1 10 Intervention Plan Design Ingrid Myers Capella University 6030 Assessment 3
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10
Intervention Plan Design
Ingrid Myers
Capella University
6030
Assessment 3 Intervention Plan
5/2021
Intervention Plan Design
This project focuses on patient satisfaction that reflects the quality of care, which patients get in health facilities. Any patient seeking care in any healthcare setting expects to receive timely and reliable services. A healthcare setting that achieves these goals has higher patient satisfaction scores. Unfortunately, many settings do not attain this objective due to various factors. For example, nurses may have increased workload that causes fatigue and burnout (MacPhee et al., 2017). Exhausted nurses cannot meet patient needs, leading to patient dissatisfaction. Another factor is inadequate attention that the nurses give to patients. Patients may wait long to get health services from nurses with increased demands, reducing both nurse and patient satisfaction. Leaders, nurses, support staff, and other healthcare stakeholders determine patient satisfaction. Therefore, efforts to increase patient satisfaction must involve multiple stakeholders. The following are the intervention plan components, theoretical foundations, stakeholders, policy and regulations, and ethical and legal implications.
Intervention Plan Components
Components of an Intervention Plan
The intervention plan involves the activities outlined in the intervention and a comparison. Two groups will be chosen. The primary activity will be to educate nurse leaders about measures to improve both nurse and patient satisfaction in one group. For example, nurse leaders will be educated on ensuring that nurses cope with their workload and engage patients to improve their experiences with care. In another group, nurses will be involved in the decision-making and scheduling of their activities, and some nonclinical tasks will be assigned to support staff. According to Sfantou et al. (2017), leaders make significant decisions and determine service efficiency and employee satisfaction in health facilities. In this case, leaders can be entrusted with initiating and sustaining activities that lead to patient and nurse satisfaction.
Additionally, nurse involvement in decision-making improves nurse experiences and satisfaction (Truglio-Londrigan & Slyer, 2018). Therefore, when nurses are involved in scheduling and planning their activities, they feel satisfaction and deliver adequate care. Overall, these components are the best options since they focus on stakeholder involvement in improving employee and patient satisfaction.
Target Population and Setting Cultural Needs and Characteristics
Nurses have a culture of caring. Therefore, they spend much of their time delivering services to patients. For example, nurses assess patients and use the assessment findings to formulate nursing diagnoses, which they use to plan and initiate interventions (Lotfi et al., 2019).
Nurses also evaluate patients and adjust their interventions to meet patient needs. Thus, nurses need support to meet their goals as they care for patients in the clinical setting. Instead, this project focuses on using nurses to implement administrative duties such as scheduling and entrusting the support staff with nonclinical tasks. Unfortunately, this intervention can divide nurses’ attention, increase their demands, and lead to more burnout. This factor can be a barrier to the success of the intervention.
Two cultural characteristics that can affect the intervention plan are empathy and commitment to advocacy. Empathy is helpful when considering patient needs while delivering care, and commitment advocacy is beneficial as it helps nurses understand and address patients’ needs (Davoodvand et al., 2016). During the intervention, nurses and their leaders are expected to focus on changes in nursing care by focusing on nursing activities instead of patient care activities. For example, nurses and their leaders should focus on workload and nonclinical tasks instead of their usual commitment to patient demands. This issue can disrupt the normal functioning of the healthcare setting and adversely affect the intervention plan.
The organizational cultural need is evidence-based practice. While the healthcare setting is committed to delivering the best care, leaders have always advocated for the culture of complying with the best evidence, which improves outcomes (Li et al., 2019). This cultural need is the need of every setting. Therefore, the setting’s cultural needs will enhance the intervention plan since it will involve using research evidence. The cultural characteristics of the setting are patient safety and patient-centered care. The intervention focuses on adjusting nursing duties through leadership and nurse involvement. They are likely to adversely affect the efforts to focus on patient needs, leading to inadequate nurse and leader involvement in the project.
Theoretical Foundation, Strategies from Other Disciplines, and Technology
Two theoretical nursing models relevant to the intervention plan include Jean Watson’s caring theory and Dorothea Orem’s Self-Care Deficit Theory. The caring theory focuses on treating patients with dignity and improving their experiences (Pajnkihar et al., 2017). This project focuses on patient satisfaction, and therefore, the caring theory is relevant. The self-care deficit theory focuses on activities that people implement to improve their well-being (Khademian et al., 2020). This project also focuses on nurse satisfaction and self-care activities among nurses to improve nurse outcomes. Therefore, the self-care deficit theory can help ensure nurse satisfaction during the implementation process.
