NR 451 Capstone Project: Milestone 1: Practice Issue and Evidence Summary Worksheet

Sample Answer for NR 451 Capstone Project: Milestone 1: Practice Issue and Evidence Summary Worksheet Included After Question

Practice Issue Worksheet Directions

  1. A tutorial with tips for completing this assignment may be viewed at https://atge.webex.com/atge/ldr.php?RCID=4905b26a67572323c11b839e3251c96a (Links to an external site.)Links to an external site. (Links to an external site.)Links to an external site.
  2. Choose the ONE systematic review topic that is of most interest to you, or most relevant to your practice situation, from the List of Approved Systematic Reviews (Links to an external site.)Links to an external site..
  3. Follow the grading criteria below to formulate your practice issue, which must be based on the topic of the systematic review you have selected.
  4. Use the worksheet to document the practice issue presented and approved by your instructor in the Week 2 Discussions.
  5. Your practice issue will be the same for all three Milestone assignments in this course.
  6. Please type your answers directly into the worksheet.

Evidence Summary Worksheet Directions

  1. Develop an evidence summary by following the grading criteria below.
  2. Document this on the evidence summary portion of the worksheet.
  3. You will use this worksheet to incorporate your evidence summary into your Week 4 Milestone 2 assignment.
  4. Please type your answers directly into the worksheet.

A Sample Answer For the Assignment: NR 451 Capstone Project: Milestone 1: Practice Issue and Evidence Summary Worksheet

Title: NR 451 Capstone Project: Milestone 1: Practice Issue and Evidence Summary Worksheet

Practice Issue Worksheet

 List the topic and include the citation for the systematic review you have selected: The Hospital discharge planning for reduction of readmission of patients The systematic review article that has been used is the article by Fox et al., (2013) on the effectiveness of early discharge planning in acutely ill or injured old adults.
What is the practice issue you have identified related to the topic you have chosen? The practice issue that has been put forward is the development of a training plan for the older population regarding o the management of their condition after they are discharged. This is related to the topic under study since the readmission rates can be reduced by ensuring that the patients are able to manage their conditions at home.
Define the scope of the practice issue: The scope of practice can be described by the use of the PICOT question as indicated below P (Population)- Old patients in the healthcare facility having acute illness or having an injury I (Intervention)- The development of an early discharge planning for the patients C (Comparison)- The use of usual care plan O (Outcome)-  A reduction in the cases of readmission of older patients to the  hospitals T (Time)- 3 months
What is the practice area? __x_ Clinical ___ Education ___ Administration ___ Other (List):
How was the practice issue identified? (check all that apply) _x__ Safety/risk management concerns _x__ Unsatisfactory patient outcomes ___ Wide variations in practice ___ Significant financial concerns    ___ Difference between hospital and community practice __x_ Clinical practice issue is a concern ___ Procedure or process is a time waster ___ Clinical practice issue has no scientific base __ Other:
Describe the rationale for your checked selections: The increasing cases of readmission of the elderly patients in hospitals have led to the increase in concerns. Along these lines, the problem has been identified from the concerns on the risks of readmission to the hospitals since it leads to an increase in costs of healthcare maintenance of the patient. Moreover, the expectations of the patients while being discharged is to ensure that there are no mistakes but the increase in the readmission has led to mistrust on the outcomes. The increase in readmission of elderly patients is as well an issue of concern in the medical practice.
What evidence must be gathered? (check all that apply)
__x_ Literature search ___ Guidelines ___ Expert Opinion ___ Patient Preferences_x__ Clinical Expertise ___ Financial Analysis ___ Standards (Regulatory, professional, community) ___ Other
Describe the rationale for your checked selections: There has been advance research on the ways that can be used in reducing the cases of readmission of elderly patients. Along these lines, the literature search will be a critical step that will help in collecting information on the plan. Moreover, the clinical experts will help in the provision of information on the ways that can be implemented to minimize readmission rates in the healthcare organizations.

Evidence Summary Worksheet

Directions: Please type your answers directly into the worksheet.

