Clinical Practice Project (CPP) Research: Module 3

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Clinical Practice Project (CPP) Research: Module 3

 

Assignment Objectives:

·      Extend academic experience into areas of nursing practice interest, working with new ideas, issues, organizations, and individuals.

·      Demonstrate the ability to think and act critically and creatively about nursing practice issues.

·      Develop analytical and ethical leadership skills necessary to address and help solve these issues.

·      Utilize evidence based research and demonstrate proficiency in written and communication skills.

 

Assignment Instructions:

This week you are going to respond to the last questions that will help you complete your project, discuss EBP and further research, identify stakeholders and resources. Lastly, you will give an overall update of your project.

 

Last week you answered the following questions:

1.    What are the scope, duration, and history of the problem?

2.    What data is available to describe the problem?

3.    What are the implications of the problem?

4.    How does/will your selected organization support your topic?

 

This week you should be able to answer the following questions:

1.    What are the gaps in the existing data?

2.    What types of additional research might be useful?

3.    Who are your stakeholders?

4.    What are you needed resources?

 

In the template below you will answer the last several questions above. Your answers should be based on supporting evidence. You may need to review the information from your EBP course. Be attentive to the instructions and remember you are professional nurses; writing and thought processes should be indicative of scholarly writing.

 

To complete this assignment type in the boxes below, the boxes will expand as you type. Be sure to save your document frequently. Points will be deducted for incomplete work, APA citation and reference formatting, spelling/grammar errors, and lack of scholarly writing. All content must be in your own words; however citations and references are required. At this point in your academic program you should be using minimal direct quotes. A good rule of thumb is one direct quote per page.

 

This assignment is worth 30 points…be sure your work reflects 30 points.

 

Make certain to refer to the rubric while completing this assignment.

 

You can cut and paste (with edits from last week) your information from Module 2’s assignment into the spaces below.


Change the FONT to red to highlight your revisions from the module two template.

 

Student Name

Date:

Marie Ott

03/06/2018

Project Topic:

 

QSEN Competency: (example, Patient-centered Care)

Smoking cessation resource handout

Patient-centered Care

 

QSEN Definition: Define your QSEN Competency in your own words (paraphrase) using the QSEN.org web site>competencies>graduate KSAS, (example: for competency Patient-Centered Care the definition on the web site is Recognize the patient or designee as the source of control and full partner in providing compassionate and coordinated care based on respect for patient’s preferences, values, and needs—take this information then write your definition in your own words (paraphrasing, remember to cite the QSEN site).

Patient –centered care requires provision of empathetic and systematic care along with an invitation for the client to take ownership in his/her care by respecting and accommodating their beliefs, wishes and desires. (QSEN Institute, 2014).

 

List two Knowledge/Skills/Attitudes (KSAs)- use two each (Knowledge/skills/attitudes) from the QSEN.org web site which are listed under your chosen competency that you think will help you to meet your selected competency. Then write your KSAS in your own words (paraphrasing/editing related to your specific project—remember to cite the QSEN site).

Knowledge

Skills

Attitudes

KSAS: Analyze reasons for common barriers to active involvement of patients and families in their own health care processes.

 

My KSAS: Discover barriers that patients may have that keep them from being involved in their own health care needs; such as their reasons for continuing to smoke cigarettes even though they know it is damaging their health.

 

KSAS: Analyze multiple dimensions of patient centered care: information, communication,

and education.

 

My KSAS: Investigate multiple facets of patient centered care in regards to making a plan to quit smoking: provision of smoking cessation information and education, tips and tricks to becoming smoke free.

 

(QSEN Institute, 2014)

 

KSAS: Elicit patient values, preferences and expressed needs as part of clinical interview, diagnosis, implementation of care plan and evaluation of care.

 

My KSAS: Interview patients to learn their values, needs and preferences to provide them with a care plan that will fit them and their lifestyle.

 

KSAS: Provide patient-centered care with sensitivity, empathy and respect for the diversity of human experience

 

My KSAS: Be conscious of patients feelings and their emotional needs in regards to  smoking cessation.

