NR 500NP Area of Interest Power Presentation

NR 500NP Chamberlain College Wk 6 Area of Interest Power Presentation

NR 500NP Area of Interest Power Presentation

Foundational Concepts & Applications (Chamberlain University)

NR 500NP Wk 6 Area of Interest Power Presentation Speaker Notes

Slide 1-Introdution

I am currently a master’s family nurse practitioner student at Chamberlain. Today, I will be exploring evidence-based practice and how it applies to nursing practice. I will provide an example of the conceptual model or diagram used to create the evidence-based practice.

Discussion of my practice track, the family nurse practitioner, will follow, addressing the rationale for obtaining this advanced degree. Also, I will be discussing specific concerns related to my area of interest and recommendations for a practice change. The problem statement in the report is the prevention of teenager depression and suicide. Furthermore, guidelines for enhancing patient outcomes, including internal and external factors, will be discussed. The National Organization of Nurse Practitioner Faculties (NONPF) sets the standards for the nurse practitioner core competencies. At least two NONPF competencies are relevant to the area of teenager depression and suicide. Lastly, the conclusion will be reflecting on the information provided today.

Slide 2-Importance of Evidence-based practice

• Evidence-based practice (EBP) collects, processing, and implements research judgments to promote better clinical trials, the work environment, or patient outcomes. It is meaningful because it aims to support the numerous beneficial care possible to enhance patient outcomes, patient safety, overall well-being, and quality of care (Schub et al.,2017). Patients require to acquire numerous adequate considerations based on the best possible evidence. EBP guarantees that clinical practice is based on reliable evidence and patients benefit as a result. Applying EBP also appears in more compatible clinical recommendations and practice crosswise the health service. Again, it strikes a purpose in securing that finite health resources are used intelligently, and that appropriate evidence is considered when decisions are made about supporting health services (Bushell, 2019). Evidence-based projects are advantageous because they form and enhance new nursing skills; they help find problem sources and assess new technologies. Evidence-based projects will stimulate the healthcare professional by requiring them to think about why methods are in place and why they are performed in such a With the evidence- based practice achieved in care, nursing becomes more effective and up-to-date with the newest improvements. Appropriating the EBP method to nursing practice encourages them to implement the extraordinary quality and most cost-efficient patient care desirable (Stevens, 2017).

Slide 3- Conceptual Model

The Advancing Research and Clinical Practice through Close Collaboration (ARCC) model was first imagined in 1999 by Melnyk as a mentorship structure to support advanced practice nurses in fulfilling the evidence-based practice (EBP) (Melynk et al., 2017). This model is used for organization use, based on cognitive-behavioral theory. It essentially addresses implementations of EBP and is most likely seen in massive organizations such as hospitals and community practices (Schaffer, 2013). The ARCC model benefits organizations as a whole. This model involves two levels: assessing the organization’s strengths and weaknesses in completing evidence-based practice and selecting evidence-based practice guides who would escort other nurses (Melynk et al., 2017). The most challenging features of this model are classifying EBP guides and encouraging their leadership and mentoring techniques. However, even if EBP mentors are not too skilled, their leadership and assistance will enable other nurses to use EBP.

Results of multiples research designate that EBP mentors, typically advanced practice nurses who struggle with a duration of care providers to execute evidence-based care, have remained a key policy in the ARCC model that has inspired positive clinical, healthcare, and patients outcomes (Melynk et al., 2017). This model presumes that development in nurses’ EBP beliefs results in advanced EBP implementation, improving nurses-related outcomes, such as nurses’ job satisfaction and group cohesion. The ARCC model could be used to explain a standard screening tool for depression in teenagers. This model would assist providers in generating the determination to start examining and screening for depression in teenagers. This would allow teenagers to get the appropriate diagnosis and mental health services needed.

Slide 4 Area of Interest:

Major depression is a well-known condition observed in the primary care environment, which generally directs to suicide. People with depressive illnesses bring out the majority of suicides. Untreated depression is a significant relevant portion to death by suicide, causing a teenager as much as 12 times more likely to attempt suicide (CDC,2019). Resembling 800,000 people die due to suicide every year (CDC, 2019). Depression and suicide is the next highest cause of death in 15 to 29 years old (Santhanam, 2019). Depression, anxiety, and suicidal ideations do not discriminate; they affect all races, genders, and backgrounds. However, suicidal behavior is more noticeable among black youth (Santhanam, 2019). In 2019 an approximated 1.9 million teenage were diagnosed with depression (CDC, 2019). The variation and emergence of these feelings lead to anxiety and depression, creating suffering on they handle and reflect on daily activities.

