The DNP comprehensive assessment provides learners the opportunity to demonstrate their achievement of core and specialty DNP competencies. It is also an appraisal of learners’ ability to integrate and synthesize knowledge within the context of their scholarly and practice interests and their readiness to complete the DPI project. The two-part comprehensive assessment includes evaluation of work completed throughout the program and a final synthesis and self-reflection demonstrating achievement of programmatic outcomes. In Part One of the assessment, learners were required to collect and review coursework deliverables and practice immersion hours completed in the program thus far. In Part Two, learners are required to synthesize and reflect on their learning and prioritize work for their DPI project.General Requirements:Use the following information to ensure successful completion of the assignment: Doctoral learners are required to use APA style for their writing assignments. The APA Style Guide is located in the Student Success Center. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance. Directions:To complete Part Two of the DNP comprehensive assessment:Use the information collected in the competency matrix from Comprehensive Assessment Part One to address the following prompts as directed. Each response should be 500-750 words. Your responses should concisely demonstrate synthesis of knowledge gained in the program and the relevant application of knowledge into your practice. You are further required to cite relevant and specific evidence from your coursework to demonstrate your achievement of these programmatic outcomes and corresponding competencies. Review the rubric for this assignment prior to responding to the prompts. Your responses should specifically address the competencies included on the rubric.Outcome 1:A DNP must integrate and apply appropriate nursing and science-based theories to evaluate and analyze health and health care phenomena and develop and implement innovative practice approaches.In what ways have you integrated and applied nursing and science-based theories in your coursework and practice during your DNP course of study? How will you apply what you have learned to your DPI project? Cite specific evidence from your coursework and practice immersion hours in your response.Outcome 2: A DNP must provide the leadership to develop and implement health care and organizational policy based on regulatory and other external and internal factors and drive effective change within organizations.In what ways have you demonstrated leadership in the development and implementation of policy or policy change and contributed to quality improvement during your DNP studies? How will you apply what you have learned to your DPI project? Cite specific evidence from your coursework and practice immersion hours in your response.Outcome 3: A DNP must be able use information systems to mine, analyze, and apply data for the purpose of improving information systems as well as patient and organizational outcomes.In what ways have you successfully applied data analysis to the improvement of information systems, patient care, and organizational outcomes during your course of study? How will you apply what you have learned to your DPI project? Cite specific evidence from your coursework and practice immersion hours in your response.Outcome 4: A DNP must be able to articulate and implement strategy and to advocate for the ethical and equitable deployment of care delivery models for improvement of individual, aggregate, and population health management. In what ways have you articulated, deployed, or advocated for such strategies in your coursework and practice immersion hours? How will you apply what you have learned to your DPI project? Cite specific evidence from your coursework and practice immersion hours in your response.Outcome 5: A DNP must be able to evaluate practice outcomes and use research, national benchmarks, and other relevant findings from evidence-based practice to design, direct, utilize, and evaluate quality improvement methodologies that lead to improved patient-centered care. In what ways have you evaluated practice outcomes and participated in quality improvement initiatives in your coursework and practice immersion hours? How will you apply what you have learned to your DPI project? Cite specific evidence from your coursework and practice immersion hours in your response.Self-Reflection:Based on an evaluation of your learning to date, assess your readiness for undertaking your DPI project. How has what you learned in your coursework and practice immersion hours and application of learning in your practice informed your approach to your project? What do you need to revise in your 10 Strategic Points document and/or your Draft Prospectus to successfully implement your project? Reflect on your progress to this point and outline the steps necessary to successfully complete your DPI Project Proposal for the Institutional Review Board (IRB) in DNP-955.DNP-840
Comprehensive Assessment Part One: Competency Matrix
For each competency below, provide no more than one or two sentences to explain how you met the competency through selected coursework. You will expand upon these achievements in the
“Comprehensive Assessment Part Two: Outcomes and Reflection” assignment. Note: You are not required to complete every column for each competency. Select evidence from coursework
relevant to that competency to discuss. Minimally, you should have one column complete for each competency.
