FSW NUR 4955 Psychiatric Nursing Implementation of EBP Discussion Paper

FSW NUR 4955 Psychiatric Nursing Implementation of EBP Discussion Paper ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON FSW NUR 4955 Psychiatric Nursing Implementation of EBP Discussion Paper Discussion: Describe how your project and developing paper is meeting both the 3 NUR 4955 course objectives and the selected EPSLOs. This requires thoughtful reflection about your project and how you correlate the EPSLOs to the project and final paper. FSW NUR 4955 Psychiatric Nursing Implementation of EBP Discussion Paper Course outcomes: Application of research and evidence-based nursing practice. Evaluation of professional practice and potential changes. Synthesis of current and previous scholarly work into an exemplar of achievement. EPSLOs: Synthesize standards of professional practice and care. Articulate the role of the professional nurse within inter-professional teams. Analyze current and changing health care information technologies and systems I have included the EBP for this discussion post…please follow the above directions attachment_1 Stress Management and the Prevention of In-Patient Readmissions in a Psychiatric Setting Student’s Name Institutional Affiliation Stress Management and the Prevention of In-Patient Readmissions in a Psychiatric Setting Introduction and Definition of Practice Setting One of the most important areas in healthcare is mental health. There is an alarming rise in the occurrence of mental health disorders in contemporary society. The focus of this paper is the psychiatric setting. Mental illnesses constitute approximately one-third of disability in the world today (Lake, 2017). In the USA, the burden of mental health care has increased significantly with more people suffering from various disorders annually. Mental health nurses and other professionals working in the psychiatric setting are charged with the responsibility of facilitating high-quality care to patients suffering from various mental health disorders. The purpose of this paper is to examine an aspect of quality care in mental health. The current paper will identify the problem and its significance as well as conduct a literature review. More importantly, it will propose a suitable evidence-based intervention to address the problem along with the means of evaluation. It is imperative to enhance the practice of mental health nursing as this area is becoming highly relevant in modern healthcare. FSW NUR 4955 Psychiatric Nursing Implementation of EBP Discussion Paper Problem Statement The main problem in this context is the high rate of psychiatric in-patient readmissions in acute care hospitals. In the USA, there is currently an alarmingly high rate of hospital readmissions among patients with psychiatric disorders. Research illustrates that hospital readmission within the first 30 days of discharge is detrimental to the overall health outcome of patients with mental illnesses (Benjek and Chen, 2018). Furthermore, the high rate of readmissions is associated with higher treatment costs and care management services (Benjek and Chen, 2018). The burden of cost affects both the government and the patient by straining national and individual resources respectively. Significance of the Problem for Nursing Practice The problem if high readmission rates in psychiatric care is significant for nursing practice because it illustrates a deficiency in the quality of care that is provided. Essentially, research indicates that high readmission rates indicate inadequacies in the pre-and post-discharge treatment of mental health patients (Kalseth, 2016). Mental health nurses are partly responsible for ensuring efficient pre- and post-discharge treatment is provided to their patients. In many cases, when adequate care is provided, the in-patient readmission rates reduce significantly. Notably, in this context, readmission is measured by a patient’s return to the hospital within the first 30 days of discharge. FSW NUR 4955 Psychiatric Nursing Implementation of EBP Discussion Paper Furthermore, the problem of high readmission is significant for nursing practice in mental health because it indicates the severity of an illness and the extent of disability regarding the patient. This is an important area for nurses to focus on as a guide to implementing suitable interventions to address serious mental health illnesses. FSW NUR 4955 Psychiatric Nursing Implementation of EBP Discussion Paper Literature Review Benjek and Chen define readmission as “an unplanned, inpatient admission, for any condition, within thirty days of discharge from the initial admission” (2018, p. 1). In the USA, the issue of hospital readmissions is so important that the government initiated the Hospital Readmission Reduction Program (HRRP) as a law in 2010 (Centers for Medicare and Medicaid Services, 2018). In a research study, Kalseth et al note that repeated hospitalizations have adverse disruptive effects on patients and their friends and families (2016). Furthermore, their study also notes that readmission rates are often employed as an identifier of the quality of mental health care provided by a hospital. In an alternate research study, Lake identified that mental disorders can result in numerous comorbid conditions and a high rate of mortality (2017). Essentially, the implication is that high readmissions are an indicator of the persistence of a mental illness. “A serious and persistent mental disorder can result in patients losing up to four years of life, compared to individuals without mental disorder.” (Sprah et al., 2017, p. 1). Generally, it is the consensus of several research studies