Benchmark – Evidence-Based Practice Project: PICOT Paper NUR 550

Benchmark – Evidence-Based Practice Project: PICOT Paper NUR 550

Benchmark – Evidence-Based Practice Project: PICOT Paper NUR 550

Trauma occurs when individuals are overwhelmed by circumstances or events and counters them with extreme horror, fear, and helplessness. Excessive stress overwhelms an individual’s coping capacity. Trauma can stem from exposure to abuse, discrimination, neglect, violence, and accidents (Shalaby & Agyapong, 2020). This paper seeks to describe populations with traumatic experiences and an intervention to address the concern and discuss factors that influence health management.

Population’s Demographics and Health Concerns

According to the National Council for Behavioral Health (NCBH), 70% of adults in the U.S. have experienced a traumatic event at least once. Almost all children who observe a parental homicide or sexual assault will develop Post Traumatic Stress Disorder (PTSD). Likewise, 90% of sexually abused children, 77% who school shootings, and 35% of youths exposed to community violence develop PTSD (NCBH, 2020). Trauma is associated with adverse effects on physical and mental health as well as social and occupational functioning.  Physical effects include headaches, excessive sweating, palpitations, altered bowel patterns, and being easily startled. Mental impact includes fear, anxiety, depression, emotional swings, increased alcohol and drug use, and sleeping difficulties (Mikhail et al., 2018). Furthermore, individuals socially isolate themselves due and have diminished interest in activities.

Proposed Evidence-Based Intervention

The proposed intervention incorporates peer support in trauma-informed care to accelerate the recovery process.  Peer support involves having persons from diverse backgrounds sharing common trauma experiences (Shalaby & Agyapong, 2020). The intervention uses peer support workers, individuals with lived trauma experiences, and who have received special training to be part of the care team. Based on their similar experiences and the shared understanding, patients may trust their peer support worker and be more willing to engage in treatment.

Incorporating peer support supports Healthy People 2020 goal of improving mental health through prevention and ensuring access to appropriate, quality mental health services. The intervention will improve the mental health outcomes of persons with trauma experiences. It will help prevent mental health issues such as anxiety, PTSD, depression, and alcohol and substance use disorders.

Comparison of the Intervention to Previous Practice or Research

Previous practice in trauma-informed care entailed using behavioral health counselors. Crisanti et al. (2019) compared cognitive behavioral therapy intervention groups guided by certified peer support workers with groups led by behavioral health counselors for trauma survivors with PTSD. At six months after baseline, persons in the peer-led sessions had a higher therapeutic alliance and stronger connection than those in the counselor-led sessions. The study shows that peer support can increase patient engagement and ultimately accelerate the recovery process.

Expected Outcome for the Intervention

Incorporating peer support is expected to increase patients’ engagement in treatment and thus accelerating their recovery. Since patients will share their trauma experiences with peer support workers who have experienced similar experiences, it will promote a shared understanding and increase patients’ trust (Shalaby & Agyapong, 2020). Peer support is expected to help patients overcome social isolation caused by trust issues by creating trust between patients and the peer workers.

Time for Implementation and Evaluation of the Outcome

The intervention will be implemented within six months. Patients will be randomly assigned to an intervention or a control group. The intervention group will be assigned to a peer support worker, while the control group will be provided the usual trauma-informed care without peer support. Evaluation will be conducted six months after the implementation of the peer support care. The recovery scores of patients in the intervention group will be compared to those of the control group to evaluate the difference in recovery and outcomes.

Synthesis of Nursing Science, Determinants of Health, and Epidemiologic, Genomic, and Genetic Data in the Management of Population Health

Nursing science is applied to support patients with trauma experiences in line with the principles of safety, respect, and trust. Nursing science is also applied in delivering patient-centered care to improve patient engagement and the quality of trauma-informed care (Fleishman et al., 2019). Social determinants such as living in under-resourced or racially segregated neighborhoods and experiencing food insecurity can result in toxic stress.  Social determinants that should be considered in trauma screening include poverty, neighborhood crime and violence, and racism (Mikhail et al., 2018). Health providers should increase protective factors to mitigate exposure to trauma and environmental factors that contribute to it.