Describe the practice problem in your own words with reference to the identified population, setting and magnitude of the problem in measurable terms: The increasing cases of readmission have mainly been identified to influence the elderly patients. Along these lines, there is a need for the development of measures that can be implemented in reducing the cases. The old population is mainly associated with longer stays in the healthcare facilities and the need for the development of an early discharge plan for the patients as elucidated by Fox et al., (2013) is a stepping stone for minimizing the cases of readmission.  Readmission has a variety of challenges include the fact that there is an increase in the cost of managing the healthcare conditions of the elderly patient. Moreover, readmission will put the quality of services offered in hospitals in question. As such, there will be a reduction in the trusts that the patients will have in the healthcare organization due to the readmission cases.
Type the complete APA reference for the systematic review article you chose from the list provided. It must be relevant to the practice issue you described above. Fox, M. T., Persaud, M., Maimets, I., Brooks, D., O’Brien, K., & Tregunno, D. (2013). Effectiveness of early discharge planning in acutely ill or injured hospitalized older adults: a systematic review and meta-analysis. BMC geriatrics, 13(1), 70.  
Identify the objectives of the article. The aim of the study by Fox et al., (2013) is to assess the effectiveness of early discharge planning for the older patient show have been admitted with the acute illness or injuries. Provide a statement of the questions being addressed in the work and how they relate to your practice issue: What is the effectiveness of early discharge plan on the older patient show have been admitted with the acute illness or injuries?
Summarize (in your own words) the interventions the author(s) suggest to improve patient outcomes. The authors have presented that the intervention for minimizing readmissions on the healthcare organization is the provision of an effective plan that will help the patients in the transition after discharge. In this regard, the elderly patients are provided with a discharge plan from the time of their admission. The authors deduce that the availability of an early plan for the patients in comparison with the usual care helps in reducing the cases of readmission of the elderly patients. This is attributed to the fact that the there is an improvement in the quality of life of the patients who have had a discharge plan from the time of their admission.

Summarize the main findings by the authors of your systematic review including the strength of evidence for each main outcome.  Consider the relevance to your project proposal for the Milestone 2 project paper.
The findings indicate that many studies have indicated that an early discharge planning is crucial at the time that the patients are in an acute state for the reduction of readmission. Specifically, the findings are applicable for old patients and are performed by the nurses within the first 24 hours before the patient is discharged. Along these lines, the patient does not get enough information on the ways of managing their condition. The discharged plans that have been identified to be supported by a variety of researchers include the assessment of the needs of the elderly patients while at home. Moreover, the other discharge plans include the provision of education to the patients o the necessary adjustments that could help in reducing the cases or readmission and the transfer of information to the community health provided on the management of the care of the elderly patients. Additionally, the proposal of the follow-up plans is adduced to be of help in reducing the cases of readmission. The results indicate that the reviews indicated that the follow-up method that is identifiable include the use of telephone calls or a mobile phone application that could provide a report on the patient conditions.
Outline evidence-based solutions that you will consider for your project.

Due to the intensity of the cases of readmission, the evidence based solution that will be proposed for the project is the education of the patients on the ways of managing their conditions before discharge. Along these lines, the patient should receive care from the nurses from the time of their admission to help in ensuring that there is enough information on the possible challenges that will be faced after their discharge. In addition, the patients should be educated on the effects of readmission on the psychological well-being and the cost of hospitalization. Moreover, the patients are trained on the use of technological devices such as the mobile application that reports the vital signs of the elderly patient or a regular basis. This will help the healthcare providers in monitoring the health of the patient.

Discuss any limitations to the studies performed that you believe impacts your ability to utilize the research in your project.

One of the limitations of the review is that there are limited study methods for the research topic. This is attributed to the fact that only nine studies have been used. The precision is as well influenced by the sample size and the conclusion made by the researchers may be affected by the fact that there is no heterogeneity. This will have an impact on the utilization of the article since it can be asserted that the issue at hand may not have had enough research studies in the past.  As such, the process of discharge planning may receive a measurable amount of resistance during the implementation.