Constructing the Written Evidence-Based Proposal (NRS-441V)

Constructing the Written Evidence-Based Proposal
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Abstract
The need to provide holistic care has gained interest in health care circles, with spirituality assessment being integrated into healthcare. Positive forms of religious coping influence adjustment to persistent pain and lead to better physical and mental health. Even though, it is difficult to integrate spirituality in health care, evidence- based practice will likely improve prospects of spiritual care in pain management. Hence, there is a need to implement changes in healthcare settings through educating healthcare providers and sensitizing them on the efficacy of spiritual care. Nurses are not obligated to carry out spiritual assessment, but emphasizing on spiritual assessment will be vital to increasing nurse leaders’ leaders in the project. Success of the project is dependent on effective implementation and evaluation plans. Hence, it is vital to seek approval and authorities from relevant authorities for an effective implementation plan. Also related to implementation is education to effect changes during implementation, while also focusing on the requisite resources to achieve this. The evaluation plan takes into account the methods and variables that facilitate spiritual assessment through training and education of key stakeholders and the nursing community. In order to evaluate project outcomes, the evaluation plan highlights on information gathering and open communication channels as being vital to success of the project. However, it is vital to know whether training has been effective in imparting knowledge on spiritual care, as evidenced by changes in behavior after the evaluation process. Tools to evaluate the success of the project should ideally show that there is a positive change of attitudes towards spiritual assessment among health care providers and patients. Büssing et al (2009), delved into religiosity and spirituality and outcome on patient health, with respondents who were religious relying on religious coping and psychological wellbeing. Thus, it is important to highlight on spiritual care for healthcare providers through using evidence based practice to show benefits of spiritual care.
Problem Description
The role of spirituality in healthcare, has gained attention because there is a need to provide more holistic care. Nonetheless, it is difficult to integrate spirituality in healthcare as because there is need for adjustment because there is still skepticism on effectiveness of spiritual care. Thus, evidence based medicine focusing on medical spirituality is likely to contribute towards better understanding of the relationship between spirituality and pain management in patients. Spirituality and religion can influence the way people deal with pain, and this has clinical implications on how medical practitioners communicate to patients when carrying out spiritual assessment.
Clinicians typically look into the biomedical aspects of pain care, and people living with chronic conditions find ways to live fulfilling lives. In some instances, patients desire to have better quality of care through integration of spiritual practice, and hence incorporating spiritual assessment may improve effectiveness in managing pain. However, pain assessment is subjective, with nurses being taught to rate pain on a scale of 0-10. Patients typically seek medical attention for pain through the Emergency Department (ED). The underlying causes of pain are injuries and chronic health conditions that result to patients suffering instances of chronic pain.
Pain assessment is complicated because patients’ perceptions and their coping mechanisms differ from person to person. Essentially, a patient may be experiencing pain and discomfort but give a lower rate, while another may provide a higher rate without really been bothered whether they give accurate information Additionally, people with chronic diseases and experiencing different episodes of pain are likely to have divergent perceptions on their level of pain. On one hand, there are those who show hostility and mistrust, while on the other there are those who accept their situations and are calm. It is not advisable to conduct spiritual assessment for patients in ED, but where possible such assessments help to show the patients spiritual history, allowing nurses to plan on the best strategies to integrate spiritual care. This may also help to highlight on ways through which patients use spirituality as a coping mechanism to deal with pain.
Nurses are care givers and show compassion, and when patients experience pain, they try to manage it. One of the most common ways through which they achieve this is by using medication, but if the patient requires frequent medication it becomes a struggle to manage time properly and attend to the needs of all the patients. At other times, patients experiencing pain are hostile to nurses, and there is need for more resources and time to address their concerns. Additional, nurses can perform reassessment and may utilize other pain management approaches. Some patients are calm and have a peace of mind and experience pain even after using pain medication, but they may be more receptive to using religious coping mechanisms.
Besides understanding the beliefs of a patient, spiritual assessment helps nurses to understand the patients’ source of hope. However, some patients have no strong religious inclinations and beliefs, and hence they need to be handled carefully for them to use coping strategies. Spiritual assessment helps to align the goals of care with holistic care, and this has a bigger impact on patients than simply relying on medical diagnosis. Spiritual care can in turn lead to marked improvement in coping and pain management, while also improving nurses’ morale and job satisfaction.
