DNP 810 Topic 7 DQ 2

DNP 810 Topic 7 DQ 2 

DNP 810 Topic 7 DQ 2

https://nursingmill.blog/dnp-810-topic-7-dq-2-describe-one-method-that-includes-using-evidence-based-data-to-support-a-new-or-innovative-way-to-care-for-those-with-chronic-disease-now-or-in-the-future/

DNP 810 Topic 7 DQ 2

Describe one method that includes using evidence-based data to support a new or innovative way to care for those with chronic disease now or in the future. How will it impact care and what are the anticipated outcomes?

Topic 7 DQ 2

Identify a method that uses evidence-based data to support new or innovative ways to care for
patients with chronic disease. What are the anticipated outcomes of employing this method and
methods like it? How can the doctoral-prepared nurse apply this information in practice? Explain.
Support your rationale with a minimum of two scholarly sources.

REPLY TO DISCUSSION

Published

Replies
In the past two decades, the prevalence of chronic illnesses in the US has grown by a steady 7 to
8 million persons every five years. Currently, chronic illnesses affect 50% of the US population,
and the treatment takes more than 85% of health care costs. The National Health Expenditure
Data reveals that 90% of the country’s $4.1 trillion yearly healthcare expenditures are spent on
individuals with chronic and mental health illnesses (CMS, 2018). For example, cancer is
attributed to huge medical costs in the US and they are estimated to increase dramatically by 2030
due to increased cancer cases, reflecting the increasing burden of cancer care among cancer
patients (Waters & Graf, 2018). In addition, heart diseases and stroke take an economic toll and
cost the US health care system $216 billion annually and $147 billion in lost productivity.
Patients with chronic illnesses have a high healthcare utilization, which increases with the number
of conditions one has. Individuals with multiple chronic diseases have one of the highest
healthcare spending as the healthcare costs increase non-linearly with each ensuing condition
(Braillard et al., 2018). Besides, multiple chronic illnesses are linked with wastage of resources
due to a fragmented healthcare system. Patients often consult different medical specialists for

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each condition, which often leads to wastage of resources from polypharmacy, duplication of
diagnostic tests, and duplication of medical procedures.
Genetics are associated with chronic illnesses like obesity, diabetes, some cancers, heart disease,
and hypertension. These conditions are associated with huge costs, and more people are
increasingly being diagnosed. Besides, the treatment of these genetic-related diseases
significantly affects the economics of the healthcare system since patients often require life-long
medication and regular follow-ups (Waters & Graf, 2018). The DNP- nurse can utilize the
information to assess patients and the risk factors for chronic diseases. The nurse can educate
patients on how to modify their lifestyle to eliminate the modifiable risk factors and manage the
diseases in those that have been diagnosed (Waters & Graf, 2018). This can lower the healthcare
costs and the wastage of health resources associated with the treatment of chronic diseases.

References
Braillard, O., Slama-Chaudhry, A., Joly, C., Perone, N., & Beran, D. (2018). The impact of chronic
disease management on primary care doctors in Switzerland: a qualitative study. BMC family
practice, 19(1), 159. https://doi.org/10.1186/s12875-018-0833-3
Centers for Medicare & Medicaid Services. (2018). National health expenditure data:
historical. webpage, December, 16.
Waters, H. U. G. H., & Graf, M. (2018). The costs of chronic disease in the US. Santa Monica, CA:
The Milken Institute.

Unread

Replies to Carolyn Smith

Thanks for sharing an informative post. I do agree that the cost of treating individuals with
chronic illness to the healthcare system is significantly high both financially and from the
human resources perspective and as DNP prepared nurses our roles and expectations in
leadership, nursing informatics, public health, knowledge translation, application of
implementation science, application of improvement science, and quality improvement will be

increasingly high to bridge theory – knowledge- practice gaps and to embrace the
interconnection between medicine and public health issues (Bekemeier et al., 2021).
Reference
Bekemeier, B., Kuehnert, P., Zahner, S. J., Johnson, K. H., Kaneshiro, J., & Swider, S. M.
(2021). A critical gap: Advanced practice nurses focused on the public’s health. Nursing
outlook, 69(5), 865–874. https://doi.org/10.1016/j.outlook.2021.03.023

