In your peer responses, offer suggestions and other thoughts for your colleagues to consider. 1, Responds to this post in half a page In an attempt to secure federal funding, healthcare organizations have adopted evidence-based practice (EBP) to bridge the gap between research and provision of best patient care. EBP has been defined as a systematic literature search of the most relevant facts to answer a clinical question with aim to improve patient outcome (Melnyk and Fineout-Overholt, 2019). Studies indicate that EBP decrease healthcare cost, contributes to delivery of high-quality care, empowers clinicians, and produces best patient outcomes (Dotson et al, 2014., Melnyk, 2017). Melnyk and Raderstorf (2021) referred to Bodenheimer & Sinkyss Quadruple Aim which includes healthcare quality, population health outcomes, costs, and clinician engagement and satisfaction. Melnyk makes reference of Duke University Medical Centers definition of EBP as the integration of clinical expertise, patient values and the best research evidence into the decision-making process for patient care. In order to integrate these four components to achieve the best outcome, a critical question have to be formulated. One of the seven steps of the EBP process is to ask that question in PICOT format (patient population, intervention or issue of interest, comparison intervention or group, Outcome and timeframe). Melnyk and Fineout-Overholt (2015) also pointed out that questions asked in PICOT format produce the best, relevant and time efficient way do a literature search. The COVID-19 pandemic has shaken and restructured the way we provide care and that has created major stresses among the hospital staff. One of the common themes at my facility is the discontent of the staff regarding recommended COVID vaccines. The new mandate is perceived by many as a way of losing control of deciding what goes into their bodies or a violation of the religious beliefs. This resistance to get the vaccinated has driven the critical question, Would hospital staffs resistance to get Center of Disease Control (CDC) recommended vaccines for healthcare workers (HCWs) decrease if the facility develops a staff vaccination center within occupational health clinic for the next influenza season or next year? P ? Healthcare workers, healthcare staff, Hospital employees, healthcare personnel I ? Hesitancy to vaccinations, declination of immunizations C? Creation of a staff vaccination center O? Decrease, reduce, minimize resistance or hesitancy, increase vaccination T ? Next influenza season or next year The CDC reports total COVID cases of 40,345,484, and death total 649,299 in the last 30 days and 109,127 new cases as of September 7th, 2021. Floridas vaccination rate is not optimal with fully vaccinated and % with at least one dose of vaccine. () Even with the increasing number of COVID infections and COVID-related deaths, and the facility expanded a mandate for COVID-19 vaccines among employees, our facility staffs vaccination rate is around 75%. This is really an issue because that leaves 25% of the staff more susceptible to COVID infection, increases the potential for them to infect co-workers and patients, and potentially creating an internal outbreak. Our facility has many high-risk areas, including hemodialysis, chemotherapy, intensive care units, and community living facilities, and many staff who could already be immunocompromised. The facility has over 3000 employees and 25% (750) of those are not immunized. Add to the mix the fact that the vaccine effectiveness decreased to around 73% against the current Delta variant and many of the staff already immunized could still get sick. An outbreak of his magnitude would be devastating and very difficult to control. As the occupational health provider in the facility, I just hope that staff vaccinated or unvaccinated adheres to the general COVID precautions of masking, good hand washing and distancing to minimize the risk of infection until the staff achieves close to full vaccination status. References Dotson, J. A. W., Roll, J. M., Packer, R. R., Lewis, J. M., McPherson, S., & Howell, D. (2014, April 6). Urban and RURAL utilization OF EVIDENCE?BASED practices for substance use and mental health disorders. Wiley Online Library. Melnyk, B. M., & Fineout-Overholt, E. (2019). getting started. In Evidence-based practice in nursing & healthcare: A guide to best practice (pp. 1718). essay, Wolters Kluwer. Melnyk, B. M., & Raderstorf, T. (2021). Making the Case for Evidence-Based Leadership and InnovationVersion (978-0-8261-9625-5 (eBook). In Evidence-based leadership, innovation, and entrepreneurship in nursing and healthcare: A practical guide to success (p. 7). Springer Publishing Company. In your peer responses, offer suggestions and other thoughts for your colleagues to consider. 2, Responds to this post in half a page Quality of care, patient satisfaction, and reduced health care costs are all achieved through the use of evidence-based practice (EBP) (Melnyk & Fineout-Overholt, 2019). The first step of the EBP approach is creating a PICO question to address a burning clinical topic (Melnyk & Fineout-Overholt, 2019). Formulating the question in this manner provides nurse researchers with the opportunity to systematically review the appraised evidence, leading to an effective search (Melnyk & Fineout-Overholt, 2019). Through the use of the PICO format, and the proper use of Boolean phrases, the nurse researcher will retrieve a comprehensive list of the literature pertaining to the topic (Melnyk & Fineout-Overholt, 2019). The alternatives to using PICO are undesirable for EBP because they may cause an inefficient search that sometimes promote an environment of uncertainty (Melnyk & Fineout-Overholt, 2019). For example, a nurse practitioner is more likely to ask a colleague about a diagnosis, than they are to formulate a PICO question and conduct a formal literature search (Cogdill, 2003). However, these practices are not ideal, and the use of the PICO format provides the nurse researcher with an exhaustive list of the literature to drive their EBP. My proposed PICO question is the following: Should pediatric primary care clinic staff (P) be trained on human lactation and supportive feeding practices (I), compared to no training (C), to increase duration of infants receiving breastmilk? P primary care clinic staff or providers or pediatricians or nurse practitioners or office staff or health workers I training of staff on human lactation and supportive feeding practices or lactation education or breastfeeding education C no training or no intervention O duration of infants receiving breastmilk or duration of breastfeeding or duration of lactation As reported through the new Healthy People 2030 objectives, the United States fell short of the goal of percent of infants receiving any human milk at 1 year (Office of Disease Prevention and Health Promotion [ODPHP], .). The new goal is to continue to increase the number of infants breastfed at 1 year (ODPHP, .). One intervention for achieving this goal, as proposed by ODPHP, is to increase education in the community, hospitals, and workplaces (ODPHP, .). References Cogdill, K. W. (2003). Information needs and information seeking in primary care: Study of nurse practitioners. Journal of the Medical library Association, 91(2), 203-215. Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare: A guide to best practice(4th ed.). Wolters Kluwer. Office of Disease Prevention and Health Promotion. (.). Increase the proportion of infants who are breastfed at 1 year MICH-16. . Department of Health and Human Services. proportion-infants-who-are-breastfed-1Show more
