Assignment: Implementation into Practice Essay

Assignment: Implementation into Practice Essay

Assignment: Implementation into Practice Essay

Introduction

The contemporary approaches in health service delivery focus on value-based care in which quality outcomes depend on the utilization of evidence-based practice. In order to achieve this, medical database need to be reviewed to acquire insights on latest practices in patient care. Comparative analysis of research is vital to inform health-care decisions based on the provision of health services to patients (Shamseer et al., 2015). The approach provides articles for care providers to analyze literature materials to affirm their effectiveness, benefits as well as harms associated with different treatment options. Often, the evidence obtained from research studies are essential for practice and policy formulation. This is because the articles found can be used to compare medical devices, surgeries, tests and drugs in addition to the analysis of the ways used for delivery of health care for a specific disease. The Agency for Healthcare Research and Quality (AHQR) provides online summaries of resources that can be retrieved to guide evidence in clinical decision. However, despite being easy to obtain the articles, the effectiveness and accuracy of the online summaries in AHQR remains uncertain. Besides, the practical application of these materials to make real-time clinical decisions in order to improve patient care is riddled by paradoxes of lack of authenticity.

The present article aims to address the gaps of ineffectiveness of research by analyzing the evidence generated by summaries of reviews on AHRQ. Specifically, the study will bridge the gap in health delivery by focusing on the topic about the efficaciousness as well as safety of the screening method as regards postpartum depression. The purpose of the assessment will be to evaluate the effectiveness of the research articles for the benefit of health workers, consumers as well as policymakers. Barriers associated with implementation of the practice will be analyzed and this will be followed by the recommendations on how to address the challenges.

Discussion of the Practice

Postpartum depression (PPD) is a condition of depressive episodes that temporarily manifest after childbirth and has a 7.1% period prevalence lasting 3 months (Kendig et al., 2017). The condition readily affects mothers with a history of negative life events, depression and those who lack social support. PPD affects the health of the mother and can have extended impact on the life development of the child (O’Connor et al., 2016). Early screening and detection of post-partum depression can support as well promote treatment for fast recovery of the women affected by the condition (Knights et al., 2016). Besides, the approach ensures adequate follow-up of mothers diagnosed with PPD to reduce the adverse events of the condition. The Edinburgh Postnatal Depression Scale (EPDS) is a structured assessment tool that can be used for early detection of PPD (Howard et al., 2014). The tool is used for early and late detection of post-partum depression in mothers to guide evidence on treatment.

Assessment of the Extent to which the Practice is being Implemented

EPDS tends to be the screening tool that receives the widest application in the detection of post-partum depression in women. According to the AHRQ reviewers in 2015, the tool is defined by a set of ten questions, which a patient is required to complete and ranges in a scale of 0 to 30 (Milgrom et al., 2015). The analysis reveals that the likelihood of developing the condition is directly proportional to the score on the scale. Besides, a score of 13 or more is used to validate a diagnosis of major depression for the post-partum women. Nonetheless, a cut-off score of 10 is used to categorize women who need further evaluation and counseling (Thombs et al., 2014).

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The AHRQ published and updated a review report on the effectiveness as well as the safety of EPDS for screening of PPD. According to a study by Knights et al. (2016), EPDS score that is conducted within 96 hours after delivery can be used to predict PPD in females. In a research by Bell and Andersson (2016), the EPDS score conducted within 2 months of delivery correlates with the

early EPDS scores. This implies that both the early and late scores can be implemented in an institution to predict the possibility of the presence of PPD for women. In addition, findings by Kendig et al. (2017) affirm that an ideal screening test to determine postpartum depression is not defined in terms of timing, sensitivity, frequency and specificity. This means that the balance between benefits and harms associated with the EPDS does not depend on time but rather with its characteristics in detecting the condition. However, screening mothers using the EPDS questionnaire 96 hours after delivery provides the best evidence in ruling out or making a diagnosis of PPD in participants. Based on this premise, implementation of early screening is essential to confirm postpartum condition for prompt recommendation with psychiatric consultation. Conversely, Milgrom et al. (2015) contend that early screening can foreshadow the likelihood of PPD and with this, late EPDS is recommended to assess the condition in women. O’Connor et al. (2016) suggest that re-screen can be implemented to complement findings from EPDS score. This entails the use of PAP10, which implies analysis of psychiatry history, preterm delivery, anomaly, as well as EPDS score rating of 10. The approach is an effective method to determine the presence of the condition and guides on decision for future follow-up.

Evaluation of the Barriers to Implementation into Practice

There was low to moderate strengths of evidence from the summaries of studies on the AHRQ reviews on the use of EPDS for screening of postpartum depression. Most of the research articles used retrospective study designs which limited the ability to obtain accurate information on the use of EPDS to guide evidence for implementation into clinical practice (Thombs et al., 2014). Nonetheless, the high scores on the EPDS scale were not confirmed as important for psychiatric consultation. This means that the implementation of EPDS cannot be used as a standalone strategy for addressing postpartum depression in women (Howard et al., 2014). Besides, the use of the tool may be associated with false reporting due to selection bias in the EPDS score.

Ways to Overcome the Barriers

The ineffectiveness associated with implementation of EPDS can be addressed by rescreening to detect unwarranted bias. This entails serial testing in which two-screening approaches are undertaken (Kendig et al., 2017). In this approach, early testing using the EPDS is undertaken and this is followed by a specific PAP10 instrument to identify or rule out the ideal characteristics of postpartum depression (Bell & Andersson, 2016).). However, post-partum follow-up rate should be increased when using the EPDS scores to reduce false negative outcomes due to poor reporting among the affected women.

Conclusion

The potential and effectiveness of implementation of EPDS for postpartum screening is based on broad consensus on the characteristics of review results from AHRQ. The latter provides comparative outcomes that inform evidence on the adoption of the approach for diagnosis of PPD. From the analysis, the use of EPDS scorings provided richer data that indicate high post-partum follow-up rate to address underlying incidences of psychiatric illness in women. Based on this argument, it is evident that AHRQ comparative effectiveness reviews offer convenient access to a host of evidence-based information which can be retrieved to guide decision on clinical practice.

DNP 820 Week 5 Implementation Into Practice Assignment
Details:
The Institute of Medicine set a goal that 90% of health care decisions should be evidence-based by 2020. At best guess, less than 10% of decisions use best evidence. Bridging the gap between research, findings, and practice implementation is one strategy to meet this important goal. This assignment will help you to find gaps that may be used for your project.
General Requirements:
Use the following information to ensure successful completion of the assignment:
• Review the Agency for Healthcare Research and Quality (AHRQ) website to complete the assignment.
• Doctoral learners are required to use APA style for their writing assignments. The APA Style Guide is located in the Student Success Center. An abstract is not required.
• This assignment uses a rubric. Please Review the rubric prior to the beginning to become familiar with the expectations for successful completion.
• Use at least two additional scholarly research sources published within the last 5 years. Provide citations and references for all sources used.
• You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.
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Directions:
Select a practice from the AHRQ comparative effectiveness research site and write a 1,000-1,250 word paper that looks at a gap that exists between research findings and the implementation of those findings in practice. Include the following:
1. Discuss the practice.
2. Assess to what extent the practice is being implemented.
3. Evaluate the barriers to implementation into practice.
4. Propose ways to overcome the barriers.
5. Discuss the resources available on the selected site to inform translation.

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Assignment: Implementation into Practice Essay

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