Read
Replies to Carolyn Smith
EBP, otherwise recognized as evidence-based practice, is the judicious and conscientious
utilization of specialized clinical expertise alongside current best evidence and patient values to
guide health care decisions. To implement evidence-based practice, practitioners must first
identify practices and programs tested and shown effective (Abidi, 2017). Moreover, leaders of
nursing backgrounds enact successful EBP integration through attaining generalized leadership
awareness and recognizing the importance of being knowledgeable about a proposed change,
partnering with a team of staff ready for the change, engaging the help of mentors or change
agents at the unit level. EBP proves its indispensable nature through how it aims to provide
efficacy within patient outcome improvement (Abidi, 2017). Patients expect the most effective care
based on the best available evidence. It is believed that with improved healthcare delivery that
focuses on evidence-based management therapies, cases of hospital readmissions can be
reduced significantly (Abidi, 2017).

Hypothesis: “Healthcare professionals can implement existing evidence-based management
therapies and develop strategies to prevent hospital readmission for patients diagnosed with
congestive heart failure (CHF).”

According to Davidson et al. (2015), it is essential to possess standardized practice concerning
congestive heart failure management. The current approach enabling doctors to embrace differing

methods rooted in biased decisions does not assume a responsible stance within a modern
society where advanced technology has enhanced health delivery. MAP, known as
multidisciplinary action plans, are some evidence-based therapies that are increasingly becoming
popular in managing congestive heart failure (Davidson et al., 2015). Designed to provide the
framework for inpatient management of CHF, MAP is a structured nursing plan for inpatients. It is
recommended that before a CHF patient is discharged from the hospital. A cardiologist,
nephrologist, dietician, family practitioner/PCP, and a hospital representative should be present
and give their approval and home health referral for medication management (Davidson et al.,
2015). The primary objective is to ensure that when the patient leaves the hospital, the entire
medical team will be confident that all the necessary factors are considered to minimize the
chances of hospital readmissions (Davidson et al., 2015).

Doctorally prepared nurses to promote the uptake of evidence by developing the knowledge and
skills of clinical nurses through role modeling, teaching, clinical problem-solving, and facilitating
change (Anderson, 2015). They must be prepared to assume the responsibility and accountability
to make complex health care decisions based on findings from rigorous or high-quality research
reports, clinical expertise, and patient perspectives. The implementation of EBP enables DNP-
prepared nurses to apply data-backed solutions that incorporate clinical expertise and current
research into the decision-making process (Anderson, 2015). As a result, to produce positive
patient outcomes by integrating the best research evidence, clinical expertise, and patient
preferences (Anderson, 2015).

References

Abidi, S. (2017). A knowledge-modeling approach to integrate multiple clinical practice guidelines
to provide evidence-based clinical decision support for managing comorbid conditions. Journal of
Medical Systems, 41(12), 1-19.

Anderson, B. A. (2015). Caring for Vulnerable Populations: The Role of the DNP-Prepared
Nurse. Caring for the Vulnerable: Perspectives in Nursing Theory, Practice and Research, 441.

Davidson, P. M., Newton, P. J., Tankumpuan, T., Paull, G., & Dennison-Himmelfarb, C. (2015).
Multidisciplinary management of chronic heart failure: principles and future trends. Clinical
therapeutics, 37(10), 2225-2233.

