NUR 513 Topic 6 DQ 1:Review the evidence-based practice project ideas you described in Topic 5 DQ 1

I currently work in Utilization Management for a Medicare Advantage plan. One of the quality indicators that are measured is the average length of stay (ALOS) for inpatients in skilled nursing facilities (SNFs). The Centers for Medicare and Medicaid (CMS) target for the ALOS in a SNF is less than 20 days. In 2020 the average length of stay was 26.3 days (Managing the length of stay at snfs 2023).

To reduce the average length of stay, I would use a quantitative research method to develop surveys for data collection, analyze the statistical data, and develop a plan to reduce the length of stay. According to Kummet (2022), the average length of SNF stay was higher for dually-eligible (person who receives both medicare and medicaid benefits), racial or ethic minorities, depression, and Alzheimer’s disease. I utilized the CRAAP method to evaluate the article as follows:

Currency: the article was published in February 2002. The data was collected in 2014-2015.

Relevancy: The data is relevant identifying possible causes for an increased average length of stay of medicare beneficiaries in skilled nursing facilities

Authority: The article was written by employees of the Centers for Medicare & Medicaid Services and the Federal Health Division of General Dynamics Informational Technology

Accuracy: The data could be verified for accuracy by surveying the SNFs that accept and do not accept dual-eligible (receives both medicare and medicaid benefits) patients and then comparing the average length of stay for both types of facilities during the same time frame to determine if the average length of stay was less than, equal to, or greater than the SNF

Purpose: The purpose of the article is to provide information that could be used to help reduce the average length of stay for those at-risk patients by implementing the discharge planning process and making referrals sooner to prevent delays once the patient is stable for discharge.

NUR 513 Topic 6 DQ 1:Review the evidence-based practice project ideas you described in Topic 5 DQ 1. Based on your initial ideas, what types of scholarly nursing research (such as quantitative or qualitative research, peer-reviewed resources, etc.) would be required to further investigate the issue? Select an article related to your topic. Identify the criteria you would use based on the CRAAP test to evaluate the appropriateness of the research. Why is it important to select research that meets these criteria? Evaluate the “CRAAP Test” article from the New Jersey Institute of Technology Library, located in the topic Resources. Explain the five criteria as they relate to your selected article.

NUR 513 Topic 6 DQ 1

Review the evidence-based practice project ideas you described in Topic 5 DQ 1. Based on your initial ideas, what types of scholarly nursing research (such as quantitative or qualitative research, peer-reviewed resources, etc.) would be required to further investigate the issue? Identify the criteria you would use to evaluate the appropriateness of the research. Why is it important to select research that meets these criteria?

Re: Topic 6 DQ 1

My evidenced-based project idea focuses on implementing a community education program that focuses on prevention in regard to stroke risk factors. When implementing any new program, it’s imperative to gather evidence and analyze how it can improve patient outcomes, health policies, service and programs as evidence allows for increased accountability (DeNisco & Barker, 2016). When gathering evidence for any project it’s important to understand different types of research and the different levels of evidence (Glasofer &Townsend, 2019).

Evidence strength is dictated by three key characteristics, quality, quantity and consistency (Glasofer &Townsend, 2019). When selecting research for any topic it should be quality research that has results that are valid and not influenced by biases or occur by chance (art). Quantity can be evaluated by identified the number of studies on said topic, the size and population of the studies and the impact of the treatments (Glasofer &Townsend, 2019). Consistency is when results that are similar are found across a few different studies (Glasofer &Townsend, 2019).

When selecting research for my topic I would typically select research topics that are considered level on in the hierarchy of evidence. These are RCT, systematic review of an RCT and metanalysis if an RCT (Glasofer &Townsend, 2019). Under this topic I would likely consider including a mixture of quantitative and qualitative research. When working with prevention practices its important to understand how behavior plays a role in changing health practices and that why it’s important to analyze qualitative research in addition to quantitative.

