Running head: NURSING: JOHN HOPKINS NURSING

Nursing: John Hopkins Nursing

Institution
Course
Date

NURSING: JOHN HOPKINS NURSING

Introduction
Ensuring delivery of high quality and adequate health Care facilities is fundamental to the
overall development of a country or community. This entirely depends on the level of economic
development of a country.
However, the problem is that the nurse to patient ratio is low, leading to overworking and
high chances of error. To ensure better service delivery in the future, most nursing institutions,
such as the US-based St. John Hopkins Nursing, have strategically designed a nursing focused
plan that outlines guidelines that will help them handle family, individual and community health
issues effectively. The nursing focused plan consist of a set of actions that outline the nursing
process From assessment, diagnosis, planning and Setting both long-term and short-term goals
for patients, implementing the nursing care According to them plan, and efficient evaluation of
patients response and effectiveness of the designed nursing care.

An Overview of the John Hopkins Nursing Evidence-Based Practice Process

John Hopkins is one of the internationally recognized health centers of the world
Associated with the delivery of high-quality healthcare services. To ensure continued success of
the health institution, John

Hopkins Nursing strategically designed and implemented an

evidence-based practice that would help streamline the nursing process in the institution. The
John Hopkins Nursing

Evidence-Based Practice Model is an outstanding problem-solving

approach to the institution's decision-making process and is usually accompanied by specially

designed user-friendly tools that guide groups or individuals. The EBP also helps the health
institution in framing its clinical inquiry initiatives (Day, 2015).

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Interprofessional Team
Being the leader of my project team, I would include several stakeholders as part of my
research And operations, most of whom will include pharmacists, clinical officers, physicians,
community health officers, doctors, clinical consultants, and other medical practitioners. The
team will also include a financier who will cater for all the research and operational costs.

Refining the EBP question

An evidence-based practice process is a problem-solving approach to how a health care
institution makes decisions, integrated with a guide and user-friendly tools to effectively meet
the needs of practicing nurses (Day, 2015). . The main proble addressed in this paper is that the
nurse to patient ratio is often too low in various clinical settings, a problem that must be
addressed in that the probability of error is greater in overworked nursing staff.

A PICO

framework is a technique that is mostly used in evidence-based practice purposefully to frame

and effectively answer a certain clinical question. A clear analysis of this problem can be done
using the PICO elements as below:
P- (Patient, population, or problem): The population refers to the group of patients
whose health is under concern. The main question is; is the nurse to patient ratio in clinical
settings sufficient? Some studies seem to indicate that it is not, and that more nursing staff are
needed in various medical settings. The problem is that the nurse to patient ratio is often too low
in various clinical settings, a problem that must be addressed in that the probability of error is
greater in overworked nursing staff.

For instance, nurses are bound to reduce their accuracy

level due to being overworked and rushing to attend to all patients within the limited scheduled
time. As a result, the probability of error in their services also increases. This poses the need to

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increase the number of nurses and other medical practitioners in the nursing industry
(Allnurses.com, 2015).
I- (Intervention): Although the current number of patients allocated per nurse is cost
effective, this poses a threat to the overall quality of services delivered, with its long-term effects
being a weak working population, and a consequential fall in the economic development of a
community or country at large. This, therefore, poses the need to invest more in clinical and
health officers, who would later ensure a healthy working population and a consequential
positive effect on the economic development.

For instance, the United States has heavily

invested in health care, realizing a reducing illness caused deaths and a general healthy working
population. This has been achieved through increased number of professional health workers in
the country and the heavy investment of the government in subsidizing health costs, and
introducing high technology clinical machines for advanced diagnosis and treatment. Also,
highly staffed hospitals have 25 percent lower odds of possibly preventable readmission rates as
compared to hospitals with low staffing (Allnurses.com, 2015).
C- (Comparison with other treatment/current practice): France, United Kingdom, and the
United states have heavily invested in health facilities, with the countries having similar features
That include advanced ambulatory care, a mix of private and public hospitals, a dominance in
office-based private practice, a widespread cost sharing approach, and the predominance in
practicing direct payments between patients and doctors.