Name:  Discussion Rubric

• Grid View
• List View

		Excellent 90–100	Good 80–89	Fair 70–79	Poor 0–69
Main Posting: Response to the Discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.		40 (40%) – 44 (44%) Thoroughly responds to the Discussion question(s). Is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources. No less than 75% of post has exceptional depth and breadth. Supported by at least three current credible sources.	35 (35%) – 39 (39%) Responds to most of the Discussion question(s). Is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module. 50% of the post has exceptional depth and breadth. Supported by at least three credible references.	31 (31%) – 34 (34%) Responds to some of the Discussion question(s). One to two criteria are not addressed or are superficially addressed. Is somewhat lacking reflection and critical analysis and synthesis. Somewhat represents knowledge gained from the course readings for the module. Cited with fewer than two credible references.	0 (0%) – 30 (30%) Does not respond to the Discussion question(s). Lacks depth or superficially addresses criteria. Lacks reflection and critical analysis and synthesis. Does not represent knowledge gained from the course readings for the module. Contains only one or no credible references.
Main Posting: Writing		6 (6%) – 6 (6%) Written clearly and concisely. Contains no grammatical or spelling errors. Adheres to current APA manual writing rules and style.	5 (5%) – 5 (5%) Written concisely. May contain one to two grammatical or spelling errors. Adheres to current APA manual writing rules and style.	4 (4%) – 4 (4%) Written somewhat concisely. May contain more than two spelling or grammatical errors. Contains some APA formatting errors.	0 (0%) – 3 (3%) Not written clearly or concisely. Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style.
Main Posting: Timely and full participation		9 (9%) – 10 (10%) Meets requirements for timely, full, and active participation. Posts main Discussion by due date.	8 (8%) – 8 (8%) Meets requirements for full participation. Posts main Discussion by due date.	7 (7%) – 7 (7%) Posts main Discussion by due date.	0 (0%) – 6 (6%) Does not meet requirements for full participation. Does not post main Discussion by due date.
First Response: Post to colleague’s main post that is reflective and justified with credible sources.		9 (9%) – 9 (9%) Response exhibits critical thinking and application to practice settings. Responds to questions posed by faculty. The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.	8 (8%) – 8 (8%) Response has some depth and may exhibit critical thinking or application to practice setting.	7 (7%) – 7 (7%) Response is on topic and may have some depth.	0 (0%) – 6 (6%) Response may not be on topic and lacks depth.
First Response: Writing		6 (6%) – 6 (6%) Communication is professional and respectful to colleagues. Response to faculty questions are fully answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English.	5 (5%) – 5 (5%) Communication is mostly professional and respectful to colleagues. Response to faculty questions are mostly answered, if posed. Provides opinions and ideas that are supported by few credible sources. Response is written in standard, edited English.	4 (4%) – 4 (4%) Response posed in the Discussion may lack effective professional communication. Response to faculty questions are somewhat answered, if posed. Few or no credible sources are cited.	0 (0%) – 3 (3%) Responses posted in the Discussion lack effective communication. Response to faculty questions are missing. No credible sources are cited.
First Response: Timely and full participation		5 (5%) – 5 (5%) Meets requirements for timely, full, and active participation. Posts by due date.	4 (4%) – 4 (4%) Meets requirements for full participation. Posts by due date.	3 (3%) – 3 (3%) Posts by due date.	0 (0%) – 2 (2%) Does not meet requirements for full participation. Does not post by due date.
Second Response: Post to colleague’s main post that is reflective and justified with credible sources.		9 (9%) – 9 (9%) Response exhibits critical thinking and application to practice settings. Responds to questions posed by faculty. The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.	8 (8%) – 8 (8%) Response has some depth and may exhibit critical thinking or application to practice setting.	7 (7%) – 7 (7%) Response is on topic and may have some depth.	0 (0%) – 6 (6%) Response may not be on topic and lacks depth.
Second Response: Writing		6 (6%) – 6 (6%) Communication is professional and respectful to colleagues. Response to faculty questions are fully answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English.	5 (5%) – 5 (5%) Communication is mostly professional and respectful to colleagues. Response to faculty questions are mostly answered, if posed. Provides opinions and ideas that are supported by few credible sources. Response is written in standard, edited English.	4 (4%) – 4 (4%) Response posed in the Discussion may lack effective professional communication. Response to faculty questions are somewhat answered, if posed. Few or no credible sources are cited.	0 (0%) – 3 (3%) Responses posted in the Discussion lack effective communication. Response to faculty questions are missing. No credible sources are cited.
Second Response: Timely and full participation		5 (5%) – 5 (5%) Meets requirements for timely, full, and active participation. Posts by due date.	4 (4%) – 4 (4%) Meets requirements for full participation. Posts by due date.	3 (3%) – 3 (3%) Posts by due date.	0 (0%) – 2 (2%) Does not meet requirements for full participation. Does not post by due date.
Total Points: 100

