NRS 493 Topic 6 DQ 1 name one financial aspect, one quality aspect, and one clinical aspect that need to be taken into account for developing the evidence-based change proposal

Sample Answer for NRS 493 Topic 6 DQ 1 name one financial aspect, one quality aspect, and one clinical aspect that need to be taken into account for developing the evidence-based change proposal Included After Question

Topic 6 DQ 1

After discussion with your preceptor, name one financial aspect, one quality aspect, and one clinical aspect that need to be taken into account for developing the evidence-based change proposal. Explain how your proposal will directly and indirectly impact each of the aspects.

A Sample Answer For the Assignment: NRS 493 Topic 6 DQ 1 name one financial aspect, one quality aspect, and one clinical aspect that need to be taken into account for developing the evidence-based change proposal

Title: NRS 493 Topic 6 DQ 1 name one financial aspect, one quality aspect, and one clinical aspect that need to be taken into account for developing the evidence-based change proposal

Over the last 2 decades there has been an undeniable rise in health care costs which has caused a shift in focus toward measuring care quality. Studies have shown that improved quality of care has been associated with lower health care costs through decreased complications and length of stay (Agarwal, Youngerman, Kaakaji, Smith, McGregor, Et. Al, 2021). In efforts to improve care quality, providers use clinical practice guidelines, which are statements that include recommendations, informed by systematic reviews of evidence, intended to optimize patient care. CAUTI caused by improper testing of urine can have financial ramifications. A urine culture can cost $80 or more. Antibiotic treatment for a UTI cost from $3 to over $300. In addition, drug-resistant infections (caused by improper treatment with antibiotics) add costs for extended lengths of stay, expensive medicines, and nursing care (ABIM Foundation, 2014).

After discussion with my preceptor, a urine culture stewardship initiative will reduce costs associated with improper testing and the treatment. Implementation of this initiative will affect clinical practice by decreasing the total number of urine cultures ordered and reducing the number of inappropriate treatments. Regarding quality, a urine culture stewardship will help identify areas where routine ordering and inappropriate practices increase costs and affect patient outcomes, as well as used to reduce excessive ordering, lower contamination rates, and decrease unnecessary antibiotic prescribing (Sinawe, Casadesus, 2022).

References

Agarwal, N., Youngerman, B., Kaakaji, W., Smith, G., McGregor, J. M., Powers, C. J., Guthikonda, B., Menger, R., Schirmer, C. M., Rosenow, J. M., Cozzens, J., & Kimmell, K. T. (2021). Optimizing Medical Care Via Practice Guidelines and Quality Improvement Initiatives. World Neurosurgery, 151, 375–379. https://doi-org.lopes.idm.oclc.org/10.1016/j.wneu.2021.02.013

American Board of Internal Medicine Foundation. (2014). Tests & treatments for urinary tract infections (UTIs) in older people When you need them—and when you don’t. https://www.choosingwisely.org/wp-content/uploads/2014/09/ChoosingWiselyUTIAGSAMDA-ER.pdf

Sinawe H, Casadesus D. Urine Culture. (2022). In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557569

A Sample Answer 2 For the Assignment: NRS 493 Topic 6 DQ 1 name one financial aspect, one quality aspect, and one clinical aspect that need to be taken into account for developing the evidence-based change proposal

Title: NRS 493 Topic 6 DQ 1 name one financial aspect, one quality aspect, and one clinical aspect that need to be taken into account for developing the evidence-based change proposal

Sharia, your capstone proposal regarding a urine culture stewardship initiative is an excellent idea to improve healthcare costs. Our facility adopted a policy to reduce the laboratory cost of urine cultures last year. Our facility must have a signed “ticket to ride” by the nurse and charge nurse that checks a list of qualifications for the patient before a specimen can be sent for culture. The checklist helps to reduce over-testing. An article from the International Journal of Urology highlighted a study that discusses the overuse of prescriptions for ASB (asymptomatic bacteriemia) due to over-testing of UCx (urine cultures). The authors stated that “another impetus to avoid UCx testing is to decrease the likelihood of treatment for ASB. Unnecessary antibiotic treatment of ASB is common, occurring in up to 83% of patients which undermines patient safety initiatives due to increased risk of development of resistant organisms” (Richards et al., 2018).

Since the implementation of our facility’s urine culture checklist, AKA ticket to ride, I have found that we continually have to educate physicians who order urine cultures when in fact the patient may not qualify for urine culture testing based on the new protocol guidelines. It will be of great financial benefit and positive health outcomes for patients should continued reduction in urine cultures be achieved.

Reference

Richards, K. A., Cesario, S., Best, S. L., Deeren, S. M., Bushman, W., & Safdar, N. (2018). Reflex urine culture testing in an ambulatory urology clinic: Implications for antibiotic stewardship in urology. International Journal of Urology, 26(1), 69–74. https://doi.org/10.1111/iju.13803

A Sample Answer 3 For the Assignment: NRS 493 Topic 6 DQ 1 name one financial aspect, one quality aspect, and one clinical aspect that need to be taken into account for developing the evidence-based change proposal

Title: NRS 493 Topic 6 DQ 1 name one financial aspect, one quality aspect, and one clinical aspect that need to be taken into account for developing the evidence-based change proposal

The urine culture stewardship program included monthly 1-hour discussions with ICU house staff emphasizing avoidance of “pan-culture” for sepsis workup and obtaining urine culture only if a urinary source of sepsis is suspected. The urine culture utilization rate metric (UCUR; i.e., no. urine cultures/catheter days ×100) was utilized to measure the effect. AN INTERACTIVE QUALITY

NRS 493 Topic 6 DQ 1 name one financial aspect, one quality aspect, and one clinical aspect that need to be taken into account for developing the evidence-based change proposal

DASHBOARD REPORTED monthly UCUR, catheter utilization ratio (CUR), and CAUTI rate. Catheterized ICU patients (2015-2016) were evaluated for 30-day readmission for UTIs to ensure safety. Time-series data and relationships were analyzed using Spearman correlation coefficients and regression analysis. The urine culture stewardship program was effective and safe in reducing UC overutilization and was correlated with a decrease in CAUTIs. The addition of urine-culture stewardship to standard best practices could reduce CAUTI in ICUs.

