Points: 100 | Due Date: Week 7, Day 7 | CLO: 1 & 5 | Grade Category: Assignments
The purpose of this assignment is to write an abstract for your capstone project. The function of an Abstract is to provide a brief, descriptive summary of the essay/report. The function of an Abstract is to inform the reader of the contents of the report /essay so that the reader can see in advance the key areas covered and the main points of the argument. An Abstract clearly states the purpose and direction, the main arguments and the conclusions reached. It is a mini version of the paper. If writing an investigative report which includes research findings, then it is usual to include in the Abstract the aims or objectives, methods, findings or results, conclusions and implications.
Your capstone abstract must be approved by the Capstone Advisor and or Faculty Chair before the final draft.
Keep these guidelines for abstracts in mind:
- Provides a professional, scholarly synopsis of the capstone project
- States the purpose of the capstone clearly and succinctly
- Provides a brief rationale for the capstone project.
- Describes the design and methodology of the main activities of the project
- Describes the expected results or the outcomes of the capstone.
- Provides a summary statement that shows the possible implication of the capstone project to studentâ€™s clinical practice setting or profession.
- Utilizes 250-300 words maximum, using 12 point font, either, Arial, Times New Roman, or Courier
- Due: Monday, 11:59 pm PT
- Length: Maximum of 250-300 words
- Format: APA 6th ed.
- Research: At least one peer reviewed reference within the last 5 years
This is my PICOT question:
For patients 65 years and older with cardiovascular disease, does setting up primary care provider appointment and home health prior to discharge in a rehabilitation unit in comparison to none, reduce hospital readmissions over a period of thirty days?
Week 2 Discussion post
Discuss the theoretical framework or model that you intend to use for your capstone project. How does your chosen framework relate to your phenomenon of interest and research?
My capstone project is about testing a theory of the effectiveness of home health referrals as well as scheduled primary care provider (PCP) follow-up appointments after discharge in reducing hospital readmission rates in thirty days. A lot of facilities have used home health referral as a continuation of care for patients that may still have health and social needs that need to be addressed or that may need resources in order to facilitate patient safety and better patient outcomes. Primary care physician follow-ups have been shown also to prevent deterioration and to help in patientâ€™s recovery and assistance in self-care.
I am planning to use Peplauâ€™s Theory of Interpersonal Relations. I mean home health referrals and physical follow-up appointments are part of discharge planning and should be well-planned to make sure that patients have the resources they need. During the orientation phase, patients hospitalized have made the realization that they need help, and the nurses are there to provide respect as well as a positive interest and gain rapport (Hagerty et al., 2017). The working phase is where nurses provide a thorough and organized education to patients and their families as preparation for home, and this is the time patients see nurses as educators and resource persons in addition to being their counselors, and providers of care (Hagerty et al., 2017). The termination phase, which is the last phase, is where discharge planning come to place. This is to prevent deterioration of health and prevent rehospitalizations. This is the part where nurses schedule follow-up PCP appointments when a discharge date has been determined. Nurses coordinate with other team members as well (i.e., social workers) to make sure patients get continued care at home (i.e., home health) (Hagerty et al., 2017). Discharge planning starts from the time of admission until they leave.
Hagerty, T. A., Samuels, W., Norcini-Pala, A., & Gigliotti, E. (2017). Peplauâ€™s theory of
interpersonal relations: An alternate factor structure for patient experience data. Nurs Sci Q, 30(2). Retrieved March 11, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5831243/.
Week 3 Discussion post
Discuss the individual and/or community needs as it relates to the reason for your capstone research inquiry. Why do you believe your research inquiry/findings will address the identified needs that prompted your inquiry?
My answer: About 27 % of readmissions among the elderly are preventable, and inadequate review of medication and medication reconciliation is one of the risk factors (Glans, Ekstam, Jakobsson, Bondesson, & Midlov, 2020). This is a common finding seen with patients. Proper education with appropriate evaluation of learning is important to make sure that the patient is informed of medications he or she will be taking at home. Also, for patients with limited cognition and limited function, home health care is important for the continuation of care. Patients who have Medicare are able to access home health care. For patients without Medicare and only have private insurance, not a lot of older patients are qualified. A patient needs to be homebound to be eligible for home health care services (Medicare.gov, 2020). Home health not only helps with education on medications, disease process, and illness, but it helps with improving independence, function, and promote self-care (Medicare.gov, 2020).