For example, when a student stops visiting classes or departs socially, it may be time to be involved. According to Santhanam (2019), patients who died by suicide were likewise to attend their primary care practitioner or provider than a psychiatrist. With that being said, the primary provider is in a unique position to recognize at-risk individuals and perhaps intervene. As an advanced nurse practitioner, we can be possible gatekeeps in suicide prevention efforts. Talking and asking about suicide ideations and depression may help the provider identify high-risk patients requiring urgent intervention. Amplifying trust with the patient is quintessential for them to be truthful and honest about their past and present circumstances, including risk factors and life stressors. Clinical judgment is required as well, and the clinician continually pays attention to detail (Santhanam, 2019). Comprehensive documentation and communication of more information are significant to ensure sufficient monitoring and patient safety.

Slide 5 Issue/Concern and recommendation for changes

Depression is a subject that most are not comfortable talking about. We must make sure we are doing what we can to screen them appropriately to identify any high-risk patients. People who have encountered domestic violence or abuse are at a significantly greater risk of undergoing a range of mental health conditions, including depression, tension, feelings of suicide. Researches reveal that relentless emotional abuse can be as crucial as physical abuse (Lusk et al., 2011).

Over time, both can give to low self-esteem and depression. For example, a patient of mine who present with a fall status post subarachnoid hemorrhage with the look on his face, nobody can tell he was in a toxic relationship, but after talking to him for a couple of days, he opened up and mentioned that he was depressed and did not want to go back home with his wife. The acute emotional effects of abuse and neglect-isolation, fear, and an inability to trust can result in lifelong outcomes. Emotionally and mentally, there is something larger going on; we as the

healthcare worker have to cut through and figure it out with the patient for their own best interest and safety. Many patients are often ashamed to admit they are suffering. Care should always be tailored to the patient, and we also must keep their values and religion in mind. Due to their faith, some patients are ashamed to ask for help or embarrassed to acknowledge suicidal thoughts or depression. Social media is a robust platform that contributes to an increase in bullying among teenagers. Teenagers are always connected to a source of their anxiety and depression, with less than 25% receiving evidenced-based treatment (Lusk et al., 2011). Creating Opportunity for Personal Empowerment (COPE) is a community based mental practice that provides treatment to depressed teenagers (Lusk et al., 2011). Teenagers who engaged in the 30-minute COPE routine explicated a reduction in anxiety and depression and increased self-concept and ability to handle negative emotions (Lusk et al., 2011). Along with a mental health program, school-aged children must receive mental screenings. Teenager mental health disorders are prevalent, yet they are inadequately addressed (O’Connor, 2016). Through early detection, a provider would select the appropriate services, referrals, and treatment to get children and teenagers on a path to recovery (O’Connor, 2016). Lastly, increasing access to mental providers is a necessary step in decreasing teenage depression. By increasing mental health providers available in schools, it gives it could help reduce depression and suicide rates (Santhanam, 2019). Being available in schools, it a vital lifeline, especially in low-income communities (Santhanam, 2019).

Slide 6 Factors influencing change

Depression and suicide can be a sensitive subject to discuss. Many patients are reluctant to seek help for their depression. The teenager can be a challenging time in life; however, it is imperative to teach teens the necessary tools to cope with life challenges (Lusk et al., 2011). Researchers suspect there are actually many different causes of depression and that it is not always preventable. Many teens struggle with the ability to discuss their day-to-day struggles. Some are fearful of repercussions, making situations worse, or discomfort discussing their feelings in unfamiliar settings. Stigma can pervade the lives of people with mental health problems in many different ways. According to Corrigan (2004), it diminishes self-esteem and robs people of social opportunities. This can include being denied opportunities such as employment or accommodation because of their illness. People might be reluctance to ask for help or to get treatment. According to Lusk & Melynk (2011), one of the most significant factors associated with the lack of mental health services was its stigma. In addition, while bullying can leave patient with physical bruises that will eventually heal, bullying can also result in long-term behavioral health issues. Depression that results from bullying can cause a wide range of symptioms and in extreme circumstances, bulling-induced depression can lead to suicide.

Another major factor that could influence teen depression is socioeconomic status and the lack of access to resources. Low-income neighborhoods often cannot afford to see a mental health provider as they are typically not even covered by insurance. The mental health providers that provide services to low-income neighborhoods are often spread too thin, and their ability to see everyone is strained (Santhanam, 2019). Other factors that contribute to teenage depression include increased stress and lack of sleep from the demands of their education and extracurricular activities. Negative peer pressure can also affect meantal health. It can decrease self-confidence and lead to poor academic performance, distancing from family and freiends or an increase in depression and anxiety. Some teenagers may not participate in sports and lack exercise with poor eating habits necessary for a healthy lifestyle. Healthcare providers may feel

reluctant to initiate this subject with the older adult to fear offending and damaging the provider- patient relationship. Suicide screening should also be mandatory; organization policies and procedures should support this outside of ED triage in all healthcare departments. The providers’ personal beliefs can affect decision making on “assuming” the patient feels safe or has no depression without asking the safety questions.