Programmatic Coursework: Summary of Competency Achievement
Section One: Programmatic Assessments
DNP Program
Reflective Journals
1.2: Apply sciencebased theories and
concepts to
determine the
nature and
significance of
health and health
care delivery
Case Reports
10 Strategic Points
DPI Project
I participated in
The use of
the Georgia State Nightingale theory
ICU related
of environment,
The Nightingale
Newman’s theory
theory of
of nursing, and
King’s theory of
nursing helped in
theory of
Committee where reaching conclusion nursing, and
I influenced policy on the use of hourly King’s theory of
makers to review
rounding for
nursing helped
policies in
reducing patient
in shaping this
treatment of ICU falls. The concept
related delirium
of increasing
from the use of
engagement also
© 2015. Grand Canyon University. All Rights Reserved.
The spread of
infectious disease is
usually rapid. This
The science and
makes it important
efficiency of
that all individuals are
technological tools and
insured, which assures
applications led to
public health leaders
recommending that
that individuals are
technology be
screened and checked
increased in the
frequently to diagnose
healthcare sector.
and prevent any
potential disease
This review
knowledge in the
effect of noise on
tranquility and
peace of mind. It
removal of noisy
patient falls
Course Assignments with
Practice Immersion
(DNP-805 Through DNP840 – Include Assignment
DNP-810 – Case Report
Application of Quality
and Safety Concepts: The
concept of the spread of
infectious diseases with
rapid pace led to the
proposition that the
government should strive
to ensure that all citizens
are insured. This ensures
that they are screened
and checked from time to
time to prevent the
possibility of an
infectious disease
interventions to
helped to shape
using psychosocial research.
According to peer
reviewed research
interventions are
more effective
1.3: Employ
theories and
concepts to
describe the
actions and
strategies to
enhance, alleviate,
and ameliorate
health and health
care delivery
phenomena as
2.1: Employ
principles of
business, finance,
economics, and
health policy to
develop and
Through research, the
use of psychosocial
and psychotherapeutic
interventions was
deemed more effective
in the treatment of
ICU related delirium.
Errors are a major
challenge in the
healthcare sector of
nearly every country.
Countries with fewer
errors tend to have
stable and reliable
medical systems, with
high efficiency in
improving healthcare
outcomes as compared
to those with excessive
errors. Working on
reducing errors is
ultimately important.
In the
development of
the prospectus,
the use of Nursing
theories helped to
emphasize the
need for and
importance of
using hourly
rounding. Hourly
rounding has
many benefits and
not only patient
falls prevention.
The use of
psychosocial and
psychotherapy has
been found to be more
effective in addressing
ICU related delirium,
which makes it a cost-
The case reports
indicate that it is much
cost effective to insure
all individuals, which
will make public health
monitoring and health
control easy. Reducing
From research,
using psychosocial
when dealing with
ICU related
delirium is more
effective, thus cost
Enhancing patientcaregiver
interaction has
been found to have
many beneficial
effects in the care
giving process.
The prospectus
utilizes the
concept of
and the benefits
of socialization
in the
enhancement of
which works to
improve health
outcomes in the
DNP 835 – Quality and
Sustainability: Analysis
and Application Part
One: The report
The effect of
presented new findings
noise was used to
that the use of antibiotic
illustrate how
impregnated catheters
bed alarms
helped in reducing the
startle patients
catheter related
and can cause
infections. This is a new
finding in recent
which can lead to
research, a major step
more falls.
forward in reducing
infections when using
Using hourly
rounding has been
found to be
efficient, cost
effective, and
applicable in many
According to
findings by
Shorr et al.
(2013), the use
of bed alarms is
cost intensive
but has few
The cost
effectiveness of
bed alarms was
investigated. It
was established
that bed alarms
led to high costs
DNP 820 – Literature
review: The review
identified that the costs
associated with patient
falls are high, coupled
with personal patient
affiliated problems, and
effective plans for
and/or system-wide
practice initiatives
that will improve
the quality of
health care
effective strategy, as
compared to using
methods exclusively.
errors in the
healthcare system also
helped to reduce
treatment costs.
2.2: Demonstrate
influence, and
advocacy in the
development and
implementation of
institutional, local,
state, federal,
health policy.
The journals
influenced the
healthcare sector to
consider using hourly
rounding to prevent
patient falls and
increase patientcaregiver interaction,
which will ultimately
increase care quality.
Policy needs to change
regarding health
insurance. Policies also
need to change
regarding hospital
operations and
procedures to reduce
hospital errors and
2.4: Provide
leadership in the
evaluation and
resolution of
policy, ethical, and
legal issues within
The reflective journals
advocated for the use
of psychotherapy in
addressing ICU
related delirium, the
use of hourly rounding
Changing the policies
relating to hospital
errors will greatly
reduce legal issues,
improve adherence to
ethics, and improve
areas of healthcare
as compared to the
preventing obesity use of bed alarms.
in the society is
more cost effective
than dealing with
the dangers
caused by obesity.
