING A PRACTICE PROBLEM AS A CRITICAL QUESTION WITH MEASURABLE OUTCOMES

After the introduction, move into the main part of the NURS 8114 Week 7: FRAMING A PRACTICE PROBLEM AS A CRITICAL QUESTION WITH MEASURABLE OUTCOMES 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 7: FRAMING A PRACTICE PROBLEM AS A CRITICAL QUESTION WITH MEASURABLE OUTCOMES

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 7: FRAMING A PRACTICE PROBLEM AS A CRITICAL QUESTION WITH MEASURABLE OUTCOMES

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 7: FRAMING A PRACTICE PROBLEM AS A CRITICAL QUESTION WITH MEASURABLE OUTCOMES

Critical Question: How can improvements in transitional care practices reduce hospital readmission rates among elderly patients?

For NURS 8114 Week 7: FRAMING A PRACTICE PROBLEM AS A CRITICAL QUESTION WITH MEASURABLE OUTCOMES, the transition of elderly patients from hospital to home is critical in healthcare delivery. The quality of transitional care during this period can significantly impact patient outcomes, particularly regarding readmission rates. According to Cilla et al. (2023), the percentage of patients experiencing readmission, either unplanned or for any reason, within 30 days varied between 10.3% and 37.6%. Additionally, readmission rates within a 90-day timeframe fluctuated between 16% and 58%. Hospital readmissions burden the healthcare system and indicate potential inadequacies in patient care. As our population ages and chronic disease prevalence rises, ensuring smooth and effective transitional care becomes increasingly urgent (Glette et al., 2018). This discussion addresses the critical question: “How can improvements in transitional care practices reduce hospital readmission rates among elderly patients?”

To explore and answer this question, we must examine the challenges faced during the transition from hospital to home and the effective strategies to overcome these challenges. In doing so, we can identify areas for improvement in our current practices and make evidence-based recommendations for enhancing the quality of transitional care provided to our elderly patients. Our exploration of this critical question will be guided by recent scholarly research on transitional care and hospital readmissions, providing a robust and up-to-date foundation for our analysis and recommendations.

Scholarly Articles:

1. The study by Kangovi et al. (2017) stands out for its focus on community health workers and their potential role in transitional care. The study found that support from these workers significantly improved health outcomes among disadvantaged patients with multiple chronic diseases. This suggests that community health workers can be a critical resource in the transitional care of our elderly patients, aiding in medication management, post-discharge follow-up, and integrating care across health systems. By investing in this workforce, we can achieve better continuity of care and reduced readmission rates.
2. The systematic review by Fønss Rasmussen et al. (2021) demonstrates the impact of transitional care interventions on hospital readmissions in older medical patients. The authors identified that effective transitional care interventions can significantly reduce hospital readmissions, especially for older patients with complex health needs. These interventions, which are Discharge planning, medication reconciliation, patient education, scheduling follow-up appointments, caregiver involvement, and coordination of care, are diverse and include measures such as discharge planning, medication reconciliation, patient education, follow-up appointments, and caregiver involvement. Their findings solidify the importance of a comprehensive transitional care program involving patients, their families, and healthcare professionals. It shows us that tackling hospital readmissions is not just about managing the immediate health issues that led to the initial hospitalization but also about effectively managing the transition from hospital to home. This study is compelling evidence that justifies our quality improvement initiative focused on enhancing transitional care practices.
3. Hong et al. (2016) identifies the critical components of successful care management programs for high-need, high-cost patients, such as comprehensive care assessment, proactive care planning, and shared decision-making. Their findings offer a roadmap for restructuring our transitional care practices, aiming for a patient-centered, aggressive, and coordinated approach. This can improve patient satisfaction, reduce caregiver burden, and significantly decrease hospital readmissions.
4. In the qualitative study by Sun et al. (2023), the authors delve into transitional care from hospital to home for older people with chronic diseases. They explore this critical issue from the perspectives of older patients and healthcare providers. Their findings reveal many challenges during this transitional phase, including communication gaps, care coordination issues, and lack of patient support. Their research highlights our urgent need to address these issues in our quality improvement initiative. They emphasize the importance of enhancing communication, coordination, and support during care transitions to reduce hospital readmissions, improve patient satisfaction, and ultimately improve health outcomes. The insights from this study serve as a stark reminder of the reality many older patients face during the transition from hospital to home. By incorporating these findings into our quality improvement initiative, we can devise strategies that directly address the issues faced by our patients and their caregivers, leading to better transitional care experiences and outcomes.
5. Fox et al. (2021) developed a study protocol to optimize hospital-to-home transitions for older persons in rural communities. While this is a protocol rather than a complete study, it outlines significant factors that need to be considered for successful transitions of care, especially in the often-overlooked setting of rural communities. They propose participatory and multimethod strategies to address the unique challenges faced by this population, suggesting that tailored approaches based on the specific context and needs of patients can lead to improved transitional care outcomes. This proposed study underscores the need to consider patients’ geographical, socio-economic, and cultural contexts when designing and implementing transitional care interventions. As we strive to improve our transitional care practices, it is crucial that we also consider these factors to ensure that our quality improvement initiative is effective, inclusive, and equitable. The work of Fox et al. (2021) points towards the need for individualized and context-specific transitional care strategies. By incorporating these considerations into our quality improvement initiative, we can ensure that our transitional care practices cater to the diverse needs of our patients, ultimately leading to better health outcomes and reduced hospital readmissions.

