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NR451 EBP Process Change

NR451 EBP Process Change

NR451 EBP Process Change

Week 6 Assignment:  EBP Change Process form 

ACE Star Model of Knowledge Transformation

Follow Nurse Daniel as your process mentor in the weekly Illustration section of the lesson. Please do not use any of the Nurse Daniel information for your own topic, nursing intervention, or change project.  Nurse Daniel serves as an example only to illustrate the change process.

Star Point 1:  Discovery (Identify topic and practice issue)

Identify the topic and the nursing practice issue related to this topic. (This MUST involve a nursing practice issue.)

The postoperative period is defined as the time from the end of the surgical procedure to the time the patient goes back home to resume normal living (Amer, 2011). There are quite a few dynamics involved in the postoperative period and nurses play a large role in them. Wound care and pain management are among the primary parts of the postoperative period.

Proper postoperative care can give way to clean and quick recovery bereft of trauma. On the other hand, if proper care is not taken, the patient can end up recovering slowly and can suffer from negative psychological aftereffects of the surgery.

This is our topic, and the nursing practice issue related to it is postoperative care for patients who have undergone amputation processes. Since amputations can create vast changes in the patient and their way of living, it is important to make sure that such patients receive the proper care after the surgery in order to cushion the impact of their loss and to help them adjust back in their lives.

Briefly describe your rationale for your topic selection. Include the scope of the issue/problem. 

NR451 EBP Process Change

Poor postoperative care can lead to different issues for the patient. It can leave them mentally scarred and physically, it can deter them from resuming their lives after the surgical process. When pain management is not properly done after the procedure, it can lead to chronic postoperative pain, impaired working and increased morbidity (Gan, 2017) . When the nurse fails to mentally relax and soothe the patient, it can create disturbance and trauma. Moreover, when the nurse fails to administer the medications and the recovery processes properly, it can lead to longevity in the healing process. The patient can end up relying on medication for an extended period, even after discharge.

That is why this topic was selected. Much needs to be said and implemented in the postoperative care area, especially for patients who have undergone a life-changing process such as amputation.

Star Point 2:  Summary (Evidence to support need for a change)

Describe the practice problem in your own words and formulate your PICOT question. 

The practice problem can be described adequately as the possible lack, deficiency or scarcity of postoperative care. Unprofessional and uncompassionate nurses can be very damaging to a person’s physical and mental health. Fruthermore, communication between the patient and professional is necessary as it can lead to reduced medical risks and chances of injury (Tiwart et al., 2019). Hence, there needs to be some sort of a road map or procedure that nurses can follow in order to 

The PICOT question that can be formed here is that among patients undergoing amputation (P), what process can be created to implement proper postoperative care (I) as compared to haphazard treatments (C) to reduce trauma and physical deterioration (O)?

The answer to this question would basically explain and elaborate which order the postoperative care steps will be taken such as when medication should be discontinued, how the wound should be treated and when the patient should be discharged. Since there are already numerous postoperative care processes, our aim is to especially focus on amputation patient.s

List the systematic review chosen from the CCN Library databases. Type the complete APA reference for the systematic review selected.

Amer, S. A. (2011). Postoperative care. Gynaecology, 116–127. https://doi.org/10.1016/b978-0-7020-3120-5.00009-6

List and briefly describe other sources used for data and information. List any other optional scholarly source used as a supplement to the systematic review in APA format.

R. L. (2010). Caring for a patient after amputation. Nursing, 40(1), 15. https://doi.org/10.1097/01.nurse.0000365908.40394.4e

NR451 EBP Process Change

This paper was done in order to elucidate, among other concepts, the basic and foremost factors that must be taken care of after the surgical process for amputation. Before any special care is prescribed, the most basic steps which are taken in all cases regardless of what type the surgery was are also followed in postoperative care for amputation. Such measures involve taking care of the patient’s vital signs, taking care of not aggravating the respiratory or circulatory system of the patient etcetera.

Briefly summarize the main findings (in your own words) from the systematic review and the strength of the evidence.

The study aimed at enumerating and explaining the main steps to be taken in postoperative care. This study was not particular about amputation patients. It was about generally every operation and what the measures are that should be taken.

The main findings included the Routine Postoperative Care steps which included drains, pain management, wound care and mobilization etcetera (Amer, 2011). The other section dealt with recognizing and tackling complications that can arise afterwards. 

Outline one or two evidence-based solutions you will consider for the trial project.

The first solution that can be tried is conducting short seminars and sessions aimed at educating nurses about their responsibilities and roles in the postoperative period.

The second solution can be the appointment of an experienced nurse over a number of junior nurses in order to ensure that they perform their duties well and take care of the patients properly.