I participated in
the Georgia State
where I helped in
conclusions to
build two health
facilities, one
around Fulton
County and
another around
Cobb county to
reduce the travel
distance of the
patients from
these areas to a
health facility.
I helped in
spearheading the
Kick Obesity out
of America
(KOOAS), where
benefits in
as compared to
reducing patient hourly rounding
falls. The use of of nurses.
hourly rounding
is expected to
reduce hospital
costs, when in
comparison to
bed alarms.
It is imperative
that the
The strategic points
advocate for the
sector uses
change of policy in
hourly rounding
the local, state, and
of nurses since
federal levels of
it is backed by
leadership to
ensure that bed
alarms are not
theories. It also
used, but rather
replaced with
patienthourly rounding as
a strategy to
prevent patient
which ensures
that quality care
is delivered.
The findings
from the
literature review
were used to
direct that bed
alarms be
eliminated in the
entire healthcare
sector to prevent
patient falls.
Ethically, the use of
bed alarms does
not have many
benefits when
compared with the
use of hourly
The efficacy and
effectiveness of
bed alarms was
analyzed and led
regarding how
patient falls are
prevented and
reduced needs
to change. This
needs quick interventions
to reduce its rate.
Reducing patient falls
will greatly help to
reduce costs associated
with medical care
nationally. It is thus
imperative that the
proposed intervention be
adopted countrywide.
DNP 835 – Quality and
Sustainability: Analysis
and Application Part
One: The paper
highlighted that the use
of antibiotic impregnated
catheters helped in
reducing the Catheter
related infections.
Implementing this policy
change would help in
reducing catheter related
infections, which are a
major challenge in many
health institutions.
DNP-810 – Case Report
Application of Quality
and Safety Concepts:
This case prevents real
public health risks and
problems. It can be used
health care
3.1: Demonstrate
the conceptual
ability and
technical skills to
develop and
execute an
evaluation plan
involving data
extraction from
systems and
as opposing to bed
alarms in preventing
patient falls, and the
need to address
obesity through
community exercising.
The ProQuest,
Cochrane, and Google
Scholar libraries
helped a lot in
reaching peer
reviewed journals for
new information on
healthcare delivery. It
shaped the student’s
ability to defend
oneself when
proposing changes to
medical care.
care quality. Ensuring
that all individuals are
insured improves
societal ethics.
The research studies
used helped to reveal
great information and
data on how errors
lead to the deaths of
about 98,000 US
citizens annually. Lack
of insurance also leads
to grave risks on the
society when infectious
diseases strike.
I influenced
individuals to
exercising, and
proper dieting
Implementation of
exercising and
among children
was emphasized
as the best
strategy in dealing
with obesity.
rounding. It is
more ethical to
increase caregiverpatient interaction
than using alarms
in the healthcare
is because the
methods – use
of bed alarms,
flashlight, and
equipment are
not effective in
patient falls.
Extraction of
data for the
Data from journal
articles helped in
guiding the
conclusions. This is professional
The use of dieting
especially the
databases for
and exercising as
research by Shorr
obesity prevention
eta al. (2013),
work, which
strategies was
which found that
directed how
influenced by
bed alarms do not
the prospectus
recent findings in
have any significant will be done to
scholarly peereffects in
offer a new
reviewed articles.
preventing patient
research, one
falls, despite high
that will help
costs and human
resource inputs.
change in
that bed alarms
do not enhance
and effectiveness
in the healthcare
This literature
review entailed
use of peer
reviewed journal
articles to elicit
information and
data relating to
the question. It
helped to
formulate the
contents of the
literature review.
to rectify policies in the
health insurance sector to
ensure that the risks are
DNP 820: 10 strategic
points: the selected topic
and information
presented in the ten
points is from peerreviewed data. It offers
current knowledge and
findings from these
journals to influence
policy change to use
hourly rounding in
preventing patient falls..
3.2: Evaluate
current consumer
health information
sources for
timeliness, and
The sources used
spanned from 2000 –
the digital era. It thus
contains technological
and current research
findings on how best
to deliver healthcare.
