Nurse practitioners actively engage in the process of translating nursing knowledge into practice, thereby establishing evidence-based approaches within the discipline. Throughout this process, a theoretical framework provides a meaningful context to guide and support the evidence-based practice. The purpose of this assignment is to identify a theory or theoretical model which can be used as a framework for a future evidence-based project during your nurse practitioner education.
• Apply nursing theory as a framework to guide the translation of knowledge and implementation of evidence-based practice in future professional settings.
• Analyze theories from nursing and relevant fields with respect to the components, relationships among the components, and application to advanced nursing practice.
Create a PowerPoint slide show with notes pages to evaluate the use of a theory for an EBP issue or concern.
Select a theory or theoretical model for a Family Nurse Practitioner specialty that would offer a meaningful context for evidence-based practice surrounding the issue or concern which you identified.
1. In a PowerPoint Presentation, address the following.
A. Introduction to the presentation
B. Identify and describe a theory or theoretical model and explain its relevance to your nurse practitioner specialty.
C. Describe an issue or concern that is related to your nurse practitioner specialty, and explain its impact on health care outcomes
D. Explain how the theory or theoretical model can be used as a framework to guide evidence-based practice to address the issue or concern, and discuss the unique insight or perspective offered through the application of this theory or theoretical model.
E. Conclusion to the presentation
F. References

1. Application: Use Microsoft PowerPoint to create the presentation.
2. Length: The PowerPoint presentation must be 6-9 total slides (excluding title and reference slides).
3. Speaker notes should be used and include in-text citations when applicable. Use the Notes Page view feature in PowerPoint to include speaker notes in the file.
4. A minimum of three (5) (References published within the past 5 years) scholarly literature sources must be used, in APA 7th.
ASSIGNMENT CONTENT
Category Points % Description
Introduction
(1 slide) 20 10% Introduction includes general information on what will be presented. Identify sections of the PowerPoint presentation.
Identification of Theory or Model (3 slides) 40 20% Identification and overview of one theory or model. Explanation of its relevance to the selected area of advanced practice nursing.
Provide speaker notes. Speaker notes and/or slides include citations from scholarly nursing literature which support the assertions made.
Issue or Concern in selected area of Advanced Practice Nursing
(2 slide) 40 20% Describe one specific issue or concern within the selected area of advanced practice nursing. Explanation of the impact of this issue or concern on health outcomes. Provide speaker notes. Speaker notes and/or slides include citations from scholarly nursing literature which validate the importance of the issue or concern.
Theory as Framework for Evidence-based Practice
(2 slides) 40 20% Explain how the theory or model can serve as a framework to support evidence-based practice to address the issue or concern. Discuss the unique insight or perspective offered through the application of this theory or model. Provide speaker notes. Speaker notes and/or slides include citations from scholarly nursing literature which support the assertions which you present.
Conclusion
(1 slide) 20 10% Summarize key information presented in PowerPoint presentation. Provide speaker notes.
No errors to grammar, spelling, word usage, punctuation, and other aspects of formal written work as found in the current edition of the APA 7th manual.

Create a two-page written narrative of the presentation for a Peer Discussion thread, with citations and references.

BMC Health Serv Res. 2017; 17: 33.
Published online 2017 Jan 13. doi: 10.1186/s12913-017-1977-x
PMCID: PMC5237281
PMID: 28086869
Evaluation of an aged care nurse practitioner service: quality of care within a residential aged care facility hospital avoidance service
Trudy Dwyer, 1 Alison Craswell,2 Dolene Rossi,1 and Darren Holzberger3
Author information Article notes Copyright and License information Disclaimer

Abstract
Background
Reducing avoidable hospitalization of aged care facility (ACF) residents can improve the resident experience and their health outcomes. Consequently, many variations of hospital avoidance (HA) programs continue to evolve. Nurse practitioners (NP) with expertise in aged care have the potential to make a unique contribution to hospital avoidance programs. However, little attention has been dedicated to service evaluation of this model and the quality of care provided. The purpose of this study was to evaluate the quality of an aged care NP model of care situated within a HA service in a regional area of Australia.
Methods
Donabedian’s structure, process and outcome framework was applied to evaluate the quality of the NP model of care. The Australian Nurse Practitioner Study standardized interview schedules for evaluating NP models of care guided the semi-structured interviews of nine health professionals (including ACF nurses, medical doctors and allied health professionals), four ACF residents and their families and two NPs. Theory driven coding consistent with the Donabedian framework guided analysis of interview data and presentation of findings.
Results
Structural dimensions identified included the ‘in-reach’ nature of the HA service, distance, limitations of professional regulation and the residential care model. These dimensions influenced the process of referring the resident to the NP, the NPs timely response and interactions with other professionals. The processes where the NPs take time connecting with residents, initiating collaborative care plans, up-skilling aged care staff and function as intra and interprofessional boundary spanners all contributed to quality outcomes. Quality outcomes in this study were about timely intervention, HA, timely return home, partnering with residents and family (knowing what they want) and resident and health professional satisfaction.
Conclusions
This study provides valuable insights into the contribution of the NP model of care within an aged care, HA service and how staff manipulated the process dimensions to improve referral to the NPs. NP service in this study was dynamic, flexible and responsive to both patient and organisational demands.

