Part 1: Based on how you will evaluate your EBP project, which independent and dependent variables do you need to collect? Why?
Part 2: Not all EBP projects result in statistically significant results. Define clinical significance, and explain the difference between clinical and statistical significance. How can you use clinical significance to support positive outcomes in your project?
Running head: HEALTH AND MEDICAL
The impact of nurse shortage on the quality of care in the primary healthcare facilities
Jessica Mock
Grand Canyon University- NRS 490
June 2, 2019
1
HEALTH AND MEDICAL
2
Introduction
There is need for adequate nursing personnel in every hospital to ensure sufficient health
services to the patients. Nurses are part of the health specialists with necessary knowledge and
competency to handle clients and patients at family level, clinics and even at the hospitals.
Health centers with adequate nursing personnel provide effective healthcare attention to their
patients effectively. The proposed topic will focus on the effect of the nurse shortage on the
hospital patient care a situation in the context US primary healthcare facilities.
Discussion
In the recent past, there has been a shortage of nursing personnel in the US primary
healthcare centers which has adversely affected the patients. Nurses provides variety of
healthcare services to the hospital-based patients in their midst (Veenema et al., 2017). Firstly, it
is the responsibility of the nursing units to ensure medication administration to the patients. For
example, a nurse in charge of an admitted patient will ensure such a patient takes the medication
as per the doctor prescriptions following the exact dose and timeline. The nursing personnel
ensure patient can move freely within the restricted zone in the healthcare in case their admission
allows such movements. Thirdly, it is the role of a nurse to ensure patient takes their meals on
time within the hospital so that they are able to remain healthy. Similarly, in the nursing units, a
Registered Nurse will be part of the leading team which helps in delegating duties regarding
patient care in the hospital premises (Smolowitz et al., 2015). In other words, Registered Nurses
guides in giving directives to the Licensed Practical Nurses to provide health attention to the
patients in the hospital set up. For example, under the supervision of the Registered Nurses,
Licensed Practical Nurses provide healthcare to the mentally challenged patients in the US health
centers (DePasquale & Stange, 2016).
HEALTH AND MEDICAL
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On the other hand, the witnessed decline in the number of the nursing personnel in the
US primary healthcare facilities threatens the lives of the patients (Snavely, 2016). One of the
main impacts as a result of the shortage of the nurse is lack of workforce to administer patient
medication appropriately. For example, a health canter with nearly fifty admitted patients and
only one or two nurses will compromise their attention to some patient regarding medicine
administration (Dellefield et al., 2015). On the same note, patients who require to movement
either outside or within the hospital may find it hard due to shortage of nurses. Hospitalized
patients will also encounter difficulties during meals time such as breakfast, lunch and dinner
due to lack of sufficient directives from a professional nurse (Bragadóttir, Kalisch &
Tryggvadóttir, 2017). Such a situation may end up worsening the patient health status due to lack
of meals considering their nature of medication. Still, patients in the primary health facilities will
not receive professional health attention due to lack of supervision and monitoring by the
Registered Nurse personnel.
There is a couple of significance linked to addressing the issue of the nursing shortage in
the US primary health facilities. Firstly, adequate nursing personnel will ensure different patients
under their care; take their mediation as per the doctor prescriptions. Secondly, patient including
them restricted in a wheelchair will get a chance to move freely with the hospital via the help of
a nurse or licensed practical nurse. It is worth addressing the problem to ensure only professional
and competent Registered Nurses offer directives in the US health facilities to the patients within
the premises (Staggs, et al, 2016). The health department ought to increase the number of the
nurses including Registered Nurses and Licensed Practical Nurses to curb the limitation of the
nursing personnel in the US healthcare facilities. In so doing, the hospital based patients will
receive sufficient health attention which aligns with their hospital charges.
HEALTH AND MEDICAL
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References
Bragadóttir, H., Kalisch, B. J., & Tryggvadóttir, G. B. (2017). Correlates and predictors of
missed nursing care in hospitals. Journal of clinical nursing, 26(11-12), 1524-1534.
Dellefield, M. E., Castle, N. G., McGilton, K. S., & Spilsbury, K. (2015). The relationship
between registered nurses and nursing home quality: An integrative review (2008-2014).
Nursing economic$, 33(2), 95-108.
DePasquale, C., & Stange, K. (2016). Labor supply effects of occupational regulation: Evidence
from the nurse licensure compact (No. w22344). National Bureau of Economic Research.
Smolowitz, J., Speakman, E., Wojnar, D., Whelan, E. M., Ulrich, S., Hayes, C., & Wood, L.
(2015). Role of the registered nurse in primary health care: Meeting health care needs in
the 21st century. Nursing Outlook, 63(2), 130-136.
Snavely, T. M. (2016). A brief economic analysis of the looming nursing shortage in the United
States. Nursing Economics, 34(2), 98-101.
Staggs, V. S., Olds, D. M., Cramer, E., & Shorr, R. I. (2017). Nursing skill mix, nurse staffing
level, and physical restraint use in US hospitals: a longitudinal study. Journal of general
internal medicine, 32(1), 35-41.
Veenema, T. G., Griffin, A., Gable, A. R., MacIntyre, L., Simons, R. N., Couig, M. P., … &
Larson, E. (2016). Nurses as leaders in disaster preparedness and response—A call to
action. Journal of Nursing Scholarship, 48(2), 187-200.