 

(QSEN Institute, 2014)

 

 

KSAS: Respect patient preferences for degree of active engagement in care process

 

My KSAS: Be understanding when patients are apathetic or unwilling to do the work that is required to quit smoking.

 

 

KSAS: Value seeing health care situations ‘through patients’ eyes’

 

My KSAS: Understand and respect patients own situations by trying to put myself in their position and life circumstance.

(QSEN Institute, 2014)

 

 

Discuss Health Care Organization (this is not the facility/organization where you are implementing your project, may be a nursing organization, or any organization which sets standards, conducts research, or publishes evidence based literature in relation to your topic) that will help support your project. Discussion should include the mission/values of the organization (in your own words). Provide citations and references (no direct quotes).

American Lung Association mission & vision is to save lives by improving lung health and preventing lung disease by creating a world free of lung disease.

(Stop Smoking, n.d.).

The American Lung Association works diligently to try and eradicate all lung diseases. They focus especially on smoking education and cessation. They are heavily involved in research, offering several grants and funding for research projects. They offer free online education, support groups such as Freedom From Smoking® (FFS) program which is a program for adults who are ready to quit smoking. They have a Lung Helpline that is staffed by respiratory therapists and certified tobacco treatment specialists (American Lung Association, n.d.).

 

 

 

Global Objective: the purpose of a global objective is to provide a vision for your overall project-what are you developing and implementing-what is your expected impact on patient outcome?  It should be broadly stated-in one sentence. (Do Not Use Any Abbreviations)

At the completion of this project I will have created a patient education handout for nurses to give to patients who show and interest in quitting smoking. The handout will be designed to assist in education of the health benefits of smoking cessation along with a list of free resources provided by Medicare, Medicaid, private insurances and The American Lung Association.

 

Project Objectives: Now your global objective should be broken down into more focused steps. Be sure your Project Objectives support your Global Objective! Write 4 Project Objectives…objectives should start with an action verb! (Do Not Use Any Abbreviations)

Research current literature about smoking cessation options.

 

Review and evaluate results of research.

 

Develop a teaching resource tool and review it with all unit nursing staff to educate them on the implementation of the project.

 

Create a list of resources and a form with benefits of being smoke free and give to all patients who smoke and are interested in quitting.

 

Possible Steps to Assist Me in Completing My Project: List at least 4 steps in your project

(Do Not Use Any Abbreviations)

Week I hope to accomplish by:

Provide hopeful completion date

Review the Centers for Disease Control, American Lung Association and American Cancer Society’s web sites for current references and resources on complications of smoking and smoking cessation programs.

 

Meet with unit manager and seek approval on project implementation

Create smoking cessation handout to give to patients

 

Distribute handouts with list of resources and health education pertaining to smoking cessation.

 

 

Complete by 3/4/18

 

 

 

Complete by 2/26/18

Complete by 3/15/18

 

Complete by 03/16/18

 

Direct patient engagement: Describe in a one or two sentences how you will provide direct engagement in your project and how this will impact patient outcomes.  Be specific.

I will engage directly with patients during assessment interview with questions about their desire to quit smoking, giving encouragement to quit, and providing resources to help them quit. I believe it will have a great impact on patients as they will have many resources at their fingertips which will make it easier for them to take the first step to being smoke free.

 

What are the scope, duration and history of the problem? Write 3-4 paragraphs related to your selected problem. Provide supportive detail. Give supportive data from facility, community, state, or national data to explain why you feel this is an issue. Your paragraphs should be professionally written, single spaced with APA formatted citations and references.

It is estimated that 40 million Americans are addicted to nicotine through smoking cigarettes and kills almost 500,000 smokers and non-smokers yearly in America. If smoking persists at the current rate among youth, 5.6 million of today’s Americans 18 years and younger are projected to die prematurely from a smoking-related illness (odh.ohio.gov, n.d.).