One strategy from another discipline that relates to this project is Lewin’s change theory model. This model involves ignoring current practices, implementing the required changes, and sustaining positive practices (Wojciechowski et al., 2016). In this case, it can be used to implement the interventions with ease. For example, in the unfreezing stage, communication is always needed to orient participants about the intervention (Wojciechowski et al., 2016). In this case, nurses and leaders should be informed about how nurse dissatisfaction leads to patient dissatisfaction. Once they recognize these issues, they can accept interventions that can improve nurse satisfaction. Any positive actions should be sustained to sustain the improved satisfaction experiences.
Audio recording devices are needed to assess patient and nurse experiences. Patient and nurse satisfaction are subjective experiences and can only be understood from their perspectives (White et al., 2019). Documenting the subjective responses can be a daunting task due to various explanations that nurses or patients can give. For this reason, digital recording is necessary for getting enough details to create themes to understand satisfaction levels.
Evidence-Based Interventions
The selected interventions are evidence-based and can improve patient and nurse experiences. According to Sfantou et al. (2017), nurse leaders determine service delivery and provide experiences with care. In this case, they can be educated on nursing self-care strategies to improve nurse satisfaction. They should be involved in creating awareness, changes, and sustaining changes as per the change model. Most importantly, they should be helped to know how to record participants and analyze their responses to observe satisfaction trends. According to Truglio-Londrigan and Slyer (2018), shared decision-making improves employee satisfaction. Thus, nurses should be helped to understand self-care measures they can take, including scheduling, to improve their satisfaction. They should be aware of the problems in the initial stages of the change model, implement change practices, and provide responses that can be recorded and considered to improve satisfaction levels.
Stakeholders, Policy, and Regulations
The main stakeholders are nurses, their leaders, and patients. Nursing needs are to work in an environment that allows them to experience satisfaction as they provide care. This project seeks to ensure nurse satisfaction. Therefore, nursing needs align with the implementation plan goals and will facilitate the implementation process. Leaders need skills that will help them ensure proper nurse and patient satisfaction. Therefore, they are likely to accept educational interventions on improving nurse and patient satisfaction. Patients also need to experience a satisfaction. White et al. (2019) indicate that nurse satisfaction can determine patient satisfaction. Therefore, patients can be open to measures that can improve nurses’ experiences to facilitate healthcare delivery.
The relevant healthcare policy is the Affordable Care Act. This policy seeks to ensure that many people have insurance and can access high-quality care in health facilities. One of the determinants of high-quality care is patient satisfaction (Karaca & Durna, 2019). Therefore, the policy can support any efforts to ensure that high-quality care is affordable and accessible.
The relevant regulation is to ensure that nurses are well-trained to provide care. The board of nursing requires that nurses undergo rigorous training. Once they acquire the needed skills, they should undertake the regulatory exam to determine their licensure and practice (Cassiani et al., 2020). This regulation ensures that only qualified nurses are employed in the health facility to address workload issues and improve nurse satisfaction. When leaders advocate for nurse staffing, they should focus on getting only qualified nurses.
The National Council of State Boards of Nursing regulates nursing care. For instance, it determines how nurses are trained, assessed, and employed (Cassiani et al., 2020). In addition, the board has the power to revoke the licenses of nurses who violate professional standards. It can also promote nurses or renew the licenses of nurses who deliver adequate care. Therefore, it can help ensure that only qualified nurses provide the needed services to ensure patient satisfaction.
Ethical and Legal Implications
The primary ethical issue is the conflict between healthcare needs and resource availability. The considerations for the intervention plans are to improve nurse satisfaction by reducing workload and burnout and eventually improve patient satisfaction. Resource availability determines the employment of nurses (Van der Heijden et al., 2019). If resources are few, leaders may find it challenging to advocate for an increase in staffing. Therefore, nurses may not deliver services to the best of their ability due to the increased workload, and patients may not get the best care. This problem can adversely affect beneficence and violate the nonmaleficence principle since burnout can increase the risk of errors. Legally, only qualified nurses are supposed to deliver care (Cassiani et al., 2020). While this legal issue can limit deploying nurses to the clinical facility to reduce clinical demands, it can ensure that the available nurses deliver adequate care.
