Integrating Evidence-Based Practice

Write a 1000-1500 word essay addressing each of the following points/questions. Be sure to completely answer all the questions for each bullet point. There should be two main sections, one for each bullet below. Separate each section in your paper with a clear heading that allows your professor to know which bullet you are addressing in that section of your paper. Support your ideas with (2) sources (1 outside source and the textbook) using citations in your essay. Make sure to cite using the APA writing style for the essay. The cover page and reference page in correct APA do not count towards the minimum word amount. Review the rubric criteria for this assignment.

Part 1:

Describe the eight steps to integrating evidence-based practice into the clinical environment. What barriers might you face in implementing a new practice to address your research topic (as identified in Module 1)? Describe strategies that could be used to increase success including overcoming barriers. 

Part 2: 

Describe six sources of internal evidence that could be used in providing data to demonstrate improvement in outcomes.

Assignment Expectations:

Length: 1000 1500 words
Structure: Include a title page and reference page in APA format. These do not count towards the minimum word count for this assignment. Your essay must include an introduction and a conclusion.
References: Use appropriate APA style in-text citations and references for all resources utilized to answer the questions. A minimum of one (1) scholarly source and the textbook are required for this assignment.

Below is what was discussed in Module 1 

Clinical Question

 In terminally ill patients and their families (P), how does the provision of educational programs to demystify benefits of hospice care (I) as compared to informal community education (C) influence their ability to increased awareness of the best options and benefits of hospice care (O) within a period of hospital stay (T)? 

Justification for the Clinical Problem

 This paper describes a hospice educational program for terminally ill patients. The main focus of this study is the lack of accurate and inconsistent information on the benefits and options of hospice care. There is a large gap of eligibility, philosophies and knowledge concerning hospice care for patients facing end of life transition. Most studies that have been carried out on the topic have either been biased or provided less detailed information on the importance of creating awareness of the benefits of hospice care for terminally ill patients. Lack of knowledge about the importance of hospice care has led to increased number of people living their last days without receiving the benefits of this service (Garcia, 2018). 

 Most families learn about the benefits of hospice care care when it is too late for the patient. In addition, the families learn about the advantages of the service once the patient has already been admitted in the program. The main reason for enrolling their terminally ill patients to the program is not because they know its benefits but for the lack of another option. The significance of this study is to help patients and families to enroll in hospice care early enough in the course of a life limiting illness for them to receive comfort care and experience easier transition. 

 According to Tofthagen, Guastella, & Latchman, 2019), the need for palliative and hospice care program has increased as people are living with complex diseases with no cure and population ages. The study suggests more hospice care professionals will be needed in the near future to meet the increasing demand for the services (Tofthagen, Guastella, & Latchman, 2019). Lack of knowledge on the importance of these services has resulted in families keeping terminally ill patients at their homes. The authors of this study suggest that providing educational programs to communities could help reduce the number of terminally ill patients who are not receiving these services (Tofthagen, Guastella, & Latchman, 2019). 

 Another study conducted in 2020, found out that healthcare professionals in the hospice care setting can only provide effective services to patients if there is a conceptual framework to guide practice and education (Dyess et al., 2020). The study suggests that most people are unable to access hospice care because of lack of knowledge. The framework builds on theoretical caring to convey elements of relational, holistic and compassion; articulates inter-professional tenets for guiding values; and aligns with constructs for palliative and hospice best practices (Dyess et al., 2020). The study suggests that such a framework invites leaders as well as clinicians to develop educational programs to promote awareness about hospice services. 

 According to Allo et al., (2016), healthcare professionals do not have exposure to provide quality home based care. This is as a result of lack of enough education among healthcare practitioners to attend to home-based patients. The study suggests that participation in patient home visits is an effective way to provide education in communities about the benefits of hospice care (Allo et al., 2016). This approach does not cause any form of distress to both patients and their families. As a matter of fact, families who participated in this study were quick to enroll their patients to hospice care (Allo et al., 2016).

 In another study conducted in 2019, the authors argue that most terminally ill patients do not have access to hospice services due to lack of knowledge in the communities (Livingstone, Welstand & Ryan, 2019). However, such patients would enroll to hospice care services if they were aware of its benefits. Livingstone, Welstand & Ryan, (2019), found out that the fears associated with end of life include not being able to stay at home, burden to the family and also fear of undignified death. Most terminally ill patients would therefore enroll to such programs to reduce these fears if they had enough knowledge. 

Article that Best Supports the Topic

 In a study conducted in 2018, the authors argue that hospice care is a service that has been widely misunderstood and underutilized (Garcia, 2018). Communities are not aware of hospice services. This results in increased suffering for patients having life limiting illnesses. Misconceptions by communities also lead to the lack of enrolling terminally ill patients to the service. Most people believe that the service is only provided for six months. People also dont understand their illnesses as well as the treatment goals for hospice care. While there are many hospice care organization in communities, lack of clarity on who should handle this conversation exacerbates the situation (Garcia, 2018). 

 Limited knowledge, misconceptions and poor communication among patients and within the health care profession, have led to terminally ill patients not being referred on a timely manner (Garcia, 2018). Communities do not have enough knowledge to identify the identify patients who need hospice care. Late referrals have led to patients being denied access to hospice care at the end of their life. The underutilization of these services has resulted in poor communication and ineffective identification of those patients who deserve end of life care. The underutilization of hospice care leads to poor quality of life for terminally ill patients and also increased healthcare services (Garcia, 2018). 

  This article provides ways in which terminally ill patients and their families can access education programs to help them understand the benefits of hospice care services. The article also provides insights on the importance of providing educational programs to communities (Garcia, 2018). The other article focus more on the importance of providing hospice care rather than the importance of educational programs on hospice care services. Unlike the other selected articles, this article provides recommendation educational programs on the importance of hospice care can be administered in the community. By implementing this recommendation most people suffering from life limiting illnesses can access hospice car and end their life with dignity. 

References

Allo, J. A., Cuello, D., Zhang, Y., Reddy, S. K., Azhar, A., & Bruera, E. (2016). Patient Home Visits: Measuring Outcomes of a Community Model for Palliative Care Education. Journal of palliative medicine, 19(3), 271-278. Retrieved from

Dyess, S. M., Prestia, A. S., Levene, R., & Gonzalez, F. (2020). An Interdisciplinary Framework for Palliative and Hospice Education and Practice. Journal of Holistic Nursing, 0898010119899496. Retrieved from

Garcia, M. J. (2018). Systematic Review of the Literature on Why There is Hospice Underutilization. Retrieved from

Livingstone, T., Welstand, J., & Ryan, K. (2019). P-188 Improving access to hospice enabled care for heart failure patientsa service evaluation. Retrieved from

Tofthagen, C., Guastella, A., & Latchman, J. (2019). Perspectives on Hospice and Palliative Care in the United States. In Hospice Palliative Home Care and Bereavement Support (pp. 105-119). Springer, Cham. Retrieved from