NUR 513 Topic 6 DQ 1:Review the evidence-based practice project ideas you described in Topic 5 DQ 1. Based on your initial ideas, what types of scholarly nursing research (such as quantitative or qualitative research, peer-reviewed resources, etc.) would be required to further investigate the issue? Select an article related to your topic. Identify the criteria you would use based on the CRAAP test to evaluate the appropriateness of the research. Why is it important to select research that meets these criteria? Evaluate the “CRAAP Test” article from the New Jersey Institute of Technology Library, located in the topic Resources. Explain the five criteria as they relate to your selected article.  Reference

DeNisco, S. M., & Barker, A. M. (2016). Advanced practice nursing: Essential knowledge for the profession (3rd ed.). Jones & Bartlett Learning.

Glasofer, A., & Townsend, A. B. (2019). Determining the level of evidence. Nursing Critical Care, 14(6), 22–25. https://doi.org/10.1097/01.ccn.0000580120.03118.1d

RESPOND  HERE (150 WORDS, 2 REFERENCES)

This is insightful Meagan, the implementation of the new research program requires collection and analysis of evidence to improve patient outcomes as well as increased accountability. Understanding different forms of research and levels of evidence are critical in enhancing the validity, reliability, and applicability of the research and evidence-based practice processes. When selecting the research process, it is necessary to consider the level of evidence. Levels of evidence, sometimes called the hierarchy of evidence, are always assigned to the studies on the basis of methodological quality of their validity, design, as well as applicability to patient care (Glasofer & Townsend, 2021).

A combination of qualitative and quantitative research processes is always required to enhance the research processes’ effective outcomes. Quantitative research designs require adherence to the data collection and analysis processes. The quantitative approaches are necessary for ensuring the establishment of valid, reliable, as well as applicability of the research outcomes (Bansal et al., 2018). To select a viable research study process, it is necessary for the researcher to consider the hierarchy or level of evidence.

NUR 513 Topic 6 DQ 1:Review the evidence-based practice project ideas you described in Topic 5 DQ 1. Based on your initial ideas, what types of scholarly nursing research (such as quantitative or qualitative research, peer-reviewed resources, etc.) would be required to further investigate the issue? Select an article related to your topic. Identify the criteria you would use based on the CRAAP test to evaluate the appropriateness of the research. Why is it important to select research that meets these criteria? Evaluate the “CRAAP Test” article from the New Jersey Institute of Technology Library, located in the topic Resources. Explain the five criteria as they relate to your selected article.  References

Bansal, P., Smith, W. K., & Vaara, E. (2018). New ways of seeing through qualitative research. https://doi.org/10.5465/amj.2018.4004

Glasofer, A., & Townsend, A. B. (2021). Determining the level of evidence: experimental research appraisal. Nursing2021, 51(1), 60-63. https://journals.lww.com/nursing/Abstract/2021/01000/Determining_the_level_of_evidence__Experimental.15.aspx

Re: Topic 6 DQ 1

My idea from Topic 5 DQ 1 was workplace violence (WPV), and my initial topic was much too broad. Before finding the best current evidence, I need to identify a specific clinical problem to best search for an answerable question (DeNisco & Barker, 2016). Using the PICOT template: population, intervention, comparison, outcome, and time, will help create that searchable question.

Click here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS: NUR 513 Topic 6 DQ 1 

Population: Healthcare Workers

Intervention: Education and Training

Comparison: Workplace Violence

Outcome: Prevent or Minimize

Time: 1-year Period

The next step is searching. I recommend a good starting point in PubMed, mostly because articles are specific to nursing and many are free to access. My organization allows access to the commonly used databases such as the Cochran Library, CINAHL, Medline and is a benefit to avoid paying fees for full review articles.  GCU library also offers students access to these same resources.

After obtaining multiple sources of evidence, critical appraisal or grading evidence is next, from the strongest to weakest evidence (DeNisco & Barker, 2016). The gold standard and strongest evidence is a meta-analysis of randomized controlled trials or clinical guidelines based on systematic reviews. Evidence sources may include qualitative or quantitative studies, reviews or clinical expertise, or patient preferences and values. The need is to quickly determine whether it is valid evidence and applicable to practice. Critical appraisal tools exist and ask specific questions based on the methodology or design of the study you are evaluating. Besides validity and usefulness, other criteria to assess include when last updated, clinical context and environment, and patient values and preference. One of my personal favorites, UpToDate, uses a graded approach, 1A being strongest whereas, 2C means a weak recommendation to use an intervention based on both quality of the evidence and patient preference.

