Summarize the PICO(T) components of the health care challenge presented in the following Vila Health scenario and qualitative research study, and write a PICO(T) question:

Vila Health: The Best Evidence for a Health Care Challenge.

Carlfjord, S., Öhrn, A., & Gunnarsson, A. (2018).

Experiences from ten years of incident reporting in health care: A qualitative study among department managers and coordinators.

BMC Health Services Research, 18, 1–9.

PLEASE SEE THE ATTACHED DOCUMENTS AN USE AT LEAST 4 SOURCES!!! PLEASE USE THE SOURCES LISTED ON THESE DOCUMENTS!!! MENTIONING VILA HEALTH

ASSINGMENT WEEK 5 NHS8065

INTEGRATING AND IMPLEMENTING EVIDENCE TO ADDRESS A HEALTH CARE CHALLENGE

Introduction

In addition to critically appraising research and the evidence it produces, one of the roles of a health care leader is to interpret research study results and determine the significance and potential impact the evidence may have in the EBP process.

Instructions

Write a paper in which you apply the first four steps of the EBP process in relation to the health care challenge presented in the 

Vila Health: The Best Evidence for a Healthcare Challenge

 multimedia simulation and readings.

Paper Format and Length

Format your paper using APA style.

· Use the 

APA Style Paper Template [DOCX]

. An 

APA Style Paper Tutorial [DOCX]

 is also provided to help you in writing and formatting your paper. Be sure to include:

. A title page and references page. An abstract is not required.

. A running head on all pages.

. Appropriate section headings.

· Your paper should be 4–6 pages in length, not including the title page and references page.

Assignment Grading

The following requirements correspond to the scoring guide criteria, so be sure to address each point. Read the performance-level descriptions in the scoring guide for each criterion to see how your work will be assessed.

· Construct a PICO(T) question (step 1 in the EBP process).

. Summarize the PICO(T) components of the health care challenge presented in the following Vila Health scenario and qualitative research study, and write a PICO(T) question:

. Vila Health: The Best Evidence for a Health Care Challenge.

. Carlfjord, S., Öhrn, A., & Gunnarsson, A. (2018). 

Experiences from ten years of incident reporting in health care: A qualitative study among department managers and coordinators.

 BMC Health Services Research, 18, 1–9.

· Your PICO(T) question will be the basis of your search for additional research evidence.

· Implement a search strategy for the best evidence (step 2 in the EBP process).

· Search for one quantitative study that supports the Chief Nursing Officer’s suggested intervention or an alternative intervention.

· Base your search strategy on your PICO(T) question and on appropriate study methods and designs with the best evidence.

· Describe your search strategy, and explain how you determined it would lead to finding the best evidence for your PICO(T) question.

. What databases did you search?

. What search terms were most effective?

. What’s your rationale for concluding that you’ve found the best evidence?

· Identify and summarize the study you found for this purpose.

· Evaluate the strengths and weaknesses of the evidence in both the qualitative and quantitative research studies, in relation to the health care challenge (step 3 in the EBP process).

· Conduct a rapid critical appraisal of the study provided by the CNO and the quantitative study you found in your search.

· Consider the research design and methods in relation to the evidence presented when you choose an appropriate critical appraisal tool and complete the appraisal for each study.

· Interpret the evidence and its implications, in relation to the health care challenge (step 4 in the EBP process).

· Synthesize all of the evidence, including research evidence, organizational evidence/data, and staff perceptions.

· Explain why the quantitative study you found and (or) the CNO’s study contains the best evidence for your PICO(T) question.

· Recommend a strategy to implement the evidence-based intervention in your PICO(T) question (also part of step 4 in the EBP process).

· Support your recommended strategy with a synthesis of the evidence presented in the studies and (or) additional relevant and timely resources.

· Explain how health care professionals in multiple roles can apply the findings of the studies to improve practice.

· Reflect on how you and other health care professionals can improve practice, based on your interpretation of the implications of these studies.

· This part of your paper extends beyond the steps of the EBP process to address how interprofessional collaboration and communication can lead to improvements in health care.

· Synthesize multiple sources into key themes or findings.

Competencies Measured

By successfully completing this assignment, you will demonstrate your proficiency in the following course competencies and assignment criteria:

· Competency 1: Apply the steps of the evidence-based practice process to a health care challenge.

. Construct a PICO(T) question.

· Competency 2: Differentiate among qualitative, quantitative, and mixed research design methods, and evidence for health care and public health.

. Implement a search strategy for the best evidence.

· Competency 3: Evaluate the design, methods, results, and overall quality of qualitative research methods and results, within the context of evidence-based practice.

. Recommend a strategy to implement an evidence-based intervention in a PICO(T) question.

. Evaluate the strengths and weaknesses of the evidence provided in a study, in relation to a health care challenge.