Trauma mainly affects minority racial groups, children, adolescents, and older adults.  The data can be applied in trauma-informed care by emphasizing screening for trauma experiences among high-risk populations. Youssef et al. (2018) found that trauma exposure can be passed to offspring transgenerationally via the epigenetic inheritance mechanism of DNA methylation alterations. The genetic data can be synthesized in trauma-informed care by emphasizing trauma screening to persons whose close relatives were exposed to trauma.

Conclusion

More than 70% of the U.S population has encountered traumatic events such as homicide, sexual assault, shooting, and community violence. Trauma is associated with adverse effects on physical and mental health and impairments in social and occupational functioning. My proposed intervention is to incorporate peer support in trauma-informed care. Peers work together with patients to create relationships where they share their strengths and support each other’s healing. Peer support is expected to increase patient engagement and accelerate recovery. The intervention will be implemented over six months using an intervention and control group.

Benchmark – Evidence-Based Practice Project: PICOT Paper NUR 550 References

Crisanti, A., Murray-Krezan, C., & Reno, J. (2019). Are treatment groups led by peers as effective as groups led by counselors for treating posttraumatic stress disorder and substance use disorder? https://doi.org/10.25302/5.2019.ce.12114484

Fleishman, J., Kamsky, H., & Sundborg, S. (2019). Trauma-informed nursing practice. OJIN: The Online Journal of Issues in Nursing, 24(2). https://doi.org/10.3912/OJIN.Vol24No02Man03

Mikhail, J. N., Nemeth, L. S., Mueller, M., Pope, C., & NeSmith, E. G. (2018). The social determinants of trauma: a trauma disparities scoping review and framework. Journal of Trauma Nursing| JTN, 25(5), 266-281.

National Council for Behavioral Health. (2020, July 17). Trauma Infographic. National Council. https://www.thenationalcouncil.org/

Shalaby, R., & Agyapong, V. (2020). Peer support in mental health: Literature review. JMIR mental health, 7(6), e15572. https://doi.org/10.2196/15572

Youssef, N. A., Lockwood, L., Su, S., Hao, G., & Rutten, B. (2018). The Effects of Trauma, with or without PTSD, on the Transgenerational DNA Methylation Alterations in Human Offsprings. Brain sciences, 8(5), 83. https://doi.org/10.3390/brainsci8050083

Engaging in evidence-based practice (EBP) projects is among the most practical interventions for addressing health problems. Nurses use nursing interventions founded on research to enhance health outcomes. This paper describes the population, intervention, and expected outcome. It also explains the implementation time and the application of nursing science, social determinants of health, and epidemiologic, genomic, and genetic data in supporting the health management of children with obesity.

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Population’s Demographics and Health Concerns

The focus population for the EBP project is children usually categorized as preschool-aged children (2-5 years) and school-aged children (6-11 years). Preschool-aged children are usually highly dependent on parents’ choices, including nutritional health, hobbies, and general lifestyle. As they move from pre-school to school age, children become somewhat dependent on some choices. They start choosing hobbies and establish relationships that influence their daily habits.

Childhood obesity is a serious health concern in the United States whose prevalence is increasing and putting children at risk of poor health. Skinner et al. (2018) found that childhood obesity’s prevalence is still high in the US since 1 in every 5 children has obesity. As the prevalence of obesity increases, children are more exposed to immediate and long term risks of obesity. Vulnerability to heart disease, type 2 diabetes, and cancer is high in children with obesity (Lindberg et al., 2020). Overall, the quality of health declines and children are not productive as desired.

As the populace, government, and health care providers intensify measures to fight obesity, it is disappointing to experience a proportional risk in risk factors. According to Tester et al. (2018), lifestyle changes characterized by low physical activity are continuously exposing children to obesity. Fast foods’ consumption is another risk factor. Pearson et al. (2020) suggested that sedentary living characterized by too much screen time must be addressed to reduce childhood’s obesity prevalence. Gaming, watching television for extended periods, and social interaction through mobile phones can be blamed for the reduced physical activity among children. Regulation is necessary as parents, educators, and health care providers collaborate to encourage physical activity at homes, schools, and communities.