Running head: PICOT STATEMENT
1
PICOT Statement
Jessica Mock
Grand Canyon University- NRS 490
June 9, 2019
PICOT STATEMENT
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Identification of Clinical Problem
Every health care system involves a primary objective, which is to promote the quality of
life of patients. Every patient expects the best quality of life whenever they go to the hospitals,
which satisfies them with the services offered. However, various issues confront health care
currently, which include long waiting times and delayed diagnosis, ADHD, or any other
dysfunction found in children. The principal aim of the investigation is to carry out an evaluation
and analysis of the child and adult growth Actions plans for Autism Spectrum Disorder to deal
with the issue of long waiting times and delayed diagnosis, ADHD or any other dysfunction.
Evidence-Based Solution
Rutherford et al. (2016) explain as to why professionals offer delayed assessment of
diagnosis of autism spectrum disorders (ASD). The investigation translates the evidence into the
practical application via actions plans for services of ASD. The authors presented an action plan
for child and adult diagnostic group to enhance the quality and efficacy of the process of
diagnostic evaluation. Zheng et al. (2016) point out that various problems need to be covered like
early identification, atypical and typical development, increased government investment,
professional development, and enhanced execution of available regulations. According to
Richards and Vostanis (2004), it is crucial for services of transitional mental health for
individuals with 16 years to 19-years in health district, as comprehended by specialists from
social, mental health, non-statutory services, and education. Besides, Chakroborty et al. (2014)
support the idea that early intervention in certain learning disability (SpLD) leads to the
enhanced outcome and controls comorbidity. This way, the authors give a comparison of
pathways for taking care of children with mental retardation and SpLD before reaching a tertiary
care center (Temper et al., 2017).
PICOT STATEMENT
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Nursing Intervention, Patient Care, Health Care Agency, & Nursing Practice
For early intervention in specific learning disability (SpLD), Rutherford et al. (2016)
claim that it is crucial to utilize Goldberg’s pathways and MINI-KID for comorbidity to care
instrument. It is necessary to enhance physical exercise for youth with intellectual disabilities, as
it is one of the intervention’s description. Frey et al. (2017) executed an intervention for
initiating, increasing, or maintaining physical activity as well as reporting the efficacy of the
intervention. However, nurses will describe to the patients how to perform various exercises for
individuals with intellectual disabilities. Through the above responses, nurses possess the
potential of influencing positive patient outcomes that could enhance the quality of life of
patients while enhancing the quality of care offered to patients. Besides, nurses should carry out
an evaluation and analysis of adult and child growth Actions plans for Autism Spectrum Defect
to deal with the issue of long waiting times, and delayed diagnosis, ADHD or any other
dysfunction. The objective of nurses is to assist patients to stay a healthy life through
maintaining or strengthening their health activities. Through the above interventions, nurses will
be in a position to execute evidence-based practices in their clinical setting to enhance patients’
health.
PICOT Statement
Can children with mental disabilities have better health outcomes in adulthood if they are
managed upon early detection vs. later detection? Does early intervention truly impact health or
does mental disability have the same result despite the starting point of interventional therapies?
(P) Population: Children with mental disabilities like delayed speech or functions, autism,
ADHD, or any other type of dysfunction in children. Some children might be diagnosed early
and get treatment, and others may not be diagnosed until late childhood or into school age stages.
PICOT STATEMENT
4
Intervention: Depends on diagnosis, level of health disparity, and stage. Enhance physical
exercise for youths with intellectual disabilities; transitional services of mental health for
individuals with 16-years to 19-years in health district; an action plan for child and adult
diagnostic group to enhance the quality and efficacy of the process of diagnostic evaluation.
(C) Comparison: Children who receive early diagnosis and intervention vs. children that go
longer with no diagnosis or delayed diagnosis and delayed responses.
(O) Outcome: Improvement in physical exercise among youths with intellectual disabilities and
medication adherence as well as prevention of long waiting times, and delayed diagnosis.
(T) Time: The outcome of the study will be assessed weekly for eight weeks.
References
Chakraborty, S., Sagar Kommu, J. V., Srinath, S., Seshadri, S. P., & Girimaji, S. C. (2014). A
Comparative Study of Pathways to Care for Children with Specific Learning Disability
and Mental Retardation. Indian Journal of Psychological Medicine, 36(1), 27. Retrieved
from
PICOT STATEMENT
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https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&
db=edb&AN=94741876&site=eds-live&scope=site
Frey, G. C., Temple, V. A., & Stanish, H. I. (2017). Interventions to promote physical activity
for youth with intellectual disabilities. Salud Pública de México, 59(4), 437. Retrieved
from
https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&
db=edb&AN=124408973&site=eds-live&scope=site
Richards, M., & Vostanis, P. (2004). Interprofessional perspectives on transitional mental health
services for young people aged 16 – 19 years. Journal of Interprofessional Care, 18(2),
115–128. https://doi-org.lopes.idm.oclc.org/10.1080/13561820410001686882
Rutherford, M., McKenzie, K., Forsyth, K., McCartney, D., O, H. A., McClure, I., & Irvine, L.
(2016). Why are they waiting? Exploring professional perspectives and developing
solutions to delayed diagnosis of autism spectrum disorder in adults and
children. Research in Autism Spectrum Disorders, 31, 53–65. https://doiorg.lopes.idm.oclc.org/10.1016/j.rasd.2016.06.004
Temple, V. A., Frey, G. C., & Stanish, H. I. (2017). Interventions to promote physical activity
for adults with intellectual disabilities. Salud Pública de México, 59(4), 446. Retrieved
from
https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&
db=edb&AN=124408974&site=eds-live&scope=site
Zheng, Y., Maude, S. P., Brotherson, M. J., & Merritts, A. (2016). Early Childhood Intervention
in China from the Families’ Perspective. International Journal of Disability,
PICOT STATEMENT
Development & Education, 63(4), 431–449. https://doiorg.lopes.idm.oclc.org/10.1080/1034912X.2015.1124988
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