Conclusion
This study provided a methodological approach to evaluate the structural, process and outcomes dimensions of a community-based NP service on the quality of care for residents in a regional ACF. Findings from this study indicate that the NP role within the HA service provides a model of care that complements the existing service where the PCP is the primary health provider. We found that the NP, because of their advanced clinical skills and prescribing rights, were able to deliver a range of timely health services within the ACF, saving the PCP time, upskilling and supporting ACF staff to keep the resident at home. Conversely, NPs lack of the access to Medicare Benefits Schedule rebates restricts their scope of practice. Aa a role that is evolving, and as with any service change that challenges traditional professional boundaries and lines of communication, ongoing adjustments and renegotiating referral processes are essential to ensure quality resident outcomes.

Conclusions
Despite growing recognition across healthcare that SDOH greatly influence pediatric health risks, management and outcomes, there is a dearth of available high quality, multidimensional, comprehensive screening tools for pediatric care professionals.
Implications
This review emphasizes the need for the continued development of effective, comprehensive and practical tools for assessing pediatric SDOH risk factors. Pediatric nursing care includes the assessment of the youth and family context to effectively evaluate resource needs. Pediatric nurses are well poised to address this knowledge and resource gap.

Research Implications
Specific implications of this review for pediatric researchers and clinicians may include consulting international studies for effective models and methods of SDOH screening, as promising methods for SDOH screening and surveillance are being employed internationally. For example, population-level indexes such as the Deprivation Index and the Material and Social Deprivation Index have been successfully used abroad for quantifying and gathering proxies for individual level SDOH risks and to evaluate health inequalities, such as socioeconomic levels (SES, education), family structure, workforce eligibility, housing instability, ethnicity and immigration (Zuijdwijk, Cuerden, & Mahmud, 2013). More recently, a promising individualized screening method comprised of a multidimensional tablet-based social history SDOH screening tool, Family fIRST (Family-based, Interactive, Risk, Screening Tool), was evaluated for feasibility in a school-based clinic in Canada (Cohen-Silver, Laher, Freeman, Mistry, & Sgro, 2017). The multi-domain tool included items across several SDOH domains such as income, transportation, housing, education, literacy, legal status, personal support and safety. Caregivers and physicians regarded the tool positively and providers found that it improved the quality of the social history (Cohen-Silver et al., 2017).
Given the cumulative nature of multiple social risks, there is a great need for effective and comprehensive SDOH risk screening and assessment tools. Tools should focus on multiple simultaneous needs. High quality, validated tools would increase early recognition and action, improve connection to social and community service resources and enable closer monitoring. Tools should be designed to increase health equity for marginalized and vulnerable groups by encouraging collaboration between healthcare teams, families and communities, employing methods borrowed from community-based participatory research. Finally, high demand exists across the healthcare continuum for creating services, policies and education to increase healthcare’s ability to address and treat the upstream factors of SDOH, rather than attempting to ameliorate downstream outcomes, such as chronic health conditions and poor well-being.
Conclusion
In conclusion, in order to best address health disparities attributed to SDOH, effective, valid, reliable, accessible and comprehensive assessment of SDOH domains must be integrated into routine pediatric care. Pediatric nurses have traditionally served as patient and family advocates, community providers and caretakers. Hence, the field of pediatric nursing is rife with opportunity to lead the way in the development, evaluation and application of tools, services and care delivery systems that provide screening, referral and interventions to address the SDOH risks of vulnerable children and families.
Using a Nursing Theory as a Framework for Evidence-Based Practice
As is evident in this week’s readings, theory, practice and research are interrelated within the nursing profession. As research efforts continue to expand nursing knowledge, efforts to translate research into practice are essential to optimize health outcomes. Nursing theories provide a necessary framework for the translation of evidence into practice, offering insight, perspective, and outcome-focused value (McEwen & Wills, 2014).
Across healthcare, application of theoretical frameworks offers a systematic approach and meaningful context for evidence-based practice (EBP). To assure effective application, the framework selected must be relevant to practice and in alignment with the overarching purpose and desired outcomes. For example, as master’s prepared nurses establish clinical practice guidelines based upon research findings, the use of a nursing theory provides a context and foundation upon which to ground the EBP (McEwen & Wills, 2014). Similarly, for master’s prepared nurses who lead planned change to improve health care quality and outcomes within an organization, use of theory offers a tangible framework for the execution of the project (Kearney-Nunnery, 2016).
In addition, the specific theory which is used as a framework can serve to substantiate key concepts which are present quality initiatives or situation-specific practice guidelines (Stevens, 2013; Kearney-Nunnery, 2016). For example, a nurse educator creating a faculty mentoring program may use Benner’s Novice to Expert Theory as a framework for the project due to alignment with the concepts surrounding professional growth and development.
Master’s prepared nurses are pivotal to the translation of evidence into practice. By selecting and applying appropriate theoretical frameworks to guide EBP, nurses can facilitate outcome achievement for patients, families, health care professionals, and health care organizations.