Benchmark – Evidence-Based Practice Project: PICOT Paper NUR 550

This is a capstone project class. All the way to NUR 590, we will focus on writing assignments that focus on your PICOT Question. Indeed, we will create the PICOT for you from week 1 of the present class. Kindly trust us with it.

Refer to the PICOT you developed for your evidence-based practice project proposal. If your PICOT required revision, include those revisions in this assignment. You will use your PICOT paper for all subsequent assignments you develop as part of your evidence-based practice project proposal in this course and in NUR-590, during which you will synthesize all of the sections into a final written paper detailing your evidence-based practice project proposal.

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Write a 750-1,000-word paper that describes your PICOT.

1. Describe the population’s demographics and health concerns.
2. Describe the proposed evidence-based intervention and explain how your proposed intervention incorporates health policies and goals that support health care equity for the population of focus.
3. Compare your intervention to previous practice or research.
4. Explain what the expected outcome is for the intervention.
5. Describe the time for implementing the intervention and evaluating the outcome.
6. Explain how nursing science, social determinants of health, and epidemiologic, genomic, and genetic data are applied or synthesized to support population health management for the selected population.
7. Create an Appendix for your paper and attach the PICOT. Be sure to review feedback from your previous submission and revise your PICOT accordingly.
8. Complete the “APA Writing Checklist” to ensure that your paper adheres to APA style and formatting criteria and general guidelines for academic writing. Include the completed checklist as the final appendix at the end of your paper.

Refer to the “Evidence-Based Practice Project Proposal – Assignment Overview” document for an overview of the evidence-based practice project proposal assignments.

You are required to cite at least four to six peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

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. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

Benchmark – Evidence-Based Practice Project: PICOT Paper SAMPLE

Engaging in evidence-based practice (EBP) projects is among the most practical interventions for addressing health problems. Nurses use nursing interventions founded on research to enhance health outcomes. This paper describes the population, intervention, and expected outcome. It also explains the implementation time and the application of nursing science, social determinants of health, and epidemiologic, genomic, and genetic data in supporting the health management of children with obesity.

Population’s Demographics and Health Concerns

The focus population for the EBP project is children usually categorized as preschool-aged children (2-5 years) and school-aged children (6-11 years). Preschool-aged children are usually highly dependent on parents’ choices, including nutritional health, hobbies, and general lifestyle. As they move from pre-school to school age, children become somewhat dependent on some choices. They start choosing hobbies and establish relationships that influence their daily habits.

Childhood obesity is a serious health concern in the United States whose prevalence is increasing and putting children at risk of poor health. Skinner et al. (2018) found that childhood obesity’s prevalence is still high in the US since 1 in every 5 children has obesity. As the prevalence of obesity increases, children are more exposed to immediate and long term risks of obesity. Vulnerability to heart disease, type 2 diabetes, and cancer is high in children with obesity (Lindberg et al., 2020). Overall, the quality of health declines and children are not productive as desired.

As the populace, government, and health care providers intensify measures to fight obesity, it is disappointing to experience a proportional risk in risk factors. According to Tester et al. (2018), lifestyle changes characterized by low physical activity are continuously exposing children to obesity. Fast foods’ consumption is another risk factor. Pearson et al. (2020) suggested that sedentary living characterized by too much screen time must be addressed to reduce childhood’s obesity prevalence. Gaming, watching television for extended periods, and social interaction through mobile phones can be blamed for the reduced physical activity among children. Regulation is necessary as parents, educators, and health care providers collaborate to encourage physical activity at homes, schools, and communities.

Evidence-Based Intervention

As proposed in the PICOT (Appendix 1), the identified intervention is educating parents and children on reducing screen time and increasing physical activity. Increased screen time increases obesity prevalence since it is associated with too much energy intake and low physical activity (Schwarzfischer et al., 2020). Educating parents and children is expected to trigger a positive behavior change as parents regulate children and children avoid spending too much time on the screens since they understand the implications. The intervention incorporates health policies and goals that support health equity for children since it focuses on ensuring that children attain their full health potential. Health equity is achieved when disadvantaged groups are protected from health disparities and helped to acquire a decent living standard. Keeping children free from obesity is a significant step towards achieving this critical goal.

Intervention Comparison to Previous Research

Previous research confirm that parents are responsible for modeling children’s behaviors by regulating screen time, and awareness to embrace this role is necessary. Pearson et al. (2020) found that shortage of parent- and home-focused interventions to address unhealthy behaviors such as intake of energy-dense snack foods and excessive screen time increases childhood obesity rates. Parental confidence and awareness of the association between screen time and unhealthy behaviors are also recommended. Goncalves et al. (2019) found that parental confidence and self-efficacy to reduce screen time is instrumental in addressing overweight problems among children. With research confirming the central role parents play in regulating screen time, it is essential to encourage them to embrace this critical role and serve as role models of healthy behaviors.

Expected Outcome

Educating parents and children on the implications of too much screen time is expected to be the foundation of behavior change. As a nursing intervention, the education program will improve knowledge on the connection between obesity in children and screen time as a risk factor. Minimizing screen time will lead to a proportional reduction in obesity rates among children, which has become a public health concern since its trend has taken an upward trajectory in the past decade (Skinner et al., 2018). The overall outcome is creating a healthy populace by reducing obesity rates among school-age children.

Time for Implementing and Evaluation

Implementation should be immediate. Since the focus population and intervention are known, parents and children’s education on screen time should be done instantly. Doing so will help to achieve the target objective within six months as proposed in the PICOT. Outcome evaluation will be progressive (monthly) and summative (after six months). Progressive evaluation will help to identify areas that need improvement, and summative evaluation will be used to deduce whether the target objectives were achieved.

Applying Nursing Science, SDOH, and Data

Population health management for children applies evidence, tools, and data from different sources. Nursing science helps to develop theories and practical concepts to manage conditions. It provides scientific ways to deliver better health services. Social determinants of health (SDOH) have much to do with living conditions. In this case, health care providers examine how environments where children are born and live, beliefs and socioeconomic status influence obesity and other illnesses and appropriate interventions. Epidemiological data is the basis for determining disease frequency and potential causes. Genomic and genetic data are closely related. Genomic data examines functional information in DNA as genetic data examines the acquired characteristics of children and their influence on health.

In conclusion, children deserve quality health and should be protected from vulnerabilities such as obesity. In response, nurses should use their knowledge and influence to promote quality public health. They should be centrally involved in identifying critical problems that hamper people’s productivity and invent lasting solutions. Addressing childhood obesity by educating parents and children on reducing screen time is an evidence-based lasting solution.

Benchmark – Evidence-Based Practice Project: PICOT Paper NUR 550 References

Goncalves, W. S. F., Byrne, R., Viana, M. T., & Trost, S. G. (2019). Parental influences on screen time and weight status among preschool children from Brazil: A cross-sectional study. International Journal of Behavioral Nutrition and Physical Activity, 16(1), 1-8. doi: https://dx.doi.org/10.1186%2Fs12966-019-0788-3

Lindberg, L., Danielsson, P., Persson, M., Marcus, C., & Hagman, E. (2020). Association of childhood obesity with risk of early all-cause and cause-specific mortality: A Swedish prospective cohort study. PLoS Medicine, 17(3), e1003078. https://doi.org/10.1371/journal.pmed.1003078

Pearson, N., Biddle, S. J., Griffiths, P., Sherar, L. B., McGeorge, S., & Haycraft, E. (2020). Reducing screen-time and unhealthy snacking in 9–11 year old children: the Kids FIRST pilot randomised controlled trial. BMC Public Health, 20(1), 1-14. doi: 10.1186/s12889-020-8232-9

