Evidence-Based Cost-Effective Quality Care Reflection Paper

The development of the DNP Project, “Mindfulness-Based Self-Care Toolkit for Healthcare Staff,” was driven majorly by the desire to improve the overall well-being of healthcare staff. Noteworthy, mindfulness is among the major self-care strategies associated with the effective management of depression and anxiety in the general population (Parmentier et al., 2019) and is a key virtue in being responsible and making ethical decisions (Small & Lew, 2019). The supervised DNP practice experience and the DNP project have created a wider perspective of the stressors within the workplace for healthcare staff. Accordingly, my conclusion from observation and experiences is that a majority of stressors faced by healthcare staff come from clinical practice. I have gained deeper insights into how such stressors impact the well-being of healthcare workers and the overall clinical decision-making, quality of care, and costs of care. The aim of the DNP project has been to develop and integrate a Mindfulness-Based Self-Care Toolkit for healthcare staff to help them manage the stress from their type of work. In this regard, this reflection paper appraises how cost-effectiveness and national quality benchmarks influence clinical decision-making. It also reflects on and examines how advanced clinical decision-making, leadership skills, systems thinking, and quality competencies can help in the design of evidence-based management practices within the context of my current DNP project and supervised DNP practice site.

A Reflection on How Contemporary Social Determinants, Indicators, and Benchmarks Have Influenced Clinical Decision-Making

The DNP project and the supervised DNP practice experience have required me to constantly and to always make critical decisions in healthcare and staff management. My understanding is that, as a DNP-prepared nurse, my future practice will not be limited to clinical practice but will also include practice in the large healthcare system, including facility management, healthcare staff leadership, and management, nursing curriculum development, nursing faculty, and nursing research. Regardless of the practice settings, I am expected to make advanced evidence-based decisions that are reflected in both my leadership and management practices.

In addition, the development of the DNP project and the supervised DNP practice experience have greatly made me aware of how contemporary social determinants, indicators, and national quality benchmarks significantly influence clinical decisions. All clinical decisions are made based on available data drawn from the various applicable and appropriate assessment tools at the point of care, as well as consulting from practice guidelines, provider-level knowledge, and practice experience, as well as through consultative collaboration with other healthcare providers. It is these clinical decisions that guide treatment decisions and the provision of patient-centered and high-quality but cost-effective care. Both at the clinical practice settings and the larger healthcare system level, the quality and safety of patients and consumers of healthcare services are paramount.

Moreover, the quality and safety outcomes of care are potentially among the key determinants of the psychological well-being of healthcare staff. Based on experience from earlier practice and during the supervised DNP practice, I noticed that the mood of the nurses and other healthcare staff, including physicians, was much influenced by the outcomes of the care they had provided to the patients. Positive outcomes put the staff in a jovial mood. However, poor and negative outcomes, as well as errors, regardless of their impact on the patient and the care outcomes, lead to negative emotions. Also, nurses develop negative emotions, including fear, guilt, or self-blame, if they make mistakes that threaten the quality and safety of patients, where most of these emotions get internalized and lead to negative mental health outcomes among nurses (Mahat et al., 2022). A deeper analysis of mental health outcomes among healthcare staff, especially nurses, as observed and experienced during the DNP supervised practice, paints a cyclic picture. This is to say, when nurses make mistakes during care delivery, these mistakes cause them to develop negative emotions towards their ability to practice accurately, which they internalize, causing significant negative mental health outcomes. Although this is among the various factors contributing to negative mental health outcomes in nursing practice, others, such as low staffing levels leading to burnout (Yeh et al., 2021) or bullying within the workplace (Shen Hsiao et al., 2022) and poor mental health among nurses are the leading causes for such errors (Alrabadi et al., 2021). The conclusion at this point, which further guided the development of the DNP project, was that the overall ability of healthcare staff to provide high-quality, safe, and cost-effective care was dependent on their overall well-being physically and mentally. These are some of the examples of the various stressors that affect the healthcare workforce. The development of the DNP project has considered the wider factors acting as healthcare staff stressors in order to design the Mindfulness-Based Self-Care Toolkit for healthcare staff to ensure their mental health and well-being in the long term.

Although the DNP project focuses on the use of mindfulness as a way of providing self-care among healthcare staff so as to prevent serious health consequences to their own health that may impact their ability to adequately care for patients, as argued by Sist et al. (2022), all decisions made to strengthen the developed toolkit have considered various underlying factors. These include staffing levels and healthcare staff workload, expected quality and safety standards during patient care, and patient expectations with care. In this case, reviews of set national quality benchmarks were done, including those provided and set by the Centers for Medicare & Medicaid Services (CMS) and the National Committee for Quality Assurance (NCQA). The CMS, for instance, besides the state health departments, has well-established staffing standards, particularly for facilities that receive Medicare and Medicaid funding. At the same time, health indicators, especially those in the community, guide resource allocation decisions. Other benchmarks, such as those set by NCQA, guide the practices to ensure the achievement of patient safety, satisfaction, and overall care quality. At the same time, contemporary social determinants have been considered during the development of the DNP project and decision-making during the supervised DNP practice, with a focus on how such social determinants influence healthcare staff well-being. Examples include the workplace environment, reimbursement levels and socioeconomic status, and the pressure to provide high-quality patient care in the most affordable way. The consideration of these safety and quality benchmarks, various health indicators influencing resource allocations, and social determinants, I was able to design a Mindfulness-Based Self-Care Toolkit for healthcare staff in a manner that integrates the underlying factors of healthcare staff well-being and incorporates mindfulness practices as a self-care strategy in everyday practice.

