The 10 Strategic Points

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Broad Topic Area

1. Broad Topic Area:

Effectiveness of competency-based behavioral training curriculum for palliative care centers in improving palliative care offered to patients with advanced cancer within 4 weeks.

Literature Review

2. Literature Review:

a. Background of the Problem/Gap:

· Patients with advanced cancer often experience poor health-related quality of life due to cancer and treatment-related side effects (Jacob, et al., 2019).

· Cancer is a leading cause of mortality in the world, it imposes a substantial economic burden on the society.

· The purpose of palliative care is to improve the quality of life of patients and their families facing progressive illness by managing pain and symptoms.

· It has been found that majority of nurses do not have adequate knowledge about palliative care (Turan, Mankan, & Polat, 2017)

b. Theoretical Foundations (models and theories to be foundation for the project):

Trait theory can help in understanding the individual traits necessary for effectively performing duties (Fukada, 2018).

The social learning theory provides critical information on expressing the need to give meaning on what nurses are learning, the importance of learning by doing, how to foster learning by fostering a sense of belonging, and how the learning process transforms personal identity (Cubas et al., 2015).

c. Review of Literature Topics with Key Organizing Concepts or Topics for Each One

Key Topic:

There is no cure for cancer, but successful treatment can remove all signs of it.

Cancer become incurable if it has spread to other parts of the body, grown to be too big for treatment to work, and have reoccurred even after treatment.

Late diagnosis of cancer makes it hard to kill all cancer cells. In this situation, cancer can only be controlled but not cured.

When the health status of a cancer patient deteriorates to a condition when he or she cannot live alone and has no person to care for him or her, or needs professional care, palliative care is the best option for obtaining professional care.

Key Topic:

Competency-based training program improves the quality of care for individuals experiencing or receiving or recovering from cancer treatment (Cox, Smith, & Lichtved, 2012).

Competency-based program is effective in successful training of competent radiation oncologists (Khader, Al-Mousa, Khatib, & Wadi-Ramahi, 2019).

Settings:

Nursing homes (Cadigan et al., 2013)

Certifications:

Centers for Medicare & Medicaid Services (2019). Retrieved from https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/CertificationandComplianc/NHs.html

Department of Health and Human Services (n.d). Retrieved from https://www.hhs.gov/

d. Summary

· Gap/Problem: The gap in the literature is that no study has been undertaken to determine the effectiveness of competency-based behavioral training for health professionals working in nursing homes using palliative care for advanced cancer patients.

· Prior studies: Prior studies have shown that competency-based behavioral training for family caregivers is effective in boosting the skills of healthcare professionals. Another study found out evidence-based education programs helps in boosting care for patients requiring palliative care.

· Quantitative application: The study will involve collecting quantitative data to determine the relationship between competency-based behavioral training and improvement of care for patients with advanced cancer and under palliative care.

· Significance: The study will add to the current literature by adding information on whether training nursing home staff using a competency-based behavioral training will be effective in enhancing their palliative care for patients with advanced cancer.

Problem Statement

3. Problem Statement:

While literature indicates that competency-based education programs enhances palliative care for patients in acute care hospitals, it is unknown whether training nursing home staff with competency-based education programs will enhance palliative care for cancer patients needing end-of-life care.

Clinical/
PICOT Questions

4. Clinical/PICOT Questions:

(P) In a nursing homes setting, (I) does a competency-based behavioral training curriculum for nursing home caregivers (O) improve palliative care provided to advanced cancer patients (T) within 4 weeks?

Sample

5. Sample (and Location):

a. Location: Montgomery, Alabama

b. Population: Three nursing homes in Montgomery, Alabama with residents comprised of individuals with advanced cancer.

c. Sample: 50 patients experiencing advanced cancer.

Define Variables

6. Define Variables:

a. Independent Variable: Competency-based behavioral training

b. Dependent Variable: Palliative Care for advanced cancer patients in nursing homes

Methodology and Design

Methodology and Design: The study will use a quantitative methodology with a quasi-experimental design with repeated measures (immediate pre- and post-training intervention). There will be an interventional group and a control group. The interventional group will receive competency-based training about palliative care for cancer patients while the control group will receive normal training.

Purpose Statement

Purpose Statement: The purpose of this quasi-experimental study is to determine to what degree a relationship exists between equipping nursing home staff using new skills and competencies using a curriculum-based behavioral training curriculum and improving the quality of palliative care they give to cancer patients in the nursing homes within four weeks at nursing homes located in Montgomery, Alabama. The type of competencies the intervention group will be equipped with during the training will define the independent variable. The dependent variable will be measured by Self-Perceived Behavioral Management Self-Efficacy Profile, Agitation Management Self-efficacy, and Preparedness and Competence Scales.

Data Collection Approach

Data Collection Approach: The study will collect data using Perceived Behavioral Management Self-Efficacy Profile, Agitation Management Self-efficacy, and Preparedness and Competence Scales. These instruments will be issued before the training and 2 weeks and 4 weeks after the training.

Data Analysis Approach

Data Analysis Approach: The study will analyze demographic characteristics using descriptive statistics using means for continuous variables and counts/percentages for categorical variables. The ANOVA analysis will determine the impacts of the training on participants’ performance of caring for advanced cancer patients in the nursing homes. Independent t-tests will help in determining the differences between the interventional and control groups for competency-based training.

PICOT Question Submission

PICOT Question Template

Section 1: In this section provide one word to describe each section of your proposed PICOT question

P

Population

I

Intervention

C

Comparison

O

Outcome

T

Timeline

Section 2: Write your PICOT question below using the words listed above.

PICOT

Section 3: Use your PICOT to develop a formalized problem statement. Use the example below to help formulate your problem statement.

As you move through the program, you will be building your project based on the PICOT question. Your problem statement, purpose statement, and clinical question(s) will be derived from the PICOT, though they are formatted differently. Use the instructions below as an initial exercise in visualizing how your problem and purpose statements might look. Read the instructions and then develop your problem and purpose statements in the designated fields below each instruction field

Problem Statement Format Instructions

A well-written problem statement begins with the big picture of the issue (macro) and works to the small, narrower and more specific problem (micro). It clearly communicates the significance, magnitude, and importance of the problem and transitions into the Purpose of the Project with a declarative statement such as “It is not known if and to what degree/extent…” or “It is not known how/why and…”.

Other examples are:

While the literature indicates ____________, it is not known in _________. (organization/community) if __________.

It is not known how or to what extent ________________.

Problem Statement

Section 4: Based on your PICOT, create a declarative purpose statement. Use the example below as a reference.

Purpose Statement Format Instructions

“The purpose of this project is….” Included in this statement are also the project design, population, variables (quantitative) to be studied, and the geographic location.

Creswell (2003) provided some sample templates for developing purpose statements aligned with the different project methods as follows:

The purpose of this quantitative ___________ (correlational, descriptive, etc.) project is to ____________ (compare or see to what degree a relationship exists) between/among ______________________ (independent variable) to ___________________ (dependent variable) for ________________ (participants) at ___________________ (project site/geographical location). The ________ (independent variable) will be defined/measured as/by _______ (provide a general definition). The (dependent variable) will be defined/measured as/by ______ (provide a general definition).

Purpose Statement