Besides, governments of the three

countries play a fundamental role in assuring a regulated health system via universal coverage,
with the characteristics being grounded on pluralism, solidarity and liberalism. However, the
three countries also have their differences in their staffing and overall nursing process
procedures.

According to Victor Godwin and Simone Sandier, France has a relatively higher

NURSING: JOHN HOPKINS NURSING

number of active physicians per thousand individuals than the United States, with 2.67a and
2.19b respectively.

Besides, France has 37.6a in the number of pediatricians, internists,

obstetricians and other specialists while the United States has a relative 53.4b (Nyu.edu, 2015).
O- (Desired outcome): The desired outcome would be to find the balance between cost
effectiveness and safe nurse to patient ratios, perhaps at a midpoint of five or six patients per
nurse but no more.

Although reducing the patient to nurse ratio would lead to improved health

care Service delivery, over reducing the ratio would drastically strain the countries economic
resources. As a result, a slight significant reduction of the ratio is required to around six patients
per nurse. This will, therefore, improve the quality of health of a countrys population, and a
consequential improvement in the economy and living standards.

Scope of the EBP

John Hopkins EBP is uniquely designed to improve delivery of healthcare services in the
hospital. With the focus of the EBP being to reduce t]patient to nurse ration in the health
institution, the model focuses on a list of risk and safety management concerns, quality concerns,
unsatisfactory staff, patient or overall organizational outcomes, different variations in practice
both internally and externally, evidence validation for the current practices and various financial
concerns. Recently, the health facility has increased the number of nurses so as to reduce the
patient to nurse ratio. The problem addresses family members, patients, and clinicians all over
the United States.

John Hopkins Nursing also has a special transportation program that was

specially designed to provide advanced and effective life support to critical health issues for
referred patients. Staff in John Hopkins hospital is satisfactorily attended to ensure a totally

NURSING: JOHN HOPKINS NURSING

effective service delivery. For instance, according to Paco USA, John Hopkins Nursing has
reduced its patient to nurse ratio to around four patients per nurse (Allnurses.com, 2015). To
ensure the institutions staff is not overworked, the nurses operate in shifts of 30-40 percent
rotation, with 12-hour average shifts in length (McQuay, 2015).
Responsibility of Team Members
All team members in my project team are chosen due to their contribution to the success
of the project.

For instance, clinical officers, doctors, and other medical practitioners are

important in offering advice and guidelines for the research part, as well as their help in
analyzing health records of different countries and health institutions. The financier of the
project will cater for the total research and operational costs of the project, countering the
problem of financial constraints.

The members are therefore closely important as their

contribution results to the overall success of the project.

Internal/ External Search for Evidence and Appraisal of Evidence
After carrying out several types of research, my project team obtained both quantitative
and qualitative evidence from various sources. Some quantitative information was also obtained
from the John Hopkins Nursing EBP model. The strength of this research was facilitated by the
reliable information obtained from various reliable sources, whose both qualitative and
quantitative data was thoroughly revised by various medical practitioners and clinician from
different health facilities and research centers.

NURSING: JOHN HOPKINS NURSING

Summary of the evidence

Reliability of the research information was guaranteed by its sources that include the
Johns Hopkins Medicine website from where the EBP model of the health institution was
obtained from. Second, the allnurses website provided us with the patient to nurse ratio of the
John Hopkins Nursing (Allnurses.com, 2015).

