Capstone Project Milestone 1:
Practice Issue and Evidence Summary Guidelines
Clear identification of the practice issue is the first step in evidence-based nursing. Next, the evidence is reviewed to determine the best intervention to change practice outcomes. Completion of the milestone will include identification of the practice issue using the ACE Star model of Knowledge Transformation and a review of the evidence that will support an intervention that will change outcomes. The evidence summary will be conducted through the ‘breaking down’ of a systematic review on your topic for your change project.
Practice Issue Worksheet Directions
- Practice Issue Worksheet:
- Read the guidelines including the grading rubrics below.You will use this worksheet to document the practice issue presented and approved by your instructor in the Week 2 Discussions (for your reference the topic that was approved by my instructor is underlined and in bold, see below).
The Clinical Question
Professor and classmates,
Our lesson this week states “a systematic analysis of a situation serves as the basis for an effective search for the best evidence” (CCN, 2016. Para.7.) Too often I encounter patients who have a history of MI and are unaware of healthy diets, safe exercise routines, smoking cessation resources. PICO is a systematic approach to recognize, research and improve patient care.My question is: Can post management of an MI reduce readmissions for further complications and reoccurrences? P- Target population is over the age of 25, male or female.I- Implement diet programs, safe exercise routines and educational material along with prevention resources.C- Hospitals to continue current management and continued increase in hospital costs, readmissions and increased surgeries vs. implementing early prevention programs and post management. O- Desired outcome will be to see a decrease in patients being re-hospitalized for myocardial infarctions and a decrease in surgeries.T- no time factor.By detecting and finding what patients are doing wrong and seeing how they can improve we can help them decrease triggers. I developed this question after coming across a number of patients who after have an MI were readmitted for triggers and after speaking to them realized they had little education on appropriate measures such as: how to follow appropriate diet, safe exercise routines, how to properly take nitroglycerin and smoking cessation. “An essential component of evidence-based practice, the literature search is important to any research and publication activity because it enables researchers to acquire a better understanding of the topic and an awareness of relevant literature” (Dearholt & Dang, 2012, p.81).Chamberlain College of Nursing. (2016). Week Two Lesson: The Clinical Question. Retrieved from www.nursingonline.Chamberlain.eduDearholt, S. L., & Dang, D. (2012). Johns Hopkins nursing evidence-based practice: Model and guidelines (2nd ed.). Indianapolis, IN: Sigma Theta Tau International.
- Your practice issue will be the same for all three Milestone assignments in this course.
- Please type your answers directly into the worksheet.
Evidence Summary Worksheet Directions
- Evidence Summary Worksheet:
- Read the guidelines including the grading rubrics below.You will use this worksheet to incorporate your evidence summary into your Week 4 Milestone 2 assignment.
- Find a systematic review article in the Chamberlain library on your topic. Your Systematic Review Article must be peer-reviewedand include a narrative summary (use the following link). http://proxy.chamberlain.edu:8080/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=edselp&AN=S0897189716300179&site=eds-live&scope=site
- Please type your answers directly into the worksheet (worksheet is attached below).
CitionTitle: Original Article: The effect of self-efficacy enhancement program on medication adherence among post-acute myocardial infarctionAuthors:Polsook, Rapin ⁎Aungsuroch, YupinThongvichean, ThidaAffiliation:Faculty of Nursing, Chulalongkorn University, Bangkok 10330, ThailandSource:In Applied Nursing Research November 2016 32:67-72Publisher:Elsevier Inc.Abstract:Aim and background Studies have reported that adherence to medications after hospital discharge for myocardial infarction is poor with about 12% to 20% of patients discontinue their medications six months after discharge. This study aimed to examine the effect of self-efficacy enhancement program on medication adherence in post-acute myocardial infarction patients. Methods A total 44 patient with post-acute myocardial infarction were recruited from the in-patient department, Police General Hospital. The participants were random assigned into control group and experimental group. The control group received conventional care while the experimental group attended a four-week self-efficacy enhancement program, which included motivation, skill practice, and monitoring skills. The mean self-efficacy score between groups was assessed. The pill count was used to measure medication adherence. Correlations between self-efficacy and medication adherence were examined. Data were analyzed using descriptive statistic, Pearson’s correlation, and t-test. Results The mean score on medication adherence of the experiment group who attended the self-efficacy enhancement program was significantly greater than the control group (t=−2.77; df=21; p=0.01). The mean scores of self-efficacy between the experimental and control group were 35.73 (SD=4.11) and 35.41 (SD=3.78). The correlations between self-efficacy and medication adherence were significantly (r=1.00, p=0.00). Conclusion The effectiveness of self-efficacy enhancement program was effective in improving medication adherence in Thai post-acute myocardial infarction.Document Type:ArticleISSN:0897-1897DOI:10.1016/j.apnr.2016.05.002Accession Number:S0897189716300179Copyright:© 2016 Elsevier Inc. All rights reserved.