The PICOT Question Assignment

The PICOT question is basically “How does the organization need to update the graduate nurse orientation period to make up for the lack on hands-on clinical experience due to the pandemic.
This is a Short-term Acute Care hospital with 306 beds, in South Central Pennsylvania (Penn State Health Holy Spirit Medical Hospital)
This must be written at the “Distinguished level” on the rubric to pass (will provide rubric) The PICOT Question Assignment
APA 7 format
References cannot be older then 5 years.
Please reach out with any questions asap.
Will upload directions for assignment (which has 2 parts 1. PICOT statement 2. Literature Review

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The outbreak of novel coronavirus has put immense pressure on healthcare organizations and highlighted some long-standing challenges these providers have been facing. Among the many challenges that emerged during the height of the pandemic is the preparedness of organizations to handle a sudden upsurge in healthcare needs. Closely linked to this is the preparedness of graduate nurses to care for critically ill patients. The context of this research analysis is a Short-Term Acute Care hospital, Penn State Health Holy Spirit Medical Hospital, located in South Central Pennsylvania with a bed capacity of 306. Drawing from the recent pandemic, it emerged that there is a need for the graduate nurse orientation period to be upgraded with the objective to make up for the lack of hands-on clinical experience due to the pandemic. The pandemic led many graduate nurses to stay out of work or have limited access to working in a clinical environment. This has led to a post-pandemic period where graduate nurses seeking to work in clinical environments have limited clinical experience. Today, graduate nurses are forced to work in clinical settings that they were unfamiliar with placing pressure and creating risks on patients. Based on this, the PICOT question that this literature review analysis is centered on is “In graduate nurses with limited clinical experience, does an increase in orientation time, by 12 – 18 weeks, post-pandemic compared to direct absorption make them better prepared to work in healthcare settings? The PICOT Question Assignment

Literature Review

The desire for graduate nurses is to smoothly join the healthcare industry and effectively contribute their knowledge acquired over the years through clinical practice. This means that nurse graduates need to be orientated by their more experienced peers to enable a smooth transition into clinical practice (Iserson, 2020). Hospitals must recognize the need for nurses to be well equipped and prepared for their roles considering that they are the ones that develop care plans for patients after treatment and spend the most time with them during recovery. Lee, Yeung, Clarke and Yoo (2019) added that with the emergence of highly communicable diseases and illnesses such as Covid-19, MERS, SARS the capability and preparedness of nurses are crucial in influencing positive health outcomes. Based on this, it is important that healthcare organizations review and update their graduate nurse orientation to alleviate the health of patients and the safety and preparedness of graduate nurses in providing their services.

Healthcare organizations could introduce nurse graduates with the quality improvement tool called the PDCA (plan-do-check-act). The PDCA is a four-step quality improvement model which can go a long way in helping nurse graduates improve their practice. The ‘plan’ aspect of the model helps in the identification of a problem or opportunity. The ‘do’ aspect implements a plan that is then used to address the identified problem or opportunity. ‘Check’ involves the process of evaluating the results of the plan and determining if they are effective. The aspect of ‘ask’ involves making necessary changes to the plan and improving it even further. In addition to this, orientation time for the nurse graduates should be increased from one to two weeks to allow for more skills to be taught to them. Examples of these skills are IV’s Foleys, charting, SBAR, and CPR/ BLS The PICOT Question Assignment

Providing Appropriate Education to Nurse Graduates

Commenting on the increasing need for nurses to be better prepared and equipped in providing care today, Spector et al. (2018) have pointed out the importance of education. Education is provided in academic institutions in liaison with hospitals where practical experience is gained. The authors have proposed the need for nurse education to be enhanced both in theory and practice, the justification for doing this is to ensure that the nurses have the right type of education that prepares them for a wide variety of healthcare situations. A health policy that requires all nurse graduates to be trained for a longer period and with set minimum standards like having them go through an educational program would help nurses trained and launched at the start of the pandemic. The justification for this is that this group of graduate nurses did not get the opportunity to get the right training and this limits their clinical practice. The measurable goal of my PICOT question is that within the proposed added time, the nurse graduates will be able to learn and gain the clinical experience they missed because of the pandemic.