The information is
from IOM, and
scholarly journal
articles published in
the last decade, which
are in line with current
hot topics in
Buckley (2016)
wrote the
information that
advocated for the
use of
interventions in
the treatment of
ICU related
delirium. The
information is
thus current and
relevant in
change of policy
to ensure there is
improved patient
The sources used
were current,
spanning not more
than ten years ago,
which indicates
that it has current
shaped by
which help to
increase quality
The prospectus
mainly uses
articles. These
articles are also
current since
they span not
more than a
decade ago. As
such, the
sources and
used is current,
considerate with
the current
DNP 830: Data analysis
and statistics: This paper
contains an evaluation of
the major sources for use
in the research. The
articles are evaluated for
The paper had
relevancy, their
sources ranging
effectiveness, the
not more than
accuracy of the data and
one decade ago.
statistics methods used
The sources were
and such factors.
thus appropriate
and accurate.
Assessing patient
improvement over
time helped in finding
out that
interventions were not
as influential in
treating ICU related
The outcome of
the use of
The effectiveness of
error reduction
interventions in
mechanisms will be
treating ICU
evaluated through the
related delirium
reduction in patient
will be assessed
deaths, reduction in
patient complains,
observation of the
increased healing and
average treatment
improved patient
periods as
compared with
insurance for all can
be evaluated through
Patients’ views
assessment of the
and opinions will
reduction in healthcare
also be relevant in
costs over time.
evaluating the
ICU related delirium
is mainly prevalent
4.1: Analyze
among elderly
individuals. Treating
such patients
environmental, and
efficiently helps in
other appropriate
reducing dependents
scientific data
significantly, which is
related to
cost effective. Treating
them ensures that they
aggregate, and
remain productive and
population health.
socially beneficial in
the society.
ICU related
Delirium mainly
affects the elderly.
On the other
hand, obesity
mainly affects
children, but it is
also widely spread
among adults.
exercising and
dieting can help in
preventing obesity
among children as
well adults.
3.4: Design, select,
use, and evaluate
programs that
monitor outcomes
of care, care
systems, and
consumer use of
health care
Lack of insurance
mainly affects the lowincome earners. They
usually remain
unemployed because
they cannot afford
paying the insurance
premiums. Errors
affect all types of
patients in the
healthcare setting.
The outcome of the
use of hourly
rounding of nurses
will depend on the
evaluation of the
change in patient
falls, change in
patient satisfaction,
and how the
effectiveness of
nursing care had
Patient falls is a
core concern in
healthcare. it
affects all frail
patients, but
specifically more
prevalent among
the elderly. Patient
suffering from
paralysis can also
be at increased
risks for falls.
The impact of
the change in
policy from
using bed
alarms to using
hourly rounding
or nurses will be
evaluated by
assessing the
changes in
patient falls,
errors and
accidents, and
efficiency of
Patient falls
mainly affects
the elderly
individuals in
However, it can
affect any sick
individual once
admitted in
The efficacy and
effectiveness of
bed alarms as
well as hourly
rounding of
nurses was done
observation and
recording of core
elements during
the study, which
helped in data
analysis and
opinions were
also used.
DNP 830 – Quantitative
Method Inquiry: This
paper presents statistical
findings from evaluation
of data. Statistics is a
good way of evaluating
the outcome of healthcare
interventions. It gives
finer details and relations
between data.
DNP-810 – Case Report
Application of Quality
The review
and Safety Concepts: The
found that the
insurance problem is
problem was
prevalent among the lowprevalent among income earners.
aged individuals, Implementing the
65 years and
proposed solutions will
above. However, help in reducing public
it cuts across the health risks and
occurrence of infectious
affecting any sick pandemics.
and frail patient.
4.4: Advocate for
social justice,
equity, and ethical
policies within all
health care arenas.
5.2: Design and
that evaluate
outcomes of
practice, practice
patterns, and
systems of care for
aggregate, and
populations against
Justice in the
treatment of ICU
related delirium needs
to follow evidence
based and current
research findings
guidelines. Using old
techniques in the
cause of poor care,
which is injustice to
the patient.
interventions in
Insuring all individuals
managing ICU
in the society boosts
related delirium
societal justice and
restores justice to
equity. Reducing
the patient
errors in the hospital
because they can
setting restores justice
now get treatment
to the patients that
using current and
suffer the
more effective
consequences of errors
means. It boosts
and accidents.
equity and ethics
in the healthcare
The change of
policy from using
bed alarms to using
hourly rounding in
promoting quality
care and
preventing falls is a
core policy change.
