Nursing Evidence-Based Practice - Assignment Example

DNP Program Outcome #1: Nursing Practice Knowledge - To generate and disseminate nursing practice knowledge to stimulate research and improve clinical outcomes. Courses that I have taken this past year to meet this outcome are the following: NUR 695b: DNP Forum; NUR 705: Philosophy of Nursing Science and Practice; NUR 646 Healthcare Informatics: Theory & Practice; NUR 650 Theories of Leadership & Organizational Management; and NUR 652: Methods of Scholarly Inquiry Writing reflective essays has helped to realize a lot of things that would have been taken for granted otherwise. Looking back at my first year at the University of Arizona I can say that this academic year has significantly impacted my professional outlook, broadened my understanding of the profession and expanded perception of the health care system and processes within and around it. Prior to joining the school, I had an intuitive understanding that advancing nursing practice and securing better patient outcomes as impossible without development of research and proper theoretical basis. At the end of the academic year I have not only come to understand such research better, but was also able to see a ‘broader’ picture of how this research fits into the healthcare system, how it can impact the national economy and the national healthcare system. Additionally, comparative analysis of the US healthcare system has given me some very valuable information as determining the strengths and weaknesses of the national health care system. After reading and reflecting on Philosophy of Nursing Science and Practice, I was capable of merging my own ideologies of nursing science and practice with existent theories in nursing and other sciences. I looked at social & political factors, analyzed influential people in my environment, analyzed significant events as well as analyzed my cognitive style. This has helped me to realize my ontological and philosophical view, single out my pattern of knowing, Metaparadigmic statement, and current research interest, which I presented for my final in Philosophy of Nursing Science and Practice and uploaded in Foliotek. I’ve also had the opportunity to work with such methods of scholarly inquiry as qualitative and qualitative research, evidence-base practice, and mixed methods. In Methods for Scholarly Inquiry, I learned to review, critique, and evaluate research based on the guidelines and tools presented in The John Hopkins Nursing Evidenced-Based Practice Rating Scale (Newhouse, 2007). Through this process I was capable of connecting evidence-based research to practice and validate the usefulness of the literature to my practice inquiry topic. I will continue to search for literature to narrow my research topic of interest. Overall, this year has been a successful introduction into advanced practice nursing and has greatly facilitated my research skills. I expect to continue practicing research, methods of use, and writing in order to develop my practice question together with my advisory committee. References: Newhouse, R.P. et al (2007). Johns Hopkins Nursing evidence-based practice: models and guidelines. Indianapolis: Sigma Theta Tau International. DNP Program Outcome #2: Improve health outcomes through scientifically-based advanced practice within a chosen specialty. Courses that I have taken this past year to meet this outcome are the following: NUR 650 Theories of Leadership & Organizational; NUR 646 Healthcare Informatics: Theory & Practice; NURS 501 Advanced Physiology & Pathophysiology; and NURS 644 Molecular & Clinical Genetics/Genomics Within the second set of DNP Program Outcomes I took the courses that took me professionally both “above” the common nursing practice and “below” it at the same time. They took me “above” because I practiced a leadership, management and an administrative role – all of which lie “above” the functions of a regular nurse. I learned various organizational theories and subsequently applied them in practice within the St. Francis Memorial Hospital – the organization I am currently working at. I can define the knowledge and skills obtained as a result of this exercise as ‘empowering’ because now I understand better how to initiate a change within an organization and what factors should be considered while implementing it. In my ‘test scenario’ for example, I practiced reducing the problem of bad debt within my hospital. While I realize this problem is a lot more complex in practice, this exercise has given me confidence to deal with a similar situation in reality. This year has also taken me “below” the regular nursing routine. During my second semester I took Advanced Physiology & Pathophysiology and Molecular & Clinical Genetics/Genomics. In this class we reviewed the core principles of genetics and learned to apply them in our nursing practice. Additionally, these specific courses included group work that included case studies and assignments that required reviewing literature in evidence-based practice as well as subsequent presentation of the findings to the class via a PowerPoint presentation. In turn, the presentation culminated into a scholarly paper. Molecular & Clinical Genetics/Genomics gave me the opportunity to work collaboratively in my group to complete a presentation about polymorphism on specific genes that can cause alteration in pain and helps to manage such pain. For instance, we have found that polymorphic genes are responsible for metabolizing drugs as the COMT gene and UGT gene play a significant part in the patient’s response to opioids. Finally, I took the Healthcare Informatics course that gave me the tools that are critical for administrative purposes. Specifically, I have practiced processing healthcare data; examined taxonomies, vocabularies and coding systems relevant to healthcare. Analysis of such information and healthcare data is critical for