Laying the Foundation for New Approaches to Practice 2 Essay Assignment Paper

Application 2
Students Name:
Institutional Affiliation:

How Current is the Science Underlying the Practice.
Electronic health records are of utmost importance in the healthcare setting. Electronic health records are a digital kind of a patient chart, and they are real-time, patient-centered records that make data easily reached instantaneously and fast to authorized users. Mostly, EHR does not incorporate the patients’ medical and treatment accounts, and it is built to go past the medical data collected in the health provider’s office and be all-encompassing of the broader view of the patient care. EHRs form a vibrant part of patient care and health, and they automate and streamline the provider workflow. According to Evans (2016), the current science underlying the use of electronic health records enables applications to communicate, deduce, and act judiciously upon complex healthcare information. However, the present electronic health records fail to meet the contemporary needs of today’s swiftly fluctuating healthcare environment. The present electronic health records can help offer universal criterions for interoperable uses which use health, social, economic, behavioral, and environmental data. In the long run, the data can help communicate, interpret, and act logically upon multifaceted health care information, thereby fostering precision medicine and learning health system (Evans, 2016).

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Possible Causes of the Difference in Outcomes
The current electronic health records are still a hybrid assortment of electronic and paper data. At the onset of using electronic health records, it became clear that there were the continued inadequacies of the paper record that continued to become apparent. As such, the Institute of Medicine recommended the drastic change from paper-based electronic medical records (Evans, 2016). Initially, the entire goal of interchanging the entire paper chart with a computerized system appeared problematic because of the large early prices resulting in the view that only some of the data should become computerized. This made the electronic health records supplement and not substitute the paper records.
With the continued change in technology, electronic health records became cheaper, and the automatic management of patient records became accessible through the growth of patient data management systems which became linked to bedside nursing devices. This made electronic health records become invaluable in inpatient care. However, over time the electronic health records have proved to be burdensome with about 50-60% of physicians undergoing exhaustion (“The Benefits and Challenges of Electronic Health Records”, 2021). Burnout can lead to differences in outcomes since it leads to reduced patient satisfaction, reduced patient safety, and higher instances of malpractices.
Effect that EBP Assignment is Having in Practice
With advances in technology, the adoption of electronic health records is changing the manner the healthcare industry functions. While previously, the healthcare practitioners used paper records that were simple and only required low costs of implementation, paper records proved cumbersome because of the incapacity to obtain files virtually and the cost of storing the immense files. Through the adoption of electronic health records, has led to the presence of organized and accessible records. Electronic health records have been shown to improve communication and engagement between the physician and patients that cannot easily occur otherwise (“The Benefits and Challenges of Electronic Health Records,” 2021). They assist doctors to link with other services providers and precisely track care and management strategies among physicians.
New Practices that are Effective in Addressing the Issue
Certainly, the adoption of the use of electronic health records has transformed patient practice and contemporary medicine, giving medics and nurses enhanced data to monitor care and generating effective processes by linking the different health systems. However, the design customization and the use of electronic health records by the health profession can lead to inadequacies or workflow challenges, thereby failing to hinder patient harm (“Ways to Improve Electronic Health Record Safety,” 2018). There are safety hazards that can arise from the EHR usability, which can discourage health professionals since they make simple tasks take longer and even contribute to patient safety outcomes. Some of the practices which help improve usability in EHR is that their implementation in the hospital must meet the least accreditation standards recognized by the central government. This can guarantee that it can portion data, offer key competences to health professionals, and defend patient privacy.
The Grade Model for Analyzing Research Evidence
The Grade model commences with asking direct questions, comprising description of all necessary outcomes. After the evidence becomes collected and summarized, GRADE offers overt guidelines for rating the quality of evidence which include the study design, imprecision, complexity, and extent of effect. The commendations can be considered weak or strong depending on the supportive evidence and the balance between desirable and undesirable outcomes of the substitute management choices (Guyatt et al., 2011). The Grade model recommends summarizing evidence in concise, apparent, and explanatory tables, which shows the quality of evidence. The research evidence conducted by Pew Trusts meets the Grade model recommendation since it provides the evidence in the manner highlighted by the grade model. The research provides comprehensive data about their reason for the quality of evidence rating.