It will foster justice
and equity in the
delivery of health
policies from
the use of bed
alarms to the
use of hourly
improves justice
in the
sector because it
ensures that all
patients are
visited and
checked every
after one hour.
It also boosts
equity and
ethics in the
care delivery
Evaluation of the
effectiveness of
psychotherapy was
reached after patient
review, mental exam
tests, and cognitive
ability tests, which
indicated whether
there was
improvement or not.
The evaluation of the
effectiveness of
reduction of errors
strategy can be done
by assessing the
reduction in errors
over a period, say
annually. Assessing the
effectiveness of
everyone’s health
insurance can be
assessed through
evaluation of the
Evaluation of the
outcomes of the
interventions will
be done using
statistics, which
will point out how
effective bed
alarms and hourly
rounding of nurses
are as means of
preventing patient
The evaluation
of the efficacy of
hourly rounding
will be done
with inferential
statistics. A
comparison of
the outcomes
from data
collected in the
bed alarms unit,
with that of the
hourly rounding
The efficacy of
using psychosocial
when handling
ICU related
delirium can be
evaluated using
statistics that
evaluate the
changes in
duration. The
efficacy of using
Social justice in
this review
entails avoiding
use of bed
alarms because
they disturb
other patients in
the ward.
The data used
indicated that
the continued use
of bed alarms as
a patient-falls
strategy does not
have benefits but
rather negative
effects on
patients and the
DNP 820 Implementation into
practice: Treatment for
Adults with ICU related
delirium: this report
indicates that although
the use of psychosocial
interventions had already
been researched and
proposed about a decade
ago, pharmacological
interventions remain the
main treatment approach
for ICU related delirium.
This is injustice,
unethical, and nonequitable for the
healthcare sector. there is
need to implement the
proposed better solution
of using psychosocial
DNP 830: Draft
prospectus: The
prospectus proposes the
use of inferential
statistics to determine
which of the two
interventions is more
effective in preventing
patient falls.
5.3: Design, direct,
and evaluate
methodologies to
promote safe,
timely, effective,
efficient, equitable,
and patientcentered care.
reduction in infectious
The use of both
pharmacological and
interventions was
deemed to be more
effective than using
interventions only. It
led to patient centered
and treatment that is
more effective.
The use of everyone’s
insurance and
reduction of errors in
the healthcare setting
are two policy changes
that are set to improve
healthcare quality and
patient satisfaction.
community-based falls.
interventions to
handle obesity can
be evaluated by
assessing the
number of obese
individuals over
five-ten years
from the onset of
the intervention to
know the changes.
interventions in
managing ICU
related delirium is
more beneficial
than using
approaches. It is
also beneficial to
use dieting
regulation and
exercising to
control obesity in
the community.
The use of hourly
rounding of
patients is more
beneficial to
caregiving because
it guarantees more
interaction and
enhancement of the
surrounding, which
fosters faster
unit will help in process.
directing which
strategy best fits
as a solution to
patient falls.
DNP 825 – Epidemiology:
Evaluation and
The increase of
Implementation Part
the patientTwo: This paper
ensures that
caregiver contact identifies that the use of
nurses can
and relationship theory of Change in
using hourly
themselves in
rounding guided community-based
shifts when
in its
interventions for the
visiting patients,
recommendation. prevention of Obesity can
which ensures
This is because
help in reducing obesity
that care
this enhances
in the country.
delivery is
care quality and Eradicating obesity in the
timely, safe, less
society is a great step
noisy, efficient
forward in offering
and equitable.
quality healthcare
outcomes to the society.
I, Julie Ann Childers, verify that I have completed 20 clock hours in association with the goals and objectives for this assignment. I have also tracked said practice in the Typhon
Student Tracking System for verification purposes and will be sure that all approvals are in place from my faculty and practice mentor.
Research Article Chart
Criteria and Defining
After reading the abstract
what do you expect to learn
from the article?
Article 1:
Article 2:
Interruptions and their effects
on the dynamics of the
nursing work
Organizational coordination and The quality of intensive care unit nurse
patient experiences of specialty handover related to end of life: a descriptive
care integration
comparative international study
Nurses’ perception about
interruptions during the
workflow and their
implications on the
professional practice
Successful coordination of
specialty care requires
understanding the perspectives
of patients, primary care
providers, and specialists—that
is, the specialty care “triad.”