Cigarette smoking became popular in the late 1800s, with the invention of the cigarette rolling machine. It popularity during WWII when soldiers received packs of cigarettes in their ration packs leaving thousands addicted and up until recently cigarettes were specifically marketed to the youth of America. (History of Tobacco in the World – Tobacco Timeline, n.d.).

 

Who does your problem affect? Write 1-2 paragraphs discussing individuals, communities, etc. that are affected by this problem. Remember to include all parties that are affected. Your paragraph(s) should be professionally written, single spaced with APA formatted citations and references (there is a reference textbox at the end of this form. Use it for your references).

According to Ohio.gov, Stark County, Ohio is home to approximately 781 smokers under the age of 18 and 4881 smokers 18 and over. Of those, as many as 16.9% of Ohio births were to mothers who smoked. Smoking during pregnancy increases the likelihood of any of miscarriage, premature delivery, stillbirth, and low birth weight (Reproductive Health, 2017). The low-income population has a higher rate of smoking than those with higher incomes as well as people who suffer with mental and/or substance abuse disorders (Smoking & Tobacco Use 2017).

 It is estimated that nearly nine out of ten smokers had their first cigarette by the age of 18. Each day in the U.S., more than 3,200 youth ages 18 and younger smoke their first cigarette, and an estimated 2,100 youth and young adults who have been occasional smokers become daily cigarette smokers (Teens & Tobacco, n.d.).

 

Your selected organization: (remember this is not the facility/organization where you are implementing your

project, may be a nursing organization, or any organization which sets standards, conducts research, or publishes evidence based literature in relation to your topic)   How does this organization support your topic? Some things to consider when researching…Have they advocated? Do they support financially? Are they involved in research to support your topic? Do they use it as part of accreditation requirements?  Write 1-2 paragraphs. Your paragraph(s) should be professionally written, single spaced with APA formatted citations and references (there is a reference textbox at the end of this form. Use it for your references.)

The American Lung Association supports measures to eliminate tobacco use and exposure to secondhand smoke, to promote access to tobacco cessation treatments, and to prevent youth from starting to use tobacco in the first place. They advocate for regulation of all tobacco products, such as creating smoke free laws and policies. They fight for increased funding for tobacco prevention, education and cessation programs, as well as fighting for insurance companies to provide coverage for tobacco cessation treatments (American Lung Association, n.d.).

The American Lung Association has worked to advance medical and scientific research for lung diseases while putting emphasis on the health effects of smoking and finding ways to help people quit. Financial support has been provided by The American Lung Association for more than 1,500 projects, with more than $79 million dedicated to research funding (American Lung Association, n.d.).

 

What are the implications of the problem? What will happen or not happen if the problem is not resolved? Write 1-2 paragraphs discussing the implications with supporting details (information from your selected organization and/or health care facility would be important here). Your paragraph(s) should be professionally written, single spaced with APA formatted citations and references (there is a reference textbox at the end of this form. Use it for your references).

Every year in the U.S., more than 480,000 people die from tobacco use and exposure to secondhand smoke, making it the leading cause of preventable death in this country (Health Effects, n.d.). More people die from lung cancer than any other type of cancer. Cigarette smoking is the number one risk factor for lung cancer and is responsible for 87 percent of lung cancer deaths (Health Effects, n.d.). Smoking causes at least a dozen cancers, including liver, colorectal, colon, cervix, stomach and pancreatic cancer (10 of The Worst Diseases Smoking Causes, n.d.).

 

About 80 percent of all Chronic Obstructive Pulmonary Disease (COPD) is caused by cigarette smoking and is the third leading cause of death in the United States. (Health Effects, n.d.). Smoking harms almost every organ in the body, including the heart. Heart damage is related to less blood and oxygen flow caused by blockages and narrowing of the arteries. Because smoking affects the arteries, it can cause stroke, which is the fourth leading cause of death in the United States.  Cigarette smokers are more likely to develop type 2 diabetes than a non-smoker and increases the risk of complications once diagnosed with diabetes, such as heart and kidney disease, poor blood flow to legs and feet (which leads to infections and possible amputation), blindness and nerve damage. Eyes are damaged by smoking, resulting in vision loss and macular degeneration.

 

 

Plan of Action: In the space below outline your plan of Action. Remember your plan of action should assist you in meeting your global and project objectives; therefore, they must be linked. Your plan of action can include your project objectives from week one or they may have changed. In either case, list your project objectives (that you have already completed and planned steps) and provide a one paragraph (per objective) explanation supporting this action. You should have a minimum of four action steps (no more than five), this means you should have a minimum of four paragraphs and no more than five.  Your actions steps should have supportive details (references). Your paragraphs should be professionally written, single spaced with APA formatted citations and references (there is a reference textbox at the end of this form. Use it for your references).

 

Review current literature, and websites of associations for references and resources on complications of smoking and smoking cessation programs. I have searched for and reviewed literature from The American Lung Association and the Ohio Department of Health. Evidence to support my project was found and incorporated into the smoking cessation handout.

 

Meet with unit manager and seek approval on project implementation.

I met with my Unit Nurse Manager and got approval to distribute handouts to patients for the purpose of smoking cessation. She was very encouraging of my project and mission and suggested that if it goes well we could look into making it a permanent part of our assessment and discharge process.

.

Create and distribute handout with list of resources and health education pertaining to smoking.

I have begun the process of making a patient handout, decided on the format and started to incorporate evidence-based literature and images.

 

Create smoking cessation handout and review with nursing staff. Once the handout is finished I plan to use it to educate the nursing staff.

 

Proposed Solution: Write 2-3 sentences describing your proposed solution to your problem. Remember that your solution should be linked to your global and project objectives. Your proposed solutions should have supportive details (references), professionally written, single spaced with APA formatted citations and references (there is a reference textbox at the end of this form. Use it for your references).

 

My solution involves research of current literature offered through The American Lung Association and other evidence based literature from organizations and peer-reviewed journals.  Data will be gathered and a handout will be created that provides education about the health risks of smoking, including the damage that is done to not only to the lungs, but the entire body as well. The handout will be given to patients who are open to the idea quitting smoking.  It will be designed to encourage them to quit smoking by providing facts about how their lungs can heal at any age, no matter how long they have been smoking (Health Effects, n.d.). I will include a list of free smoking cessation resources that are available to them. Once the handout is created I will meet with nursing staff on my unit and educate them on the use of the handout.

 

 

What are the gaps in the existing data? Write 1-2 paragraphs related to your selected problem. Your paragraph(s) should be professionally written, single spaced with APA formatted citations and references (there is a reference textbox at the end of this form. Use it for your references). You may need to look back at your Evidence-based Nursing Textbook for some help.

***

 

What types of additional research might be useful? Write 1-2 paragraphs discussing additional research that describes individuals, communities, other issues etc. that are affected by your topic. Your paragraph(s) should be professionally written, single spaced with APA formatted citations and references (there is a reference textbox at the end of this form. Use it for your references). Be sure the research relates to your problem.

***

 

Identify Stakeholders: Write 1-2 paragraphs identifying the key stakeholders to your problem with supporting examples. Individuals or groups that are directly or indirectly influenced by the problem or solution are the stakeholders. In some cases the stakeholders are obvious; however in some cases stakeholders can be developed. Your paragraph(s) should be professionally written, single spaced with APA formatted citations and references (there is a reference textbox at the end of this form. Use it for your references).

All people are stakeholders but especially:

 

 The poor In the U.S., people living below the poverty level and people having lower levels of educational attainment have higher rates of cigarette smoking than the general population.  Among people having only a GED certificate, smoking prevalence is more than 40%, the highest of any SES group. (Smoking & Tobacco Use, 2017).

 

The mentally ill36.5% of adults with any mental illness reported current use* of tobacco in 2013 compared to 25.3% of adults with no mental illness (Smoking & Tobacco Use, 2017).

 

 Pregnant women and their babies. Women who smoke during pregnancy are more likely than other women to have a miscarriage.

Smoking can cause problems with the placenta—the source of the baby’s food and oxygen during pregnancy. For example, the placenta can separate from the womb too early, causing bleeding, which is dangerous to the mother and baby.

Smoking during pregnancy can cause a baby to be born too early(https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pretermbirth.htm) or to have low birth weight—making it more likely the baby will be sick and have to stay in the hospital longer. A few babies may even die.

Smoking during and after pregnancy is a risk factor of Sudden Infant Death Syndrome (SIDS)(https://www.cdc.gov/sids/index.htm). SIDS is an infant death for which a cause of the death cannot be found.

Babies born to women who smoke are more likely to have certain birth defects, like a cleft lip or cleft palate(https://www.cdc.gov/ncbddd/birthdefects/cleftlip.html).

(Reproductive Health, 2017).

 People who are exposed to second hand smoke- Secondhand smoke exposure is higher among people living below the poverty level and those with less education. Low SES populations are more likely to suffer the harmful health consequences of exposure to secondhand smoke. Blue-collar workers are more likely to be exposed to secondhand smoke at work than white-collar workers (Reproductive Health, 2017).

  Medicaid/Medicare/ state/federal health care costs. (Hall & Doran, 2016).

 

 

List needed resources: A successful change agent will identify all available resources. Resources include money, time, connections, and those resources which help you to meet your objectives. You may list your resources, but explain why the resource is needed and how these resources will help support your change.

Literature from organizations that conduct research and publish information, such as the American Lung Association and peer-reviewed journals. These organizations provide facts that are needed for me to put together a smoking cessation resource handout to give to patients.

 

 Nursing staff and management cooperation.  I will need the nursing staff and management to be on board with this project or it will not work.

 

 

Project Update: Write 2-3 paragraphs discussing your project progress. Include in your discussion how your QSEN competency and KSAs are supporting your project and if your global and project objectives are close to being met. You do not need citations or references; however this should be professionally written.

 

So far, I have been able to find a lot of smoking cessation information and education, tips and tricks by searching in peer-reviewed journals and professional organization websites. I have also finished creating the smoking cessation resource handout and will be making copies tomorrow to show my nurse manager for final approval to go live.

 

Work with Mentor this week: In 2-3 paragraphs discuss activities with your Mentor (Preceptor) for this project so far. Include positive and negative thoughts, what was helpful and what information or activity would have been helpful. No citations or references are needed; it should still be professionally written.

Working with my preceptor this week has been a positive experience. He is very encouraging and brings excitement to this project. He has many ideas and understands how to apply them. Over the course of this project we have discussed the problem, who it affects and what information should be included in the patient smoking cessation handout and nursing education.

 

This week in particular we identified evidence-based journal articles and literature from The American Lung Association, analyzed the content and decided how to educate the unit nurses and where I would conduct the education for the project.

For instance, he informed me that our facility offers employee smoking cessation classes, which includes several nurses from my unit, and suggested presenting my project at the next class to get feedback from peers before I go live with patients.

 

     

Log update:  Begin typing documentation on your Clinical Log, provide here a brief explanation of time you have completed this week-you will need to document on your clinical log in addition to the templates, this update does NOT take the place of completing your required log. This is a non-graded item.

 

Do not include: Orientation off the Unit, Observation, writing or researching papers/assignments, Lunch    or Break time.

 

Do include: A total over the course includes a Minimum of 3 hours with preceptor, Maximum of 6 hours on research of topic, a minimum of 1-2 hours in direct patient engagement and the remainder- 10-11 hours in implementation of your project, Total of 21 true hours.

Type

Date

Time

(ex: 1:00pm-2:00pm)

Total Time Spent

(ex: 1 hour)

Description

(describe specifically what you did in one or two sentences)

 

Preceptor

(a minimum of 3 hours is required for the course)

 

03/05/18

1:00pm-

2:30pm

1.5 hours

 

 

Research on topic

(a maximum of 6 hours is allowed for the course)

 

03/05/18

7:00pm-8:00pm

1 hour

 

Direct Patient Engagement Time

(a minimum of 1-2 hours)

03/08/18

03/09/18

 

 

 

 

Implementation

(the remainder should be spent in implementation)

 

03/05/18

 

03/06/18

 

03/07/18

8:00pm-10:30pm

11:00am-1:30pm

12:00pm-1:00pm

2.5 hours

 

2.5 hours

 

1 hour

Development of handout, printing

Educated nursing staff during unit meeting.