References
Evans, R. (2016). Electronic Health Records: Then, Now, and in the Future. Yearbook Of Medical Informatics, 25(01), 48-61. doi: 10.15265/iys-2016-s006
Guyatt, G., Oxman, A., Akl, E., Kunz, R., Vist, G., & Brozek, J. et al. (2011). GRADE guidelines: 1. Introduction—GRADE evidence profiles and summary of findings tables. Journal Of Clinical Epidemiology, 64(4), 383-394. doi: 10.1016/j.jclinepi.2010.04.026
The Benefits and Challenges of Electronic Health Records. (2021). Retrieved 31 March 2021, from https://www.sehealthcarequalityconsulting.com/2018/09/18/the-benefits-and-challenges-of-electronic-health-records/
Ways to Improve Electronic Health Record Safety. (2018). Retrieved 31 March 2021, from https://www.pewtrusts.org/en/research-and-analysis/reports/2018/08/28/ways-to-improve-electronic-health-record-safety

Question
Application 2: Laying the Foundation for New Approaches to Practice
This week you have been exploring the interrelationship between theory, knowledge, and research and evidence-based practice. As you begin Application 2, which builds on the work completed for Application 1, consider how evidence-based approaches based on theories from disciplines other than nursing could be used to guide your EBP Assignment.
To prepare:
• Using the Walden Library and other scholarly resources, locate evidence-based practice approaches based on theories from disciplines other than nursing.
• Evaluate various approaches and determine if one could be used to support your EBP Assignment.
You will incorporate this information into Application 2 as you continue to develop it next week.

Application 2: Laying the Foundation for New Approaches to Practice
As frequently noted in the literature, there is often a gap between research evidence and practice. This is not a new phenomenon; however, with the rapid growth of knowledge, it is essential that nurses hone their ability to identify this gap, determine best practices based on the evidence, and then apply this evidence to practice through the development of new approaches. In order for that to transpire, nurses must be skilled in leading change efforts so that adoption of new practice approaches can be successful.
For your EBP Assignment in Week 2 (Application 1), you identified an issue in your practicum setting in which the outcome is different from what would be expected according to the research literature. This week continue to explore current research literature looking for new evidence to address the problem. In addition, you build on the work you began in this week’s Discussion and select an evidence-based practice model and change theory or framework that will support your efforts.
To prepare for Application 2 address the following:
• How current is the science underlying the practices related to your EBP Assignment issue?
• Consider possible causes of the difference in outcomes from what would be expected according to the research literature.
• Evaluate the effect the EBP Assignment issue is having in practice.
• Using the Walden Library and other credible sources, locate current research evidence of new practices that are effective in addressing the issue.
• Use the GRADE model presented in the Guyatt et al. (2011) article to evaluate the research evidence.

In a 3-page paper, include the following:

• A brief summary of the currency of the science underlying the practices used to address your EBP Assignment issue

• Possible causes of the difference in outcomes from what would be expected according to the research literature

• The effect the EBP Assignment issue is having in practice

• Current research evidence on new practices for addressing the EBP Assignment issue

• A summary of the evidence-based practice model (including models from other disciplines as appropriate) and/or change theory or framework you will utilize to systematically integrate new approaches to practice to address the issue

• Learning Resources
• Required Readings

• Gallagher-Ford, L., Fineout-Overhold, E., Melnyk, B.M. & Stillwell, S.B. (2011). Evidence-based practice step-by-step: Implementing an evidence-based practice change American Journal of Nursing, 111(3), 54-60.

• Rosswurm, M. A., & Larrabee, J. H. (1999). A model for change to evidence-based practice. Journal of Nursing Scholarship, 31(4), 317-322.