This study used qualitative
methods to compare these
perspectives in an integrated
health care system, using
diabetes specialty care as an
© 2014. Grand Canyon University. All Rights Reserved.
Article 3:
Quality ICU end-of-life-care has been found
to be related to good communication.
Handover is one form of communication
that can be problematic due to lost or
omitted information. A first step in
improving care is to measure and describe it.
Introduction: Summarize
the following in paragraph
• What is the purpose of
the study?
• What is the scope of
the study?
• What is the rational for
the study?
• What is the hypothesis
or research question?
• What key concepts and
terms are noted?
• Is a review of the
literature provided?
Establish how interrupting
nurses in the workplace
affect their service delivery.
Comparing perspectives of the
“triad” in an integrated
healthcare system.
A school hospital in Sao
Paulo with 133 nurses over a
period of one year.
VA medical center, VA New
The interruptive processes
have repercussions on the
working dynamics, on the
caring process and on the
patient’s safety.
“In what situations, in what
form and at what frequency
do interruptions occur during
the care process? How do
nurses perceive their
implications for the work
Quality care for specialty
patients requires an
understanding of the
perspective of the patient,
primary care physician and the
specialist in charge.
Care coordination is the
deliberate organization of
patient care between 2 or more
participants (including the
patient) to account for each
other’s actions and facilitate the
appropriate delivery of health
care services.
© 2014. Grand Canyon University. All Rights Reserved.
Describe the quality of ICU nurse handover
related to end-of-life care and to compare
the practices of different ICUs in three
different countries.
7 ICU units in 3 different countries;
Australia (1), UK (3) and Israel (3) covering
157 handovers.
Despite technological changes, handover has
survived as an important formal process of
nursing communication. Yet, there is little
known about the quality of ICU nurse to
nurse handover communication, especially
associated with end-of-life care.
Practices of end-of-life-handover
communication vary greatly between units.
However, room for improvement exists in
all areas in all of the units studied.
Workflow; Time
management; Nursing staff;
Nursing process
Care coordination, qualitative
methods, referrals and specialty
Handover, End of life, Communication,
Nurse, Intensive care unit
Methods: Summarize the
following in paragraph
• What is the population
being sampled?
• What data collection
procedure is
• What other procedures
are described?
The article samples a medical
center for the care of 102
cities that belong to the
Regional Health Division of
Rio Preto (RHD 15). It has
708 beds and makes an
average of 89,025 monthly
appointments. The nursing
team is composed of 242
nurses, 565 nursing
technicians and 481 nursing
16 diabetic patients; 8 from an
Urban VA Medical center and 8
from a rural VA Medical
© 2014. Grand Canyon University. All Rights Reserved.
157 handovers that occurred in seven ICUs
in three countries; 45 UK, 46Australia and
66 Israel.
Focus groups
Results: Summarize the
following in paragraph
• What are the given
• How was data
55 (42%) of the nurses have
reported being interrupted
more than 13 times during
their work activities, and also
that this discontinuity is more
frequent during the
documentation process
Interviews ranged from 16 to 45
minutes. Participant
characteristics are shown in
Tables 1 and 2. Clinicians
represented 23 different VHA
facilities in 10 different
Veterans Integrated Service
© 2014. Grand Canyon University. All Rights Reserved.
The highest levels of handover quality were
in the areas of goals of care and pain
management while lowest levels were for
legal issues (proxy and advanced directives)
related to end of life. Significant differences
were found between countries and units in

Are the findings
supported by graphs
and charts?
What does the analysis
of data state?
(n=118, 91.5%), followed by
patient/family guidance
(n=58; 45%).