Name:  Discussion Rubric

In the past two decades, the prevalence of chronic illnesses in the US has grown by a steady 7 to 8 million persons every five years. Currently, chronic illnesses affect 50% of the US population, and the treatment takes more than 85% of health care costs. The National Health Expenditure Data reveals that 90% of the country’s $4.1 trillion yearly healthcare expenditures are spent on individuals with chronic and mental health illnesses (CMS, 2018). For example, cancer is attributed to huge medical costs in the US and they are estimated to increase dramatically by 2030 due to increased cancer cases, reflecting the increasing burden of cancer care among cancer patients (Waters & Graf, 2018). In addition, heart diseases and stroke take an economic toll and cost the US health care system $216 billion annually and $147 billion in lost productivity.

Patients with chronic illnesses have a high healthcare utilization, which increases with the number of conditions one has. Individuals with multiple chronic diseases have one of the highest healthcare spending as the healthcare costs increase non-linearly with each ensuing condition (Braillard et al., 2018). Besides, multiple chronic illnesses are linked with wastage of resources due to a fragmented healthcare system. Patients often consult different medical specialists for each condition, which often leads to wastage of resources from polypharmacy, duplication of diagnostic tests, and duplication of medical procedures.

Genetics are associated with chronic illnesses like obesity, diabetes, some cancers, heart disease, and hypertension. These conditions are associated with huge costs, and more people are increasingly being diagnosed. Besides, the treatment of these genetic-related diseases significantly affects the economics of the healthcare system since patients often require life-long medication and regular follow-ups (Waters & Graf, 2018). The DNP- nurse can utilize the information to assess patients and the risk factors for chronic diseases. The nurse can educate patients on how to modify their lifestyle to eliminate the modifiable risk factors and manage the diseases in those that have been diagnosed (Waters & Graf, 2018). This can lower the healthcare costs and the wastage of health resources associated with the treatment of chronic diseases.

References

Braillard, O., Slama-Chaudhry, A., Joly, C., Perone, N., & Beran, D. (2018). The impact of chronic disease management on primary care doctors in Switzerland: a qualitative study. BMC family practice, 19(1), 159. https://doi.org/10.1186/s12875-018-0833-3

Centers for Medicare & Medicaid Services. (2018). National health expenditure data: historical. webpage, December, 16.

Waters, H. U. G. H., & Graf, M. (2018). The costs of chronic disease in the US. Santa Monica, CA: The Milken Institute.

EBP, otherwise recognized as evidence-based practice, is the judicious and conscientious utilization of specialized clinical expertise alongside current best evidence and patient values to guide health care decisions. To implement evidence-based practice, practitioners must first identify practices and programs tested and shown effective (Abidi, 2017). Moreover, leaders of nursing backgrounds enact successful EBP integration through attaining generalized leadership awareness and recognizing the importance of being knowledgeable about a proposed change, partnering with a team of staff ready for the change, engaging the help of mentors or change agents at the unit level. EBP proves its indispensable nature through how it aims to provide efficacy within patient outcome improvement (Abidi, 2017). Patients expect the most effective care based on the best available evidence. It is believed that with improved healthcare delivery that focuses on evidence-based management therapies, cases of hospital readmissions can be reduced significantly (Abidi, 2017).

Hypothesis: “Healthcare professionals can implement existing evidence-based management therapies and develop strategies to prevent hospital readmission for patients diagnosed with congestive heart failure (CHF).”

