Discussion: Evidence-Based Practice Project Literature Review

Benchmark -Evidence-Based Practice Project Literature Review NUR 550

The purpose of this assignment is to write a review of the research articles you evaluated in your Topic 5 “Evidence-Based Practice Project: Evaluation of Literature” assignment. If you have been directed by your instructor to select different articles in order to meet the requirements for a literature review or to better support your evidence-based practice project proposal, complete this step prior to writing your review.

The occurrence of medication administration errors hinders effective attainment of quality and safe patient care and outcomes. Medication administration errors are significant safety issue in health care sector, especially when there are different crises affecting healthcare and quality outcomes. The susceptibility of patients to medication administration errors increase with reduced number of healthcare workers against an increase in demand for services due to several factors. Medication administration errors (MAEs) increase the length of stay for critically ill patients and cost of care. Studies demonstrate that leveraging health information technologies that include barcode scanning and other interventions can reduce and prevent the occurrence of these events, especially among the critically ill patients. The purpose of this literature review is to offer a comparison of the articles that supports the evidence-based practice project of using health information technology to reduce the occurrence of medication administration errors among the critically ill patients. The review also identifies the methods used to search the literature and synthesizes it for effective understanding and use for the selected eight articles.

PICOT Statement

The use of health information technology can reduce and prevent the prevalence of medication administration errors (MAEs) among critically ill patients. The use of interventions like barcode scanning and electronic dispensation ensures that human errors that occur during medication dispensation are reduced or minimized, especially the critically-ill patients in different health settings.

PICOT Question for the Evidence-Based Practice Project

Among the critically ill patients (P), does the integration of health information technology (I) compared to conventional medication administration process (C), lead to a reduction in medication administration errors (O) during patient’s stay (T)?

Search Methods of the Literature

Effective search of articles comprises of using appropriate approaches and terms that align with the topic of interest. In this assignment, I employed different yet related strategies to search for the articles that support the EBP project. These included using institutional library to get databases of journals and their published peer-reviewed articles. I used terms like “peer review” and “scholarly works” about medication administration errors. Through these approaches, I obtained the articles that I used in providing this literature review as they support my EBP project. I also ensured that the article meet the criteria of being published within the last five years and are relevant to the nursing context and use.

Part B: Literature Review

Diabetes is one of the health issues that has placed a significant burden on the global population. Diabetes was diagnosed in approximately 1.4 million Americans in 2015, according to the Centers for Disease Control and Prevention. The diabetes population was reported to be 30.2 million during this time period, accounting for 12.2% of all adults in the United States (CDC, 2017). As a result, effective treatments are required to reduce the state’s diabetes prevalence and effects. According to a study, African-Americans are disproportionately affected by diabetes in the United States. This is evident in their high prevalence of type 2 diabetes, as well as the disease’s worsening course. This population’s low adherence to therapy can also be attributed to their increased illness burden. As a result, many of the poor in developed countries have low levels of adherence to therapy in patients with chronic diseases (Elsous et al., 2017). Low or poor adherence to diabetes treatment frequently results in health outcomes such as worsening of pre-existing conditions, high rates of diabetes-related mortality, increased hospital visits and stays, increased healthcare spending, and a decline in individual and social productivity (Alqarni et al., 2019). Treatment adherence interventions for African-American patients with type 2 diabetes should be implemented. Studies have been conducted to determine the efficacy of health information technologies such as telemedicine and mHealth in promoting treatment adherence (Conway & Kelechi, 2017). As a result, this research study provides a literature review on the potential benefits of using health information technologies to promote treatment adherence in type 2 diabetes patients.

A literature review provides a concise comparison of the literature for the reader and explains how the research demonstrates support for your PICOT. In this NUR-590 assignment, you will conduct a literature review and prepare a final paper outlining your evidence-based practice project idea.