Third, a comparison of health statistics in

America and Europe by Daniel Foulon and other researchers provided us with the statistical
comparison of the current treatment practice of France and the U S such as the governments
fundamental role in ensuring better health services to its citizens, patient to nurse ratio of these
countries, and the number of medical staff in both countries (Insee.fr, 2015). Fourth, some
information was also obtained from the Massachusetts Nurses Association website that consisted
of the need to increase staffing in health Facilities to reduce the impact of overloading nurses to
ensure effectiveness (Massnurses.org, 2015). The general reliability of information from these
sources was high.
Recommendations for Change Based on Evidence
Some recommended changes for the change based model would be increasing staffing so
as to reduce the patient to nurse ratio, eventually improving service delivery and reducing the
probability of error. Also, governments and other stakeholders in the medical field should be
encouraged to subsidize the costs of health services to ensure affordability for all patients.
Purchase of better, more technologically advanced health machines will help in the patient
diagnosis problems, guaranteeing effective treatment and medication.

NURSING: JOHN HOPKINS NURSING

Action Plan
A pilot study for the project is significant as it will help in gathering data and testing the
technical feasibility of the project. As a result, the action plan for our project will involve a clear
definition of the purpose of the pilot study, methods of evaluating success or failure of the study,
and designing the study around the desired outcomes. The project is expected to take around 4-5
months to ensure adequate research and collection of information.

Results of the medical

research project will be reported in both prints and digitally to ensure safety and reliability for
future use.
Evaluating Outcomes and Reporting Outcomes
The desired outcomes of our research project will be an effective analysis of different
health facilities and health practices in different countries. Besides, the project will entirely
major on the collecting both qualitative and quantitative data that will be used to improve
Service health delivery. As a result, the projected outcome of the project will be reduced patient
to nurse ratio, developing cost-effective health measures and a general improvement in the
quality of health and life.
Identifying Next Steps
Implementing the plan on a larger scale will involve engaging with the government and
the John Hopkins Nursing management team who will fund part of the implementation.

The

plan will also be helpful to other health facilities across the world as similar problems are
experienced in almost all other health facilities.

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Disseminate Findings
Internal dissemination of the findings will be done through print whereby interested
parties will get a copy of the whole research project and online via the website that will be given
thereafter. Also, interested parties will engage in direct conversations with of some of our
research members.
External communication of the information can be done through the website that will be
communicated later, publications in various magazines, and a complete publication in the John
Hopkins Nursing website. A print copy of the final findings can also be issued to the external
interested parties.
Conclusion
Poor health service delivery in most health facilities is caused by understaffing and poor
financial support. As a result, government and other stakeholder involvement in the health
industry would significantly reduce health costs, increasing affordability and reducing deaths
caused by unaffordability. Increasing the number of qualified clinical specialists reduces the
patient to nurse ratio, reducing the overall workload for the clinical specialists and eventually
improving the quality of health services delivered. The Hopkins EBP process consists of three
fundamental aspects that include an effective approach to decision making in the clinical field,
user-friendly tools that guide groups or individuals, and its special design to meet the demands of
practicing nurses.

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10

Reference List
Allnurses.com,. (2015). Johns Hopkins Nurse/Patient Ratios?. Retrieved 21 November 2015,
from http://allnurses.com/maryland-nursing/johns-hopkins-nurse-930660.html
Day, J. (2015). Evidence-Based Practice | Institute for Johns Hopkins Nursing.
Hopkinsmedicine.org. Retrieved 21 November 2015, from
http://www.hopkinsmedicine.org/institute_nursing/continuing_education/evidence_based
_practice.html
Insee.fr,. (2015). Donnes sociales, INSEE, 1999 edition. Retrieved 21 November 2015, from
http://www.insee.fr/en/ffc/docs_ffc/ds9936.html
Massnurses.org,. (2015). Massachusetts Nurses Association - Legislation & Politics - Safe
Staffing - Scientific Research. Retrieved 21 November 2015, from
http://www.massnurses.org/legislation-and-politics/safe-staffing/scientific-research
McQuay, J. (2015). Emergency Nursing at Johns Hopkins Bayview. Bayviewjobs.org. Retrieved
21 November 2015, from http://www.bayviewjobs.org/nursing/emergency.html
Nyu.edu,. (2015). Health Care Under French National Health Insurance. Retrieved 21
November 2015, from https://www.nyu.edu/projects/rodwin/french.html