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It is necessary that even after the nurses graduate from college, the education learned is contextualized by creating an orientation model that places them in different situations to help prepare them for situations they might face in the future during practice. Hampton, Smeltzer and Ross (2021) argued that while there are curriculums followed by colleges and universities of nursing, it is important that a structured and standardized model of orientation in practice is developed. Such a model should be constantly verified and reviewed for validity by healthcare professionals (Powers, Herron & Pagel, 2019). The rationale for constantly reviewing and updating these education programs is to ensure that they are equipped to orientate the nurse graduates with the requisite skills and knowledge they need to apply in real-life practice. An issue that has been emphasized by Welch and Carter (2018) is that when healthcare organizations develop educational tools to be relied on for orientating nurse graduates, they need to be constantly compared with others to ensure that only the most advanced and applicable ones are used The PICOT Question Assignment

The Value of Instilling the Right Knowledge in Nurse Graduates

The pandemic was a painful yet important reminder for medical practitioners of the importance of having the right knowledge on current and emerging issues. Wardrop, Coyne and Needham (2019) mentioned that everyone in the healthcare industry was unprepared for the Covid-19 pandemic but the importance of having the right knowledge of similar diseases in the past such as SARS and MERS formed a basis for managing and reacting to the pandemic (Logue & Cynthia Olson, 2021). A key question that must be asked on the preparedness of nurse graduates in a real-world health setting is how knowledgeable they are and what the individual healthcare organizations are doing to imbue the nurse graduates with the necessary knowledge. Iserson (2020) suggested the need for healthcare provider organizations in the course of orienting nurse graduates to have plans of instilling the right knowledge in these nurses. Knowledge could be attained in a number of ways including written content and experience sharing received from experienced practitioners.

While the more experienced medical staff may have adjusted well to this emergency, there were concerns about the nurse graduates who had not had sufficient experience and preparation. Beyond the pandemic, the unavailability of opportunities to effectively train nurse graduates on clinical practice has in a way denied them experience that they would then apply in their practice today. The proposal for educational programs for nurse graduates has the potential to prepare them for a healthcare environment where professionals from a variety of fields work together with an objective to improve the health outcome of patients. The education programs designed for the orientation period prepares the graduates for an environment where interprofessional care is provided in the sense that different professionals and stakeholders to patients work in cooperation to help deliver the best quality of care.

Theory and practice need to be matched to prepare the nurse graduates for a world of work. Two types of training and knowledge that Li et al. (2021) have suggested for nurse graduates today are precautions in handling different communicable diseases and the control of infection. Powers, Herron, and Pagel (2019) mention that nursing practice has shifted away from offering subordinate support to medical staff to one where the practitioners are actively involved in alleviating health outcomes for patients and society by engaging in acts such as practicing standard precautions and controlling infections The PICOT Question Assignment

Programs to Address the Psychological Needs for Nurse Graduates

Nurse graduates need time to develop emotional control in intense work environments and settings. This can be planned and executed in phases. Harder (2020) recognizes the nature of healthcare practice, especially for nurses who they are required to care for patients with varying illnesses and injuries. The rate of patients being brought under their care was so high during the pandemic that a majority of them were in critical conditions. Collectively, this placed a lot of pressure and expectations on the nascent nurse practitioners leading to their own mental health being placed at risk. Stoffels et al. (2019) argued that while nurse practitioners played important roles during the pandemic to alleviate the health of patients and communities as a whole, little attention was placed on their own health leading some of them developing mental distress. This is especially considering that they were forced to work for very long hours, especially during the peak of the pandemic, and isolated from their friends and families. Following this, it has become necessary for the nurse graduates to be better treated and prepared for future work depending on the situation will be. Iserson (2020) suggested the need for organizations in liaison with academic institutions to have programs that are designed specifically for medical staff where emotional and psychological needs are addressed.