Together, these studies underline the significance of patient-centered, coordinated, and comprehensive transitional care practices in reducing hospital readmissions and improving patient outcomes. This focus is especially critical for elderly patients, who often face multiple chronic conditions and complex care needs. By striving for excellence in transitional care, we have the potential to enhance the quality of our healthcare services significantly.

In summary, the evidence points towards the value of a comprehensive, patient-centered, and proactive approach in transitional care to reduce hospital readmissions among elderly patients. This involves harnessing community health workers’ skills, addressing caregivers’ needs, and drawing from successful strategies in managing high-need patients and specific patient populations. By prioritizing these areas in our quality improvement initiative, we can deliver better care for our elderly patients and improve their health outcomes.

References

Cilla, F., Sabione, I., & D’Amelio, P. (2023). Risk Factors for Early Hospital Readmission in Geriatric Patients: A Systematic Review. International journal of environmental research and public health, 20(3), 1674. https://doi.org/10.3390/ijerph20031674

Fønss Rasmussen, L., Grode, L. B., Lange, J., Barat, I., & Gregersen, M. (2021). Impact of transitional care interventions on hospital readmissions in older medical patients: a systematic review. BMJ open, 11(1), e040057. https://doi.org/10.1136/bmjopen-2020-040057Links to an external site.

Fox, M. T., Sidani, S., Butler, J. I., Skinner, M. W., Macdonald, M., Durocher, E., Hunter, K. F., Wagg, A., Weeks, L. E., MacLeod, A., & Dahlke, S. (2021). Optimizing hospital-to-home transitions for older persons in rural communities: a participatory, multimethod study protocol. Implementation science communications, 2(1), 81. https://doi.org/10.1186/s43058-021-00179-wLinks to an external site.

Glette, M. K., Kringeland, T., Røise, O., & Wiig, S. (2018). Exploring physicians’ decision-making in hospital readmission processes – a comparative case study. BMC health services research, 18(1), 725. https://doi.org/10.1186/s12913-018-3538-3

Hong, C. S. (2014). Caring for high-need, high-cost patients: What makes for a successful care management program? The Commonwealth Fund, 19, 1–19. https://doi.org/10.15868/socialsector.25007Links to an external site.

Kangovi, S., Mitra, N., Grande, D., Huo, H., Smith, R. A., & Long, J. A. (2017). Community Health Worker Support for Disadvantaged Patients With Multiple Chronic Diseases: A Randomized Clinical Trial. American journal of public health, 107(10), 1660–1667. https://doi.org/10.2105/AJPH.2017.303985Links to an external site.

Sun, M., Qian, Y., Liu, L., Wang, J., Zhuansun, M., Xu, T., & Rosa, R. D. (2023). Transition of care from hospital to home for older people with chronic diseases: a qualitative study of older patients’ and health care providers’ perspectives. Frontiers in public health, 11, 1128885. https://doi.org/10.3389/fpubh.2023.1128885

Sample Peer Response 2 for NURS 8114 Week 7: FRAMING A PRACTICE PROBLEM AS A CRITICAL QUESTION WITH MEASURABLE OUTCOMES

Based on the available evidence, it is indeed plausible to assert that educating staff about improvements in transitional care practices can augment their knowledge and understanding of such practices, which, in turn, may lead to reduced hospital readmission rates among elderly patients. Educating healthcare staff about improvements in transitional care practices is a powerful approach to enhancing their knowledge and understanding of these practices. This heightened awareness can substantially reduce hospital readmission rates among elderly patients (Boltz et al., 2021).

Transitional care, which involves the coordination and continuity of healthcare during a movement from one healthcare setting to another or at home, is particularly important for elderly patients with complex medical needs. High-quality transitional care ensures positive patient outcomes and reduces hospital readmissions (Naylor et al., 2017).