Networks (VISNs) across the
country. Six patients were from
the rural VAMC and 7 were
from the urban VAMC in VA
New England Healthcare
the total handover score (country: F (2,154)
= 25.97, p = < .001; unit: F (6,150) = 25.25. NO; Tabular representation of data dominates therein. YES NO; just tables. When interruptions by external stimuli occur, there is a concentration breakdown, raising the mental workload and leading to reduced performance. The instability related to the interruptions and associated with performing tasks can induce errors such as failures Clinicians required excellent coordination with each other, but clinicians’ work suffered from a lack of procedures and protocols to clarify roles and responsibilities related to the organization of specialty care, that is, “programming approaches” in organizational theory © 2014. Grand Canyon University. All Rights Reserved. The highest levels of handover quality were in the areas of goals of care and pain management while lowest levels were for legal issues to fill in documents that are relevant to the patient and to the team. Conclusion: Summarize in paragraph form. • What is the summary of the study? • What is the conclusion of the hypothesis? • What are the questions for future research? It has been proposed in this study the mapping of interruptive processes contributing to examine its implications on the context of professional practice. In the nurses’ opinion, they are constant, recurrent and occur more frequently during the documentation process (n=118, 91.5%) and during patient/family guidance (n=58; 45%), affecting the care dynamics, and patient’s safety. They are caused mainly by telephone ringing (n=114; 87%) and problem solving in the unit (n=107; 81.7%). We identified 4 overarching themes common to PCPs and endocrinologists and 2 overarching themes among patients with respect to what was most important to successful specialty diabetes care coordination. © 2014. Grand Canyon University. All Rights Reserved. The quality of communication related to end of life at handover in the ICU was found to be universally low in legal issues surrounding end-of-life (such as proxy status and advanced directives), moderate to high in pain management but varied in all other content areas related to end of life. Room for improvement exists in all areas in all of the units studied. However the total handover score was higher when quality of care might be deemed at greater risk (if the nurses did not know the patient or the patient was expected to die), indicating that nurses were exercising some form of discretionary decision making around handover communication. There is a global need for improvement of handover practices in all areas related to end-of-life. A deeper look at the findings of this research refers to how professionals are dealing with interruptions. Although the nursing work is considered to be interruptive, consideration should be given to what frequency it would be acceptable and would cause less harm to the patient/family and to the professional staff. In integrated care delivery models, specialists and primary care teams work under the same organizational roof to serve the same set of patients. This structure provides opportunities for VHA and ACOs to improve specialty care coordination by building approaches that serve all 3 members of the “triad.” N/A N/A N/A 19 references References • What are the total number of references used in the study? • List two of the references used. Sorensen EE, Brahe L. Interruptions in clinical nursing practice. J Clin Nurs. 2014;23 (9-10):1274-82. [ Links ] . Kalisch BJ, Aebersold M. Interruptions and multitasking in nursing care. Jt Comm J Qual Patient 36 references 41 references Parchman, M. L., Noel, P. H., & Lee, S. (2005). Primary care attributes, health care system hassles, and chronic illness. Medical Care, 43(11), 1123– 1129. World Health Organization, 2014. Definition of palliative care, In: Young, G. J., Charns, M. P., Daley, J., Forbes, M. G., Henderson, W., & Khuri, S. F. (1997). Best practices for managing surgical services: The © 2014. Grand Canyon University. All Rights Reserved. Scovell, S., 2010. Role of the nurse-to-nurse handover in patient care. Nurs. Standard 24 (20), 35–39 Safety. 2010;36 (3):126-32. [ Links ] Criteria and Defining Characteristics Abstract After reading the abstract what do you expect to learn from the article? role of coordination. Health Care Management Review, 22(4), 72–81 Article 4: Article 5: Describing clinical faculty experiences with patient safety and quality care in acute care settings: A mixed methods study The quality and safety culture in general hospitals: patients', physicians' and nurses' evaluation of its effect on patient satisfaction Improving Communication with Primary Care Physicians at the Time of Hospital Discharge A major safety initiative in acute care settings across the United States has been to transform hospitals into High Reliability Organizations. The initiative requires developing cognitive awareness, best practices, and infrastructure so that all healthcare providers including clinical faculty are accountable to deliver quality and safe care. Exploring the disparities between patients’ and health care workers’ perception of the quality and safety culture and to explore the relationship between patient perceptions, and engagement in, and satisfaction with their care and treatment. Communication with primary care physicians (PCPs) at the time of a patient's hospital discharge is important to safely transition care to home. The goal of this quality improvement initiative was to increase discharge communication to PCPs at an academic children's hospital. © 2014. Grand Canyon University. All Rights Reserved. Article 6: Introduction: Summarize the following in paragraph form. • What is the purpose of the study? • What is the scope of the study? • What is the rational for the study? • What is the hypothesis or research question? • What key concepts and terms are noted? • Is a review of the literature provided? Methods: Summarize the following in paragraph form. • What is the population being sampled? • What data