Reference

Al-Bizri LA, Vahia AT, Rizvi K, Bardossy AC, Robinson PK, Shelters RT, Klotz S, Starr PM, Reyes KQ, Suleyman G, Alangaden GJ.(2021 ) Effect of a urine culture stewardship initiative on urine culture utilization and catheter-associated urinary tract infections in intensive care units. Infect Control Hosp Epidemiol. 2021 Jul 8:1-4. DOI: 10.1017/ice.2021.273. Epub ahead of print. PMID: 34236024.

Click here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS: NRS 493 Topic 6 DQ 1 name one financial aspect, one quality aspect, and one clinical aspect that need to be taken into account for developing the evidence-based change proposal

Grading Rubric Guidelines

Performance Category	10	9	8	4	0
Scholarliness Demonstrates achievement of scholarly inquiry for professional and academic decisions.	Provides relevant evidence of scholarly inquiry clearly stating how the evidence informed or changed professional or academic decisions Evaluates literature resources to develop a comprehensive analysis or synthesis. Uses valid, relevant, and reliable outside sources to contribute to the threaded discussion	Provides relevant evidence of scholarly inquiry but does not clearly state how the evidence informed or changed professional or academic decisions. Evaluates information from source(s) to develop a coherent analysis or synthesis. Uses some valid, relevant, reliable outside sources to contribute to the threaded discussion.	Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions. Information is taken from source(s) with some interpretation/evaluation, but not enough to develop a coherent analysis or synthesis. Little valid, relevant, or reliable outside sources are used to contribute to the threaded discussion. Demonstrates little or no understanding of the topic.	Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions. Information is taken from source(s) without any interpretation/evaluation. The posting uses information that is not valid, relevant, or reliable	No evidence of the use of scholarly inquiry to inform or change professional or academic decisions. Information is not valid, relevant, or reliable
Performance Category	10	9	8	4	0
Application of Course Knowledge – Demonstrate the ability to analyze, synthesize, and/or apply principles and concepts learned in the course lesson and outside readings and relate them to real-life professional situations	Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources; Applies concepts to personal experience in the professional setting and or relevant application to real life.	Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources. Applies concepts to personal experience in their professional setting and or relevant application to real life Interactions with classmates are relevant to the discussion topic but do not make direct reference to lesson content	Posts are generally on topic but do not build knowledge by incorporating concepts and principles from the lesson. Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life Does not demonstrate a solid understanding of the principles and concepts presented in the lesson	Posts do not adequately address the question posed either by the discussion prompt or the instructor’s launch post. Posts are superficial and do not reflect an understanding of the lesson content Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life	Posts are not related to the topics provided by the discussion prompt or by the instructor; attempts by the instructor to redirect the student are ignored No discussion of lesson concepts to personal experience in the professional setting and or relevant application to real life
Performance Category	5	4	3	2	0
Interactive Dialogue Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days. *(5 points possible per graded thread)*	Exceeds minimum post requirements Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts three or more times in each graded thread, over three separate days. Replies to a post posed by faculty and to a peer Summarizes what was learned from the lesson, readings, and other student posts for the week.	Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days Replies to a question posed by a peer Summarizes what was learned from the lesson, readings, and other student posts for the week.	Meets expectations of 2 posts on 2 different days. The main post is not made by the Wednesday deadline Does not reply to a question posed by a peer or faculty	Has only one post for the week Discussion posts contain few, if any, new ideas or applications; often are a rehashing or summary of other students’ comments	Does not post to the thread No connections are made to the topic
	Minus 1 Point	Minus 2 Point	Minus 3 Point	Minus 4 Point	Minus 5 Point
Grammar, Syntax, APA Note: if there are only a few errors in these criteria, please note this for the student in as an area for improvement. If the student does not make the needed corrections in upcoming weeks, then points should be deducted. Points deducted for improper grammar, syntax and APA style of writing. The source of information is the APA Manual 6th Edition	2-3 errors in APA format. Written responses have 2-3 grammatical, spelling, and punctuation errors. Writing style is generally clear, focused, and facilitates communication.	4-5 errors in APA format. Writing responses have 4-5 grammatical, spelling and punctuation errors. Writing style is somewhat focused.	6-7 errors in APA format. Writing responses have 6-7 grammatical, spelling and punctuation errors. Writing style is slightly focused making discussion difficult to understand.	8-10 errors in APA format. Writing responses have 8-10 grammatical, spelling and punctuation errors. Writing style is not focused, making discussion difficult to understand.	Post contains greater than 10 errors in APA format. Written responses have more than 10 grammatical, spelling and punctuation errors. Writing style does not facilitate communication. The student continues to make repeated mistakes in any of the above areas after written correction by the instructor
	0 points lost				-5 points lost
Total Participation Requirements *per discussion thread*	The student answers the threaded discussion question or topic on one day and posts a second response on another day.				The student does not meet the minimum requirement of two postings on two different days
Early Participation Requirement *per discussion thread*	The student must provide a substantive answer to the graded discussion question(s) or topic(s), posted by the course instructor (not a response to a peer), by Wednesday, 11:59 p.m. MT of each week.				The student does not meet the requirement of a substantive response to the stated question or topic by Wednesday at 11:59 pm MT.

Check Out Also: