SWOT Analysis Discussion Response: Health & Medical Answers 2021

SWOT Analysis Discussion Response: Health & Medical Answers 2021

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Preventing Patient Falls Within
Facilities
Melissa Levitt
INDIANA WESLEYAN UNIVERSITY
NUR 440: EVIDENCE-BASED NURSING
FACULTY: Sara Strohminger
DATE: 3/29/2021
Falls: Risk Factors and Interventions
? The average number of falls per 1,000 occupied bed days in the United States of America (USA) was 3.44
(Baris & Seren Intepeler, 2019, p. 2).
? ?Estimated that 391,000 people died in 2002 because of falls, making it the second leading cause of
death resulting from unintentional injury after traffic accidents,? (Midori Sakai et al, 2016, p. 2)
? Risk factors are mental status, body functions, and environmental factors.
? ?71 causes of falls were determined, 27 of which were related to body functions, three were related to
body structures, 11 were related to activity and participation, 27 were related to environmental factors,
and three were related to personal factors,? (Baris & Seren Intepeler, 2019, p. 5).
? ?321 falls of hospitalized patients were recorded, of them,58.9% occurred in clinical hospitalization units
and 19.2% in surgical hospitalization units,? (Midori Sakai et al, 2016, p. 4)
? Some interventions are the use of walking?assistant devices, educating patients by visual (video etc.)
methods, and warning posters (Baris & Seren Intepeler, 2019, p. 6).
? Risk factors like excessive conversations or noise and illumination not adequate. Interventions like
elevation of the lateral bed rails and beds in low position (Midori Sakai et al, 2016, p. 5)
Research Question
What are the risk factors for falls
and how can we prevent them?
Hypothesis
?Giving nurses the autonomy to
implement fall preventions and
interventions will aide in decreasing
patient falls and length of stay within
facilities.
Research Article #1:
Views of key stakeholders on the causes of patient falls and
prevention interventions: A qualitative study using the
international classification of functioning, disability and health
? Purpose: To examine the views and suggestions of healthcare professionals, patients and family
members on the causes of inpatient falls and fall?prevention practices.
? Conduction: Designed using a descriptive qualitative research method, with semi?structured
interviews of four physicians, four charge nurses, 12 nurses, four support staff members, eight
patients and eight family members of patients in the palliative, internal disease, surgery and
orthopedic clinics
? Results and findings: Causes of falls were mostly related to body functions and environmental
factors; stakeholders in the further studies of patient falls will provide a more detailed analysis
of this topic; asking patients and family members for their opinions on the practical
development of fall?prevention programs and their developmental process will lead more
comprehensive and effective fall?prevention programs; systematic and detailed classification of
the causes of falls will be useful to define the prioritized areas of the prevention programs.
(Baris & Seren Intepeler, 2019)
Research Article #2:
RISK OF BED FALLS IN ADULT PATIENTS AND
PREVENTION MEASURES
? Purpose: To analyze the adequacy between the evaluation of the risk in adult patients? fall and
the prevention measures adopted.
? Conduction: This is a descriptive, cross-sectional study with a quantitative approach. The
sample consisted of 1,408 patients from a public university hospital. Data were collected
through the application of the Morse Scale and evaluation of bed fall prevention measures.
? Results and findings: Patients older than 60 years old had a higher risk of falls. Individuals
classified as having high risk were those who were connected to venous devices, and those with
a previous history of falling and with a disoriented state of mind. Prevention measures were
adequate in 91.0%. Knowing the risks of falling and the quality indicators, associated with the
awareness and training of professionals are essential measures in the prevention of incidents
and adverse events.
(Midori Sakai et al, 2016)
Interventions
?
?
?
?
Collaborate with floor manager
Gain approval from facility IRB
Assess mental, physical, and physiological status
Do not place SCD?s on confused patients that spontaneously try to get
out of bed
? Place fall mats when patient is appropriate
? Have appropriate assistive devices nearby
Evaluation of the intervention
? From charts, compare
? From fall trends, before and after implementations
? From patient surveys
? Control group from the past 6 months.
Communicating findings of pilot study?
Power Point presentation to:
? Floor manager
? Preceptor
? Director of nursing
? Safety Committee/IRB
Potential Barriers to Implementation
of Pilot Study findings
1. Lack of support from OR director
2. Lack of staff cooperation to implement
3. Patient compliance/understanding
Strategies to Overcome Barriers?
1. Present to the directors the benefits of implementing new interventions
2. Educate the employees on the new interventions to be implemented and address all
questions
3. Educate and reeducate the patients on the importance of compliance
Evaluation: How will you measure whether the
intervention achieved the desired results?