Solution Description
In order to implement changes in hospital settings, it is necessary to educate healthcare providers on spiritual assessment. Spiritual assessment has not been readily applied in many hospitals as there is still skepticism on how to tackle the issue. Hence, to deal with spiritual assessment in healthcare settings, nurse leaders will ensure that there is effective implementation and evaluation of spiritual assessment. The main reason behind this is that at times nurses have no motivation to conduct spiritual assessment as it is seen as being outside there mandate in professional practice. Hence, ensuring that there is a follow up on utilizing spiritual assessment tolls following training and education is critical to the project’s success. Spiritual care is not only a function of the faith leaders, but also that of nurses who provide holistic care.
In any case, there is no professional obligation of nurse to understand spiritual assessment, and it is through laying emphasis on the role of spiritual care, that nurse leaders have a bigger impact on integrating spiritual care in hospital settings. To farther increase interest in the project, there will be sensitization of nurse leaders who may be skeptical about spiritual care especially those with little information on the process. Essentially, this seeks to minimize misunderstandings between nurses and the hospital leadership based on different perspectives about the efficacy of spiritual care. There may be role conflicts because nurse leaders may not fully understand spiritual assessment, whereby training nurses and sensitizing stakeholders will increase role engagement in spiritual care.
Implementation Plan
The implementation plan of the proposal first depends on seeking approval from the management and involving nursing staff. Seeking approval makes it easier to adopt the implementation plan as there is less resistance to change. Thus, to ensure that this is successful there will be a need to consult with nurses and inform them about the implementation plan. Similarly, the nurses need to understand the project’s goals and how this fits with their professional work. To complement the implementation plan will be emphasis on nursing professional goals, which play a part in improving patient safety and care.
There is also a need to incorporate hospital administrators who need to understand the projected benefits of the project, and having a well detailed implementation plan is crucial to the success of evaluating the project. In any case, hospital administrators append their signatures as a sign of approval, while nurses will be duly informed about the projection before there is full implementation. This seeks to encourage participation in the project and allows changes to be implemented by the nurses. The hospital management typically needs to understand the goals, and objectives of the project and how they will be achieved. The implementation plan touching on spiritual assessment will focus on what is to be achieved after implementation. Overall, the hospital leadership needs to be convinced that the project will have a return on investments, with policy changes set to improve hospital operations on spirituality.
Education plays a critical role in the implementation of the proposed changes as it helps nurses to understand and utilize spiritual assessment. There has been emphasis on the role of spirituality in health care, but actual implementation of changes to reflect knowledge has not been effective. Thus to improve integration of spiritual assessment tools in hospital settings, it is necessary to impart knowledge that will impact positively on nursing perceptions. Also related to education, is follow up on spiritual assessment, with nursing leaders being sensitized on the need to initiate changes that would facilitate the implementation. Understanding the role of spiritual assessment inpatient care is vital to nursing, as some nurses see this as a role of spiritual leaders. Therefore, adopting spiritual care policies facilitates adoption of spiritual assessment polices and there implementation.
The implementation plan takes into account preparation as critical aspect to the success of the plan. This is based on attitudes towards spiritual care, where nurses encounter some form of education on spiritual care, but do not apply these practices regularly’ at the same time. Nurse leaders may have little knowledge on spiritual assessment, and assume that nurse readily use spiritual assessment tolls. This scenario creates mismatch in perceptions whereby nurse leader are less likely to follow up on spiritual assessment as they can adequately account for the need of spiritual assessment. Hence, an adequate implementation plan seeks to include nurses and nurse leader in educating stakeholders about spiritual assessment. An all inclusive implementation plan facilitates success of the spiritual assessment project, as even the less knowledgeable people participate more for the success of the project.
Critical to the success of the implementation plan are the implementation logistics that enable changes to be well effected in the hospital settings. Nurses and nurse leaders are the main stakeholders to effect changes in the project, with nurse leaders overseeing the success of the project. Additionally, the nurse leader performs an internal analysis to highlight on the strength and weaknesses which then help the leaders to emaciate whether they can leverage on opportunities available to maximize on the project’s viability. The need to integrate changes in the hospital settings will require that the nurse leader motivates nurses to ensure that there is minimal resistance to change, while integrating the changes with other departments gradually.
The project is long term, and as such it will take into account the spiritual assessment of patients in long term care, or those spending more than a day in the hospital. Consequently, the hospital administration should have a positive view of the project, for the proposal to be a success before implementation. This requires that there is supervision and delegation of departments to be affected by the changes during and after implementation of the plan. The implementation plan envisions that there are clear guidelines on staff roles and responsibilities with division of labor to teams and individual nurse aligned with staff members’ competencies. Nurse leaders have an important role to play to ensure success of the teams, and evaluation of the team’s work will be done continuously, and is the first step towards success of the implementation plan.