Inquiry and asking the best clinical question in a PICOT format is critical to searching and finding the best evidence. Appraising the evidence and integrating this with patient values and preferences is necessary to make evidence-based-practice decisions within nursing.  My Cochrane Library search resulted in very low-to low-quality evidence, with the common databases searched and seven studies being included. There is limited evidence that some interventions might reduce aggression toward healthcare workers (Spelten et al., 2020).  April is National WPV Month and a great place to start to recognize that more research is needed. I recognize I need more experience in this process too.

NUR 513 Topic 6 DQ 1:Review the evidence-based practice project ideas you described in Topic 5 DQ 1. Based on your initial ideas, what types of scholarly nursing research (such as quantitative or qualitative research, peer-reviewed resources, etc.) would be required to further investigate the issue? Select an article related to your topic. Identify the criteria you would use based on the CRAAP test to evaluate the appropriateness of the research. Why is it important to select research that meets these criteria? Evaluate the “CRAAP Test” article from the New Jersey Institute of Technology Library, located in the topic Resources. Explain the five criteria as they relate to your selected article.  References

DeNisco, S. M., & Barker, A. M. (2016). Advanced practice nursing: essential knowledge for the profession. Jones & Bartlett Learning.

Spelten E;Thomas B;O’Meara PF;Maguire BJ;FitzGerald D;Begg SJ; (2020, April 29). Organizational interventions for preventing and minimizing aggression directed towards healthcare workers by patients and patient advocates. The Cochrane database of systematic reviews. https://pubmed.ncbi.nlm.nih.gov/32352565/.

RESPOND TO BARBARA HERE

This is insightful, Barbara, consideration of the PICOT question is necessary for undertaking different research processes (Abbade et al., 2016). Also, it is always necessary to identify the ideal sources of information such as databases that may be applied in supporting the research process. Most of the databases contain essential forms of information that may be applied in addressing various aspects of the project. CINAHL, Cochran Library, and Medline are some of the databases that can be applied to review some of the best sources of information that can be used to authenticate the information required in the research processes.

The quality of research processes often depends on the levels of evidence (Glasofer & Townsend, 2019). The level of evidence is always assigned to the studies on the basis of methodological quality of their validity, design, as well as applicability to patient care. To better develop a quality, reliable, valid, and applicable research process, sticking to the PICOT question is necessary. In other words, different researchers need to consider the PICOT question in ensuring the achievement of quality outcomes.

NUR 513 Topic 6 DQ 1:Review the evidence-based practice project ideas you described in Topic 5 DQ 1. Based on your initial ideas, what types of scholarly nursing research (such as quantitative or qualitative research, peer-reviewed resources, etc.) would be required to further investigate the issue? Select an article related to your topic. Identify the criteria you would use based on the CRAAP test to evaluate the appropriateness of the research. Why is it important to select research that meets these criteria? Evaluate the “CRAAP Test” article from the New Jersey Institute of Technology Library, located in the topic Resources. Explain the five criteria as they relate to your selected article. References

Abbade, L. P., Wang, M., Sriganesh, K., Mbuagbaw, L., & Thabane, L. (2016). Framing of research question using the PICOT format in randomised controlled trials of venous ulcer disease: a protocol for a systematic survey of the literature. BMJ open, 6(11). https://bmjopen.bmj.com/content/6/11/e013175.short

Glasofer, A., & Townsend, A. B. (2019). Determining the level of evidence. Nursing Critical Care, 14(6), 22–25. https://doi.org/10.1097/01.ccn.0000580120.03118.1d

GINA

Re: Topic 6 DQ 1

My evidence-based practice would be centered around the utilization of new technologies by bedside nurses. I would do a literature review of peer-reviewed studies to further investigate this issue. Then I would develop a framework and intervention with said technology that could be both quantitatively and qualitatively measured. Both quantitative and qualitative data would be important because it would be necessary to study the numerical data regarding technology use, and it would also be important to know both nurse and patient responses to interventions, which could be gathered through surveys, questionnaires, and interviews. When researching, data would have to be recent, within the last five years, peer-reviewed, with adequate sample sizes. DeNisco and Barker say it best, “Not all evidence is created equal, and there is a need to use the best available evidence,” (2016, p.465).