Hampton, Smeltzer and Ross (2021) stated that orientating graduate nurses is important because it provides them with important information and resources that they require in order to effectively perform clinical work. In addition to this, the adoption of new methods of orienting graduate nurses such as developing education programs offers them opportunities to meet and interact with other nurses within and outside the organization, and also the support networks for nursing practice. According to Wardrop, Coyne and Needham (2019), orientation strategies intended at improving the clinical experience for graduate nurses do this by allowing the graduates to learn about the patient populations that they will be working with, their characteristics, and the types of care that they are provided with. More to this is the fact that a well-organized orientation for graduate nurses gives them time to get acquainted with the policies and procedures of the organization. The bottom line is that there is a need for organizations to update their approaches to orientating nurse practitioners, especially with the challenges that emerged at the height of covid-19. There is a need for organizations to adapt educational programs intended to transition nurse graduates into the job market. While the pandemic is over now, it is important for healthcare organizations to recognize that this was not the first time the world or whole regions were faced by pandemics or epidemics. In view of this, the healthcare sector must anticipate future pandemics and be prepared to handle them by, among other things, preparing practitioners such as nurse graduates. It is especially beneficial for educational programs thus developed by different organizations be done in liaison with academic institutions and to be constantly reviewed to ensure they adhere to minimum standards of practice The PICOT Question Assignment

Timeframe for Development and Implementation of Intervention

The intervention for nurse graduates should be immediate – this means that it should be developed at present and rolled out within the next three to six months. The three to six months would allow for the proposed policy to be reviewed and perhaps improved by other professionals in the field, and also for it to be communicated to nurse graduates and their managers. The likely challenge with the implementation is the existing nurse shortages but this would be remedied by orientating graduates in small and manageable batches.

References

Goni-Fuste, B., Wennberg, L., Martin-Delgado, L., Alfonso-Arias, C., Martin-Ferreres, M. L., & Monforte-Royo, C. (2021). Experiences and needs of nursing students during pandemic outbreaks: A systematic overview of the literature. Journal of Professional Nursing, 37(1), 53-64. https://doi.org/10.1016/j.profnurs.2020.12.004

Graf, A. C., Jacob, E., Twigg, D., & Nattabi, B. (2020). Contemporary nursing graduates’ transition to practice: A critical review of transition models. Journal of clinical nursing, 29(15-16), 3097-3107. https://doi.org/10.1111/jocn.15234

Hampton, K. B., Smeltzer, S. C., & Ross, J. G. (2021). The transition from nursing student to practicing nurse: An integrative review of transition to practice programs. Nurse Education in practice, 52, 103031. https://doi.org/10.1016/j.nepr.2021.103031

Harder, N. (2020). Simulation amid the COVID-19 pandemic. Clinical Simulation in Nursing, 43, 1-2. https://doi.org/10.1016/j.ecns.2020.03.010

Iserson, K. V. (2020). Augmenting the disaster healthcare workforce. Western journal of emergency medicine, 21(3), 490. https://doi.org/10.5811/westjem.2020.4.47553

Lee, J. J., Yeung, K. C., Clarke, C. L., & Yoo, J. (2019). Nursing students’ learning dynamics and perception of high-fidelity simulation-based learning. Clinical Simulation in Nursing, 33, 7-16. https://doi.org/10.1016/j.ecns.2019.04.008

Li, Y., Wang, Y., Jiang, J., Valdimarsdóttir, U. A., Fall, K., Fang, F., … & Zhang, W. (2021). Psychological distress among health professional students during the COVID-19 outbreak. Psychological medicine, 51(11), 1952-1954. https://doi.org/10.1017/S0033291720001555

Logue, M., & Cynthia Olson, D. N. P. (2021). Innovative Solutions for Clinical Education during a Global Health Crisis. Online Journal of Issues in Nursing, 26(1). https://doi.org/10.3912/OJIN.Vol26No01Man06

Powers, K., Herron, E. K., & Pagel, J. (2019). Nurse preceptor role in new graduate nurses’ transition to practice. Dimensions of Critical Care Nursing, 38(3), 131-136. https://doi.org/10.1097/DCC.0000000000000354

Spector, N., Blegen, M. A., Silvestre, J., Barnsteiner, J., Lynn, M. R., Ulrich, B., … & Alexander, M. (2018). Transition to practice study in hospital settings. Journal of Nursing Regulation, 5(4), 24-38. https://doi.org/10.1016/S2155-8256(15)30031-4

Stoffels, M., Peerdeman, S. M., Daelmans, H. E., Ket, J. C., & Kusurkar, R. A. (2019). How do undergraduate nursing students learn in the hospital setting? A scoping review of conceptualizations, operationalization’s and learning activities. BMJ open, 9(12), e029397. http://dx.doi.org/10.1136/bmjopen-2019-029397