Another individual/community need is the access of primary care provider (PCP). Patients with no insurance are mostly the ones with no PCP. Other obstacles include language barriers, disability, inability of the patient to take off work to go to follow-up appointments, no transportation, geographic location, and PCP shortages (HealthyPeople.gov, 2020). Some patients are also unable to understand the purpose of having a PCP especially on medication refills, durable medical equipment (DME) needs, and monitoring of health.
I believe my research inquiry/findings can address the needs being identified above by promoting awareness and understanding of the consequences of limited education, review, and resources, and enhancing processes to help older patients and prevent readmissions. Readmissions can be costly as well. With my research, nurses and other healthcare professionals can be more involved in making the discharge planning process more efficient. Also, by making sure that patients have a PCP and home health referral prior to discharge in addition to thorough education, it can lower the risk of older patients going back to the hospital.
Glans, M., Ekstam, A. K., Jakobsson, U., Bondesson, A., & Midlov, P. (2020). Risk factors for
hospital readmission in older adults within 30 days of discharge: A comparative retrospective study. BMC Geriatrics. Retrieved March 15, 2021, from https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-020-01867-3.
HealthPeople.gov. (2020). Access to primary care. Office of Disease Prevention and Health
Promotion. Retrieved March 15, 2021, from https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-health/interventions-resources/access-to-primary.
Medicare.gov. (2020). Home health services. U.S. Centers for Medicare & Medicaid Services.
Retrieved March 15, 2021, from https://www.medicare.gov/coverage/home-health-services.
Week 4 Discussion:
Discuss how you intend to implement your evidence-based findings. What are your anticipated challenges? How do you intend to overcome some of those challenges?
My answer: Implementation of any findings that is evidence-based or even evidence-based practice (EBP) is considered a vital competence that can improve the quality of healthcare (Weng, 2013). The process of EBP starting with a clinical question then doing a search and critically appraise the evidence collected (Ginex, 2018). First and foremost, it is important for me to understand the data, and this is important so I can adapt the EBP to fit the population and organization (Advisory Board, 2019). I need to look at the data as to why readmission rates are high in the older population. What are the factors that affects these rates? Primary care provider (PCP) appointment is one of the factors. But is the timing of their appointments also a factor as well. A study has shown that patients were discharged prior to their scheduled PCP appointments, so their needs to be improvement with the timing and scheduling. Patients may need to be seen within 1 week instead of within 2 weeks. Also making sure the stakeholders are on board and have understood the EBP change or process will help in implementing the findings. I also need to consider my resources if it is adequate for the evidence-based findings to be implemented. Do we have enough? What other resources do we need? These are important questions to consider.
Challenges that I can anticipate is the inadequate time and the lack of knowledge from stakeholders (Ginex, 2018). In the healthcare field, time is a priority, and sometimes we do not have enough time. In addition to that, there is uncertainty and resistance from the stakeholders, and part of that is because they have lack of knowledge of the evidence-based findings. To overcome the challenge of uncertainty and lack of knowledge, it is important to engage the stakeholders and provide the knowledge and information that they need (Ginex, 2018). Explaining to them the data as well as the purpose of this change to the overall patient outcomes is crucial. It will also help if the administration will have my support to implement the evidence-based findings so it will make the implementation process go smoothly and efficient.
Advisory Board. (2019). 4 ways to implement evidence-based practice at your hospital: Daily
briefing. Retrieved March 23, 2021, from https://www.advisory.com/en/daily-briefing/2019/09/10/evidence-based-practice.
Ginex, P. K. (2018). Overcome barriers to applying an evidence-based process for practice
change. ONS VOICE. Retrieved March 23, 2021, from https://voice.ons.org/news-and-views/overcome-barriers-to-applying-an-evidence-based-process-for-practice-change.
Weng, Y., Kuo, K. N., Yang, C., Lo, H., Chen, C., & C, Y. (2013). Implementation of evidence-
based practice across medical, nursing, pharmacological and allied healthcare professionals: A questionnaire survey in nationwide hospital settings. Implementation Science. Retrieved March 23, 2021, from https://implementationscience.biomedcentral.com/articles/10.1186/1748-5908-8-112.