According to Davidson et al. (2015), it is essential to possess standardized practice concerning congestive heart failure management. The current approach enabling doctors to embrace differing methods rooted in biased decisions does not assume a responsible stance within a modern society where advanced technology has enhanced health delivery. MAP, known as multidisciplinary action plans, are some evidence-based therapies that are increasingly becoming popular in managing congestive heart failure (Davidson et al., 2015). Designed to provide the framework for inpatient management of CHF, MAP is a structured nursing plan for inpatients. It is recommended that before a CHF patient is discharged from the hospital. A cardiologist, nephrologist, dietician, family practitioner/PCP, and a hospital representative should be present and give their approval and home health referral for medication management (Davidson et al., 2015). The primary objective is to ensure that when the patient leaves the hospital, the entire medical team will be confident that all the necessary factors are considered to minimize the chances of hospital readmissions (Davidson et al., 2015).

Doctorally prepared nurses to promote the uptake of evidence by developing the knowledge and skills of clinical nurses through role modeling, teaching, clinical problem-solving, and facilitating change (Anderson, 2015). They must be prepared to assume the responsibility and accountability to make complex health care decisions based on findings from rigorous or high-quality research reports, clinical expertise, and patient perspectives. The implementation of EBP enables DNP-prepared nurses to apply data-backed solutions that incorporate clinical expertise and current research into the decision-making process (Anderson, 2015). As a result, to produce positive patient outcomes by integrating the best research evidence, clinical expertise, and patient preferences (Anderson, 2015).

References

Abidi, S. (2017). A knowledge-modeling approach to integrate multiple clinical practice guidelines to provide evidence-based clinical decision support for managing comorbid conditions. Journal of Medical Systems, 41(12), 1-19.

Anderson, B. A. (2015). Caring for Vulnerable Populations: The Role of the DNP-Prepared Nurse. Caring for the Vulnerable: Perspectives in Nursing Theory, Practice and Research, 441.

Davidson, P. M., Newton, P. J., Tankumpuan, T., Paull, G., & Dennison-Himmelfarb, C. (2015). Multidisciplinary management of chronic heart failure: principles and future trends. Clinical therapeutics, 37(10), 2225-2233.

I agree with you that evidence-based practice (EBP) uses current best evidence in guiding health care decisions. EBP deploys scientific knowledge in nursing practice. As a result, healthcare organizations with EBP reduces chances of making mistakes when attending to their patients. Identifying practices and programs tested are some of the critical steps of implementing EBP. Healthcare organizations depend on nursing leadership in implementing evidence-based practice. Successful implementation of EBP demands interference with the normal operations within a facility (Camargo et al., 2018). Unfortunately, some people are uncomfortable with change. However, leaders rely on stakeholders to implement the proposed change. Therefore, nursing leaders take adequate time to convince key stakeholders about the importance of the proposed change. Doctorally prepared nurses are best suited to team up with nursing leaders to implement EBP (Melnyk et al., 2018). These healthcare professionals have adequate experience and insights to guide other stakeholders in deploying change. The success of the proposed initiative depends on the goodwill and support from other agents of change.

References

Camargo, F. C., Iwamoto, H. H., Galvão, C. M., Pereira, G. D. A., Andrade, R. B., & Masso, G. C. (2018). Competences and barriers for the evidence-based practice in nursing: an integrative review. Revista brasileira de enfermagem, 71, 2030-2038. https://doi.org/10.1590/0034-7167-2016-0617

Melnyk, B. M., Gallagher‐Ford, L., Zellefrow, C., Tucker, S., Van Dromme, L., & Thomas, B. K. (2018). Outcomes from the first helene fuld health trust national institute for evidence‐based practice in nursing and healthcare invitational expert forum. Worldviews on Evidence‐Based Nursing, 15(1), 5-15.  https://doi.org/10.1111/wvn.12272

Despite the increasing availability of many Health Information technologies (HIT) such as telehealth, several factors may limit their adoption and subsequent impact on chronic disease management. Older adults, who are frequently the target of chronic disease management programs, are less likely to have access to portable devices and may have limited literacy in health technologies. Although health care communities across the country have made some strides in adopting, implementing, and using health information technologies (HIT) to share rel