Expert Answer and Explanation
My selected website is the Centers for Medicare & Medicaid Services (CMS) website. CMS is a federal agency under the Department of Health and Human Services tasked with administering the Medicare program and also works with the different states to administer Medicaid (CMS, n.d.). The website provides different kinds of helpful information to both enrollees of either program (Medicare and Medicaid) and the public.
According to Melnyk et al. (2010), evidence-based practice is a problem-solving approach that applies the best evidence from valid and verifiable research, patient data, and clinician expertise to inform patient-care delivery. From my analysis of the CMS website, there were various areas where evidence-based practice appeared. For example, the website has detailed information on COVID-19 and the vaccination approved by the FDA supported by evidence-based data, which is made available to the public and the beneficiaries of the Medicare and Medicaid services. The website also provides different forms of assessment information which compiles evidence from patient data on different performance metrics, for example, the Medicaid & CHIP Scorecard. The different packages offered by the organization as described on the website are also backed by evidence.
From the general outlook of the website, the work done by CMS is purely grounded on EBP. The organization caters to different public healthcare needs, which require the backing of proven statistics and evidence on best practices. For example, the Basic Health Program incorporates statistics from different state agencies, including the Census Bureau and the CDC, to advise the program’s implementation, including administration of the COVID-19 vaccine. Without EBP, the CMS would be operating at a loss given that it may not have a proper estimation of where it needs to focus its interventions, the budget estimates for its interventions, and the expected outcomes that also inform its scorecard reports. The application of evidence facilitates continuous improvement efforts in reducing health care costs and improving the quality of care for Medicare and Medicaid beneficiaries which goes a long way in realizing quadruple aims (Sikka et al., 2015).
Based on the information discovered from the CMS website, my perception of the organization has improved. The positive perception is due to the evident inclusion of EBP in the different activities conducted by the organization.
Reference
Centers for Medicare & Medicaid Services (CMS) (n.d.). Centers for Medicare & Medicaid Services. https://www.cms.gov/
Melnyk, B.M., Fineout-Overhold, E., Stillwell, S.B., & Williamson, K.M. (2010). Evidence-based practice step-by-step: The seven steps of evidence-based practice. American Journal of Nursing, 110(1), 51-53.
Sikka, R., Morath, J. M., & Leape, L. (2015). The Quadruple Aim: Care, health, cost, and meaning in work. BMJ Quality & Safety, 24, 608–610. doi:10.1136/bmjqs-2015-004160
Second Alternative Answer
The current facility at which I am employed uses Elsevier Nursing Skills as its policy for performing nursing skills to include tracheostomy care. However, the tracheostomy care policy states that the nurse should refer to their facilities policy for the frequency of which to perform the trach care. Therefore, a gap exists in our trach care policy or lack thereof. It created confusion among the nursing staff as to how to care for established versus fresh trach sites. There is also no guidance on how to taper down care as the trach site heals.
Joint Commission offers a function on their website called Tracers. Nurses can use it to make individual tracers that target a specific practice at the point of care (Siewert, 2018). For the nursing leadership to determine current practice, a tracer could be established to evaluate the frequency of trach care provided for new versus established tracheostomies, the occurrence of HAIs in relation to trach care frequency, and respiratory distress/desaturation episodes in relation to the frequency of cleaning or changing out the inner cannula. Data for the tracer can be collected via staff interviews, observation of practice, and chart auditing (Siewert, 2018). From this data, it can be determined if harm is coming to the patient from current trach care practices and what are those practices.
Nursing leaders can use clinical reasoning and judgment based on the data, along with a literature review, to formulate a trach care policy to include time intervals based on the age and condition of the tracheostomy. The new policy can be evaluated by implementing a small test of change and creating a correspon
Order this paper