NUR 699 EBP Section B: Problem Description - All ShadowHealthAssessments

NUR 699 EBP Section B: Problem Description

Evidence-Based Practice Proposal—Section B Problem Description

A nurse on a medical-surgical floor in a northeast hospital examined a study regarding the reason for falls within the hospital environment. Reviewing a computerized data retrieval system that recorded falls relating to call light usage in a 15-month study, she found a fall rate of approximately as high as 3.37 patients per every 1000 patients per day (Olrich, Kalman, & Nigolian, 2012). The main reasons given for using the call light were for patient care needs, such as, toileting, the need for pain control, and repositioning (Olrich, Kalman, & Nigolian, 2012). When call lights go off and they are not answered in a timely manner, the patient will often become inpatient and instead of waiting for help, they will get up on their own, which puts them at a high risk for injury or a fall (Mitchell, M. D., Lavenberg, J. G., Trotta, R., & Umscheid, C. A. 2014). NUR 699 EBP Section B: Problem Description.

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Fall prevention intervention, include an act of everyone getting involved, from the patient, family, nurses, other staff members and leadership that practice a safe fall prevention plan, which includes education and changes in attitudes that understand the importance to follow a fall prevention program that has been put in place (Goldsack, Bergey, Mascioli, & Cunningham, 2015). After incorporating hourly rounding into a fall prevention plan, it was determined that hourly rounding on patients did reduced falls significantly in the hospital setting (Goldsack et al., 2015) NUR 699 EBP Section B: Problem Description.

Along with the general public, a variety of stakeholders that include administrators, physicians, nurses, accrediting agencies, professional associations, student nurses, and legislative groups are concerned about patient safety and are responsible to make sure that care is delivered safely to the patient. These stakeholders are responsible for taking certain actions and making specific decisions that encourages safe care (ECRI Institute, 2014). A qualitative study was conducted that focused on the patient experiences during hospitalization, AIDET (Acknowledge, Introduce, Duration, Explanation, and Thank you), and hourly rounding. After the data was collected, transcribed and coded; the outcome findings presented a common theme that all residents who participated in this study felt that their emotional needs were met NUR 699 EBP Section B: Problem Description

PICO Question

On a medical-surgical hospital unit, how does implementing hourly nursing rounding, compared to no scheduled rounding, affect patient safety, within 6 months of implementing?

The Purpose and Objective of the Project

To educate nurses and other staff members that participating in a hourly rounding routine will decrease hospital falls in the hospital setting and will create a safer environment for the patient. This EBP has been proven to improve a safer outcome for patients and it also has increased patient satisfaction by decreasing anxiety from not having to have to use the call light as frequent and knowing that there would be someone there to check on them frequently during their stay in the hospital NUR 699 EBP Section B: Problem Description.

The project literature research will be measured through using the interactive online DISCERN, which allows the researcher to follow a brief questionnaire for assessing the quality of literature and other published articles online regarding EBP research. This online tool consists of 15 questions that includes a rating system for quality information on literature research (The DISCERN Instrument, 1997).

Reference

Allen, T., Rieck, T., & Salsbury, S., (2016). Patient Perceptions of an AIDET and Hourly Rounding Program in a Community Hospital: Results of a qualitative study. Patient Experience Journal. (3)1. Retrieved from http://pxjournal.org/cgi/viewcontent.cgi?article=1115&context=journal

ECRI Institute (2014). Patient safety, risk, and quality. Healthcare Risk Control. Retrieved from https://www.ecri.org/components/HRC/Pages/RiskQual4.aspx

Goldsack,J., Bergey, M., Mascioli, S., & Cunningham,J., (2015). Hourly rounding and patient falls: What factors boost success? Nursing Journal 2017, 45(2), 25-30. Retrieved from NUR 699 EBP Section B: Problem Description http://journals.lww.com/nursing/Fulltext/2015/02000/Hourly_rounding_and_patient_falls__What_factors.10.aspx

Mitchell, M. D., Lavenberg, J. G., Trotta, R., & Umscheid, C. A. (2014). Hourly Rounding to Improve Nursing Responsiveness: A systematic review. The Journal of Nursing Administration, 44(9), 462–472. http://doi.org/10.1097/NNA.0000000000000101

Olrich,T., Kalman, M., & Nigolian, C. (2012). Hourly Rounding: A replication study. MedSurg Nursing, 21(1), 23. Retrieved from http://search.proquest.com/openview/78664e73c9de01b6ca2b1580c98ca4b6/1?pq-origsite=gscholar&cbl=30764

The DISCERN Instrument (1997). DISCERN Online: quality criteria for consumer health information. British Library and the University of Oxford. Retrieved from http://www.discern.org.uk/discern_instrument.php#feedback NUR 699 EBP Section B: Problem Description

Evidence-Based Practice Proposal—Section B Problem Description

Today, maternal depression can be as common as one in every seven women during their third or fourth trimester’s. Postpartum depression (PPD) is a mental health condition that can start before delivery or right afterwards. If postpartum symptoms are not recognized, it can become very serious if it goes undiagnosed. It is important to educate the mother, significant other, and family members to recognized the symptoms of PPD so that symptoms may be detected early and seek help right away because PPD can have a very negative impact on mother, family and the baby. . (Fitelson, Baker, & Leight,, 2011).

