The Process For Defining The 10 Strategic Points

o   If you have the scholarly referenced article, you may begin adding them now)

MUST have 1-2 original research articles from the USA to support the intervention within five years of your graduation date

MUST have 2 original research articles from the USA to support the intervention within five years of your graduation date

MUST have 2 original research articles from the USA to support the intervention within five years of your graduation date. Other research articles may added from US, Canada, UK, Denmark, India, New Zealand, Germany, or Australia.

Hint: What would I title my project?  (Follow APA rules, title needs to be 12 words or less. Avoid acronyms in the title.)

List primary points for four sections in the Literature Review: Background of the problem/gap, theoretical foundations (models and theories to be the foundation for the project); review of literature topics with the key theme for each one; and summary.

a.      Background of the Problem/Gap:

·         Rural ambulatory clinics have had to reorganize their management structures to enhance reimbursement.

·         Access to appropriate health services for rural Americans needs to be improved in areas where specialists are not available (Schoenberg, 2012).

·         Telehealth nursing services can be provided through rural health clinics to support specialty clinics (Schoenberg, 2012).

·         Approximately 200 telemedicine networks have been established nationwide. (American Telemedicine Association, 2017)

b.      Theoretical Foundations (models and theories to be the foundation for the project):

·         The Greenhalgh’s Dissemination of Innovations model (Greenhalgh, Robert, Bate, Macfarlane, & Kyriakidau, 2005) can be used to implement rural telehealth services for rural Americans.

·         The D&M Information System Success model (DeLone &McLean, 2003) is a framework to conceptualize and operationalize information system success.

·         Path constitution theory combines two contrasting perspectives on technology, path dependence, and path creation (Singh, Mathiassen, & Mishra, 2015).

c.       Review of Literature Topics with Key Themes and Subthemes

Rural Telehealth Services: (Theme example)

·         Rural telehealth can improve care in burn patients (McWilliams, Hendricks, Twigg, Wood, & Giles, 2016); smoking cessation (Carlson, Lounsberry, Maciejewski, Wright, Collacutt, & Taenzer, 2011), psychotherapy (Gonzales & Brossart, 2015);  cancer education (Doorenbos et al., 2011); diabetes (Holloway, Coon, Kersten, & Clemins, 2011).

Population Specific Telehealth Services:

·         Community-based telehealth: Home-based telehealth can enhance older adults’ access to care and facilitate patient-provider collaboration, which may, in turn, improve patient self-management (Hsieh, Tsai, Chic, & Lin, 2015).

·         Chronically ill: Disease management needs of chronically ill patients include prescription refills, medication and symptom management, lab results, and patient education (Vinson, McCallum, Thornlow, & Champagne, 2011).

·         Rural Native American telehealth:  Telehealth can improve health disparities in Native American communities (Kruse, Bouffard, Dougherty, & Parro, 2016)The Process For Defining The 10 Strategic Points.

·         Diabetes education and management:  Telehealth education improves glycemic control (Barker, Mallow, Theeke, & Schwertfeger, 2016).

·         Mental health emergencies can be managed effectively through telehealth services (Saurman et al., 2011).

Settings:

·         Rural health clinic/hospital (Carlson et al., 2011); Doorenbos et al., 2011; Gonzales & Brossart, 2015; Holloway et al., 2011).

·         Home-based (Demiris et al., 2023).

·         Community center (Demiris et al., 2023).

·         Library (Demiris et al., 2023).

·         Smartphone, computer-based (Forchuk et al., 2016).

Certifications:

·         National Committee for Quality Assurance (n.d). Disease Management Accreditation. Retrieved from http://www.ncqa.org/programs/accreditation/disease-management-dm

·         American Association of Critical-Care Nurses (n.d.). CCRN-E: Certification for Tele-ICU Nurses. Retrieved from https://www.aacn.org/certification?tab=First-Time%20Certification

·         Acute stroke ready designation (Slivinski, Johes, Whitehead, & Hooper, 2017).

Network Systems:

·         American Telemedicine Association: Approximately 200 telemedicine networks have been established nationwide (Frederick, 2013).

·         Tablet PC Enabled Body Sensor System: a continuous real-time collection of physiological parameters (Panicker, Kumar, 2016).

d.      Summary

·         Gap/Problem: There is a need to implement evidence-based methods of improving the health outcomes of rural residents through the use of telehealth.

·         Prior studies: Prior studies show that telehealth improves patient outcomes in diverse settings, including rural areas.

·         Quantitative application: Sources of data exist to collect numerical data on the rate of follow-up with the primary care provider in rural areas.

·         Significance: Improving the rate of follow-up with the primary care provider will improve the health outcomes of rural residents.

Describe the variables/groups to project, in one sentence.

A well-written problem statement begins with the big picture of the issue (macro) and works to the small, narrower, and more specific problem (micro). It clearly communicates the significance, magnitude, and importance of the problem and transitions into the Purpose of the Project with a declarative statement such as: “It is not known if and to what degree/extent…” or “It is not known how/why and….”

It was not known if or to what degree the implementation of __________________would impact ______________ when compared to _______________ among ___________ (population).

While the literature indicates that telehealth is an important emerging technology for rural patient access, it is unknown if the implementation of telehealth impacts the rate of patient follow up for patients living in a rural area.

 (P) Among adult patients in a rural care setting, (I) how does the implementation of a telehealth program (C) compare to traditional commute-for-care (O) impact rate of follow-up with the primary care provider (T) over a period of four weeks?

Clinical Question:

To what degree does the implementation of _______________ (intervention) impacts __________________ (what) when compared to _____________ among _____________ (population) patients in a ______ (setting) in _______ (state)?

Identify sample, needed sample size, and location (project phenomena with small numbers and variables/groups with large numbers).

a.       Location: Arizona

b.      Population (Participants)

c.       Sample: 40 participants include a power analysis if appropriate.

d.      Inclusion Criteria

§  Who can participate?

e.       Exclusion Criteria

§  Who cannot participate

a.       Independent Variable (Intervention): Telehealth program.

b.      Dependent Variable: Follow-up rate with the primary care provider.

Name the selected methodology and specific design to address the problem statement and clinical questions:

This project will use a quantitative methodology with a quasi-experimental design.

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Provide one sentence statement of purpose including the problem statement, sample, methodology, and design:

The purpose of this quantitative, quasi-experimental project was to determine if or to what degree the implementation of _________________ (intervention) would impact ______________(what) when compared to _______________________ among ___________(population)  in a ________ (setting ie: primary care clinic, ER, OR) in ________ (state) over _____ time.

Describe primary instruments that will be used to answer the clinical question. Think about your step by step data collection approach from start to finish.

Descriptive statistics will describe the sample characteristics and variable results.

Explain the test used to obtain the statistical analysis and results of the measurable patient outcome.

What method will be used to justify the sample size?