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In a paper of 1,250-1,500, select eight of the ten articles you evaluated that demonstrate clear support for your evidence-based practice and complete the following for each article:

1. Introduction – Describe the clinical issue or problem you are addressing. Present your PICOT statement.
2. Search methods – Describe your search strategy and the criteria that you used in choosing and searching for your articles.
3. Benchmark -Evidence-Based Practice Project Literature Review NUR 550 Synthesis of the literature – For each article, write a paragraph discussing the main components (subjects, methods,key findings) and provide rationale for how the article supports your PICOT.

Literature Synthesis, Part A

The research articles by Greenwood et al. (2017), Hashmi and Khan (2018), Xu et al. (2018), Yoshida et al. (2018), and Huang et al. (2019) were selected for this review of literature. The research by Greenwood et al. (2017) is a systematic review of the technologies used in promoting self-management and educational support by patients with diabetes. The methodology entailed a review of high quality research articles as well as meta-analyses on the use of technology for self-management and education in diabetes. The articles used in the review were published between 2013 and 2017. The results from 25 articles that were included in the review showed that health information technologies promoted a reduction in the level of A1c post-intervention. The reduction was attributed to improved communication, adherence, feedback, and education (Greenwood et al., 2017). This article supports my PICOT statement by demonstrating that the use of health information technologies can improve the outcomes of care in patients with type 2 diabetes. It shows that the technologies promote positive behavioral change in the patients, hence, better management of the condition.

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The research article by Hashmi and Khan (2018) is an interventional study that investigated the use of mobile health in improving adherence to diabetic guidelines in Pakistan. The study used 62 medical officers and trainees who were placed to either intervention or control groups. their knowledge and adherence to guidelines of diabetes management were obtained at the beginning and end of the study to determine the effect of the intervention. The treatment group received regular SMS on the guidelines for five months. The outcomes showed that the use of m-Health technology resulted in significant improvement in knowledge, practice and adherence to guidelines among the participants. Therefore, the authors concluded that the improvement in adherence to the use of technology could also be replicated in patients with diabetes. This article supports my PICOT by showing the effectiveness of health information technologies in improving adherence to treatment in patients with diabetes.

The article by Xu et al. (2018) investigated the use of telemedicine in the treatment of type 1 diabetes. The researchers used veterans with the condition who resided in rural Georgia and Alabama. The methods utilized included retrospective review of patient charts with a focus on the level of hemoglobin A1c. The results from 32 patients who received telehealth care revealed that there was a decrease in the mean level of hemoglobin A1c and variability in glucose. There was also increased adherence among patients (88%) to scheduled appointments and 100% satisfaction with the use of telehealth. Therefore, the authors recommended the use of telehealth in improving adherence and other treatment outcomes in diabetes management. This article supports my PICOT statement by demonstrating the efficacy of health information technology in promoting adherence to treatment in patients with diabetes. It also shows that it improves other metrics of care such as satisfaction with care.

1. Comparison of articles – Compare the articles (similarities and differences, themes, methods, conclusions, limitations, controversies).
2. Suggestions for future research: Based on your analysis of the literature, discuss identified gaps and which areas require further research.
3. Conclusion – Provide a summary statement of what you found in the literature.
4. 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 an 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 eight 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 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

3.2: Analyze appropriate research from databases and other information sources to improve health care practices and processes.

Course Code Class Code Assignment Title Total Points
NUR-550 NUR-550-O503 Benchmark -Evidence-Based Practice Project: Literature Review 175.0

Criteria Percentage Unsatisfactory (0.00%) Less Than Satisfactory (80.00%) Satisfactory (88.00%) Good (92.00%) Excellent (100.00%)
Content 70.0%
Introduction 5.0% The clinical issue or problem and PICOT statement are omitted. The clinical issue or problem and PICOT statement are incomplete or incorrect. The clinical issue or problem and PICOT statement are presented. Some aspects are vague. There are minor inaccuracies. The clinical issue or problem and PICOT statement are adequately described. The clinical issue or problem and PICOT statement are thoroughly described.

