NURS 8410 Week 10 Discussion Post:Evaluation of Outcomes.

To prepare:
• Review the Learning Resources focusing on the various evaluation frameworks presented. Select a framework and determine how you would evaluate the outcomes you identified in the Week 9 Discussion.
• Based on the possible results of your evaluation, envision new practice guidelines you would develop.
• What new standards of care might this lead to?NURS 8410 Week 10 Discussion Post:Evaluation of Outcomes.

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By Day 3
Post a cohesive scholarly response that addresses the following:
• In the first line of your posting, state the outcomes you are addressing (those you initially identified in the Week 9 Discussion).
• How would you evaluate the outcomes? Support your response with evidence from the literature.
• What new practice guidelines would you create based on your evaluation of those outcomes?
• Discuss any new standards of care that would be appropriate based on the new practice guidelines.NURS 8410 Week 10 Discussion Post:Evaluation of Outcomes.

NURS 8410 Week 10 Discussion Post:

Desired Clinical Outcomes

The use of electronic medical records (EMR) to facilitate telemedicine visits will benefit both the patients and the clinic.  Telemedicine visits incorporate the ability to provide patient care services remotely, which will generate revenue for the struggling clinic.  Furthermore, telemedicine is a solution to closing the gap between the need for healthcare and access to available providers. NURS 8410 Week 10 Discussion Post:Evaluation of Outcomes.

Evaluating Outcomes

Evaluation is the process of examining a program to determine what is working, what is not, and why.  This helps to determine the value or benefits of the program and becomes the blueprint for judgment and improvement (“Formative and Summative Evaluations in the Instructional Design Process”, 2015).  There are many phases of evaluation, for this practice problem the focus will be on formative and outcome evaluations.  Formative evaluations also known as the internal evaluation, begin with the conception of the program and is a method used to identify the worth of the program while the plan is forming and in progress (“Formative and Summative Evaluations in the Instructional Design Process”, 2015).NURS 8410 Week 10 Discussion Post:Evaluation of Outcomes.  Formative evaluations permit the monitoring of how well the goals and objectives are being met and are needed to catch deficiencies so that proper interventions can take place (“Formative and Summative Evaluations in the Instructional Design Process”, 2015).  Outcome evaluations are used to assess the effectiveness of a program in producing change.  These evaluations focus on what happened to the participants and what differences the program made for them.  This is usually the standard evaluation requested by foundations to gauge the benefits of the program (MissionWorks, 2020).  The outcome evaluation is the most useful evaluation in trying to change policy.  The outcome evaluation should show that the initiation of EMR for telemedicine visits would close the gap between access to care for patients while generating revenue for the clinic.

As mentioned in previous discussions the COVID 19 pandemic has caused a strain on healthcare and revenue affecting this small practicum setting.  Providing telemedicine services that are billed at the same rate as face to face visits will help compensate for missed revenue.

New Practice Guidelines

A system would need to be developed to designate time slots for telemedicine visits with 15-minute grace periods before and after the scheduled visit times.  The provider should be able to access the patient’s EMR during the visit to answer any questions.  Initially, the program would be rolled out slowly with no more than 2 telemedicine visits scheduled per day, per provider to maintain quality visits and not make the provider or patient feel rushed.  A quality assurance/process Improvement (QAPI) leadership team will be developed.  This team’s role will be to ensure the improvement of quality measures with the EMR and telemedicine visits.  The leaders on this team are responsible for deciding which tools will be used to analyze problems, promote change and improvement, and assure that once quality goals are achieved, they are being maintained through control. NURS 8410 Week 10 Discussion Post:Evaluation of Outcomes.

New Standards of Care

When implementing changes to clinical practice, there will likely be changes in the standards of care.  When using EMR to facilitate telemedicine visits some of the new standards would include using a service that has protocols in place to prevent unauthorized access and security features for protected health information. and system access specific to individual roles (“Ethical Practice in Telemedicine”, 2020).  Providers should uphold standards of professionalism in the same manner as to face-to-face visits, be forthcoming in regards to limitations in visits, have the means to obtain vital information, and ensure they have all needed information before making clinical decisions (“Ethical Practice in Telemedicine”, 2020). NURS 8410 Week 10 Discussion Post:Evaluation of Outcomes.

Desired Clinical Outcomes

Nursing engagement is the term used to describe the level of commitment and satisfaction that a nurse has for their job as well as for the organization for which they are in the employ. Nursing engagement has been seen to correlate directly with quality, safety, as well as with patient experience outcomes (Dasgupta, 2016). Research conducted by Prybil (2016) has shown that nursing engagement is an essential factor in the prevention of complications and the determination of healthcare quality for patients with dementia. Nursing engagement has also been seen to be a predictor of mortality variation across healthcare facilities even more than the organization’s number of nurses on staff. Further research by the (Carthon et al.,2019). has indicated that just 32% of Registered Nurses are currently engaged in their work. Conservative estimates go on to suggest that every disengaged nurse costs their organization losses amounting to $22,200 every year due to a lack of productivity. The benefits of engaged nurses, on the other hand, can have significant financial implications as well as benefits to patient care and strong patient relationships.NURS 8410 Week 10 Discussion Post:Evaluation of Outcomes.

Evaluating Outcomes

Multiple barriers to nursing engagement have been identified. These include a loss of momentum, inclusion of another discipline on the proposed change and controversial or a low level of evidence. Practice issues have, however, been linked to cost of care, quality metrics, patient satisfaction, patient safety and regulatory compliance (Chapman, 2017). The active engagement of nurse leaders can be seen to be essential for practice change to take place. However, to solidify practice change, research has shown that a supportive culture will encourage employees to file reports on practice improvement opportunities as well as to provide resources that can help in navigating practice changes that have been identified (Bradford et al., 2019).NURS 8410 Week 10 Discussion Post:Evaluation of Outcomes.

New Practice Guidelines

            New practice guidelines in employee engagement for nurses include the provision of research training opportunities for nurses engaged in point-of-care. This will have immense benefits on evidence-based practice. These opportunities will also empower nurses and signify excellence in clinical research. Nurse leaders should also work to ensure that their subordinates are empowered by technology to acquire information on evidence-based practice and nursing outcomes so they can have guidelines on how to provide optimum patient care for patients with dementia.NURS 8410 Week 10 Discussion Post:Evaluation of Outcomes.

New Standards of Care

Patients with cognitive impairments, members of their families and those providing care to the patients would identify “quality of life” as a core goal in the treatment of dementia. This response, therefore, looks into quality of life as a standard for nursing care. Nurses should implement evidence-based practice to ensure that patients with dementia are well-positioned to live quality lives. Secondly,NURS 8410 Week 10 Discussion Post:Evaluation of Outcomes.