Training affects the implementation plan, and as such education materials are important resources utilized in training and education. Pamphlets, power points and training manual materials highlight on the important aspects of spiritual assessment and tools to ease the assessment. In line with this, the implementation plan focuses on nurses as important pillars of the assessment, with training geared towards improving how spiritual assessments are carried out. Additionally surveys carried out before and after use of assessment tools will provide information on whether training has being successful. Cooperation of nurses also helps to achieve the goals of the implementation plan, with quantitative assessment allowing evaluation of the training methods and there influence on how nurse make decisions on spiritual assessment.
Besides training materials there are technology requirements for the training ease the process of information retrieval, storage of information and allow access to all the team members. The technology utilized will be personal computers and hand held devices which help achieve the goals of training and implementing change in the hospital. Technology supplements information from the training, while also making it easier to refer and point out on weaknesses in the training program. Similarly, it is possible to focus on opportunities that can be turned to successes through use of technology resources, while also comparing changes that occur during and after implementation of spiritual assessment.
Evaluation Plan
The evaluation plan of the project focuses on the methods and variables that facilitate spiritual assessment. Even though, health care providers understand the role of spirituality in health care, realizing the full potential spiritual assessment should be emphasized through education and training. Thus, there ought to be observable changes after training on utilizing spiritual assessment. Evaluation also features evidence based practice to show the need for spiritual assessment and how it is possible to integrate spirituality in healthcare.
There are also differences on perceptions about the impact of spirituality on health care, whereby nurse beliefs and cultures affect the way the make decisions. Hence, training should help to improve attitudes towards spiritual assessment. Essentially, training is critical to the success of spiritual assessment, as there is emphasis on positive perceptions that help to integrate spirituality in health care. The evaluation will hence look into changes in perceptions that come about after training, and it is expected that there are positive changes on what nurses perceive about the role of spirituality in health care.
Patient behavior on spirituality assessment before and after the changes
It is expected that there is positive attitude towards spiritual assessment by patients, as shown by changes before and after the assessment. The evaluation plan highlights on health from the physical aspects to the spiritual nourishment. Essentially, health incorporates social and spiritual aspects rather than simply focus on physical aspects. Patients typically have different experiences with spiritual assessment, and patients who are religious are likely to appreciate efforts towards improving their healthcare needs without failing to incorporate spirituality. It is also expected that even those who are less religious observant will appreciate the role of spiritual assessment.
The evaluation plan delves into addressing the healthcare needs of patients, with health care providers performing this function after training. Even though, spiritual assessment seeks to address spirituality and medical care, assessment may not address the patent’s needs at all. Hence it is pertinent to know whether training has been effective in integrating spirituality with patient care, and this is possible through the evaluation process. Thus, evaluation will best serve the needs of patients and impact more on health care providers when performed at the end of spiritual assessment, and to achieve this, the evaluation plan will highlight on variables that match with the highlighted methods.
Variables
Staff perceptions and attitudes on spirituality before and after training or education
Behavioral changes in staff as indicated by their willingness and frequency in using spiritual assessment tools before and after training.
Patient perceptions, thoughts and influence on behavior towards spiritual assessments indicated by changes in number of those willing to undergo spiritual assessment.
Reported cases on nurses ability to address both spiritual and health care needs comparing the period before training and after assessment is conducted.
Tools to educate project participants
For the evaluation plan to be effective there is a need to have open communication with participants, while utilizing training materials to get the message across. Hence, power points will be used to ensure that the participants understand the main highlights of the training sessions, as they capture the summarized information and are easy to grasp. Even though, pamphlets cannot be shared electronically, they are crucial to the evaluation process as they focus on information that is useful for the review and assessment process. Similarly, training manuals will be utilized to emphasize the importance of spiritual assessment tools and there applicability to unique situations. Since the manuals also touch on evidence based practice they are more likely to impact positively on the participants’ perceptions about spiritual assessment. In essence, training should seek to improve nurse attitudes through encouraging open communication as this is crucial to the evaluation as health care providers are more likely to have a good rapport with the patients and understand them better.
Both qualitative and quantitative assessments play a vital role in the evaluation process, and it is necessary to understand and educate participants on the role of assessment in achieving the project’s objectives. Hence, the most useful tools include questionnaire which makes it easier for the healthcare providers to understand the spiritual history of patients, and how this has affected their choices in health care. For, the evaluators, the questionnaire is an important tool that enables one to share information on the best ways to improve evaluation through focusing on different aspects of the assessment. Essentially, open ended questions are the best way through which to understand patients’ spirituality, as they are able to express themselves better. To achieve the best ...