A systematic review by Morkisch et al. (2020) underscores the profound impact of educating healthcare providers on transitional care practices. The study reveals that comprehensive and ongoing education programs can equip healthcare staff with the necessary skills and knowledge to effectively manage transitional care, resulting in a notable decrease in hospital readmissions. This research emphasizes the need for healthcare systems to prioritize staff education to ensure high-quality patient care and improved patient outcomes.

Similarly, a study by Kangovi et al. (2014) corroborates these findings, demonstrating that well-educated staff members are more proficient in handling complex transitional care scenarios. The research further emphasized the positive correlation between staff education and reduced hospital readmission rates. Staff education improved care delivery and enhanced patient satisfaction and engagement in their care process (Kangovi et al., 2014).

Complementing these findings, a systematic review by Fønss Rasmussen et al. (2021) underscored the efficacy of transitional care interventions in preventing hospital readmissions for older patients. In this context, the authors attributed a substantial part of the intervention’s success to the competence and knowledge of healthcare staff, further highlighting the significance of staff education in transitional care (Fønss Rasmussen et al., 2021).

To conclude, a robust body of evidence suggests that educating staff about improvements in transitional care practices can considerably enhance their knowledge and understanding. This education results in improved delivery of transitional care, leading to better patient outcomes and a significant reduction in hospital readmission rates among elderly patients.

References

Boltz, M., Capezuti, L., Zwicker, D., & Fulmer, T. T. (2021). Evidence-based geriatric nursing protocols for best practice (6th ed.). Springer Publishing Company.

Fønss Rasmussen, L., Grode, L. B., Lange, J., Barat, I., & Gregersen, M. (2021). Impact of transitional care interventions on hospital readmissions in older medical patients: a systematic review. BMJ open, 11(1), e040057. https://doi.org/10.1136/bmjopen-2020-040057Links to an external site.

Kangovi, S., Mitra, N., Grande, D., White, M. L., McCollum, S., Sellman, J., Shannon, R. P., & Long, J. A. (2014). Patient-centered community health worker intervention to improve posthospital outcomes: a randomized clinical trial. JAMA internal medicine, 174(4), 535–543. https://doi.org/10.1001/jamainternmed.2013.14327

Morkisch, N., Upegui-Arango, L. D., Cardona, M. I., van den Heuvel, D., Rimmele, M., Sieber, C. C., & Freiberger, E. (2020). Components of the transitional care model (TCM) to reduce readmission in geriatric patients: a systematic review. BMC geriatrics, 20(1), 345. https://doi.org/10.1186/s12877-020-01747-w

Naylor, M. D., Shaid, E. C., Carpenter, D., Gass, B., Levine, C., Li, J., Malley, A., McCauley, K., Nguyen, H. Q., Watson, H., Brock, J., Mittman, B., Jack, B., Mitchell, S., Callicoatte, B., Schall, J., & Williams, M. V. (2017). Components of Comprehensive and Effective Transitional Care. Journal of the American Geriatrics Society, 65(6), 1119–1125. https://doi.org/10.1111/jgs.14782

Sample Peer Response 3 for NURS 8114 Week 7: FRAMING A PRACTICE PROBLEM AS A CRITICAL QUESTION WITH MEASURABLE OUTCOMES

My critical question is why there are so many people who suffer from co-occurring mental health and substance use disorders. Comorbidities are defined as two conditions or illnesses that manifest in the same individual, either concurrently or consecutively. Additionally, comorbidity suggests that the disorders interact, influencing each other’s course and prognosis. It may be challenging to diagnose the underlying mental illness in those who use drugs, and some patients require abstinence for a while for diagnostic reasons. (Igbal, 2019). People who suffer from co-occurring mental health and drug use disorders appear to be becoming more and more prevalent every day. I understand there is a critical part that health practitioners and the legislature need to play in reducing the incidence of comorbid mental health illness and substance use. In the United States, 9.2 million adults have a co-occurring disorder, according to SAMHSA’s 2023 National Survey on Drug Use and Health. (SAMHSA, 2023). The rate of substance abuse is very alarming and makes one wonder if there is a possibility of a decrease in the number of substance users. In certain instances, people self-treat underlying mental disorders with illicit drugs. Chronic drug use can eventually result in a substance use disorder (SUD), which can exacerbate the underlying mental disorder. Extensive education needs to be provided on the risk of illicit drug abuse in all populations, especially in women of childbearing age, to reduce incidents like fetal alcohol syndrome/exposure of the fetus to illegal drugs. Compared to individuals without mental illness, patients with comorbid disorders exhibit worse treatment adherence and increased rates of treatment dropout, which has a detrimental impact on outcomes. For better patient outcomes and quality improvement, the problem of an increase in patients with co-occurring mental health illnesses and substance use disorders needs to be addressed.