Conclusion
This project seeks to ensure patient and nurse satisfaction and involves two interventions. One of them is to educate nurse leaders on measures to improve nurse satisfaction and improve patient satisfaction. The second one is to include nurses in scheduling their activities and assigning nonclinical tasks to the support staff. The healthcare setting has a culture of care and two characteristics: empathy and commitment to advocacy, which focus on patients. Thus, culture and characteristics may adversely affect the intervention that prioritizes nurse satisfaction. However, the setting encourages evidence-based care and justifies the need to utilize other proven strategies to improve nurse and patient satisfaction. Jean Watson’s caring theory can be used to focus on patient satisfaction, and Dorothea Orem’s Self-Care Deficit Theory can be used to focus on nurse satisfaction. The Kurt Lewin change theory can facilitate the implementation process, and data collection should involve voice recording to assess satisfaction, which is subjective. The Affordable Care Act policy can help nurses focus on high-quality care, and the National Council of State Boards of Nursing can ensure that only qualified nurses are part of the project. While resource allocation may be an issue, only qualified nurses will be part of the project and will initiate reliable approaches to improving patient safety.
References
Cassiani, S., Lecorps, K., Rojas Cañaveral, L. K., da Silva, F., & Fitzgerald, J. (2020). Regulation of nursing practice in the Region of the Americas. Pan American Journal of Public Health, 44, e93. https://doi.org/10.26633/RPSP.2020.93
Davoodvand, S., Abbaszadeh, A., & Ahmadi, F. (2016). Patient advocacy from the clinical nurses’ viewpoint: A qualitative study. Journal of Medical Ethics and History of Medicine, 9, 5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4958925/
Karaca, A., & Durna, Z. (2019). Patient satisfaction with the quality of nursing care.Nursing Open,6(2), 535–545. https://doi.org/10.1002/nop2.237
Khademian, Z., Kazemi Ara, F., & Gholamzadeh, S. (2020). The effect of self-care education based on Orem’s nursing theory on quality of life and self-efficacy in patients with hypertension: A quasi-experimental study. International Journal of Community Based Nursing and Midwifery, 8(2), 140–149. https://doi.org/10.30476/IJCBNM.2020.81690.0
Li, S., Cao, M., & Zhu, X. (2019). Evidence-based practice: Knowledge, attitudes, implementation, facilitators, and barriers among community nurses-systematic review. Medicine, 98(39), e17209. https://doi.org/10.1097/MD.0000000000017209
Lotfi, M., Zamanzadeh, V., Valizadeh, L., Khajehgoodari, M., Ebrahimpour Rezaei, M., & Khalilzad, M. A. (2019). The implementation of the nursing process in lower-income countries: An integrative review. Nursing Open, 7(1), 42–57. https://doi.org/10.1002/nop2.410
MacPhee, M., Dahinten, V. S., & Havaei, F. (2017). The impact of heavy perceived nurse workloads on patient and nurse outcomes.Administrative Sciences,7(1),7. https://doi.org/10.3390/admsci7010007
Pajnkihar, M., Štiglic, G., & Vrbnjak, D. (2017). The concept of Watson’s carative factors in nursing and their (dis)harmony with patient satisfaction. PeerJ, 5, e2940. https://doi.org/10.7717/peerj.2940
Sfantou, D. F., Laliotis, A., Patelarou, A. E., Sifaki-Pistolla, D., Matalliotakis, M., & Patelarou, E. (2017). Importance of leadership style towards quality of care measures in healthcare settings: A systematic review. Healthcare (Basel, Switzerland), 5(4), 73. https://doi.org/10.3390/healthcare5040073
Truglio-Londrigan, M., & Slyer, J. T. (2018). Shared decision-making for nursing practice: An integrative review. The Open Nursing Journal, 12, 1–14. https://doi.org/10.2174/1874434601812010001
Van der Heijden, B., Brown Mahoney, C., & Xu, Y. (2019). Impact of job demands and resources on nurses’ burnout and occupational turnover intention towards an age-moderated mediation model for the nursing profession. International Journal of Environmental Research and Public Health, 16(11), 2011. https://doi.org/10.3390/ijerph16112011
White, E. M., Aiken, L. H., & McHugh, M. D. (2019). Registered nurse burnout, job dissatisfaction, and missed care in nursing homes. Journal of the American Geriatrics Society,67(10), 2065–2071. https://doi.org/10.1111/jgs.16051
Wojciechowski, E., Pearsall, T., Murphy, P., & French, E. (2016). A case review: Integrating Lewin’s theory with lean’s system approach for change. Online Journal of Issues In Nursing, 21(2). https://doi.org/10.3912/OJIN.Vol21No02Man04[supanova_question]
1 The Efficacy of Behavioral Activation for Postpartum Depression: An Integrative Review
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The Efficacy of Behavioral Activation for Postpartum Depression: An Integrative Review
Jane Doe
College of Nursing, Thomas Jefferson University
NU603: Research Design
Dr. Amy Szajna
August 11, 2021
Introduction
Provide background information – description of the clinical problem in nursing to be examined.