? Addresses the issue of nursing knowledge risk factors for falls and proper interventions
? Quantitative nonexperimental descriptive study
? Participants voluntarily completed an electronic survey
? Findings indicate a need for continuing education regarding the parameters for fall risks
References
? Baris, V. K., & Seren Intepeler, S. (2019). Views of key
stakeholders on the causes of patient falls and prevention
interventions: A qualitative study using the international
classification of functioning, disability and health. Journal of
Clinical Nursing (John Wiley & Sons, Inc.), 28(3/4), 615?628.
https://doi.org/10.1111/jocn.14656
? Midori Sakai, A., Rossaneis, M. ?., Fernandez Louren?o Haddad,
M. do C., & Willamowius Vituri, D. (2016). Risk of Bed Falls in
Adult Patients and Prevention Measures. Journal of Nursing
UFPE / Revista de Enfermagem UFPE, 10, 4720?4726.
https://doi.org/10.5205/reuol.8200-71830-3SM.1006sup201602
Lost in translation: how to care
for our patients who speak
another language
Amanda Short
Indiana Wesleyan University
NUR 440: Evidenced-Based Nursing
Professor Sarah Strohminger
April 5, 2021
Research problem:
The problem is how do we, as nurses, make sure that our patients that
come from a different culture and speak a different language than our
own are getting the care they deserve.
Language barriers have always been a huge barrier in patient care and
education. Patients feel as though they slip through the cracks and are
not given adequate care.
How are we sure that our patient fully understands the medical
explanation I gave to them? How do we know that the patient has all of
their questions answered?
Research question:
If educational pamphlets are translated into each
language that our patients speak by a native speaker
of that language, will there be less questions called in
to the clinic after appointments?
Hypothesis:
Having educational materials that the patients can
take home and read and reread about their illnesses
and their medications will reduce the number of calls
we have after appointments to clarify directions of
home care and directions of medications.
Review Article 1:
The first article took an instrument (HSOPSC) used here in the United States and
translated it into Spanish to use in Peru to see if the instrument can be used crossculturally.
They had trouble with translating the instrument from English to Spanish due to different
cultures using different slang to describe the same thing. They also had issues translating
because there are certain English words that do not have a Spanish equivalent.
The conclusion of the article states that they had to make the instrument similar but very
different from other Spanish versions. It did work for the patients but with further study
and research they could make it better for future use.
Palmieri, P., Leyva-Moral, J., Camacho-Rodriguez, D., Granel-Giminez, N., Ford, E., Mathieson, K., & Leafman, J. (2020). Hospital survey on patient
safety culture (HSOPSC): a multi-method approach for target-language instrument translations, adaptation, and validation to
improve the equivalence of meaning for cross-cultural research. BioMed Central. 19(23). DOI: 10.1186/s12912-020-00419-9.
Review Article 2:
The second article is a study about fieldworkers from 4 different languages and how they
felt about their healthcare.
This study used thematic analysis to identify, analyze, and report patterns from the data
collected.
In conclusion, the researchers found that there are several complex factors that help or
hinder patients? experiences through their health care. The main factor is poor
engagement by the healthcare worker that does not speak the patient?s language. The
patient?s experience was not based on just the words that were being translated but on
the experience as a whole.
Harrison, R., Walton, M., Chitkara, U., Manias, E., Chauhan, A., Latanik, M., & Leone, D. (2020). Beyond translation: Engaging with
culturally and linguistically diverse consumers. Health Expectations, (23) pp. 159-168. DOI: 10.1111/hex.12984.
Evidenced based strategy:
For four weeks, patients will be selected with certain illnesses
and medications and will be given prepared pamphlets before
leaving the office. Calls will be monitored to see if these
patients call the office for any questions regarding their
illnesses or medications. The pamphlets will also be gone over
before leaving the office to give the patient a chance to ask
any questions they may have. The patient will be instructed to
use the sheet as a reference on their illness or medication.
After the four weeks, the data will be collected and analyzed
for patterns among the patients and their return calls.
Barriers:
The first major barrier is that it is not feasible to make pamphlets for
every illness and every medication.
How to make it cost saving while serving our several dialects that are
spoken in the office.
Support by staff in passing out the pamphlets to the appropriate
patients and appropriate dialects.
Strategies to Overcome Barriers:
Print out pamphlets on the top 20 illnesses and the top 30 medications only.
Make them available in a central location, so they are easily accessible.