Addressing the critical question

A strategy that can help to address comorbid substance use and mental health illness is education. Clinical could provide teaching opportunities to both clinicians and patients to ensure the clinician is knowledgeable on the topic and provide evidence-based education to the patient. (Frank et al., 2022). Clinicians can provide patients with education on the dangers of illicit drug use and the health implications. When two or more conditions are the focus of treatment, it is referred to as integrated treatment. One example of integrated treatment is using several therapies, such as pharmacotherapy and psychotherapy. Research has consistently demonstrated that integrated treatment for comorbidity is superior to treating individual illnesses with separate treatment programs. (Kelly & Daley, 2013). Encouraging syringe exchange programs can help reduce the risk of infection from sharing needles with intravenous drug users. Research demonstrates that funding preventative initiatives can help communities save money and lives. For example, Patient education on syringe exchange locations can help reduce the risk of sharing or reusing needles for IV drug users. Monthly community fairs or adding a drug prevention class to all schools would help create the needed awareness and save the lives of innocent students who might be introduced to drugs.

Consequently, President Biden unveiled his Unity Agenda at the State of the Union address. President Biden’s agenda includes addressing our country’s mental health problem and combating the overdose epidemic. (NIDA, 2022). The President’s mental health initiative is built around three pillars:

Boost System Capability, Link Americans to Care, and Assist Americans through the Development of Healthy Environments. (NIDA, 2022). These interventions can help enlighten, provide care to those with comorbid disorders and ensure a safer environment for everyone.

The value of addressing the quality improvement initiative.

The value of addressing this quality improvement initiative would help reduce the initiation of illegal drug use, addiction/dependence on illicit drug use, the incidence of drug-induced psychosis/coma, or even Death from drug overdose. Clinicians can help improve patient health by encouraging patients with mental health and substance use to seek care and utilize pharmacotherapy and psychotherapy as treatment modalities to help ensure patient well-being.

Syringe exchange Programs can help halt the spread of HIV and other infectious diseases, such as hepatitis C. They also assist in connecting drug injectors with addiction treatment and HIV screening. (NIDA, 2022). By treating patients for SUDs and other mental diseases regardless of their color, socioeconomic background, sex, or location, healthcare professionals can contribute to the reduction of health disparities and reduce possible stigmatization. The aforementioned evidence-based quality improvement measures are all warranted in their attempt to lower the proportion of individuals who have a co-occurring mental health illness and substance use disorder and who do not seek treatment.

In conclusion, proper interdisciplinary collaboration can help reduce gaps in treatment and ensure prompt care to patients dealing with comorbid mental health disorders and substance use.

 Reference

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. Chapter 4, “The Practice Question” (pp. 73–98)

Frank, A. A., Schwartz, A. C., Welsh, J. W., Ruble, A. E., Branch, R., DeMoss, D., & DeJong, S. M. (2022). Enhancing Addictions Education in Patient Care and Medical Knowledge Competencies for General Psychiatry Residents. Academic psychiatry: the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry, 46(3), 375–380. https://doi.org/10.1007/s40596-022-01634-zLinks to an external site..

Iqbal, M. N., Levin, C. J., & Levin, F. R. (2019). Treatment for Substance Use Disorder With Co-Occurring Mental Illness. Focus (American Psychiatric Publishing), 17(2), 88–97. https://doi.org/10.1176/appi.focus.20180042Links to an external site..

Kelly, T. M., & Daley, D. C. (2013). Integrated treatment of substance use and psychiatric disorders. Social work in public health, 28(3-4), 388–406. https://doi.org/10.1080/19371918.2013.774673Links to an external site..

NIDA. 2022, March 23. Strengthening Federal Mental Health and Substance Use Disorder Programs: Opportunities, Challenges, and Emerging Issues. Retrieved from https://nida.nih.gov/about-nida/legislative-activities/testimony-to-congress/2022/strengthening-federal-mental-health-and-substance-use-disorder-programs-opportunities-challenges-and-emerging-issues on 2024, January 7.

Substance Abuse and Mental Health Services Administration (SAMHSA). (2023, January 4). Samhsa announces National Survey on Drug Use and Health (NSDUH) results detailing mental illness and substance use levels in 2021. HHS.gov. https://www.hhs.gov/about/news/2023/01/04/samhsa-announces-national-survey-drug-use-health-results-detailing-mental-illness-substance-use-levels-2021.html