Improving healthcare quality, patient outcomes with evidence-based practice

Project evaluations provide information on the effectiveness of projects to optimize the outcomes, efficiency, and quality of health care (Harris et al., 2020). The implementation of this project sought to meet the high-level goal for improving rural population health by providing a mode to conduct the structured monitoring of depression in rural primary care. This EBP project proved successful in enhancing rural primary care staff knowledge on depression symptoms, depression screening guidelines, and the components of the PHQ-9 and increasing the routine utilization rate of the PHQ-9 among adult patients at the project site. This chapter will describe the participant demographics and the two outcome findings related to increasing rural primary care staff knowledge and the adoption of EBP practice change by increasing the routine utilization of PHQ-9 screening at the project site.

Participant Demographics

Eight staff members at the project site comprised the participant group. Participant demographic information such as name, age, ethnicity, race, or gender was insignificant for the evaluation of the project outcomes. The participants were demographically classified as clinical or ancillary staff. 7 participants were clinical staff, and 1 participant was an ancillary staff member at the project site. All pre and post data forms (quizzes, surveys) were deidentified as participants were asked to use their mother’s date of birth (MM/DD/YY) format as their participant identification number. The participant identification numbers were used by the  project manager to log the results of the surveys and quizzes on the pre- and post-test score sheet (Appendix G. For the evaluation of the utilization rate of the PHQ-9 depression screening tool (Appendix I) at the project site, the project manager used a sequential numbered chart audit tool (Appendix H) with no patient identifiers.

Outcome Findings

Outcome data measured two major areas for the evaluation of this EBP project. The first outcome measure evaluated rural primary care staff knowledge on depression diagnosis and depression screening. The second outcome measure evaluated the utilization of PHQ-9   utilization after the education session intervention at the project site. The outcome data on the  pre- and post-intervention calculations from the surveys, tests and chart audits will show whether the intervention was effective at addressing the clinical problem. The educational session evaluation tool consisted of two project-manager developed questionnaires that will assess staff knowledge of depression, depression screening guidelines and the components of the PHQ-9 screening tool. The knowledge questionnaires are Likert-style. Weekly data was collected on the number of depression screenings conducted at the project site prior to and after the educational intervention. The data collected included the total number of patients seen during the evaluation period and the number of PHQ-9 screenings performed during the project evaluation period.

Outcome One

After the completion of all educational sessions, a total of 8 individuals participated. Each participant completed a 10-question pre-and post-education session quiz along with a 5- question pre-and post-education survey that assessed knowledge base of depression, depression screening guidelines and the components of the PHQ-9 screening tool. The project manager set the benchmark of 10-15% for an increase in staff knowledge post-intervention. The overall participant score achieved by the participants on the pre-education quiz was 73.6 percent. Based on review of all participants post-education quiz scores, the average score increased to 88.9 percent. Table-1 is an outline of the comparison of the pre- and post-test using a matched t-test. There was a significant increase in the participant score values from pre-educational session knowledge in comparison to post-educational session knowledge. The average score increase was 15.3 percent (t=3.27, p=.014)

Outcome Two

The benchmark of a 10-15% increase in PHQ-9 screenings at the practice site was set as an expectation by the project manager to evaluate outcome 2 of the project. Data was collected prior to the implementation of the project. Data related to depression screening compliance rates was ascertained by dividing the number of completed depression screenings by the number of eligible patients seen during this period. During a 4-week pre-implementation evaluation period, the project reviewed a randomized number of charts at the project site. During this 4-week

period, 50 patient charts were assessed for the completion of depression screenings. The results yielded that an average of 12 completed depression screenings during this time. The percentage rate during the reviewed pre-implementation period was an average of 24 percent. For the post- implementation evaluation of PHQ-9 depression tool compliance, the project manager evaluated a random number of patient charts on a weekly basis for a total of 8-weeks after the completion of the educational sessions. The total number of charts audited for PHQ-9 completion was 50. The chart audit tool was used to track the data. Charts accessed for review were identified only by sequential number to get an overall tally of 50 reviewed charts. No patient identifiers were used, and the data collected was anonymous and inventoried on the data sheet. The post- implementation retrospective record/chart review was used to evaluate the number PHQ-9 screenings being conducted at the project site and yielded that out of 50 reviewed charts, 38 PHQ-9 screenings were completed. The percentage rate of post-implementation PHQ-9 depression tool compliance was 76 percent. The overall increase in PHQ-9 screenings at the project site was 52 percent which exceeded the evaluation benchmark by a significantmargin.