Peer-reviewed research is essential, because it helps maintain the quality of the research. Critical appraisals of research by other academic minds can both validate, provide transparency, ensure professionalism, academic integrity and ethically conducted research (Kelly, et al., 2014). Additionally, research should be recent. Just like the rest of the world, data ages and isn’t always applicable as people, the world, the population, and societies adapt and change. You want sources that reflect the newest and most up to date research available. And finally, data in research can be easily statistically manipulated, so sample sizes matter. If a sample size is too small, it often holds less statistical significance and cannot often be used to generalize to a population.

NUR 513 Topic 6 DQ 1:Review the evidence-based practice project ideas you described in Topic 5 DQ 1. Based on your initial ideas, what types of scholarly nursing research (such as quantitative or qualitative research, peer-reviewed resources, etc.) would be required to further investigate the issue? Select an article related to your topic. Identify the criteria you would use based on the CRAAP test to evaluate the appropriateness of the research. Why is it important to select research that meets these criteria? Evaluate the “CRAAP Test” article from the New Jersey Institute of Technology Library, located in the topic Resources. Explain the five criteria as they relate to your selected article. References

DeNisco, S. M., & Barker, A. M. (2016). Advanced practice nursing: Essential knowledge for the profession (3rd ed.). Jones & Bartlett Learning.

Kelly, J., Sadeghieh, T., & Adeli, K. (2014). Peer review in scientific publications: Benefits, critiques, and a survival guide. EJIFCC, 25(3), 227–243. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4975196/

RESPOND  HERE

This is insightful, Gina; in general, the application of technology is on the rise, which calls for increased research processes to enhance the understanding of different ways to integrate technological approaches in the research processes (Spelten et al., 2020). The utilization of technology by the bedside nurses is critical in ensuring quality treatment outcomes and patient safety. Usually, the integration of technology in the healthcare processes reduces the errors associated with general care. The literature review is essential in the study processes because it enhances the understanding of past research outcomes that may be applied in addressing some of the research processes’ aspects. In the research process, it is also necessary to consider qualitative and quantitative research approaches to enhance the achievement of valid, reliable, and applicable research processes (Bansal et al., 2018). While undertaking a literature review, it is necessary for the researcher to consider different databases that have authentic, reliable, and applicable sources of information that can be utilized in identifying the required information.

NUR 513 Topic 6 DQ 1:Review the evidence-based practice project ideas you described in Topic 5 DQ 1. Based on your initial ideas, what types of scholarly nursing research (such as quantitative or qualitative research, peer-reviewed resources, etc.) would be required to further investigate the issue? Select an article related to your topic. Identify the criteria you would use based on the CRAAP test to evaluate the appropriateness of the research. Why is it important to select research that meets these criteria? Evaluate the “CRAAP Test” article from the New Jersey Institute of Technology Library, located in the topic Resources. Explain the five criteria as they relate to your selected article. References

Spelten E;Thomas B;O’Meara PF;Maguire BJ;FitzGerald D;Begg SJ; (2020, April 29). Organizational interventions for preventing and minimizing aggression directed towards healthcare workers by patients and patient advocates. The Cochrane database of systematic reviews. https://pubmed.ncbi.nlm.nih.gov/32352565/.

Bansal, P., Smith, W. K., & Vaara, E. (2018). New ways of seeing through qualitative research. https://doi.org/10.5465/amj.2018.4004

The evidence-based project idea I described in Topic 5 DQ 1 was reducing patient readmission rates via care management. The scholarly nursing research that would best support further investigation of this issue would be quantitative.  Data related to “fee-for-service” readmission rates versus “pay-for-performance” readmission rates would be a good base data set to further investigate this issue. I selected the 2018 article: “The hospital readmissions reduction program: learning from failure of a healthcare policy” from the European journal of heart failure (Gupta & Fonarow, 2018).”

The criteria I would use from the CRAAP test to evaluate the appropriateness of the research includes: currency (timeliness of the information), relevance (how well does the information relate to the research topic), authority (what is the sources of the information), accuracy (reliability and correctness of content), and purpose (why does the information exist). In the article selected, the 5 criteria of the CRAAP test relate to the selected article. The article was written in 2018 making it less than 5 years old, and appropriately current.