Competencies Applied in the DNP Project and Supervised DNP Project Experience

I have and will continue to integrate various competencies in the DNP project and the supervised DNP practice site, as well as in the design and development of evidence-based management practices. My major areas of focus are competencies in advanced clinical decision-making, leadership skills, and systems thinking. For example, in advanced clinical decision-making, I will continue to utilize the best available evidence combined with improved skills in patient-level communication and critical thinking to guide the making of shared clinical decisions. The same applies to my leadership competencies, in which I will continue to utilize effective communication and set examples on self-care, as well as collaborate with other stakeholders through the integration of the principles of transformational leadership during the supervised DNP practice and in the implementation of the DNP project. In addition, from a systems thinking perspective, I will continue to explore the interconnectedness of various factors within the healthcare systems that influence safety and quality practices, patient outcomes, cost-effectiveness of care, and healthcare staff experiences in order to align the project and my practice in a manner that helps achieve evidence-based management and overall patient well-being.

Conclusion

The development of the DNP project, “Mindfulness-Based Self-Care Toolkit for Healthcare Staff,” and my experience from the supervised DNP practice site have greatly improved my competencies in advanced clinical decision-making. I have significantly improved my skills and abilities to consider and integrate aspects of cost-effectiveness, national quality benchmarks, health indicators, and contemporary social determinants into clinical decision-making and the design of evidence-based management practices. I will continue to improve the DNP project and experiences from my supervised DNP practice site by integrating various competencies in leadership, systems thinking, advanced clinical decision-making, and evidence-based management to ensure sustainable well-being for healthcare staff.

References

Alrabadi, N., Shawagfeh, S., Haddad, R., Mukattash, T., Abuhammad, S., Al-Rabadi, D., Farha, R. A., AlRabadi, S., & Al-Faouri, I. (2021). Medication errors: A focus on nursing practice. Journal of Pharmaceutical Health Services Research, 12(1), 78–86. https://doi.org/10.1093/JPHSR/RMAA025

Mahat, S., Rafferty, A. M., Vehviläinen-Julkunen, K., & Härkänen, M. (2022). Negative emotions experienced by healthcare staff following medication administration errors: A descriptive study using text-mining and content analysis of incident data. BMC Health Services Research, 22(1), 1–11. https://doi.org/10.1186/S12913-022-08818-1/TABLES/2

Parmentier, F. B. R., García-Toro, M., García-Campayo, J., Yañez, A. M., Andrés, P., & Gili, M. (2019). Mindfulness and symptoms of depression and anxiety in the general population: The mediating roles of worry, rumination, reappraisal and suppression. Frontiers in Psychology, 10(MAR). https://doi.org/10.3389/fpsyg.2019.00506

Shen Hsiao, S. T., Ma, S. C., Guo, S. L., Kao, C. C., Tsai, J. C., Chung, M. H., & Huang, H. C. (2022). The role of workplace bullying in the relationship between occupational burnout and turnover intentions of clinical nurses. Applied Nursing Research, 68, 151483. https://doi.org/10.1016/J.APNR.2021.151483

Sist, L., Savadori, S., Grandi, A., Martoni, M., Baiocchi, E., Lombardo, C., & Colombo, L. (2022). Self-care for nurses and midwives: Findings from a scoping review. Healthcare, 10(12). https://doi.org/10.3390/HEALTHCARE10122473

Small, C., & Lew, C. (2019). Mindfulness, moral reasoning and responsibility: Towards virtue in ethical decision-making. Journal of Business Ethics, 169(1), 103–117. https://doi.org/10.1007/s10551-019-04272-y

Yeh, T. F., Chang, Y. C., Hsu, Y. H., Huang, L. L., & Yang, C. C. (2021). Causes of nursing staff burnout: Exploring the effects of emotional exhaustion, work–family conflict, and supervisor support. Japan Journal of Nursing Science, 18(2), e12392. https://doi.org/10.1111/JJNS.12392

ORDER A PLAGIARISM-FREE PAPER HERE

We’ll write everything from scratch

Question

Outcomes:

NU743-2: Analyze the effect of clinical reasoning and decision-making relative to cost, evidence-based practice, and quality improvement within the healthcare system.

Evidence-Based Cost-Effective Quality Care Reflection Paper

NU743-3: Apply advanced clinical decision-making, leadership skills, and systems thinking in the design of evidence-based management practices.

Purpose:

You will appraise how cost-effectiveness and national quality benchmarks influence clinical decision-making. Incorporate evidence-based management practices, leadership, and quality competencies into your reflection. Your work will reflect advanced clinical decision-making, leadership skills, and systems thinking in the design of evidence-based management practices. Describe these concepts in relation to your DNP project and your supervised DNP practice site.

Project Title: Mindfulness-Based Self-Care Toolkit for Healthcare Staff

Directions:

In this document, you must:

Appraise how contemporary social determinants, indicators, and benchmarks have influenced your clinical decision-making within your DNP project and your supervised DNP practice experience.
Include a description of all competences you will integrate in your DNP project and your supervised DNP project experience.
State your conclusions based on your appraisal.
Provide examples to support your ideas.

For this paper, you will create a document that:

is 5–7 pages in length (excluding title page and references);
is supported with a minimum of five scholarly, peer-reviewed sources external to those assigned for this unit;
follows the conventions of Standard English (correct grammar, punctuation, etc.);
is well ordered, logical, and unified, as well as original and insightful;
displays superior content, organization, style, and mechanics; and
uses APA 7th edition style and format.

Evidence-Based Cost-Effective Quality Care Reflection Paper