Educated 4 nurses not at meeting.

Total Time spent this week (by the end of the course you should spend at least 21 true hours)

Total for this week =8.5 hours

 

Continue to work on your log and submit your completed log in the week 5 submission area

 

References (double-space and use correct APA format)

This should include references from Week 1 and 2

 

 

10 of the Worst Diseases Smoking Causes. (n.d.). Retrieved February 28, 2018, from http://www.lung.org/dev/our-initiatives/tobacco/reports-resources/sotc/by-the-numbers/10-worst-diseases-smoking-causes.html

American Lung Association ®. (n.d.). Retrieved February 27, 2018, from http://www.lung.org/

Centers for Disease Control and Prevention. (2017, April 26). Retrieved March 06, 2018, from https://www.cdc.gov/

Hall, W., Doran, C. (2016). How much can the USA reduce health care costs by reducing smoking?

 

           PLoS Med 13(5):1002021. doi:10.1371/journal.pmed.1002021

 

Health Effects. (n.d.). Retrieved February 27, 2018, from http://www.lung.org/stop-smoking/smoking-facts/health-effects.html

History of Tobacco in the World – Tobacco Timeline. (n.d.). Retrieved March 04, 2018, from https://tobaccofreelife.org/tobacco/tobacco-history/

QSEN Institute. (2014). Graduate QSEN competencies. Retrieved from http://qsen.org/competencies/graduate-ksas/

Reproductive Health. (2017, September 29). Retrieved March 07, 2018, from https://www.cdc.gov/reproductivehealth/maternalinfanthealth/tobaccousepregnancy/index.htm

Rosvall, A., RN, MNSc, & Carlson, E., PhD, RN, MNEd. (2017). Registered nurses’ perception of self efficacy and competence in smoking cessation after participating in a web based learning activity. Journal of Clinical Nursing, 26(23-24), 4777-4785. doi:10.1111/JOCN.13831

Seitz, C. M., Shiplo, S., Filippini, T., Kabir, Z., Lennon, J.L., & Fowler, D. (2017). The reading level of government and voluntary health organization smoking cessation websites: A descriptive analysis. American Journal of Health Education, 48(6), 392-399. Doi:10.1080/19325037.2017.1358122

Shelley, D., Goldfeld, K.S., Park, H., Mola, A., Sullivan, R., & Austrian, J. (2017). System changes to implement the Joint Commission Tobacco Treatment (TOB) performance measures for improving the treatment of tobacco use among hospitalized patients. The Joint Commission Journal On Quality and Patient Safety, 43234-240. Doi:10.1016/j.jcjq.2017.02.008

Smoking & Tobacco Use. (2017, March 10). Retrieved March 07, 2018, from https://www.cdc.gov/tobacco/disparities/mental-illness-substance-use/index.htm

Stop Smoking. (n.d.). Retrieved February 25, 2018, from http://www.lung.org/stop-smoking/

Teens and Tobacco. (n.d.). Retrieved March 03, 2018, from https://www.odh.ohio.gov/en/odhprograms/eh/quitnow/Tobacco/Initiation/YouthPrevention

West, R., Raw, M., McNeill, A, Stead, L., Aveyard, P., Bitton, J., & Borland, R. (2015). Health-care interventions to promote and assist tobacco cessation: A review of efficacy, effectiveness and affordability for use in national guideline development. Addiction, 110(9), 1388-1403. Doi: 10.1111/add.12998  

Zeng, E. Y., Heffner, J. L., Copeland, W. K., Mull, K. E., & Bricker, J. B. (2016). Get with the program: Adherence to a smart phone app for smoking cessation. Addictive Behaviors, 63, 120-124. doi:10.1016/J.ADDBEH.2016.07.007