Wardrop, R., Coyne, E., & Needham, J. (2019). Exploring the expectations of preceptors in graduate nurse transition; a qualitative interpretative study. Nurse Education in Practice, 34, 97-103. https://doi.org/10.1016/j.nepr.2018.11.012

Welch, T. D., & Carter, M. (2018). Deliberate practice and skill acquisition in nursing practice. The Journal of Continuing Education in Nursing, 49(6), 269-273. https://doi.org/10.3928/00220124-20180517-07 The PICOT Question Assignment

Guiding Questions

Problem Statement (PICOT)

This document is designed to give you questions to consider and additional guidance to help you successfully complete the Problem Statement (PICOT) assessment. You may find it useful to use this document as a pre-writing exercise, an outlining tool, or as a final check to ensure that you have sufficiently addressed all the grading criteria for this assessment. This document is a resource to help you complete the assessment. Do not turn in this document as your assessment submission.

Part 1: Problem Statement

Need Statement

Analyze a health promotion, quality improvement, prevention, education, or management need.

What type of need is your project trying to address? New graduate nurses lacking clinical experience due to pandemic, how can the organization adjust to the needs of the new GN’s?
Why is addressing this need important?
What are one or more key pieces of evidence that support the urgency of the need? The PICOT Question Assignment

Population and Setting

Describe a target population and setting in which an identified need will be addressed.

What is the population you will be targeting with your project?
- Why is it important to address your identified need within this population?
What is the setting you will be targeting with your project? 306 bed Short-term Acute Care hospital (Penn State Health Holy Spirit Hospital, Camp Hill, PA)
- Why is it important to address your identified need and target population within this setting?

Intervention Overview

Explain an overview of one or more interventions that would help address an identified need within a target population and setting.

What interventions could be applied to your identified need?
- How well do the interventions fit your target population?
- How well do the interventions fit your target setting?
- How well do the interventions address your identified need? The PICOT Question Assignment

Comparison of Approaches

Analyze potential interprofessional alternatives to an initial intervention overview with regard to their possibilities to meet the needs of the project, population, and setting.

Discuss one or more alternatives to the intervention(s) presented in your Intervention Overview.
- How do the alternatives encourage interprofessional care approaches compared to the interventions in your overview?
- How well do the alternatives fit your target population compared to the interventions in your overview?
- How well do the alternatives fit your target setting compared to the interventions in your overview?
- How well do the alternatives address your identified need compared to the interventions in your overview? The PICOT Question Assignment

Initial Outcome Draft

Define an outcome that identifies the purpose and intended accomplishments of an intervention for a health promotion, quality improvement, prevention, education, or management need.

What is one outcome (or goal) that you want to achieve with your intervention and project?
- How does this outcome illustrate the purpose of your intervention and project?
- How does this outcome illustrate what you hope to accomplish with your intervention and project?
- How does this outcome establish a framework that can be used to achieve an improvement in the quality, safety, or experience of care? The PICOT Question Assignment

Time Estimate

Propose a rough time frame for the development and implementation of an intervention to address an identified need.

What is a rough time frame for developing your intervention?
- Is this time frame realistic?
- What potential challenges may impact this time frame?
What is a rough time frame for implementing your intervention?
- Is this time frame realistic?
- What potential challenges may impact this time frame?
  
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Part 2: Literature Review

Analyze current evidence to validate an identified need and its appropriateness within the target population and setting.

How does the evidence validate your identified need?
How does the evidence support the appropriateness of attempting to address your identified need within your target population?
How does the evidence support the appropriateness of attempting to address your identified need within your target setting? The PICOT Question Assignment

Evaluate and synthesize resources from diverse sources illustrating existing health policy that could impact the approach taken to address an identified need.

What health policy exists that is relevant to your identified need?
- How will this health policy impact the way to try to address your identified need?
  - In other words, are there considerations that you need to be sure you include or approaches that will be unavailable to you based on policy, as you continue to develop your project?
- Remember: In this literature review you are expected to have addressed 10–15 unique resources.

Address Generally Throughout

Communicate problem statement and literature review in a way that helps the audience to understand the importance and validity of a proposed project.

Is your writing clear and professional?
Does your writing effectively communicate your problem statement?
Does your writing effectively communicate your literature review?
Is your writing free from errors?
Is your submission 5–9 pages?
Does your submission conform to current APA style standards? The PICOT Question Assignment