NSG 7220 Week 4 Discussion SU • Online Nursing Essays

The discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered.

For this assignment, make sure you post your initial response to the Discussion Area by the due date assigned.

To support your work, use your course and text readings and also use the South University Online Library. As in all assignments, cite your sources in your work and provide references for the citations in APA format.

Start reviewing and responding to the postings of your classmates as early in the week as possible. Respond to at least two of your classmates’ initial postings. Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion. Cite sources in your responses to other classmates. Complete your participation for this assignment by the end of the week.

Organization Evidence and Application

In this assignment, we will discuss organizational evidence as it pertains to your topic. Everything we do in nursing should be supported by evidence. Whether we are looking to understand the organizational barriers that exist to change a policy or conducting a root-cause analysis to understand organizational failure, we know all too well that there are types of organizations that are more prone to success and those that are more prone to failure. Visit the South University Online Library and retrieve two peer-reviewed articles pertaining to organizational research and your topic of interest. Critique each article, highlighting the strengths and the weaknesses of each article. Interpret the statistical analysis and significance of results. Lastly, analyze the feasibility of applying this evidence to your topic of interest in your current practicum setting. Both articles should support nursing standards and patient safety within your chosen topic.

The articles I reviewed had different focuses for how the organization impacts evidence.  The first article followed the implementation of a screening process and how that process affected the organization and ultimately the outcome of the implementation.  The second article was a reflection on how an organization may propose to make an internal organizational change.  The first article is a source that could be utilized in my project topic because my improvement is implementing a screening tool. This provides some insight into potential pitfalls or barriers to plan for.  The second article is not relatable to my project.

Article 1 – Implementing SBIRT for adolescents within community mental health organizations: A mixed methods study

The first article I reviewed identified 27 community mental health organizations (CMHO) who received funding from Medicaid in urban and rural settings to participate in the implementation of Screening, Brief Intervention, and Referral to Treatment (SBIRT) protocol over an 18-month period.  This screening protocol is endorsed by the American Pediatric Association for use in adolescents (Stanhope et al., 2018).  The study design used a mixed-method design to collect quantitative patient-level data and qualitative organizational-level data.  Quantitative data was analyzed over the course of the study to identify how the implementation of the SBIRT program worked, while the qualitative data was analyzed longitudinally to identify the implementation process and when barriers to implementation occurred. Stanhope et al. (2018) identified several barriers to implementation:

• Adaptability and complexity related to the ability to integrate the process with electronic health records, data tracking, multiple documentation work for clinicians, and technical issues, which resulted in implementation gaps.
• External policies and incentives- This barrier included governmental regulations that related to reimbursements through Medicaid either related to denials for duplicate billing or funding cuts.
• Structural characteristics – One of the biggest barriers to implementation was staffing and an inability to train and retain staff, followed by funding.  Additionally, internal conflicts related to multiple organization or initiatives occurring simultaneously.

Results found that all organizations experienced implementation barriers (Stanhope et al., 2018).   

A strength of this article is that it is a mixed-methods study.  Mixed methods studies aim to integrate both quantitative and qualitative data resulting in a more comprehensive study (American Psychological Association [APA], 2020).  Both quantitative and qualitative data was collected at the same time, qualitative data was analyzed longitudinally. Longitudinal studies are large-scale studies that collect data over time points to provide contributions over.

A weakness of this study identified by the researchers was the competitive process the organizations completed, which they felt may have biased the selection of participants based on the perception of the organization’s motivation (Stanhope et al., 2018)

This article is one I would consider adding to my project topic.  Primarily because my current improvement project topic is implementing a screening tool in a primary care setting. This article identified important processes and pitfalls that could impact a similar study.  For example, the barrier of staffing and training, this will be important to address to avoid creating a barrier that halts the implementation process.

Article 2 – Embedding lived experience into mental health academic research organizations: Critical reflections

This article provided a detailed review of the considerations made by the Centre for Addiction and Mental health as they contemplate integrating the lived experience of mental health conditions into the research hospital, academic researcher role.  Hawke et al. (2022) propose that a researcher who is qualified by credential (Master’s, Doctorate) and has the lived experience of mental health has a more intimate knowledge of mental health and therefore is dually qualified to serve as a ranked professional.  The proposal of new professional roles that identify the lived experience as a qualification would be incorporated into the academic setting inclusive of specific roles defined by the lived experience and research performed would follow this role, or a limited role of acknowledging the lived experience without expected academic output.   Addressed in this reflection article are three organizational objectives when contemplating a change to the current structure:

1. critical appraisal of mental health systems and advocacy for change
2. relevance and de-stigmatization
3. reputation benefits to the organization

Strengths of this article are the innovative idea and probing questions that can open the door to new research questions. Reflection is an evidence-based, integrative, and analytical process that helps deepen and document learning, which challenges new ideas or alternatives (Brock University, 2023).

Weakness to this article is that it is primary supposition of ideas without supporting evidence for inclusion or exclusion of the lived experience.  The article appears to be an opinion of the writer without either quantitative or qualitative data.  

I would not use this article in my study. While the content is interesting the content is very specific to the niche of academics and research. My proposed topic is not organizational change in nature.

References

American Psychological Association [APA]. (2020). Publication manual of the American psychological association (Seventh edition. ed.). American Psychological Association.

Brock University. (2023). Role of reflection. https://brocku.ca/pedagogical-innovation/resources/experiential-education/role-of-reflection/#:~:text=Reflection%20is%20not%20a%20superficial%20process%20of%20introspection.,serves%20to%20generate%2C%20deepen%2C%20critique%2C%20and%20document%20learning.

Hawke, L. D., Sheikhan, N. Y., Jones, N., Slade, M., Soklaridis, S., Wells, S., & Castle, D. (2022). Embedding lived experience into mental health academic research organizations: Critical reflections. Health Expectations, 25(5), 2299-2305. https://doi.org/10.1111/hex.13586

Stanhope, V., Manuel, J. I., Jessell, L., & Halliday, T. M. (2018). Implementing SBIRT for adolescents within community mental health organizations: A mixed methods study. Journal of Substance Abuse Treatment, 90, 38-46. https://doi.org/10.1016/j.jsat.2018.04.009