Make sure the medications and illnesses are double checked before passing out
pamphlets to make sure the patient receives the correct ones.
Make the pamphlets electronic so that they can be selected as part of an office
discharge and printed out as the patient checks out.
Evaluation:
Evaluation of this project will show that more research and studies should be done to
see how to best educate patients who speak a different language from the educator.
This study can be evaluated by the number of pamphlets passed out versus the number
of calls made after appointments. This can be done by tracking the patients that
received pamphlets and if they called back after their appointment within the following
week.
Communication Methods:
This study will be shared by acknowledging the data
and sharing the results with coworkers at different
locations within the same healthcare network. It will
be shared to them in PowerPoint form as well as
email, and shown examples.
References:
Harrison, R., Walton, M., Chitkara, U., Manias, E., Chauhan, A., Latanik, M., & Leone, D. (2020). Beyond translation:
Engaging with culturally and linguistically diverse consumers. Health Expectations, (23) pp. 159-168. DOI:
10.1111/hex.12984.
Palmieri, P., Leyva-Moral, J., Camacho-Rodriguez, D., Granel-Giminez, N., Ford, E., Mathieson, K., & Leafman, J. (2020).
Hospital survey on patient safety culture (HSOPSC): a multi-method approach for target-language instrument
translations, adaptation, and validation to improve the equivalence of meaning for cross-cultural research.
BioMed Central. 19(23). DOI: 10.1186/s12912-020-00419-9.
Foundations of Nursing Research
Seventh Edition
Chapter 3
Evidence-Based Nursing
Practice
Copyright ? 2018, 2013, 2008 Pearson Education, Inc. All Rights Reserved
Learning Objectives
3.1 Explain how the concept of evidence-based practice (E
BP) is evolving in nursing
3.2 Describe models that promote the implementation of E
BP in nursing practice
3.3 Identify barriers that could challenge the effective
implementation of an EBP
3.4 Incorporate ideas into a plan for facilitating the success
of an EBP
3.5 Develop a plan for implementing an EBP for nurses in a
clinical setting
Copyright ? 2018, 2013, 2008 Pearson Education, Inc. All Rights Reserved
Learning Objective 3.1
Explain how the concept of evidence-based practice (E
BP) is evolving in nursing
Copyright ? 2018, 2013, 2008 Pearson Education, Inc. All Rights Reserved
The Evolving Nature of Evidence-Based
Practice (1 of 3)
? Definition of EBP has evolved to include concepts of
quality and efficiency.
? Translation science has been used interchangeably with
EBP.
Copyright ? 2018, 2013, 2008 Pearson Education, Inc. All Rights Reserved
The Evolving Nature of Evidence-Based
Practice (2 of 3)
? Titler defines EBP as the application of ?the conscientious
and judicious use of current best evidence in conjunction
with clinical expertise and patient values to guide health
care decisions?
? Translation science is described as ?the study of
implementation interventions, factors, and contextual
variables that affect knowledge uptake and use in
practices and communities?.
Copyright ? 2018, 2013, 2008 Pearson Education, Inc. All Rights Reserved
The Evolving Nature of Evidence-Based
Practice (3 of 3)
? Nursing profession is in process of using EBP
interventions that rest on best research knowledge
available.
? Researchers are to demonstrate interventions are
effective in producing desired outcomes in clinical
practice.