Summary

The measurement of outcomes is important in determining the impact on healthcare quality (Melnyk & Fineout-Overholt, 2019). The outcome supported educational interventions on improving provider knowledge depression and depression screening in rural primary care settings. Furthermore, the outcome supported the impact of educational-based interventions with improving the routine utilization of depression screening tools in rural primary carepractices.

Reflection Paper 3 Guidelines: Reflection papers are designed to formally consider what you have been learning and to organize it through writing. The following will help you understand the

Papers must be typed, double-spaced, Times-New-Roman, 12-point font, and one-inch margins.

Papers should be 3 pages long
Writing should use formal language and correct spelling and punctuation
Topics reflected upon may include any information covered in class or in the reading assignment for the week
Papers may take 1 or 2 topics and examine them deeply, or more topics examined in less detail
When writing, consider the following:
What have we studied that is interesting?
What new things have you learned?
How has your learning affected the preconceptions or misconceptions you brought with you into class?
How does your learning affect your view of the world and the universe?
Will what you have learned change your professional behavior in the future?

Ultimately writing these papers encourages you to find what is meaningful to you and thus it adds value to your learning. Do not simply outline or summarize the material we have covered. I want to know what the material means to you. Topic: High School Ages-Obesity and Living in Underserved Communities.

Paper Format: APA

CCMH/506: Personality Theories And Counseling Models
Wk 3 Discussion – Adlerian Therapy Assumptions
Wk 3 – Adlerian Lifestyle Assessment
Discussion Topic

Post a total of 3 substantive responses over 2 separate days for full participation. This includes your initial post and 2 replies to classmates or your faculty member.

Due Thursday

Respond to the following in a minimum of 175 words:

What are the Adlerian assumptions of human nature?
Do you agree or disagree with these assumptions? Why or why not? Support your response with examples and relevant details.
What are three Adlerian concepts that relate to these assumptions?

Post 2 replies to classmates or your faculty member. Be constructive and professional.
I need 175 words reply to this

Paper Format: APA

Examine changes introduced to reform or restructure the U.S. health care delivery system. In a 1,000-1,250 word paper, discuss action taken for reform and restructuring and the role of the nurse within this changing environment.

Include the following:

Outline a current or emerging health care law or federal regulation introduced within the last 5 years to reform or restructure some aspect of the health care delivery system. Describe the effect of this on nursing practice and the nurse\’s role and responsibility.

Discuss how quality measures and pay for performance affect patient outcomes. Explain how these affect nursing practice and describe the expectations and responsibilities of the nursing role in these situations.

Discuss professional nursing leadership and management roles that have arisen and how they are important in responding to emerging trends and in the promotion of patient safety and quality care in diverse health care settings.

Research emerging trends. Predict two ways in which the practice of nursing and nursing roles will grow or transform within the next five years in response to upcoming trends or predicted issues in health care.

You are required to cite a minimum of three sources to complete this assignment. Sources must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

The challenges of the new public health that include caring for an aging population while also coping with chronic diseases and inequality

In the first sentence of page 87 of Chapter 2 of the textbook, Tulchinsky, and Varavikova explain the challenges of the new public health that include caring for an aging population while also coping with chronic diseases and inequality. Read this paragraph, and write a reflection paper that includes the following:

Describe what you believe the authors meant through this statement in relation to the new public health.

Define what the “new public health” means to you, how to effectively communicate it, and how it goes about solving future problems in public health.

Explain opportunities for future learning for yourself and for public health communication.

Your completed reflection paper should be a minimum of two and a half pages in length. Outside sources and APA Style are not requirements for this reflection paper.

Requirements: 2.5

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