Star Point 3:  Translation (Action Plan)

Identify care standards, practice guidelines, or protocols that may be in place to support your intervention planning (These may come from your organization or from the other sources listed in your Summary section in Star Point 2).

The care standards that are usually employed at the time of wound treatment and pain management can be of help during the intervention planning phase. Each hospital or institution can have its own set of guidelines and standards for providing care that can be applied.

However, for our intervention planning, we can consider the postoperative care guidelines given by WHO (World Health Organization, 2003).

List your stakeholders (by title and not names; include yourself) and describe their roles and responsibilities in the change process (no more than 5). 

The people that will be responsible for the change process include the operating nurse (myself), the head nurse, surgeon and physician.

The role of the operating nurse will be to actively and actually take part in the recovery process of the patient. This can involve administering the medications, pain management and wound treatment. After a surgical process, the patient can be susceptible to vomiting, blockage of respiratory passages and cardiac issues (Stephens & Boaler, 1977). The care and prevention of these issues is the duty of the nurse.

The role of the head nurse will be to supervise the work of the operating nurse and see that no protocol is breached or omitted. The responsibilities would be to make regular rounds to check on the progress of the operating nurse.

The role of the surgeon would be to respond to any emergency and accident during wound treatment. The responsibilities would involve checking in on the patient once every day and responding to an emergency situation.

The role of the physician would be to determine the recovery and the condition of the patient. If improvements are needed, he would advise the head nurse who will, in turn, apprise the operating nurse. The responsibilities of the physician would be to check in once a day.

What specifically is your nursing role in the change process? Other nursing roles? 

The nursing role described answers this question. In the change process, it will be mainly the responsibility of the nurse to implement changes.

List your stakeholders by position titles (charge nurse, pharmacist, etc.). Why are the members chosen (stakeholders) important to your project?

The stakeholders chosen are the head nurse, operating nurse, general surgeon and physician.

As explained above, each of these members plays a vital role in the recovery process of the patient. Every member has a role that is important for the postoperative period.

What type of cost analysis will be needed prior to a trial?  Who needs to be involved with this?

A cost-benefit analysis will be useful prior to the trial. This will enable us to evaluate the efficacy of the current method and identify a better modus operandi, should it exist.

Star Point 4: (Implementation)

NR451 EBP Process Change

Describe the process for gaining permission to plan and begin a trial.  Is there a specific group, committee, or nurse leader involved?

As mentioned prior, the head nurse will be in charge of overseeing the progress of the trial. The operating nurse will seek permission to begin the process, as well as for every subsequent major step that needs to be taken.

Describe the plan for educating the staff about the change process trial and how they will be impacted or asked to participate.

The plan for educating the staff is to merely notify them about the patient who is part of the trial. This will be just one or two patients in the care of the junior, operating nurse. They will be asked to accommodate and help the operating nurse if the need arises. Since the whole study is about identifying a set of rules for postoperative care, there is not going to be a lot of intrusive impact on the rest of the staff. It will involve some observatory and experimental practices on the operating nurse’s part.

Outline the implementation timeline for the change process (start time/end time, what steps are to occur along the timeline).

The trial will start at the end of the surgical process. When the patient is kept in the ward/room for a brief period after amputation, the process will start. It will terminate when the patient is discharged.

The steps to occur along the timeline will be the administering of medication, wound care and pain management. Steps must be taken to avoid postoperative complications.

List the measurable outcomes based on the PICOT.  How will these be measured?

The measurable outcomes can include the efficacy of the process adopted for the postoperative. The order of the steps such as when the wound care and the pain management is adjusted as well as the psychological care will make up the process.

What forms, if any, might be used for recording purposes during the pilot change process. Describe.

Since the whole point of the study is to define a method, or order of treatment measures for amputation patients, recording and keeping track of information is essential. A form will be used to record the efficiency of a certain medication at a certain time, how well the wound is healing and how much pain the patient is experiencing.

What resources are available to staff (include yourself) during the change pilot?

The hospital resources that are available to nurses normally will be used during the change pilot. Observational and recording forms will be used to keep track of the outcomes and developments.

Will there be meetings of certain stakeholders throughout the trial?  If so, who and when will they meet?

As described above, there will be regular meetings of the stakeholders. The head nurse will check on the operating nurse. The physician will check on the progress and report to the head nurse if any complications are noticed. Once every two or three days, all the stakeholders can also hold a meeting to discuss the patient.

Star Point 5: (Evaluation)

How will you report the outcomes of the trial?

The outcomes will be reported in the form of how well the patient recovered as well as how comfortable and mentally calm the patient was when leaving the premises. The time taken will be the main statistic of the outcomes.

What would be the next steps for the use of the change process information?

The next step would be to take the order and the methodology of the steps taken in this trial and to make them into a general form for all to implement.

NR451 EBP Process Change


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