· Competency 4: Interpret the practical significance of quantitative and qualitative health care data analyses and results, using the evidence-based practice process.

. Interpret evidence and its implications, in relation to a health care challenge.

. Explain how health care professionals in multiple roles can apply the findings of a research study to improve practice.

· Competency 5: Produce original, written work, in compliance with Capella’s writing standards, that is a creative synthesis of information from credible sources.

. Synthesize multiple sources into key themes or findings.

2/9/2021 Integrating and Implementing Evidence to Address a Health Care Challenge Scoring Guide

https://courserooma.capella.edu/bbcswebdav/institution/NHS/NHS8065/200400/Scoring_Guides/u05a1_scoring_guide.html 1/2

Integrating and Implementing Evidence to Address a Health Care Challenge
Scoring Guide

Due Date: End of Week 5
Percentage of Course Grade: 20%.

CRITERIA NON-PERFORMANCE BASIC PROFICIENT DISTINGUISHED

Construct a PICO(T)
question.

15%

Does not
construct a
PICO(T)
question.

Constructs a
PICO(T) question
in which one or
more of the
PICO(T) elements
is misidentified.

Constructs a
PICO(T)
question.

Constructs a PICO(T) question. Applies
PICO(T) components within the question
appropriately, and refines PICO(T)
components with the appropriate level of
detail and specificity.

Implement a search
strategy for the best
evidence.

15%

Does not
implement a
search strategy
for the best
evidence.

Implements an
ineffective search
strategy that does
not yield the best
evidence, based
on a PICOT
question.

Implements a
search
strategy for
the best
evidence

Implements a search strategy for the
best evidence that is clearly based on
the PICO(T) question and on appropriate
study methods and designs with the best
evidence. Explains the criteria used for
identifying the best evidence, and
executes a search of appropriate
databases, using appropriate search
terms.

Evaluate the
strengths and
weaknesses of the
evidence provided
in a study, in
relation to a health
care challenge.

14%

Does not
evaluate the
strengths and
weaknesses of
the evidence
provided in a
study, in
relation to a
health care
challenge.

Provides
unsubstantiated
claims about the
strengths and
weaknesses of
the evidence
provided in a
study, in relation
to a health care
challenge.

Evaluates the
strengths and
weaknesses
of the
evidence
provided in a
study, in
relation to a
health care
challenge.

Evaluates the strengths and weaknesses
of the evidence provided in a study, in
relation to a health care challenge.
Chooses an appropriate critical appraisal
tool and justifies the criteria used to
evaluate the evidence.

Interpret evidence
and its implications
in relation to a
health care
challenge.

14%

Does not
interpret
evidence in
relation to a
health care
challenge.

Interprets
evidence in
relation to a health
care challenge.

Interprets
evidence and
its
implications in
relation to a
health care
challenge.

Interprets evidence and its implications
in relation to a health care challenge.
Identifies significant and relevant
implications, based on a perceptive and
coherent synthesis of sufficient best
evidence for a PICO(T) question.

Recommend a
strategy to
implement an
evidence-based
intervention in a
PICO(T) question.

14%

Does not
recommend a
strategy to
implement an
evidence-
based
intervention in
a PICO(T)
question.

Recommends an
unsubstantiated
strategy to
implement an
evidence-based
intervention in a
PICO(T) question.

Recommends
a strategy to
implement an
evidence-
based
intervention in
a PICO(T)
question.

Recommends a strategy to implement an
evidence-based intervention in a
PICO(T) question. The strategy is well-
supported by an insightful synthesis and
interpretation of the research evidence.

2/9/2021 Integrating and Implementing Evidence to Address a Health Care Challenge Scoring Guide

https://courserooma.capella.edu/bbcswebdav/institution/NHS/NHS8065/200400/Scoring_Guides/u05a1_scoring_guide.html 2/2

CRITERIA NON-PERFORMANCE BASIC PROFICIENT DISTINGUISHED

Explain how health
care professionals
in multiple roles can
apply the findings of
a research study to
improve practice.

14%

Does not
explain how
health care
professionals in
multiple roles
can apply the
findings of a
research study
to improve
practice.

Explains how the
findings of a
research study
can be applied to
improve practice,
irrespective of
interprofessional
collaboration and
communication.

Explains how
health care
professionals
in multiple
roles can
apply the
findings of a
research
study to
improve
practice.

Explains how health care professionals
in multiple roles can apply the findings of
a research study to improve practice and
draws well-reasoned conclusions based
on clearly articulated study implications
and insight into the efficacy of
interprofessional collaboration and
communication in improving practice.

Synthesize multiple
sources into key
themes or findings.

14%

Does not
synthesize
multiple
sources into
key themes or
findings.

Cites multiple
sources with no
clear indication of
key themes or
findings.

Synthesizes
multiple
sources into
key themes or
findings.