Presentation Narrative

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Presentation Narrative

The evidence-based model used in the presentation is the Donabedian model which according to Dwyer et al. (2017), is a theoretical framework that considers multiple dimensions of the healthcare process when assessing the quality of care offered by providers. The model considers the main components of healthcare delivery: structure, processes, and outcomes. The structural component includes the characteristics of the healthcare environment such as the availability of sufficient and qualified human resources, equipment, and physical space. The process component includes the nature of activities undertaken by healthcare professionals when providing care including assessment, diagnosis, patient education, and treatment. The outcome component is the direct impact of care processes on the health status of the patients. The Donabedian framework is relevant to the family nurse practitioner (FNP) role because FNPs provide services in numerous settings and to diverse patients. Dwyer et al. (2017) explain that FNPs directly influence the healthcare process as they interact with patients. Therefore, to improve the quality of care provided and patient outcomes, FNPs should engage in actions that improve the structural and process components of the Donabedian model.

One of the major issues impacting the FNP role is social determinants of health. As per Coppa et al. (2021), social determinants of health refer to the conditions in which individuals are born, live, work, and age which directly influences their health and wellbeing. Examples of these determinants include education, income, employment status, neighborhood, and access to social support. People affected by negative social determinants of health are more likely to have negative health outcomes. For instance, Islam (2019) explains that low-income families may be unable to afford quality and nutritious food thus increasing the risk of developing chronic illnesses such as type 2 diabetes and obesity. Moreover, low income is linked to poor access to and utilization of healthcare resources due to lack of health insurance and inability to afford treatment. Other social determinants of health such as poverty and culture influence health behaviors. These factors increase the risk of poor health among specific individuals and populations thus leading to health disparities.

FNPs are trained to address social determinants that lead to health disparities. As they interact with patients, they have the opportunity to assess for any social determinants that act as barriers to good health and wellbeing and use this information to develop patient-centered interventions. FNPs are also expected to provide culturally competent care to address social determinants (Coppa et al., 2021).

The Donabedian framework can be used to address social determinants of health. According to Howard and Scemons (2018), FNPs should focus on improving the structural and process components which are critical when working with underserved or marginalized individuals and communities. They should provide culturally-relevant services and develop positive nurse-patient relationships that facilitate easy identification of healthcare services. They should work with other professionals such as social workers to improve the physical and mental wellbeing of patients as well as access to community resources. The Donadebian framework provides a unique perspective for addressing social determinants of health since as per Dwyer et al. (2017), it focuses on the processes that nurses can engage in within their clinical practice to improve patient outcomes. The framework enhances understanding of the role of FNPs in promoting quality nurse-patient interactions that improve outcomes.

References

Coppa, D., Winchester, S., McAlvin, E., Roberts, M., & Maestri, X. (2021). Use of social determinants of health codes in home-based primary care. Journal of the American Association of Nurse Practitioners, 34(1), 42-49. https://doi.org/10.1097/jxx.0000000000000586

Dwyer, T., Craswell, A., Rossi, D., & Holzberger, D. (2017). Evaluation of an aged care nurse practitioner service: quality of care within a residential aged care facility hospital avoidance service. BMC Health Services Research, 17(1). https://doi.org/10.1186/s12913-017-1977-x

Howard, K., & Scemons, D. (2018). Addressing the social determinants of health: The nurse practitioner′s role. Journal of Advanced Practices in Nursing, 3. https://doi.org/10.4172/2573-0347-C1-017

Islam M. M. (2019). Social Determinants of Health and Related Inequalities: Confusion and Implications. Frontiers in public health, 7, 11. https://doi.org/10.3389/fpubh.2019.00011