The information contained in the article is relevant because it is related to hospital readmission reduction programs and associated concerns. The journal in which the article is contained is a recognized professional journal with evidence-based, peer reviewed content. This supports the authority of the journal. The article contents have been peer reviewed for accuracy, and methods of analysis are described thoroughly. The purpose of the article is to provide insight into benefits, and concerns, that can arise with hospital readmission reduction programs. It is important to select research that meets these criteria because they provide guidelines for ensuring high quality data is included when investigating existing research and basing further investigation on the merit of that information.

NUR 513 Topic 6 DQ 1:Review the evidence-based practice project ideas you described in Topic 5 DQ 1. Based on your initial ideas, what types of scholarly nursing research (such as quantitative or qualitative research, peer-reviewed resources, etc.) would be required to further investigate the issue? Select an article related to your topic. Identify the criteria you would use based on the CRAAP test to evaluate the appropriateness of the research. Why is it important to select research that meets these criteria? Evaluate the “CRAAP Test” article from the New Jersey Institute of Technology Library, located in the topic Resources. Explain the five criteria as they relate to your selected article.  References

Gupta, A., & Fonarow, G. C. (2018). The hospital readmissions reduction program: learning from failure of a healthcare policy. European journal of heart failure, 20(8), 1169–1174. https://doi.org/10.1002/ejhf.1212

New Jersey Institute of Technology. (2022). How to evaluate information sources: CRAAP test. https://researchguides.njit.edu/evaluate/CRAAP

The evidence-based practice project idea that I described in Topic 5 DQ 1 is that public health nurses needed to be and still need to be more visible during the pandemic. Based on my initial idea, I would start with peer-reviewed resources such as articles and nursing journals written by public health experts during the initial phases of the pandemic to gather a real-time perspective of the public health nurse at the time as well as what actions they may have implemented that I am not aware of as a member of the general public. I selected an article found on The Commonwealth Fund website.

Per the website The Commonwealth Fund provides financial resources to promote independent research, on public health and to improve access, quality, and efficiency in healthcare (The Commonwealth Fund, n.d.). The specific article that I chose to assess using the CRAAP test is titled “A Strong Public Health System Depends on Making the Invisible Visible,” written in 2022 by Shanoor Seervai, M.P.P. The article has functioning links, is current and in date to my topic. The article provides relevant insight and answers to my question regarding what roles public health experts in certain parts of the country played and programs that they organized in response to the pandemic.

Unfortunately, the article focuses heavily on the medical doctor interviewed, it mentions the public health workforce but does not specifically discuss the role of the public health nurses. Ms. Seervai obtained a Master of Public Policy from Harvard Kennedy School, and her qualifications are easily verified via an internet search where there are multiple articles written by her on the topic of public health on multiple websites both scholarly and non-scholarly. Both her telephone number and email address are available. The accuracy of the information provided in the article is verifiable by doing an independent search for the organizations, people and or events mentioned in the article such as the New York City Public Health Corps. I was unaware that this program existed and was pleased to learn about it from this article.

The article’s purpose is to inform. It looks backwards to how the public health system in America responded to the pandemic and seeks to learn from that experience to create a stronger public health system. I do feel that both the author and the medical doctor interviewed for the article do express a small amount of opinion but mainly focus on their experience and expertise on the topic. Although this is an article that passes most elements of the CRAAP test, I would use this article in addition to scholarly peer-reviewed journal articles to eliminate all personal bias and or potential financial influence.

NUR 513 Topic 6 DQ 1:Review the evidence-based practice project ideas you described in Topic 5 DQ 1. Based on your initial ideas, what types of scholarly nursing research (such as quantitative or qualitative research, peer-reviewed resources, etc.) would be required to further investigate the issue? Select an article related to your topic. Identify the criteria you would use based on the CRAAP test to evaluate the appropriateness of the research. Why is it important to select research that meets these criteria? Evaluate the “CRAAP Test” article from the New Jersey Institute of Technology Library, located in the topic Resources. Explain the five criteria as they relate to your selected article. References:

Seervai, S. (2022). A strong public health system depends on making the invisible visible. (2022). The Commonwealth Fund. https://www.commonwealthfund.org/publications/podcast/2022/jun/strong-public-health-system-depends-on-making-invisible-visible

The Commonwealth Fund. (n.d.). https://www.commonwealthfund.org/

The evidence-based practice project idea that I had the idea of doing research on is a m