Provide a problem statement that describes the identified problem that your review of the evidence will address. (Explains what issue or controversy needs to be resolved).
Identify the significance of the problem to nursing.
State the purpose of the review. This is a concise statement regarding the aim(s) of the integrative review that flows from the problem and its significance for nursing.
Identify and describe the theoretical framework that will serve to guide this integrative review.
Identify the PICO question
Notes: This section should be 2 pages (slightly less is ok). To get full credit for this section, you want to make sure you address everything bulleted above. For this section, you will need to include about 2-4 references that help your case to identify why this problem is significant and a brief background of the information and topic. These citations will not be on any TOE template but must be included on the reference page. An example could be: Postpartum depression can occur up to six months postpartum and can lead to long-term effects on both the mother and child (Patel, 2019). Further, statistics show that PPD is highest among mother who have a history of mood disorders (CDC, 2019). . .
When stating the PICO question, do not list out each section with a label (P, I, C, O), simply write the PICO question. An example: The research question guiding this review is: Among woman with postpartum depression, how does behavioral activation affect depressive symptoms compared to usual care?
Literature Review (2-3 succinct pages)
Locate previous quantitative research studies (from peer reviewed journals) that have contributed to the field of nursing in a similar manner to this proposed study. Contain search to the last 5 years. Describe your search strategy.
Your integrative review will include 3 research studies published in the last five years.
The literature review is objective, organized and provides a synthesis or a line of reasoning that leads to your conclusion. Compare and contrast the literature and do not report each study separately. Identify the methods and common variables and results. How were the studies the same? Identify the uncommon features and results. How did the studies differ? The synthesis table will serve as a tool to help you organize and synthesize your findings.
Notes: This is the “meat” of the paper and this is where you discuss your findings. The best way to approach this section is to “check off” each separate section for each prompt on the TOE template. Again you must ensure you are not simply going TOE by TOE listing out all findings separately. This is a synthesis of findings. Please follow this format:
Literature Review
Briefly state that you included three studies as part of this review and that studies were quantitative for the purpose of this review. (about 2 sentences)
Notes: This is not meant to be copied as your own, but rather a guide of what to include to earn full credit for this section.
Search Strategy and Synthesis
The author conducted a search strategy to incorporate relative studies to assist in answering the PICO question. The author located studies through searches included in the following databases: PubMed and Google Scholar. The search was conducted during July, 2021. The search terms included “postpartum depression”, “behavioral activation”, and “maternal health.” Other search parameters used were publications no older than 10 years, English-language-only, and human subjects only. The author selected the three most relevant studies.
The studies differed slightly differently. Two studies employed a quasi-experimental design (Smith, 2016; Jones, 2019), while Miller (2020) designed a correlational study.
Again: You need address ALL columns of your TOE template.
Conclusion. (1 page)
After reviewing the 3 studies, discuss your answer to the PICO question. Write a closing conclusion summary that summarizes and synthesizes the evidence presented in your review.
Identify the implications of your conclusions to healthcare practice. Discuss your recommendations for further research.
NOTE: Notice the APA format of the above headings. Be sure to follow all formatting exactly as this sample is presented.
References (start on new page)
Include all references cited in your paper in APA format.
Appendix
NOTES: This is where you include your three TOE templates with revisions based on your TOE assignment feedback. Place all 3 templates as one Appendix (do not have Appendix 1, 2 and 3). Also, notice that this section goes AFTER the Reference page.
Additional Key Information:
Follow APA precisely (ex” double space everything. . .)
This document is a sample of certain sections and how to approach them. It is NOT all-inclusive.
Start early! Try to write a few sections per day. This is not something you can successfully complete in 3 days.[supanova_question]