Slide 7 NONPF

The National Organization of Nurse Practitioner Faculties (NONPF) is a premier organization engaged exclusively in promoting high-quality nurse practitioners’ literacy. This organization has evolved from modest beginnings to a progressive organization for superiority in nurse practitioner’s education. It was created to guarantee that nurses obtain the knowledge, skills, and ability to practice autonomously as licensed practitioners (Chan et al.,2020). The use of ledership competency and policy competency is important in the area of teenage depression and suidice, by analyzing the most current evidence and resources to improve patient outcomes (NONPF,2017). Leadership competencies have been and will always be the most important competency. With leadership skills we can collaborated with the primary care providers, school counselors, psychiatric institutions if needed to make a change or difference in the patient ‘s life. Critical and relative thinking skills are important for leadership. The FNP needs to be able to get to the bottom of these issues for the patient and advocate for them if needed. This may include asking the parents, foster parents, or legal guardian to step out of the room if it is related to them. Another competency that’s important is policy competency. Policy competence is a set of skills and knowledge about the policymaking process that enable aperson to effectively act in a policymaking situation.

Policy competency deals with advocating in ethical ways to make sure each individual has the same equal, quality, and cost-effective care(National Organization of Nurse Practitioner Faculties, 2017). Understanding not only ethical but legal and social factors that influences these changes in policies(National Organization of Nurse Practitioner Faculties, 2017).

Helping to develop new health policies and understanding its implications to everyone effected locally and nationally(National Organization of Nurse Practitioner Faculties, 2017). Ensuring to provide the safest and healthiest practices available for the teenager depression and suidice, as Nurse Practitioners(National Organization of Nurse Practitioner Faculties, 2017).

Slide 8 Conclusion

As advanced practice nurses going into the family nurse practitioner track, we need to understand and apply evidence-based practice (EBP), so we can transform the care that we will be delivering into safe, efficient, and effective care. Using evidence-based practice allows us to standardize healthcare practices while reducing unreasonable variation in care. Evidence-based practice (EBP) improves patient outcomes and quality of care, creating a safer environment for patients and nurses. There are many models available to aid us in developing an evidence-based project to implement necessary change, but with the use of the ARCC model, EBP can be implemented and sustained by identifying barriers that need to be removed. ARCC is a tool that utilizes a mentor for nurses to develop confidence in the implementation and development of new nursing processes. By using a mentor in the ARCC model, practitioners can acquire the necessary competencies to improve the delivery and practice processes. EBP, NP core competencies, and utilization of the ARCC model are essential to developing early depression screenings among teenagers. By increasing the availability and knowledge of mental health services, there will be a decrease in teenage depression rates. As advanced practitioners, we face many challenges as we respond to our patients’ growing health needs and psychosocial complexity.

Increasingly, we will play a vital role in the screening, diagnosis, and treatment of depression. Depression in primary care thus must be managed like any other chronic disease. Depression and suicide in our elderly population is a public health concern and needs attention. More refined screening processes need to be utilized daily so that early recognition of risk factors, and warning signs can be addressed. We can reduce the incidence of suicide in this vulnerable population.

Reflection:

As I consider my NP practice position, I feel that it is essential to enforce the EBP. The best practice given is focused on the EBP and the analysis done to find the best possible solution to the problem. I want to use the best evidence practice offering the best possible treatment for my patients. I am hoping to introduce EBP as much as I can and in any situation I can. I want the best for my patients, the best for my practice. I also expect to engage in evidence-based initiatives to continue to grow on the evidence-based approach that we have. I want to work to make our future professional practice perfect.

Community is one of the obstacles I see when it comes to adopting evidence-based practices. I respect all cultures, as I know they have justification and conviction to do what they do. No matter how much evidence-based research we have on the subject, if it goes against those cultures, it doesn’t matter because there’s no way individuals can go against their culture based on the evidence we’ve collected. As nurse practitioners, the most we can do in these cases is inform our patients about the dangers and benefits of those situations.

