Project description
Evaluation is done so one can determine if the changes were successful and need to be continued or no successful and should be revised or eliminated. Evaluation of the changes will be based upon what the changes were and how you determined what the problem was to begin with. That method of determination can probably be used to measure the changes after implementation.
Dissemination can be done in many forms. As a nurse serious about making things better for patients or staff, you are obligated to share your successes and failures with others to improve things for all patients or staff. The type of dissemination should fit the audience you are addressing
1. How will you evaluate your strategy success once implemented?
2. How will you share your findings with others in your facility (or elsewhere)?
Certainly your personal opinion may have value if you based your evaluation on your own ideas but be aware that most of your knowledge has other origins and must be cited / referenced. Most of your responses should show critical analysis of the topic and, and all discovered information must be supported by evidence from the scholarly literature. The maximum word limit is 300 with at least 2 peer-reviewed journals within the last 5 years. Please double space between paragraphs but do NOT use double spacing or indentions throughout. The only APA format should be for citation of sources in-text and the reference list.

My discussion was about the lack of performing dysphagia screening in ER for patients who are admitted with stroke symptoms, and how this deficiency disturb patients health outcome, in term of aspiration pneumonia and other health issues.
I work in neuro IMCU floor and the majority of the patients who are admitted to our floor are stroke patients. However, the majority of time ER nurses dont perform dysphagia screening or they feed the patients cold trays.
For this matter my discussion was about the need to implement a mandatory dysphagia screening on every patient representing to ER with stroke symptoms.

Im sending you my discussion bellow as well so u will have an idea and will help u to answer questions 1 and 2.

The lack of dysphagia screening
After reviewing several issues faced by the facility, I realized that the area of my concern is the lack of performing dysphagia screening in ER for patients representing with stroke symptoms. According to Wright (2014), there are various methods of identifying a facility problem (p.12). As argued by the author of the book, the area, to review, is a single event in a facility (p.72). In addition, the personal clinical encounter. About fifty percent of the patients suffering from stroke admitted to Neuro IMCU where I work as a staff nurse didnt have the appropriate dysphagia screening in ER or they were feed a cold try by staff or family members. As nurses our most important role is to provide the best care and safety to our patients. Dysphagia can happen in approximately sixty-five percent (65%) of patients suffering from stroke (American Stroke Association, 2014).
Performing dysphagia screening aligns with my interest and professional goals. It is my responsibility as a nurse to ensure patients safety, adequate plan of care and treatment. The objective is to ensure that dysphagia screening becomes mandatory for patients indicating stroke symptoms as early as possible in the emergency room. In addition, the diet of these patients should be altered in the viscosity of fluids and the texture of food. This will help eliminate the events where nurses feed the patients on cold trays. The diet helps prevent aspiration and the likelihood of pneumonia by ensuring safe swallowing (Schwab, Hanley & Mendelow, 2014). According to Blitzer & Brin (2011), an estimated 50,000 individuals die yearly due to aspiration pneumonia after stroke (p.89).
Evidence-based practice models are utilized in nursing practice to provide the nurses with the most recent research knowledge. The evidence is used in decision-making integrating patient preferences and clinical skill to direct patient care (Schmidt & Brown, 2014). The best model to use in this case is Conduct and Utilization of Research in nursing model (CURN) project. The model states that the priority is to carry out research that will give findings to prove that a particular behavior in practice will improve the patient health outcome. In the dysphagia screening, the priority is to conduct a research to prove that it saves lives of individuals diagnosed with stroke (Schmidt & Brown, 2014)

American Stroke Association. (2014, May 27). Difficulty Swallowing After Stroke (Dysphagia).
Retrieved January 15, 2015, from https://www.strokeassociation.org/STROKEORG/LifeAfterStroke/RegainingIndependence/CommunicationChallenges/Difficulty-Swallowing-After-Stroke-Dysphagia_UCM_310084_Article.jsp
Blitzer, A., & Brin, M. (2011). Clinical Evaluation. In Neurologic Disorders of the Larynx (2nd
ed., p. 256). Thieme.
Schwab, S., Hanley, D., & Mendelow, A. D. (Eds.). (2014). Critical Care of the Stroke Patient.
Cambridge University Press.
Schmidt, N. A., & Brown, J. M. (2014). Evidence-based practice for nurses. Jones & Bartlett.
Wright, A. (Ed.). (2014). Clinical Problem Lists in the Electronic Health Record. CRC Press.




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