that hospital readmissions in psychiatric practice settings are a major problem in America with one in every seven patients being readmitted (Sprah et al., 2017). This calls for the employment of measures to reduce the high rate of hospital readmissions. FSW NUR 4955 Psychiatric Nursing Implementation of EBP Discussion Paper Proposed Interventions and Justification Given the importance of the problem, there are numerous proposed interventions to resolve the issue. One of the interventions that are widely publicized is Assertive Community Treatment (ACT), which is a community-based care model that mainly helps people with serious mental illnesses such as bipolar and schizophrenia (Clausen et al., 2016). Moreover, other proposed interventions are Compulsory Treatment Orders (CTOs), Involuntary Outpatient Commitment (OPC), collaborative care, case management, peer support, and psychoeducation. While many of these interventions are useful in reducing readmissions in psychiatric care, they each have their limitations mainly because they rely on external support and resources more than internal measures by the patients. In this context, the most suitable intervention is the cognitive-behavioral stress management approach. “Stress management program with cognitive-behavioral approach includes elements such as awareness of stress, relaxation training, identification or dysfunctional thoughts, cognitive restructuring, problem-solving process training, asserting training, anger management, and time management” (Ghazavi, 2016, p. 1). The justification for selecting this intervention is that it addresses common psychiatric problems such as depression, anxiety, social isolation, coping demands, and poor self-control all of which are crucial in managing mental illnesses (Shariatkhan, Farajzadeh, and Khazaee, 2017). The premise of this method is that reducing stress is the most effective way of reducing readmissions for psychiatric patients. Implementation of Intervention Briefly, a person’s capacity to minimize stress and cope effectively under stress is referred to as stress management (Sahranavard et al., 2018). Stress management enhances an individual’s health both mentally and physically. “Psychotherapy is effective when the patients realize that their problems are not only physical but are influenced by their dissatisfaction, conflicts, and psychological problems” (Ghazavi et al., 2016, p. 1). Cognitive-behavioral therapy (CBT) is considered to be one of the most important psychotherapy methods of treating psychiatric disorders (Sahranavard et al., 2018). In CBT, patients are guided to detect the errors in their behaviors and thoughts and how to amend them. The proposed intervention strives to combine CBT with stress management techniques. Implementing the cognitive-behavioral stress management approach in the present psychiatric setting will require the integration of psychoeducation techniques. Psychoeducation mainly relates to providing patients and their families with the necessary information to handle their individual situations (Srivastava and Panday, 2017). The plan for implementation includes the hosting of programs that endeavor to provide psychiatric patients with the necessary education regarding how to manage stress pre- and post-discharge. Notably, the idea for this implementation approach is derived from the study conducted by Ghazavi et al in 2016. In the study, the researchers organized eight sessions weekly for programs that ran for 90 minutes, which significantly improved the patients’ quality of life. However, to minimize cost and other resources, the proposed implementation program will host six sessions of 90-minute programs every week. FSW NUR 4955 Psychiatric Nursing Implementation of EBP Discussion Paper During the session, patients will be given information on how stress and poor stress management affect an individual’s health both physically and mentally. More importantly, the sessions will provide patients with information on how to cope with stressful conditions to enhance their stress management abilities. This includes insight on relaxation techniques, the importance of exercise and social interaction, as well as enforcing certain lifestyle changes to enhance their stress coping mechanisms. Furthermore, patients will be guided on how to understand cognitive distortions in alignment with CBT such that they can unlearn certain behaviors and eliminate thoughts that increase their stress levels. Basically, the current implementation strategy focuses on teaching patients how to cope with stressful situations particularly when they are discharged from hospital. The sessions will begin during their hospital stay and continue even after they are discharged from hospital. FSW NUR 4955 Psychiatric Nursing Implementation of EBP Discussion Paper Certain resources will be required for implementation. Firstly, nurse volunteers must be recruited to run the program. Essentially, given that the sessions are hosted once every week, six nurse volunteers will be required to host the sessions for six weeks. While in the study the researchers used pamphlets to aid the learning process, the current strategy will minimize on costs by replacing pamphlets with emails. Essentially, each patient will receive an email summarizing the sessions for each week. Fundamentally, the emails are important to serve as reminders for patient activities during the week before the next session. The only equipment required to conduct the sessions are a computer and projector for making presentations. Given that these are largely available at the facility, acquiring them would not be a challenge. Furthermore, apart from nurse