It is important to help the mother differentiate the different types of postpartum depression through proper education. Many mothers may experience the baby blues, which is very common amongst most women and have been known to affect up to 75% of new mothers. The baby blues usually will have an onset within ten days following the delivery of their baby and will only last for approximately two weeks. Symptoms are mild and will consist of mild emotional disturbance such as feeling fatigue, anxiety and tearfulness. Next is postpartum depression, which is often, inaccurately diagnosed for the baby blues at first because the symptoms are very similar to the baby blues but with more intensity and the symptoms can last up to six months and may interfere with mother’s ability to care for herself, her baby and many other task throughout the day. Next we have postpartum psychosis which is a extreme mental health condition that needs intervention immediately. Symptoms found with postpartum psychosis are severe mood swings, mothers can experience delusions and hallucinations, anxiety, mood changes and suicidal ideation to hurt themselves or homicidal ideation towards their baby and other children. (Fitelson, Baker, & Leight, 2011).

According to Zauderer, there has been several studies showing that bringing awareness about postpartum depression through education and parenting classes has helped unprepared expecting moms and new mothers learn about unusual emotions that they may feel, what to watch for regarding postpartum depression and resources that they can seek if needed. By educating new moms and family, the hope is to give them the knowledge they need to empower them to speak up for help when they recognize possible symptoms of postpartum depression to seek the help that is needed (2009). NUR 699 EBP Section B: Problem Description

Along with the general public, a variety of stakeholders that include administrators, physicians, nurses, accrediting agencies, professional associations, student nurses, specialized Obstetricians, Pediatricians, APNs, Mental Health and Social Service. Legislative groups are concerned about patient safety and are responsible to make sure that care is delivered safely to the patient. These stakeholders are responsible for taking certain actions and making specific decisions that encourages safe care (ECRI Institute, 2014). Much of the research and studies presented in the articles were empirical studies, systematic reviews and meta-analyses that were published between the years of 2009-2016.

PICO Question

Does postpartum education (I) during the third and fourth trimester (T) reduce the risk of postpartum depression (O) in mothers (P) compared to those who receive no form of education on postpartum depression (C). NUR 699 EBP Section B: Problem Description

The Purpose and Objective of the Project

To research data and provide data that there is evidence-base practice showing that there is a benefit to providing new moms and families education on postpartum depression compared to new mothers who do not receive any form of education on postpartum depression. Will education help decrease the risk of postpartum depression because the mother and family have been taught to recognize the symptoms in advance so that they may seek help as needed.

Reference

Ertel, K. A., Rich-Edwards, J. W., & Koenen, K. C. (2011). Maternal Depression in the United States: Nationally Representative Rates and Risks. Journal of Women’s Health, 20(11), 1609–1617. http://doi.org/10.1089/jwh.2010.2657

Field T (2017) Postpartum Depression Effects, Risk Factors and Interventions: A Review

3: 122. doi:10.4172/2572-0791.1000122

Fitelson, E., Kim, S., Baker, A. S., & Leight, K. (2011). Treatment of postpartum depression: clinical, psychological and pharmacological options. International Journal of Women’s Health, 3, 1–14. http://doi.org/10.2147/IJWH.S6938

Kettunen P, Koistinen E, Hintikka J (2014). Is postpartum depression a homogenous disorder: time of onset, severity, symptoms and hopelessness in relation to the course of depression Is postpartum depression a homogenous disorder: Time of onset, severity, symptoms and hopelessness in relation to the course of depression. BMC Pregnancy Childbirth 14:1-18.

Warfa N, Harper M, Nicolais G, Bhui, K (2014). Adult attachment style as a risk factor for maternal postnatal depression: a systematic review. Retrieved from Adult attachment style as a risk factor for maternal postnatal depression: A systematic review. BMC Psychol 2: 56. Zauderer, C. (2009). Postpartum Depression: How Childbirth Educators Can Help Break the Silence. The Journal of Perinatal Education, 18(2), 23–31. http://doi.org/10.1624/105812409X426305 NUR 699 EBP Section B: Problem Description