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• Pryse, Y., McDaniel, A., & Schafer, J. (2014). Psychometric analysis of two new scales: The evidence-based practice nursing leadership and work environment scales. Worldviews on Evidence-Based Nursing, 11(4), 240-247.

• Sadeghi-Bazargani, H., Tabrizi, J.S., & Azami-Aghdash, S. (2014). Barriers to evidence-based medicine: a systematic review. Journal of Evaluation in Clinical Practice, 20, 793-802.

• Schaffer, M.A., Sandau, K.E., & Diedrick, L. (2013). Evidence-based practice models for organizational change: overview and practical applications. Journal of Advanced Nursing, 69(5), 1197-1209.

• Developing an Evidence-Based Practice (EBP) Project Question
• With the delicate nature of the clients in the mental health outpatient clinical setting with different kinds of symptoms, it is important for all staff members to be informed about cultural differences and put the knowledge into practice with the admission, treatment, and follow-up care of patients.
• According to (Kathleen et al., 2021), – “Culture can be defined as a blueprint for our way of living, thinking, behavior and feeling”. This is important in how will assess and treat mental health patients. We need not assume that something is odd or bizarre without first understanding the culture of a client.

Project Question
•
• What are the Best Practices that can Promote Cultural Awareness in Outpatient Clinical Settings?
• Do the best practices that can promote cultural awareness improve patient care and treatment in outpatient mental health clinics in the Southwestern part of the United States?
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• P: Age 6 years to the geriatric population in an outpatient mental health clinic.
• I: Increase awareness of cultural differences, improves assessment, treatment, and de-escalate discomfort situations of clients. in the plan of care and improves health care services.
• C: No comparison.
• O: Increase in knowledge of staff members (satisfaction measured by Qualtrics with pre- and post-questionnaires)
•
• According to (Kleinman, 1988). To increase understanding of other people’s cultures in rendering health care services we will need to answer some questions including:
• – “What is the problem?
• -What do you think caused the problem?
• -Why do you think it started when it did?
• -What do you think the sickness does/how does it work?
• -How severe is the sickness?
• -What kind of treatment should be given? What results do you want to achieve?
• -What problems has it caused?
• -What do you fear most about the sickness?”
• In mental health settings, there are varying beliefs in mental health diagnosis. Some cultures do not accept any diagnosis that has to do with hallucinations, psychosis, or bizarre thoughts. They classify all diagnoses as mood disorders and have challenges understanding the need for antipsychotics.
• The mental health outpatient admission settings with patients with varying symptoms may prove to be of concern to patients and family members.
• The outpatient clinical settings’ organizational culture will affect how the staff members will adopt Evidenced-Based Practice –(EBP) and will affect their willingness to develop new cultural understandings, embrace new knowledge and implement learning.
• I plan to use the Qualtrics Survey Tool with pre-knowledge questionnaires, evaluate barriers to knowledge, staff culture, and behavior to education and training, and compare them to the post-knowledge questionnaires to evaluate the improvement in knowledge and quality of health care services.
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• I would like to study the effect of an increase in knowledge of varying cultural groups to improve staff members’ understanding and improve care in the outpatient clinic, this is referred to as the “Emic perspective” according to (Allison J. Terry 2018).

References
• Allison. Terry Clinical Research for The Doctor of Nursing Practice (2018). Clinical research for the Doctor of Nursing practice (3rd ed.). Burlington, MA: Jones & Bartlett Learning.
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• Kathleen M. White, Sharon Dudley-Brown, Mary F. Terhaar, (2012) Translation of Evidence into Nursing and Healthcare. Third Edition.
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• Melnyk, B.M., Fineout-Overhold, E., Stillwell, S.B., & Williamson, K.M. (2010). Evidence-based practice step-by-step: The seven steps of evidence-based practice. American Journal of Nursing, 110(1), 51-53.
•
• Walker, E. R., & Druss, B. G. (2016). A Public Health Perspective on Mental and Medical Comorbidity. JAMA, 316(10), 1104–1105. https://doi.org/10.1001/jama.2016.10486

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