volunteers, other stakeholders are certified therapists. It is imperative to enlist a practicing therapist who can sit in on the session and provide guidance whenever needed. Multidisciplinary collaboration is often important in improving patient outcomes through education (Green and Johnson, 2015). FSW NUR 4955 Psychiatric Nursing Implementation of EBP Discussion Paper Concerning regulatory factors, permission will be obtained from the hospital’s administration for the sessions to be held at the facility weekly. It is important to adhere to the policies and protocols of the hospital regarding patient education to avoid legal and ethical ramifications in the future. All the methods that are provided to the patient regarding cognitive-behavioral stress management techniques will be based on evidence retrieved from research materials. This will ensure that they only serve to benefit the patients and not harm them. Evidence-based practice is the basis for the implementation process. To ensure compliance with regulatory and legal components, no untested methods will be proposed to patients during the sessions. FSW NUR 4955 Psychiatric Nursing Implementation of EBP Discussion Paper Barriers to Implementation Implementing the cognitive-behavioral stress management intervention will incur certain obstacles. One potential barrier is resistance by stakeholders. This particularly relates to the hospital’s administration and the healthcare practitioners that will be required to volunteer their services, especially nurses and therapists. Healthcare workers are known to work for long hours (Wong, Chan, and Ngan, 2019). It would be difficult to convince them to volunteer their extra time to the program. Moreover, the hospital’s administration may be unwilling to support the program due to potential legal ramifications for errors. Overcoming this obstacle of resistance requires a convincing proposal to the stakeholders. People are often more inclined to support and sacrifice for causes that they believe in. Both the administration and the staff should be persuaded concerning the benefits of the proposed program. Essentially, reducing hospital readmissions is beneficial to these stakeholders in the long run. The hospital will not only minimize its costs but also it will be ranked highly in terms of providing high quality psychiatric care. Furthermore, when hospital readmissions reduce, the additional workload and stress for the staff also minimize. An additional barrier is that patients may be unwilling to participate in the sessions at first. This is an obstacle that can be addressed in two ways. Firstly, patients can be handled in the same way as the hospital staff, whereby they may be convinced of the benefits of the program. Moreover, recruiting patients’ families to support the program will prompt patients to participate in the programs. Essentially, patients may be allowed to attend the weekly sessions with a close family member or friend for support. Evaluation of Intervention The evaluation process is arguably the most important process of running the program. Essentially, evaluation involves monitoring the program to ensure that it is yielding the desired results (Cheng et al., 2017). In this case, the evaluation will focus on the main goal of the intervention, which is to reduce the rate of hospital readmissions. The first indicator of progress will be a reduction in hospital readmission for psychiatric patients within the first 30 days of discharge. Before the program is launched, the rate of readmissions at the facility will be examined. Upon completion of the program, the rate of readmissions, particularly involving the patients that participate in the program, will be reviewed to determine whether any changes have occurred. If the readmission rate reduces, it would prove that the program is effective. However, if it remains constant or increases, it would prove the ineffectiveness of the program. Another method of evaluation would be to conduct an examination or therapy session with the psychiatric patients that participate in the program before, during, and after the completion of the program. As has been established, one of the main reasons for high readmission is the severity of an illness to the point whereby a patient is overwhelmed. Therefore, if a patient’s condition is severe at the beginning of the program, regular assessments will be conducted to determine whether their condition is improving over the course of the program. Impact of the Proposed Intervention The anticipated impact of the proposed intervention is that it will reduce the rate of psychiatric hospital readmissions at the facility. The working concept is that one of the main reasons why psychiatric patients get readmitted is their inability to effectively cope with the stressors in their regular lives once they are discharged from the hospital. The implementation of the cognitive-behavioral stress management approach is intended to improve their stress management and coping mechanisms, which will undoubtedly reduce the rate of hospital readmissions for psychiatric patients. Moreover, it is anticipated that the proposed intervention will help to reduce the cost of mental health care once hospital readmissions are minimized. An additional impact of the proposed intervention is that it will improve the general health of psychiatric patients. Research highlights stress as one of the major impediments to good health and a high quality of life (Slavich, 2016). The intended impact of the proposed intervention is that patients’ health will improve significantly due to effective stress management. Subsequently, their quality of life will also be enhanced