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Assessment task 4: Research / evidence-based practice paper Part 1 You are working as a registered nurse in a large metropolitan hospital. The hospital has introduced the ‘EARLY SAVE’ program to reflect best practice in early recognition and response to clinical deterioration in addition to the existing Code Blue process for severe/life threatening medical emergencies. The program includes education for clinical staff, a more formalised Medical Emergency Team (MET) process, and the introduction of an Observation and Escalation Chart. Figure 1 presents the patient outcomes following a Code Blue or MET call from data collected before the introduction of the program (Pre EARLY SAVE) and data collected over the same length of time post the introduction of the program (Post EARLY SAVE). There were 160 MET calls in the pre period, and 360 in the post period. In the pre period, the reasons for calling the MET included seizure/fitting (20%); worsening respiratory function (20%); acute respiratory distress (25%); suspected cardiac pain (20%); and alteration in vital signs indicating clinical deterioration (15%). In the post period, the reasons for MET calls included worsening respiratory function (30%); acute respiratory distress (10%); a seizure or fitting (20%); suspected cardiac pain (10%); and alteration in vital signs indicating clinical deterioration (30%). There were 140 Code Blue calls pre EARLY SAVE and 60 post, mainly for cardiac or respiratory arrest. 1. Based on the data presented, do you think the EARLY SAVE program has been effective in improving early recognition and response to clinical deterioration in your hospital? Why/ why not? 2. How might the data obtained pre and post the EARLY SAVE program be used by the hospital when reporting against National Safety and Quality Health Service (NSQHS) Standard 9: Recognising and responding to clinical deterioration in acute health care? Part 2 Should family members be allowed to be present during the resuscitation of their loved one in the acute care setting? Why, or why not? Please ensure that you refer to the highest possible levels of research evidence available to justify your answer. 0 10 20 30 40 50 60 Could not be resuscitated (died) Transferred to ICU Transferred to HDU Remained on ward Figure 1: Patient outcomes following Code Blue and MET calls (as a percentage) Pre EARLY SAVE program Post EARLY SAVE program Guideline for completing Assessment Task 4: Research / evidence-based practice paper Please make sure you are familiar with the assessment criteria in the unit outline and the rubric. Performance in Part 1 of this assessment will be measured against criteria 1 and 2 in the rubric. Performance in Part 2 of this assessment will be measured against criteria 3, 4 and 5. Criterion 6 relates to the whole paper. Part 1 (450-600 words) Part 1 presents data from a case scenario in the form of a graph and in text information. You are asked to interpret this data and apply it to a NSQHS Standard. This is not designed to be answered as an essay – it is more like short answer questions. So the use of headings would be helpful to organise your answer. You need to clearly state your answer to the question, and then use the data to support your position. So if you think the data shows that the program was effective, you need to be able to explain why and how the data supports this, and the same if you think the data shows the program was not effective. The aspects of the data that you are choosing to support your answer can be presented as dot points, but the remainder should be written in sentences and paragraphs so that you can demonstrate your ability to construct a written argument. To perform well in criterion 1 on the rubric, you need to demonstrate an ability to read and interpret data, construct an argument based on this data, and provide additional sources to support your argument. A suggested approach therefore is to: a) Clearly state your answer to the question (probably best to do this at the start) b) Identify the data that you think supports your answer, and be specific – what data? Why? c) Use scholarly sources to demonstrate why you think this data supports your answer To perform well on criterion 2 in the rubric, you need to demonstrate your understanding of NSQHS Standard 9 by being specific about how and why the data outlined in the case scenario could be used as part of the reporting requirements against that standard. Part 2 (750 – 900 words) The answer to this part should be presented in a short essay format. Headings can be used if it helps to structure your work. It is very important that your answer to the question posed in Part 2 is based on the highest possible levels of research evidence. To perform well in criteria 3, 4 and 5 on the rubric, you need to understand levels of evidence, be able to search for relevant research, select the highest level of research available to answer the question, and read and understand the research findings. In this way you demonstrate that you can access research, read and understand research papers and use the information obtained from the research to answer a clinical question. A suggested approach would be: Introduction (75 – 100 words) Brief introduction to the topic and description of how you are going to approach answering the question. For example, you may choose to answer the question broadly, or to restrict your answer to a particular area of practice, such as resuscitation within the emergency department or the resuscitation of a child. You might focus on a range of outcomes or specifically focus on the outcomes for the patient, or on the impact on staff members, or for family members attending the resuscitation. This is entirely your choice, but it is important to state your approach in the introduction so that it is clear to the person marking your work. Also include one – two sentences detailing where you searched for the research (eg. databases used) and the search terms you used in the search. Main body of the paper (600-700 words) This section should include: The research findings. What does the research show? What needs to be considered if family members are/are not allowed to be present during the resuscitation of their loved one in the acute care setting? Make sure that you keep this focused on the approach you identified in the introduction – it is not necessary to present all of the findings from all of the research in this area (and you do not have sufficient word count to do this). So just present the relevant findings from the highest possible levels of evidence. The key thing is quality not quantity – so two or three pieces of high quality research is better than a large number of low level research studies. Of course, this does depend on what research is available to answer the question, particularly if you are taking a specific focus. Explanation for selecting the research that you have chosen. Why did you select the chosen research articles? For example, how do they answer the question? Why is it considered high level evidence? If you are unable to find high level evidence to answer your question, state this and then discuss why the research you have chosen is the best available to answer the question. Scholarly sources should be used to support points made in this section. Conclusion (75 – 100 words) Brief (couple of sentences) to conclude the paper. This is where you could clearly state what you think the answer to the question is, based on the research findings that you have presented. Please keep in mind these are only suggested approaches to take. Similarly, the word count for each part is also only a guide. Assessment 4 Rubric CNA153 Foundations for Professional Practice 2 Assessment task 4: Research / evidence-based practice paper Overall weighting: 40% CRITERIA HD DN CR PP NN Your paper has: Demonstrates an understanding of how data is used to evaluate our practice (10% weighting) Demonstrated exceptional knowledge and understanding of data interpretation and application Drawn upon credible and relevant academic sources to support your interpretation of the data Demonstrated very good knowledge and understanding of data interpretation and application Drawn upon credible and relevant literature and evidence to support your interpretation of the data Demonstrated a clear knowledge and understanding of data interpretation and application Drawn upon limited literature and evidence to support your interpretation of the data Demonstrated a reasonable knowledge and understanding of data interpretation and application Used few or no references to support your interpretation of the data Demonstrated poor knowledge and knowledge and understanding of data interpretation and application Used few or no references to support discussion and/or failed to use credible sources Shows an understanding of the link between evidence and quality patient outcomes (5% weighting) Demonstrated exceptional knowledge and understanding by clearly and accurately identifying the role played by data in meeting quality and safety obligations Demonstrated very good knowledge and understanding by accurately identifying the role played by data in meeting quality and safety obligations Demonstrated knowledge and understanding of the role played by data in meeting quality and safety obligations Demonstrated limited knowledge and understanding of the role played by data in meeting quality and safety obligations Demonstrated poor knowledge of the role played by data in meeting quality and safety obligations Demonstrates an ability to search for research evidence to answer a clinical question (4% weighting) Demonstrated and applied comprehensive knowledge and understanding of database searching resulting in a highly successful search Demonstrated and applied very good knowledge and understanding of database searching resulting in a very successful search Demonstrated clear knowledge and understanding of database searching resulting in a successful search