The master’s program allowed me to develop a greater understanding of certain nursing concepts and to learn more about applying them in real-world practice. One of the highlights of the course was my practicum project, which provided an exciting opportunity for me to combine theory and practice by studying the implementation of evidence-based practice in a hospital’s cardiology department. As a result of the program, I have become more competent on the subject and more confident in applying the concepts and ideas I’ve studied into my future work in nursing research or education.
Reflection on the Program
In general, I can say that my master’s program experience was mostly positive and enlightening. I chose this program because I was interested in learning more about research and education in nursing, and my studies have allowed me to pursue my area of interest while at the same time improving my competency in diverse subjects related to nursing administration. The program was relatively well organized and separated into different subject areas that allowed me to focus my attention on certain concepts such as administration practices and contemporary issues in nursing. In the last stages of the program, we also had to complete a practicum project, which was designed to improve our understanding of one concept of choice: either teamwork and collaboration or evidence-based practice. I chose to focus on the latter, as I was excited to explore how evidence-based practice can be used to improve the efficiency of workers in medical institutions. I believe that one of the main goals of nursing managers is to ensure that all operations in their departments are conducted promptly, effectively, and with the best patient outcomes possible.
In this case, the use of evidence-based practice could be useful in several ways. First, recent studies and developments have offered new ways of performing certain procedures, both medical and administrative, which help make them more effective and less time-consuming, thus optimizing the operations overall. Secondly, allowing the specialist’s previous knowledge and expertise on the subject to affect treatment decisions could reduce the time for diagnosis, therefore improving patient outcomes in areas where promptness of treatment is essential. Finally, because evidence-based practice also focuses on each patient’s unique values and preferences, the approach is especially useful in treating patients from different cultural and ethnic backgrounds. Taking the patient’s views into account promotes patient empowerment and increases his or her overall satisfaction gained from the treatment experience. All in all, my master’s program helped me better understand the effect of the evidence-based approach on operations, the novelty of treatment methods, patient outcomes, and the overall patient experience. Since all of these components are major determinants of the effectiveness of nursing management, I can say with confidence that the development of competency in these subjects will help me in my future career.
Areas for Improvement
One area of the program that could be improved in the future is the timeline of the practicum project. In my case, the project was introduced too late in the term, when students were already busy with other subjects and assignments. This resulted in many of the students, including myself, feeling pressured to start the project as soon as possible, while at the same time being unable to do so without decreasing the amount of time and attention devoted to other areas of the program. As a result, some people chose either to postpone the start of the practicum project, which significantly affected its outcome or to fully shift their attention to it, which led to a decrease in grades for other subjects. It was challenging to keep a desirable level of achievement both in the practicum project and in other subjects taken, which is why I believe that the project should have been introduced to us earlier. Such advanced notice would give us more time to think about the project and find a better balance between the practicum and the rest of the program, resulting in better outcomes for both.
Reflection on the Practicum Project
My practicum project was to develop evidence-based practice strategies to reduce door-to-balloon (DTB) time in STEMI patients at Kendall Regional Medical Center. The multi-step project involved a needs evaluation, the development of an evidence-based approach based on previous research, and the formulation of a plan for its implementation. As part of the project, I had to consult various articles, books, and other sources related to the topic of evidence-based practice. For instance, to develop an implementation strategy, I read a variety of publications on both effective and ineffective methods of application. This helped me get a more complete picture of what the evidence-based approach means in practice, as well as what some of the challenges and opportunities associated with it are.
I also needed to provide a rationale for the use of an evidence-based approach for reducing DTB time in the cardiology department. During this part of the project, I learned more about the reasons for high or low DTB time and its effects on patients with STEMI and other heart diseases. For instance, I discovered that a low DTB time reduces the risk of complications and improves the outlook for the patient, which is why it is necessary to ensure that every hospital that provides heart surgery services operates within the DTB framework set by the government. The application of evidence-based practice in cardiology departments, according to my hypothesis, would increase the efficiency of operations for all medical specialists, including physicians, surgeons, and nurses. In doing so, the evidence-based approach could potentially decrease the DTB time reported by patients, providing for more positive patient outcomes in the long term.
After gathering the necessary information on the relationship between evidence-based practice, DTB, and patient outcomes, I performed a needs assessment of the target practice. During the needs assessment, I discovered that DTB time is not consistent and depends on many external factors, which means that some cases within the same practice have a significantly higher DTB time than others. This supported my hypothesis that an evidence-based approach is needed, as one of the major goals of balancing the DTB time distribution was to optimize operations within the clinic. As I was devising the implementation plan for Kendall Regional Medical Center, I also found that some organizational factors can impact the effectiveness of evidence-based practice in the clinic.
For example, the diversity of departments and services offered means that the practice must be implemented across the entire institution at once, not just within a single department. This necessity created cost concerns, as the introduction of the practice would entail significant employee training; given that the entire medical center employs over one thousand people, this would turn out to be an expensive enterprise. Moreover, different departments have different circumstances of work, so there is no unified training approach that would suit the entire practice at once. On the contrary, it would be necessary to appoint a project supervisor for each department to help tailor the plan and ensure its effectiveness in all areas of the center’s operations. Overall, the practicum project helped me improve my understanding of the concepts of evidence-based practice; most importantly, however, it allowed me to study the challenges and opportunities for the implementation of the approach in contemporary medical institutions, providing me with the specialized expertise that I will be able to use in my future work.
My main interests in nursing lie in the fields of education and research. As a result of the program and my practicum project, I find myself well equipped to follow either one of those directions. For instance, in research, I could study evidence-based practice further to develop current implementation strategies to make them more universal and suitable for a wider variety of departments and clinics. In the sphere of education, on the other hand, I could try to promote the evidence-based practice to students by applying it to all of the work performed as part of the learning process, thus increasing the students’ awareness of the concept and the challenges of its implementation in the modern clinical context.
Overall, I found that the program provided me with foundations that are crucial to my future work. Despite some organizational failures discussed above, my studies have allowed me to pursue my interests in the field of nursing administration and have equipped me to work in nursing research or education, which is my main goal for the future.