Search Methods 10.0% The search strategy and criteria used in choosing and searching for articles are omitted. The search strategy and criteria used in choosing and searching for articles are only partially described. The search strategy and criteria used in choosing and searching for articles are summarized. More information is needed. The search strategy and criteria used in choosing and searching for articles are described. Some detail is needed for clarity or accuracy. The search strategy and criteria used in choosing and searching for articles is thoroughly described.Benchmark -Evidence-Based Practice Project Literature Review NUR 550

Synthesis of Literature 10.0% A paragraph for one or more article is missing. All articles are presented, but the synthesis of literature is incomplete. A summary for each article is presented. The main components (subjects, methods, key findings) are generally discussed. General rationale for how each article supports the PICOT is provided. More information is needed. A paragraph for each article is presented. The main components (subjects, methods, key findings) are adequately discussed, and rationale for how each article supports the PICOT is provided. Some detail is needed for clarity or accuracy. A well-developed paragraph for each article is presented. The main components (subjects, methods, key findings) are thoroughly discussed, and substantial rationale for how each article supports the PICOT is clearly provided.

Comparison of Articles 10.0% One or more article is missing in the comparison. All articles are presented, but the comparison is incomplete. A general comparison of the similarities, differences, themes, methods, conclusions, limitations, and controversies among the articles is presented. Some aspects are unclear. More information is needed. A comparison of the similarities, differences, themes, methods, conclusions, limitations, and controversies among the articles is adequately presented. Some detail is needed for clarity or accuracy. A detailed comparison of the similarities, differences, themes, methods, conclusions, limitations, and controversies among the articles is thoroughly presented.

Suggestions for Future Research 10.0% Identified gaps and areas requiring further research are omitted. Identified gaps and areas requiring further research are only partially presented. Some identified gaps and areas requiring further research are generally discussed. The narrative is generally based on the analysis of the literature. More information is needed. Identified gaps and areas requiring further research are adequately discussed. The narrative is based on the analysis of the literature. Some detail is needed for clarity or accuracy. Identified gaps and areas requiring further research are thoroughly discussed and clearly based on the analysis of the literature. The narrative is insightful and demonstrates an understanding of research analysis necessary for future study.

Conclusion 5.0% The conclusion is omitted. A conclusion is presented but fails to present a summary statement of what was found in the literature. The conclusion presents a vague summary statement of was found in the literature. There are inaccuracies. The conclusion presents an adequate summary statement of what was found in the literature. The conclusion is well-developed and presents a clear and accurate summary statement of what was found in the literature. Benchmark -Evidence-Based Practice Project Literature Review NUR 550

Ability to Analyze (C3.2) 10.0% The literature review presented does not demonstrate an ability to analyze appropriate research from databases and other information sources to improve health care practices and processes. The literature review presented does not consistently demonstrate an ability to analyze appropriate research from databases and other information sources to improve health care practices and processes. The literature review presented demonstrates a general ability to analyze appropriate research from databases and other information sources to improve health care practices and processes. The literature review presented demonstrates an adequate ability to analyze appropriate research from databases and other information sources to improve health care practices and processes. The literature review presented demonstrates a strong ability to analyze appropriate research from databases and other information sources to improve health care practices and processes.

Appendix 5.0% The appendix and required resources are omitted. The APA Writing Checklist is attached, but an appendix has not been created. The paper does not reflect the use of the APA Writing Checklist during development The APA Writing Checklist is attached and in the appendix. The APA Writing Checklist was generally used in development of the paper, but some aspects are inconsistent with the paper format or quality. The APA Writing Checklist is attached in the appendix. It is apparent that the APA Writing Checklist was used in development of the paper. The APA Writing Checklist is attached in the appendix. It is clearly evident by the quality of the paper that the APA Writing Checklist was used in development.

Required Sources 5.0% Sources are not included. Number of required sources is only partially met. Number of required sources is met, but sources are outdated or inappropriate. Number of required sources is met. Sources are current, but not all sources are appropriate for the assignment criteria and nursing content. Number of required resources is met. Sources are current and appropriate for the assignment criteria and nursing content.