Copyright ? 2018, 2013, 2008 Pearson Education, Inc. All Rights Reserved
Learning Objective 3.2
Describe models that promote the implementation of EB
P in nursing practice
Copyright ? 2018, 2013, 2008 Pearson Education, Inc. All Rights Reserved
Models to Promote Evidence-Based
Practice in Nursing (1 of 21)
? Stetler Model
? Stetler Model of Research Utilization to Facilitate EBP
? Iowa Model
? Iowa Model of Evidence Based Practice to Promote
Quality of Care
Copyright ? 2018, 2013, 2008 Pearson Education, Inc. All Rights Reserved
Models to Promote Evidence-Based
Practice in Nursing (2 of 21)
? The Stetler Model
? Provides framework to facilitate use of research
evidence in practice for individual nurses or
healthcare institutions
Copyright ? 2018, 2013, 2008 Pearson Education, Inc. All Rights Reserved
Models to Promote Evidence-Based
Practice in Nursing (3 of 21)
? Five phases of activities that guide the nurse:
1. Preparation
2. Validation
3. Comparative evaluation and decision making
4. Translation and application
5. Evaluation
Copyright ? 2018, 2013, 2008 Pearson Education, Inc. All Rights Reserved
Models to Promote Evidence-Based
Practice in Nursing (4 of 21)
? Preparation
? Collection of information that provides the reason to
change the practice
? Validation
? Critical analysis of research related to potential
practice
? Comparative evaluation and decision making
? Deals with fit of evidence to clinical setting
? Feasibility of using the research findings
? Decision that a new practice activity would make a
positive difference to patient outcomes
Copyright ? 2018, 2013, 2008 Pearson Education, Inc. All Rights Reserved
Models to Promote Evidence-Based
Practice in Nursing (5 of 21)
? Translation and application
? Involves the actual implementation of the practice
? Evaluation
? Includes both informal and formal evaluations
Copyright ? 2018, 2013, 2008 Pearson Education, Inc. All Rights Reserved
Models to Promote Evidence-Based
Practice in Nursing (6 of 21)
? The Iowa Model
? Provides direction for development of EBP in a
clinical agency with a built-in focus toward informing
QI after practice is established
Copyright ? 2018, 2013, 2008 Pearson Education, Inc. All Rights Reserved
Models to Promote Evidence-Based
Practice in Nursing (7 of 21)
? Continuum of activities advancing from
1. Identifying either problem-focused or knowledge-focused
triggers
2. Forming a team
3. Assembling, synthesizing, and critiquing research associated
with a practice that would provide a solution for the trigger
4. Piloting the new practice
5. Evaluating the structure, processes, and outcomes of the
practice
6. Disseminating the results
7. Returning to first steps of identifying triggers that may
indicate a need for a revision of EBP
Copyright ? 2018, 2013, 2008 Pearson Education, Inc. All Rights Reserved
Models to Promote Evidence-Based
Practice in Nursing (8 of 21)
? Discussion of Iowa Model Concepts
? Problem-focused trigger
? Clinical problem or data that relates to risk
management, process improvement,
benchmarking, and financial issues
? Knowledge-focused trigger
? Relates to new research findings or changes in
agency standards
Copyright ? 2018, 2013, 2008 Pearson Education, Inc. All Rights Reserved
Models to Promote Evidence-Based
Practice in Nursing (9 of 21)
? Success of the implementation of an EBP depends on
a team effort.
? Important to build a cultural environment for
implementation of transferring research evidence into
clinical practice
? Required before team is feasible
Copyright ? 2018, 2013, 2008 Pearson Education, Inc. All Rights Reserved
Models to Promote Evidence-Based
Practice in Nursing (10 of 21)
? At organization level, agency can:
? Recognize staff members who actively work
toward improving their practice with EBPs on
annual nursing performance evaluations.
? Create a novice-to-expert competency framework
for nurses who wish to eventually guide EBP
project.
? Offer educational opportunities from experts from
local universities to help nurses search databases
and critique sources of information.
Copyright ? 2018, 2013, 2008 Pearson Education, Inc. All Rights Reserved
Models to Promote Evidence-Based
Practice in Nursing (11 of 21)
? At unit level, agency can:
? Arrange for time allotments and shared
governance committees.
? Provide built-in coaching supports with the nurses?
daily responsibilities.
Copyright ? 2018, 2013, 2008 Pearson Education, Inc. All Rights Reserved
Models to Promote Evidence-Based
Practice in Nursing (12 of 21)
? Need to assemble, synthesize, and critique research
that addresses a specific trigger stems
? Not all interventions are appropriate for all clinical
settings
? Assembled research evidence must be evaluated
? Nurses must be active learners
Copyright ? 2018, 2013, 2008 Pearson Education, Inc. All Rights Reserved
Models to Promote Evidence-Based
Practice in Nursing (13 of 21)
? Consideration for appraising evidence rests on
understanding hierarchy or level of evidence of
studies.
? Different levels of evidence provide various types
of confidence.
? Hierarchy of evidence
? Ranks from systematic review of randomized
controlled trials (RCT) as highest
? Least high level of evidence is consensus opinion
Copyright ? 2018, 2013, 2008 Pearson Education, Inc. All Rights Reserved
Models to Promote Evidence-Based
Practice in Nursing (14 of 21)
? Nurses need to:
? Understand more than essential elements of the
quality of an EBP.
? Combine clinical expertise with knowledge of a
patient?s preferences, values, and engagement in
care decisions.
Copyright ? 2018, 2013, 2008 Pearson Education, Inc. All Rights Reserved
Models to Promote Evidence-Based
Practice in Nursing (15 of 21)
? Implementing research-based evidence into nursing
practices:
? Pr?

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