collection procedure is presented? To describe the experience of baccalaureate To explore the disparities clinical nursing faculty concerning safety and near between patients’ and health miss events, in acute care hospital settings. care workers’ perception of the quality and safety culture A major safety initiative in acute care hospitals and to explore the across the country has been transforming hospitals relationship between patient into High Reliability Organizations (HROs). This perceptions, and engagement involves developing best practices for safety that in, and satisfaction with their are characteristic of other high-risk industries, care and treatment. such as aviation, manufacturing and nuclear power. Many hospitals are training employees in The key concepts and terms safety behaviors. The training includes all levels used were care quality, of employees and providers, and it is expected organizational culture, that clinical nursing faculty and student nurses are patient safety, patient compliant with the expected behaviors. engagement, patient satisfaction, service YES evaluation NO A cross-sectional study was conducted in medical– surgical wards of four Israeli general hospitals. Data were collected using a selfadministered questionnaire. This cross-sectional study used a nonexperimental, descriptive, mix methods design. After receiving Institutional Board Review Approval, the authors recruited participants for this pilot study who were clinical faculty at one university's School of Nursing Baccalaureate Program, located in the northeast. All clinical faculty who taught during the Spring 2015 semester (n = 30, teaching a total of 39 clinical rotations) were provided with information about this study and invited to participate. A total of 18 © 2014. Grand Canyon University. All Rights Reserved. To increase discharge communication to PCPs at an academic children's hospital. Is communication with primary care physicians (PCPs) at the time of a patient's hospital discharge important to safely transition care to home? YES A multidisciplinary team at Lucile Packard Children's Hospital Stanford used Lean A3 problem solving methodology to address the problem of inadequate discharge communication with PCPs. Emphasis was placed on frontline provider (resident physicians) involvement in the • What other procedures are described? Results: Summarize the following in paragraph form. • What are the given findings? • How was data collected? • Are the findings supported by graphs and charts? clinical faculty who taught 20 clinical rotations to sophomore and junior baccalaureate nursing students in acute care settings during the Spring 2015 semester consented to participate (for a 60% participation rate) in weekly online surveys about the quality and safety events that they observed in the clinical agency setting with their students. For each week that a participant completed an electronic survey, they were offered one entry into the end of study raffle for one of two $75 gift certificates to a store of their choosing. Fourteen medical–surgical wards of the four hospitals where data were collected. improvement process, creating standards, and error proofing. Root cause analysis identified several key drivers of the problem, and successive The sample comprised of countermeasures were 390 physicians and nurses implemented beginning in and 726 inpatients admitted August 2013 aimed at for at least 3 days. achieving the target of 80% attempted verbal communication within seven days before or after (usually 24–48 hours) on the pediatric medical services. Run charts were generated tracking the outcome of PCP communication. Clinical faculty identified a total of 24 patient Patients evaluated the quality On the pediatric medical occurrences: 15 Incidents, 1 Near miss event, and and safety culture services, the goal of 80% 8 Unsafe conditions. Focus group participants (n significantly higher than did communication was met and = 7) described benefits and challenges the health care workers. sustained during a sevenexperienced by nursing clinical faculty and Significant correlations were month period starting students in relation to the culture of safety in acute found between patients’ October 2013, a statistically care hospital settings. Six themes resulted from engagement in and significant improvement. In the content analysis. satisfaction with their care the eight months prior to and their quality and safety October 2013, hospital wide assessments. Their PCP communication prior to evaluation of this culture was discharge averaged 59.1% the only predictor of their (n = 5,397) and improved to satisfaction and engagement. 76.7% (n = 4,870) in the © 2014. Grand Canyon University. All Rights Reserved. • What does the analysis of data state? Conclusion: Summarize in paragraph form. • What is the summary of the study? • What is the conclusion of the hypothesis? • What are the questions for future research? References Nursing faculty and clinical partners agree that it is essential to provide safe and quality care to patients. Regardless of clinical rotation, quality and safety focus brings us together as a unifying practice. That unity means that all healthcare providers involved in patient care are accountable for high reliability practice in delivering safe care. Hence, Schools of Nursing and practice partners must prepare the next generations of nurses by incorporating quality and safety concepts into the nursing curriculum and clinical practice. One strategy to incorporate it into the curriculum would be for Schools of Nursing to consider the utilization of this survey instrument to track and analyze aggregate data like hospital event reporting systems. Implementation of such a strategy would align with the BSN Essentials, specifically Essential II: Basic Organizational and Systems Leadership for Quality Care and Patient Safety. 20 references Arabic-speaking patients rated four variables, including patients’ satisfaction with their care, lower than did Hebrew and Russian speakers. seven months after (p Purchase answer to see full attachment

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