Schwarzfischer, P., Gruszfeld, D., Socha, P., Luque, V., Closa-Monasterolo, R., Rousseaux, D., … & Grote, V. (2020). Effects of screen time and playing outside on anthropometric measures in preschool aged children. PloS One, 15(3), e0229708. https://doi.org/10.1371/journal.pone.0229708

Tester, J. M., Phan, T. L. T., Tucker, J. M., Leung, C. W., Gillette, M. L. D., Sweeney, B. R., … & Eneli, I. U. (2018). Characteristics of children 2 to 5 years of age with severe obesity. Pediatrics, 141(3). doi: https://doi.org/10.1542/peds.2017-3228

Skinner, A. C., Ravanbakht, S. N., Skelton, J. A., Perrin, E. M., & Armstrong, S. C. (2018). Prevalence of obesity and severe obesity in US children, 1999–2016. Pediatrics, 141(3). https://doi.org/10.1542/peds.2017-3459

Benchmark Information

This benchmark assignment assesses the following programmatic competencies:

MBA-MSN; MSN-Nursing Education; MSN Acute Care Nurse Practitioner-Adult-Gerontology; MSN Family Nurse Practitioner; MSN-Health Informatics; MSN-Health Care Quality and Patient Safety; MSN-Leadership in Health Care Systems; MSN-Public Health Nursing

MS Nursing: Public Health

MS Nursing: Education

MS Nursing: Acute Care Nurse Practitioner

MS Nursing: Family Nurse Practitioner

MS Nursing: Health Care Quality and Patient Safety

4.1: Synthesize nursing science, determinants of health, and epidemiologic, genomic, and genetic data in the management of population health.

Course Code Class Code Assignment Title Total Points
NUR-550 NUR-550-O503 Benchmark – Evidence-Based Practice Project: PICOT Paper 150.0

Criteria Percentage Unsatisfactory (0.00%) Less Than Satisfactory (80.00%) Satisfactory (88.00%) Good (92.00%) Excellent (100.00%)
Content 70.0%
Population Demographics and Health Concerns 5.0% The demographics and health concerns for the population are not described. The demographics and health concerns for the population are incorrect or only partially described. The demographics and health concerns for the population are summarized. More information and supporting evidence are needed. The demographics and health concerns for the population are described using sufficient evidence. The demographics and health concerns for the population are accurate and thoroughly described using substantial evidence.

Proposed Evidence-Based Intervention 13.0% The proposed evidence-based intervention is omitted. The proposed evidence-based intervention is incomplete. It is unclear how the proposed intervention incorporates health policies and goals that support health care equity for the population of focus. The proposed evidence-based intervention is outlined. Explanation of how the proposed intervention incorporates health policies and goals that support health care equity for the population of focus is general. Some aspects are unclear. More information is needed. The proposed evidence-based intervention is described. Explanation of how the proposed intervention incorporates health policies and goals that support health care equity for the population of focus is adequate. Some detail is needed for clarity or accuracy. The proposed evidence-based intervention is well-developed and clearly described. Explanation of how the proposed intervention incorporates health policies and goals that support health care equity for the population of focus is thorough.

Comparison of Intervention to Current Research 12.0% Comparison of intervention to previous practice or research is omitted. Comparison of intervention to previous practice or research is incomplete. Comparison of intervention to previous practice or research is generally presented. Some areas are vague. Comparison of intervention to previous practice or research is adequately presented. Comparison of intervention to previous practice or research is thorough and clearly presented.

Expected Outcome for Intervention 10.0% The expected outcome is for the intervention is omitted. The expected outcome is for the intervention is incomplete. The expected outcome is for the intervention is summarized. More information and supporting evidence is needed. The expected outcome for the intervention is explained using sufficient evidence. The expected outcome for the intervention is thoroughly explained using substantial evidence.

Time Estimated for Implementing Intervention and Evaluating Outcome 10.0% A description of the timeline is not included. A description of the timeline is incomplete or incorrect. A description of the timeline is included but lacks evidence. A description of the timelines is complete and includes a sufficient amount of evidence. A description of the timelin