due to their capacity to handle unexpected challenges in their lives. FSW NUR 4955 Psychiatric Nursing Implementation of EBP Discussion Paper Dissemination of Results Dissemination of the results of a project is important because it provides a chance for others to learn from the implemented practices (Curtis et al., 2017). In this context, the results of the study will be disseminated through the use of professional nursing journals. Professional nursing journals are often accessible to practicing mental health nurses. Once the project is complete and the findings are documented, the records will be distributed via professional nursing journals to ensure that the information is available publicly to any nurses or healthcare practitioners that may be interested in pursuing a similar course to reduce their rates of patient readmission in psychiatric care. In conclusion, the proposed intervention is aimed at reducing the problem of high rate of hospital readmissions for psychiatric patients. The problem is significant to nursing practice because it signifies a deficiency in the quality of care that is provided to psychiatric patients before and after discharge from the hospital. According to available literature, high rates of hospital readmissions have adverse effects to all stakeholders including the government, hospital, staffs, and the patients. Subsequently, the proposed intervention is cognitive-behavioral stress management, which will be implemented by holding weekly sessions to teach patients about stress management and coping mechanisms. The main barrier to implementation is stakeholder resistance. Moreover, one of the ways of evaluation is by examining the rise or fall in hospital readmission rates. Ultimately, the anticipated impact of the proposed intervention is to reduce hospital readmissions for psychiatric patients. Conclusively, the findings of the project will be disseminated through professional nursing journals. FSW NUR 4955 Psychiatric Nursing Implementation of EBP Discussion Paper References Benjenk, I., & Chen, J. (2018). Effective mental health interventions to reduce hospital readmission rates: a systematic review. Journal of hospital management and health policy , 2 , 45. https://doi.org/10.21037/jhmhp.2018.08.05 Centers for Medicare and Medicaid Services. (2018). Hospital Readmission Reduction Program . Retrieved from https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/HRRP/Hospital-Readmission-Reduction-Program.html Cheng, J., Chu, Y., Li, Y., Tan, Q. (2017). Research and perspectives on criteria for evaluation of nursing research achievements. Chinese nursing research, 4 (3), 107-112. Clausen, H., Landheim, A., Odden, S., Šaltyt? Benth, J., Heiervang, K. S., Stuen, H. K., Killaspy, H., & Ruud, T. (2016). Hospitalization of high and low inpatient service users before and after enrollment into Assertive Community Treatment teams: a naturalistic observational study. International journal of mental health systems , 10 , 14. https://doi.org/10.1186/s13033-016-0052-z Curtis, K., Fry, M., Shaban, R. Z., & Considine, J. (2017). Translating research findings to clinical nursing practice. Journal of clinical nursing , 26 (5-6), 862–872. https://doi.org/10.1111/jocn.13586 Ghazavi, Z., Rahimi, E., Yazdani, M., & Afshar, H. (2016). Effect of cognitive-behavioral stress management program on psychosomatic patients’ quality of life. Iranian journal of nursing and midwifery research , 21 (5), 510–515. https://doi.org/10.4103/1735-9066.193415 Green, B. N., & Johnson, C. D. (2015). Interprofessional collaboration in research, education, and clinical practice: working together for a better future. The Journal of chiropractic education , 29 (1), 1–10. https://doi.org/10.7899/JCE-14-36 Kalseth, J., Lassemo, E., Wahlbeck, K., Haaramo, P., & Magnussen, J. (2016). Psychiatric readmissions and their association with environmental and health system characteristics: a systematic review of the literature. BMC psychiatry , 16 (1), 376. https://doi.org/10.1186/s12888-016-1099-8 Lake, J., & Turner, M. S. (2017). Urgent Need for Improved Mental Health Care and a More Collaborative Model of Care. The Permanente journal , 21 , 17–024. https://doi.org/10.7812/TPP/17-024 Sahranavard, S., Esmaeili, A., Dastjerdi, R., & Salehiniya, H. (2018). The effectiveness of stress-management-based cognitive-behavioral treatments on anxiety sensitivity, positive and negative affect and hope. BioMedicine , 8 (4), 23. https://doi.org/10.1051/bmdcn/2018080423 Shariatkhah, J., Farajzadeh, Z., & Khazaee, K. (2017). The Effects of Cognitive-Behavioral Stress Management on Nurses’ Job Stress. Iranian journal of nursing and midwifery research , 22 (5), 398–402. https://doi.org/10.4103/1735-9066.215683 Slavich G. M. (2016). Life Stress and Health: A Review of Conceptual Issues and Recent Findings. Teaching of psychology (Columbia, Mo.) , 43 (4), 346–355. https://doi.org/10.1177/0098628316662768 Sprah, L., Dernovsek, M., Wahlbeck, K., & Haaramo, P. (2017). Psychiatric readmissions and their association with physical comorbidity: a systematic literature review. BMC Psychiatry, 17(2). Srivastava, P., & Panday, R. (2017). Psychoeducation: an effective tool as treatment modality in mental health. The international journal of Indian psychology, 4 (1), 123-130. Wong, K., Chan, A., & Ngan, S. C. (2019). The Effect of Long Working Hours and Overtime on Occupational Health: A Meta-Analysis of Evidence from 1998 to 2018. International journal of environmental research and public health , 16 (12), 2102. https://doi.org/10.3390/ijerph16122102 Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10

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