Synthesizes multiple sources into fully-
developed key themes or findings that
support a clearly discernable thesis or
central idea of the work.

Vila Health: The Best Evidence for a Healthcare Challenge

·

Introduction

·

Your Office

·

Jackie

·

Email

·

Jackie

·

Email

·

Conclusion

Introduction

Leading the Change with the First Steps in EBP.

You are a senior staff member at

St. Anthony Medical Center

, and also a graduate student who has been focusing on Evidence-Based Practice (EBP). Because of your expertise in this area, you have been asked to serve on the hospital’s new EBP Intervention Team. The hospital needs your help in using EBP to address the issue of substandard patient safety scores. In order to complete this task, you will be following the six-part Evidence-Based Practice model, which appears in this activity.

St. Anthony Medical Center

Evidence-Based Practice Model

Here is the six-part Evidence-Based Practice model, which you will use to address the issue of substandard patient safety scores. For this activity, you will be focusing on the first four steps.

· Step 1: Compose a suitable PICOT question.

· Step 2: Search for the best evidence to answer the PICOT question.

· Step 3: Conduct a rapid appraisal of the studies found in the search.

· Step 4: Integrate research evidence with internal evidence, clinical expertise, patient preferences/values.

· Step 5: Evaluate the outcomes of the practice change.

· Step 6: Disseminate the outcome of the EBP practice change.

Jackie
St. Anthony Medical Center

The

Chief Nursing Officer

,

Jackie Sandoval

, stops you in the hallway to chat.

Check in with Jackie Sandoval, the Chief Nursing Officer to continue.

Jackie Sandoval
Chief Nursing Officer

Hi there! I’m going to be forwarding to you an email from

Marcus

Hartley about a new project. Marcus is our Chief Quality Officer. I feel that you’d be the perfect person for this project because you’ve been focusing your graduate studies on Evidence-Based Practice. We’re so lucky to have a nurse on staff like you who has expertise in EBP!

When you get back to your station, please take a look at this forwarded email. There are two documents attached to this email that you should review as well.

Using the information in this email and the documents, you will be able to construct a PICOT question. You will use this PICOT question as a foundation for your search for additional research evidence for an appropriate intervention. Then we can meet again to start on the next step.

Thank you so much! I’m confident that your expertise in Evidence-Based Practice will better enable the hospital to provide quality care for patients.

Your Office

You arrive back at your station. You should read that email that the CNO forward to you from the CQO and look over the documents.

Email

From: Jackie Sandoval, CNO, St. Anthony Medical Center

FW: EBD and Patient Safety Scores

Hi,

Here’s that email I mentioned that I’m forwarding to you from Marcus Hartley. Thanks so much!

–Jackie

From: Marcus Hartley, CQO, St. Anthony Medical Center

To: Jackie Sandoval, CNO, St. Anthony Medical Center

Subject: EBD and Patient Safety Scores

Hello Jackie

As you know, one of our most pressing initiatives right now is patient safety. We are very concerned with our Patient Safety Scores and the incidences related to staff and patient safety over the last two years, many of which could have been prevented. The aggregate scores for the system fell into the Worse than Expected category, which means that the hospital had a higher rate of incidences than what was projected when providing high quality care.

The hospital needs to develop an intervention to address these Patient Safety Scores, and it is important to us that this intervention is evidence-based and that we are using Evidence-Based Practice to improve. We need to see improvement in these safety scores within the next three months, and we need your help.

I’ve attached two documents to this email. The first document is a report that summarizes patient safety incidents at St. Anthony Medical center over the past two years. The second document is a report from Anne Marie McConnell, the Director of Risk Management, which summarizes the results of a focus group that we conducted in regards to patient safety issues.

Is there someone on our staff with expertise in Evidence-Based Practice who could help us with this? I’ve heard that there might be a nurse on staff who’s been studying EBP in graduate school. If so, that would be a good person to get on board.

Thank you.

Sincerely,

Marcus

Patient Safety Data

2018

Aggregate Scores: Worse than Expected

1. Patient Falls – Expected: 0 Observed: 3

2. Medical Errors causing patient allergic reaction – Expected: 0 Observed: 2

3. Staff member in Emergency Department (ED) needed urgent treatment for concussion = 1

2019

Aggregate Scores: Worse than Expected

1. Medical Errors causing patient allergic reaction – Expected: 0 Observed: 4

2. Staff member in Emergency Department needed urgent treatment for lacerations = 1

3. Nurse on critical care unit slipped and broke her arm = 1

Focus Group Results

Between March 13 and March 20, 2020, the Executive Team at St. Anthony Medical Center held four focus groups with staff members from the hospital. The purpose of these focus groups was to acquire their perspectives on safety at the hospital. A total of 31 staff members participated in these focus groups.

Here is a summary of common themes that emerged from the focus groups.