supporting administration, practice, education and research within a health care institution. DNP Program Outcome #3: Engage in and lead collaborative practice teams. Courses that I have taken this past year to meet this outcome are the following: NUR 695b: DNP Forum; NUR 705: Philosophy of Nursing Science and Practice; NUR 646 Healthcare Informatics: Theory & Practice; NUR 650 Theories of Leadership & Organizational Management; NURS 501 Advanced Physiology & Pathophysiology; and NURS 644 Molecular & Clinical Genetics/Genomics. Looking back at the course syllabi I can clearly see that team work and collaboration played a significant role in the DNP program. It would be logical to assume that a special emphasis was laid on group work not only because of its educational efficiency, but also because collaboration is the key to successful practice. In the last academic year I took several courses that revolved heavily around team work and collaboration. I was assigned the functions of both a group facilitator and a rank-and-file group member. Group work was attained through discussing group topics, organizing and constructing timelines for the group, providing summary of the group input for the class, and taking responsibility for the completed work of the group. I was a leader in one group discussion and I had to lead the discussion by posting the questions, taking the group discussion in a direction, and providing the summary and conclusion of topics to the professor. Working in a group was a very insightful experience for me personally because it nearly always gave me an alternative viewpoint, even in situations that appeared to have no alternative. The most striking example of group work was when I worked on a health care policy memo and received a couple of comments from my fellow classmates who suggested several improvements. After analyzing their suggestions, I decided to incorporate the suggested changes and my memo became even more convincing. Prior to receiving those comments I thought my project was ideal. Summing up, I can see that group work requires one to be open to alternative opinions – it’s a skill that should be worked on and developed. It’s a skills that’s not easy to hone, however when you are open to new suggestions, your group becomes extremely helpful. Another example of collaborative practice was during Advanced Physiology & Pathophysiology which required me to do a large group project on fibromyalgia with an introduction, relevant physiology and pathophysiology, relevance of the pathophysiology to advanced nursing practice and description of how the original research studies examined the problem. The task required me to restate question/purpose, methods of the research, results of the studies, and the study conclusions. A summary with references was also required. A 30 page final paper and a PowerPoint presentation subsequently followed – a result of close group interaction and joint work. DNP Program Outcome #4: Influence clinical practice transformation and policy initiatives. Possible evidence: Exemplars of work done in NURS646 and 642; and CV. NUR 646 Healthcare Informatics: Theory & Practice; NURS 642 Health Policy & Economics; and NUR 650 Theories of Leadership & Organizational Management The section dealing with policy initiatives appeared to be the most interesting because it opened nursing from a totally different prospective. Previously, nursing was mostly about nurse-patient interaction for me; I have never realized the possibility of transforming clinical practices and even initiating a change in legislation. These courses made me realize that a legal initiative can also be coming from health care professionals and not only politicians. Understanding of these mechanisms have achieved an objective that is two-fold: on the other hand they have dramatically increased the value of theory and research (because it’s the results of research that make a reason for initiating a change) while on the other hand they have increased the role and importance of the nursing practice within a health care system. For example, my courses in Health Policy & Economics and NUR 650 Theories of Leadership & Organizational Management had a particular interest in change and policy initiatives. Particularly, in Theories of Leadership & Organizational Management I learned about the change theory and learned to apply it to complex health systems. This helped me to develop potential solutions for problems identified through case study analysis. Using change theory to influence practice has provided me with the ability to synthesize theoretical perspectives to develop a guiding framework for organizational analysis and innovation. I did this by creating a proposal through use of a leadership grid and applied it to organization challenges to initiate change of practice within this organization. In health policy, I developed a health policy memo and requested that Senate Bill No 1387 (2012) “Abortion, ultrasound imaging” is supported in the Senate by the state Senator. Making an ultrasound scan a mandatory procedure before the abortion can decrease the number of abortions in the long run. It will provide a woman with the information she will need to make an informed choice, plus it will give her time to think it over. The Bill doesn’t prohibit abortions as such, so all women would still be getting a choice; however it would give them a realistic picture of the processes that are occurring in their bodies and will give them more information. A woman will be able to weigh all the pros and cons and then take a final decision. I believe making such an informed decision will help her avert the feeling of self-betrayal (Knight, 2007). References: Knight, K. (2007, May 7). The doctor: Why I’m so passionately against abortion. Mail Online. Retrieved from http://www.dailymail.co.uk/femail/article-452818/The-doctor-Why-Im-passionately-abortion.html Read More