NRS 490 Professional And Practicum Reflective Journal 2021/2022

NRS 490 Professional And Practicum Reflective Journal 2021/2022 Week 1 Objectives: 1-Identify problems, issues, and opportunities to improve patient care, patient outcomes, and organizational procedures within a clinical practice setting. 2-Examine a health care clinical problem or an organization issue and its implications to nursing practice. 3-Determine evidence‐based solutions that address patient care or clinical practice quality problems or issues. 4-Analyze health care clinical problems and organizational issues utilizing the PICO(T) process 5-Demonstrate values consistent with the role of a nursing professional through fundamental knowledge and advanced skills. My first week in this class has been overwhelming. Adjusting to a new class environment, with different expectations is very difficult. My mentor and I could not meet as expected to discuss the research proposal, just talked over the phone, which was still helpful but did not ease my anxiety. I want to decide my research proposal this week, so I can start gathering my resources, and review the requirements for the next weeks I plan to stay healthy and focused by taking time during the week to exercise and sleep well. My family and boyfriend are very supportive, and I know they will help me through this. This week, I was asked to work on my ISP, which will help me to stay organized and see the big picture for his class. This week, I will also be learning about different research databases and which sources of information to utilize during project development implementation. Each database has specific search features that help to focus on the area of study in practice. Running Head: BENCHMARK-PROFESSIONAL AND PRACTICUM REFLECTIVE JOURNAL Week 2 -Health Disparity Objectives: 1-Identify problems, issues, and opportunities to improve patient care, patient outcomes, and organizational procedures within a clinical practice setting. 2-Examine a health care clinical problem or an organization issue and its implications to nursing practice. 3-Determine evidence‐based solutions that address patient care or clinical practice quality problems or issues. 4-Analyze health care clinical problems and organizational issues utilizing the PICO(T) process 5-Demonstrate values consistent with the role of a nursing professional through fundamental knowledge and advanced skills. This week, Stefanie and I were able to meet to discuss our project topic. Stefanie works in an academic hospital in San Diego, University of California in San Diego-Medical Center, a public, non-profit institution, where new therapies and practices are supported through a variety of high payers’ stakeholders. I work in a private hospital, struggling financially, serving mostly low-income people and Medicaid population. The population seeking healthcare services is very different between hospitals. In my hospital, most of the patients are homeless or low-income patients, requiring not only treatment for acute/chronic illness but also shelter, transportation for clinics/appointments or pharmacies, and mental support post-discharge. Also, most individuals do not have adequate resources to follow a proper diet, health regiment or even exercise routines. For that reason, patient is at higher risk for having health problems like obesity, substance abuse, and intentional and unintentional injury. These patients most of the time are incapable of following discharging instructions properly due to mental issues or financial issues. Nevertheless, Stefanie works in a public hospital, where mostly of the patients are insured, Running Head: BENCHMARK-PROFESSIONAL AND PRACTICUM REFLECTIVE JOURNAL monetarily stable, and have emotional support of family/friends or other healthcare providers. The organizations are different in terms of organizational culture and population served, and therefore identifying common barriers to discuss in this project was the first step. Health disparities emerge when certain groups of people enjoy better health services and access to health than others. It has to do with the health and death rate of certain groups of less fortunate individuals. Disparities are mainly brought about by inequalities in people’s levels of income across the entire population. Nurses need to be non-bias when taking care of patients with different socioeconomic level, background, and economic level, and try everyone the same way. This week Stephanie and I have met and talked about narrowing down project ideas of interest. By the end of the week, we decided that Central-Line Associated Bloodstream Infection (CLABSI) was a common issue in both hospitals. Central line infection is an extremely important issue in hospitals today, due to the possibility of bacteria placed directly into the blood stream and causing a life-threatening situation, such as septic shock or even death. Reducing CLABSI would address Healthy People 2020 goals, which is reduce by half the CLABSI incidents in hospitals. CLABSI results in thousands of deaths each year and several million dollars in added costs to the U.S. health care system. The Center of Disease Control created a set of guidelines for the prevention of CLABSI, and despite the successful adaptation of these guidelines worldwide, CLABSI continues to be a problem in most clinical facilities across the world.Many states now require public reporting of hospital CLABSI rates and the Center for Medicare and Medicaid services instituted financial penalties for hospital reimbursement for CLABSI, which I believe will be one of the reasons why our hospitals would support the implementation of our project. My mentor and I shared experiences on the CLABSI issue in our Running Head: BENCHMARK-PROFESSIONAL AND PRACTICUM REFLECTIVE JOURNAL hospital as well policies/protocols taking place to prevent CLABSI, and the topic intrigued my curiosity and intent to become more involved in the subject. Week 3-New Practice Approach Objectives: 1-Evaluate evidence‐based research and other appropriate resources to inform the development of a change plan. 2-Identify strategies for logistical implementation of proposed solutions. 3-Demonstrate the ability to evaluate levels of evidence into a concise format. 4-Integrate evidence, clinical judgment, interprofessional perspectives, and patient preferences in planning, implementing, and evaluating outcomes of care. This week my mentor and I met and decided on our PICOT statement. My mentor works in the Intensive Care Unit (ICU), where most of CLABSIs incidents occur due to the critical level of care of the patients. I work in the medical-surgical/cardiac floor. In both units, despite having a written policy in place for CLABSI prevention CLABSIs incidents are still prevalent. After discussing the pros and cons of topic choice, my mentor and I decided to focus our project on CLABSI prevention through compliance with the set of guidelines created by the Center of Disease Control guidelines to prevent CLABSI. My PICOT statement is such: In adults in the Intensive Care Unit (ICU) (P) will compliance with all elements of the Central Line (CL) bundle (I) versus only partial compliance with the CL bundle (C) decrease the rate of CLABSIs (O) over 12 weeks (T)? To compile enough evidence for my research I was required to find six peer reviewed articles related to my topic and discuss one strength and one weakness of each, and discuss reasons why the article may or may not provide enough evidence for my practice change. Steffanie and I not only