· Staff members are concerned that the EHR needs to be updated to better alert staff about red flags and other information that pertains to patient safety. One concern is that the EHR does not automatically flag patients with allergies to medications. Staff members are especially concerned that the EHR does not flag patients who are allergic to antibiotics.

· In addition to concerns that the EHR may need to be updated, staff members are concerned that the forms are not being filled out correctly, which may lead to patient safety issues. Staff members report that training on the EHR is insufficient; the system was updated three years ago, and while new staff members are trained on how to use the EHR, older staff members received only minimal training when the system was updated. Also, staff members report that EHRs are not always filled out in as much detail as they should be, in part because of time constraints, and also because management does not consistently emphasize the importance of filling out the EHRs in detail.

· Staff members are concerned that patient files are not routinely marked when a patient is at risk of falling.

· Staff members recall seeing incidents of patient violence against staff members that were not reported, especially in the ER. These incidents include violent outbursts from patients and from patients’ families, and well as incidents of physical violence. Staff members said that while the hospital has an official policy about reporting these kinds of incidents, staff members may feel pressured to handle these incidents themselves, and to treat these incidents as “just part of the job.” Staff members report that there is a culture of acceptance at the hospital when it comes to violent incidents and a “code of silence,” even though that is almost never stated explicitly. Several staff members said that they wished the hospital would increase the number of police officers or security guards on the premise, and also that the hospital would install more panic buttons.

· Several staff members discussed an instance in 2017 when a nurse slipped and broke her arm. Two staff members reported seeing spilled saline solution on the floor when this occurred.

Jackie
St. Anthony Medical Center

Jackie Sandoval, the CNO, stops by your station.

Check in with Jackie Sandoval, the Chief Nursing Officer to continue.
Jackie Sandoval
Chief Nursing Officer

Hi again! I see you’ve read the email I forwarded to you from Marcus Hartley about your assignment. I hope that this information and data will help you develop an appropriate PICOT question. I’d like to emphasize how important it is for the hospital see improvement in patient safety scores in the next three months.

I trust that you know how to identify appropriate research evidence to support your proposed evidence-based intervention, but I have found an article to get you started. It’s a study on incident reporting. Please use this article as a start to your search for the best evidence.

It’s a good idea to create a search strategy based on your PICOT question to find additional research evidence to support an intervention to improve our safety scores.

Once you have found relevant and timely evidence, it’s standard practice to critically appraise the studies. After that, I will look forward to seeing a good synthesis of the research evidence you found combined with all of the quantitative and qualitative organizational evidence provided by Marcus and Melissa.

Oh, and here’s the citation.

Carlfjord et al. (2018). Experiences from ten years of incident reporting in health care: a qualitative study among department managers and coordinators. BMC Health Services Research (2018) 18:113. DOI 10.1186/s12913-018-2876-5

Your Office

You get to work on your PICOT question. Later, Jackie Sandoval forwards to you another email.

Email
From: Jackie Sandoval, CNO, St. Anthony Medical Center

FW: Committee response to EBP presentation

Hi,

I’m forwarding another email to you that I think you’ll find useful. This email is a summary is from Melissa Cohen, our COO, who conducted an EBP presentation to our medical staff last night. You should be able to use this as additional data to integrate into an implementation strategy for the evidence-based intervention to improve safety scores.

I am giving you this because it represents the kind of qualitative evidence and clinical expertise that must be integrated into recommendations on strategies to implement an evidence-based intervention.

Best,
Jackie

From: Melissa Cohen, COO, St. Anthony Medical Center

To: Jackie Sandoval, CNO, St. Anthony Medical Center

FW: EBP and Patient Safety Scores

Hi Jackie

I just wanted to let you know about the presentation I made last night at the Medical Committee’s quarterly meeting about EBP. As an example in my presentation, I discussed the research evidence article you found by Carlfjord et al. To my surprise, this sparked some heated debate!

· Some of the committee members were excited about EBP, but others were very skeptical – and to paraphrase Dr. Booker, the Chief Medical Officer, there isn’t consensus among the Medical Committee on the effectiveness and value of evidence-based interventions.

· Most of the committee members want to see more information and data about how EBP is going to be used in order to support improvements in safety and other areas. Several doctors stated explicitly that they were not on board with using EBP to make such big changes, and that they were not going to change their own practices unless they saw solid research evidence to support the need for those changes. In addition, some of the committee members also wanted to see evidence that substantiates our poor safety scores and the intervention.

· Dr. Booker argued that we need to see what other physicians have to say about EBP, and he suggested that a focus group might be helpful.

· Some committee members were enthusiastic about evidence-based interventions, and several said that they think we should be working towards a culture of evidence across the organization. They expressed the opinion that EBP is the new trend in improving quality of care.

Anyway, I thought you should be aware of this debate as you work on your intervention.

Best,
Melissa