List of Possible Topics

Note: The purpose of the MSN project proposal is to translate evidence currently found in the literature into practice within the chosen specialty track. Due to the research complexity, time involvement,  and implications regarding human subjects, drug studies are not acceptable areas of interest for a MSN project. NR 500NP Area of Interest Power Presentation

FNP                                                                                                                 

• Best evidence available about a topic (i.e. frequency of mammography)
• Screening recommendations (i.e. PSA for prostate cancer)
• Information about a healthcare-related phenomenon (i.e. when to talk to a person about ending treatment for a terminal illness, non-compliance of diet for individuals with congestive heart failure)
• Vaccinations for adults and/or children
• Early assessment for health-related concerns (i.e. depression in teenagers; suicide prevention for the elderly)
• Life style changes (i.e. smoking cessation, increasing activity in teenagers)
• Relationship between events or health concerns (i.e. relationship between dementia and caffeine
• Selection on an intervention (i.e. use of small group theory to lessen anxiety)
• Symptom management (i.e. pain, vomiting)

NR 500NP Chamberlain College Wk 6 Area of Interest Power Presentation

For this presentation, select an area of nurse practitioner (NP) practice that is of interest to you and in which you would like to see a practice change occur. Conduct a review of literature to see what is currently known about the topic and to find research support for the practice change you are recommending.  You may use a topic from the list at the link below or may investigate a topic of your choice as long as it pertains to NP practice. If you are unsure of your topic, please reach out to your instructor. Be sure to provide speaker’s notes for all slides except the title and reference slides. 

List of Possible Topics (Links to an external site.)

Creating a Professional Presentation (Links to an external site.)

Create an 8-12 slide PowerPoint Presentation that includes the following:

• Introduction: slide should identify concepts to be addressed and sections of the presentation. Include speaker’s notes that explain, in more detail, what will be covered.
• Evidence-based projects: slide should explain the general importance of master’s-prepared nurses engaging in evidence-based projects related to nursing practice and profession. Provide speaker’s notes with additional detail and support from at least one outside scholarly source (not the textbook or course lesson).
• Conceptual Model: slide should provide an illustration of a conceptual model that could be used to develop an evidence-based project. Possible models include The John’s Hopkins or Advancing Research and Clinical Practice through Close Collaboration (ARCC) Models or you may select another model you find in the literature. In the speaker’s notes, explain how the model would be applied to the development of an evidence-based project. Provide support from at least one outside scholarly source (not the textbook or course lesson).
• Area of Interest: identify an area of interest related to NP practice in which a practice change may be needed. Slide should identify the area of interest and what is currently known on the topic. Speaker’s notes more fully explain what is currently known and should provide rationale for why the area of interest is important to NP practice. Provide support from at least one outside scholarly source (not the textbook or course lesson).
• Issue/concern and recommendation for change: slide should identify a specific concern related to your general area of interest and your recommendation for a practice change. Speaker’s notes should more fully explain the recommended change and rationale for the change. Recommendation should be supported by at least one outside scholarly source (not the textbook or course lesson).
• Factors Influencing Change: slide should identify at least 2 internal and external factors that could impact your ability to implement your recommended change. Speaker’s notes should more fully explain how the factors you’ve identified would support or impede the implementation of your recommendations. Factors may be based on personal experience or on information you found in your research. If the identified factors come from the literature, provide reference citations to support your ideas.
• NONPF Competencies: slide identifies at least two NONPF Competencies that are relevant to an evidence-based project related to your area of interest. Speaker’s notes should explain how the competencies relate to your area of interest. Provide support from at least one outside scholarly source (not the textbook or course lesson).
• Conclusion: slide provides summary points of presentation. Speaker’s notes provide final comments on the topic.

Part Two

Reflection: write 1-2 paragraphs reflecting on your learning for the week. Guiding questions are provided or you may write about what you felt was most significant to you for the week.

• As you contemplate your future NP practice, how do you view your role in the implementation of EBP?
• What thoughts do you have about how you will engage in scholarship in your NP role?
• What are some barriers you see to implementing evidence-based practice?

ADDITIONAL INSTRUCTIONS FOR THE CLASS

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• Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, including a minimum of one scholarly source, and be at least 250 words. Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source. One or two-sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words. I encourage you to incorporate the readings from the week (as applicable) into your responses.

• Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately. In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies. Participation posts do not require a scholarly source/citation (unless you cite someone else’s work). Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week. NR500NP Wk 6 Area of Interest

• APA Format and Writing Quality

Familiarize yourself with the APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required). Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation. I highly recommend using the APA Publication Manual, 6th edition.

• Use of Direct Quotes

I discourage over-utilization of direct quotes in DQs and assignments at the Master’s level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source. NR500NP Chamberlain College Wk 6 Area of Interest Power Presentation

• LopesWrite Policy

For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me. Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes. Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own? Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for tips on improving your paper and SI score. NR 500NP Area of Interest Power Presentation –  Chamberlain College Wk 6 Area of Interest Power Presentation

• Late Policy

The university’s policy on late assignments is a 10% penalty PER DAY LATE. This also applies to late DQ replies. Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances. If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect. I do not accept assignments that are two or more weeks late unless we have worked out an extension. As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading. NR500NP Wk 6 Area of Interest

• Communication

Communication is so very important. There are multiple ways to communicate with me: Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class. Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours. NR 500NP Area of Interest Power Presentation -n  Chamberlain College Wk 6 Area of Interest Power Presentation

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