Organization and Effectiveness 20.0%
Thesis Development and Purpose 7.0% Paper lacks any discernible overall purpose or organizing claim. Thesis is insufficiently developed or vague. Purpose is not clear. Thesis is apparent and appropriate to purpose. Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose. Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear. Benchmark -Evidence-Based Practice Project Literature Review NUR 550

Argument Logic and Construction 8.0% Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources. Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility. Argument is orderly but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis. Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative. Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.

Mechanics of Writing (includes spelling, punctuation, grammar, language use) 5.0% Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used. Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed. Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech. Writer is clearly in command of standard, written, academic English.

Format 10.0%
Paper Format (Use of appropriate style for the major and assignment) 5.0% Template is not used appropriately or documentation format is rarely followed correctly. Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent. Template is used, and formatting is correct, although some minor errors may be present. Template is fully used; There are virtually no errors in formatting style. All format elements are correct.

Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style) 5.0% Sources are not documented. Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors. Sources are documented, as appropriate to assignment and style, although some formatting errors may be present. Sources are documented, as appropriate to assignment and style, and format is mostly correct. Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.

Topic 7 DQ 1

Identify two major policy issues that affect the current state of health care delivery and population health equity in the United States (may be state or federal). What impact do these population health policies and initiatives have on advanced nursing practice?

Re: Topic 7 DQ 1

Maternal morbidity and mortality is often caused by factors such as cardiovascular disease and hypertension requiring care longer than two months postpartum. One-third of pregnancy related deaths occur between one week and one year after delivery, and almost 12% occur after the regular six-week postpartum visit. This had led to an increased recognition that postpartum women need comprehensive care beyond two months—therefore also need the insurance coverage to ensure continuity of services.

Women who qualify for Medicaid on the basis of pregnancy receive a variety of services including prenatal care, and labor and delivery services. Under current law, states must provide Medicaid coverage to all pregnant women who earn up to 138% of the federal poverty level (FPL) through two months postpartum and provide Medicaid coverage for the infant for the first year of birth. Extending Medicaid coverage beyond two months postpartum ensures access to services both during and after pregnancy (Association of State and Territory Health Officials, 2021).

Since 2015, legislators in at least seven states, as well as Congress, have introduced 15 bills to finance substance use disorder prevention and treatment activities by imposing a surcharge, tax, or fee on prescription opioids. Although none of these bills have been enacted, it is a new approach that states are exploring to combat the opioid epidemic. Proponents of the measures claim that as the opioid epidemic is driven, in part, by the over-marketing and over-prescribing of opioid painkillers, raising dedicated revenue from those drugs to address substance abuse prevention and treatment is necessary (Kramer, 2017)

Nursing care is a central component in key programs and strategies to promote maternal and infant outcomes. Example are evidence-based home-visiting programs, such as Nurse Family Partnership (NFP) which deploys RNs to visit first-time mothers in their homes for prenatal and postnatal care. NFP in particular has been found to have positive impacts on families, as well as positive cost outcomes. Incorporation of advanced registered nurses would help achieve the essence of the medicare coverage and reduce maternal mortality.

As educators and patient advocates, nurses are in a unique position to help patients with non-opioid pain management including other medication modalities, regional anesthetic interventions, surgery, psychological therapies, rehabilitative/physical therapy, and complementary and alternative medicine (CAM) (ANA, 2018)

Reference

ANA (2018). The Opioid Epidemic: The Evolving Role of Nursing Retrieved from https://www.ncsbn.org/2018_ANA_Opioid_Epidemic.pdf

Association of State and Territory Health Officials (2021). How States are Using Policy to Reduce Maternal Mortality and Morbidity. Retrieved from https://www.astho.org/statepublichealth/how-states-are-using-policy-to-reduce-maternal-mortality-and-morbidity/07-21-21/

Kramer, K. T. (2017). State Legislatures Explore Taxing Prescription Opioids to Raise Revenue for Prevention and Treatment. Retrieved from https://www.astho.org/StatePublicHealth/State-Legislatures-Explore-Taxing-Prescription-Opioids-to-Raise-Revenue-for-Prevention-and-Treatment/3-23-17/