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DQ: What changes will you need to make in order to have a feasible topic for your PICOT-D?

DQ: What changes will you need to make in order to have a feasible topic for your PICOT-D?

DQ: What changes will you need to make in order to have a feasible topic for your PICOT-D?

DNP 801 Topic 8 DQ 2

REPLY TO DISCUSSION

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I must be the odd one out here. I did not have a topic in mind when I started this program. I had no idea that I had to have an idea of what I wanted to work on or accomplish when I started this program and it was one of the things that delayed my starting the program in January among other things. Even when I applied, I still had no definite idea of what I wanted to do. So, based on my last stationed unit as a full-time case manager/discharge planner, I chose a topic that was dear to my heart to find a way to fix some of the issues that contributes to people having strokes especially recurrent strokes. Also, not having a practice site as well as a mentor was also another barrier to deciding on a topic and also not being in direct patient care anymore, I am not familiar with all the products and knowledge of all the things that are used in other areas of nursing except for the one in my unit and with discharge planning. Now that I have a mentor, I have to mention this topic to her and she will have to be comfortable with the topic as well or she may not be able to help guide me.

Based on Professor Etheridge’s feedback so far, it appears that my topic may or may not be feasible depending on the angle it takes. It will not be feasible as a nurse to teach preventive or monitoring strategies to other disciplinary professionals such as Physical or Occupational therapists or Nutritionists or even physicians unless I work in collaboration with them but for a nursing DPI project, I should be managing and directing the nurses involved. Also, since this is a quality improvement project, I have to be able to find enough articles that have dealt with this topic that will enable or effect a quality improvement (QI) change. Quality improvement is the framework used by healthcare professionals to improve the quality of health care provided to patients. Therefore, nurses are tasked with being part of the team to improve the quality of care given to patients since they are the primary care providers and very much concerned with the safety of patients (Adolfo, Albougami, Roque, & Almazan, 2021).

I will search more databases and review more articles to look for quality improvement interventions. I will also discuss some more with my mentor and professor to see what other ideas and feedback they will give me. Of which I will implement. If it is still not feasible, then I will have to pick another topic. Something in sepsis or hospital acquired infection.

Reference:

Adolfo, C., Albougami, A., Roque, M., & Almazan, J. (2021). Nurses’ attitudes toward quality improvement in hospitals: Implications for nursing management systems. Nursing Practice Todayhttps://doi.org/10.18502/npt.v8i3.5935

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You are not the odd one out. I had no clue about a topic, which is actually part of the reason why I did not start school until now! It looks like you have a good outline from which you can continue to develop your DPI!

Click here to ORDER an A++ paper from our MASTERS and DOCTORATE WRITERS: DQ: What changes will you need to make in order to have a feasible topic for your PICOT-D?

Having practiced in a COVID unit for the major part of the COVID-19pandemic, we witnessed several challenges in healthcare delivery ranging from an inadequate supply of PPEs (personal protective equipment) to congestion among others. However, the greatest challenge was that of a shortage of skilled nurses in home health to facilitate the continuity of care of COVID-19 patients discharged

DQ What changes will you need to make in order to have a feasible topic for your PICOT-D
DQ What changes will you need to make in order to have a feasible topic for your PICOT-D

early for home based care (HBC). The organization noted that most patients who were discharged early for HBC got readmitted within 30 days, an indicator of poor quality of care and potential gaps in discharge and follow up. To address this issue, the author proposed telenursing/telehealth as the intervention of choice (Tabacof et al., 2021).  Researchers recommend telenursing/telehealth as an intervention to follow up chronically ill patients, particularly those with heart failure to reduce 30-day readmissions (Xu et al., 2022).  Since my population of interest (COVID-19 patients) is different from that of patients with Heart failure, it would not be appropriate to conclude that telehealth/telenursing is an intervention that homecare nurses can implement to follow up COVID-19 patients enrolled for home based care and prevent 30-day readmission. Therefore, I formulated the following PICOT-D question to determine the appropriateness of my clinical issue, intervention, and outcome:  Among COVID-19 patients enrolled for Home Based Care (HBC), does remote care through telenursing compared to direct patient home visits reduce the rates of readmission within 30 days.

Based on the instructor feedback, I have a feasible topic for my PICOT-D. Feasibility simply refers to whether a study can be conducted with consideration of the study, time, stakeholder cooperation, participant availability, and availability of resources, researcher’s interest, and expertise (Fandino, 2019).  The author purposes to demonstrate to the organization in which he will conduct the study the value of the study in regards to the resource expenditure versus outcome value, for potential funding. This also includes the need for special telenursing equipment, having in mind that the organization has already integrated technology in the delivery of healthcare services. In regards to participants’ availability, researcher interest, and expertise, I work in a COVID-19 unit and have undergone several COVID-19 trainings for inpatients and those on HBC, I am certain that I have the needed experience and expertise in this area of study. Besides, it will be easier to get an adequate number of voluntary participants for the study. Considering the time factor, six to twelve months maximum provides an adequate duration to complete this study.

 

References

Fandino, W. (2019). Formulating a good research question: Pearls and pitfalls. Indian journal of anaesthesia63(8), 611. https://dx.doi.org/10.4103%2Fija.IJA_198_19

Xu, H., Granger, B. B., Drake, C. D., Peterson, E. D., & Dupre, M. E. (2022). Effectiveness of Telemedicine Visits in Reducing 30‐Day Readmissions Among Patients With Heart Failure During the COVID‐19 Pandemic. Journal of the American Heart Association, e023935.

Tabacof, L., Kellner, C., Breyman, E., Dewil, S., Braren, S., Nasr, L., … & Putrino, D. (2021). Remote patient monitoring for home management of coronavirus disease 2019 in New York: a cross-sectional observational study. Telemedicine and e-Health27(6), 641-648.

Great topic Asiatu. I also worked at a covid unit during the pandemic because of the shortage of PPE such as gowns, masks and shields and just as there was shortage of nurses in your practice site of home health, there was also shortages of nurses in the hospitals. In the hospital ED, we knew that patients that were not symptomatic were sent home as well. Also, patients were assessed with telehealth as well. It will be great to see the outcome of your project and to know if telehealth helps to reduce readmission rates within 30 days. All quality improvement projects require the support of the organization and stakeholders. Without the need of the organization and stakeholders, it will be difficult for you to buy your equipment like the telehealth monitor. I hope that your topic is feasible because of the timeline that you have put in place. If not, you will have to readjust some things to make it more feasible.

Before I started my proposed DPI project there are a lot of ideas I have in mind that I can think of to use. I am so happy that the one I chose to do is feasible enough for my PICOT-D project. I was able to discuss my proposed DPI project first with my mentor and seek for her advice if this will be a better project that I should be concentrating and she agreed with me. At first, I wanted to concentrate on mortality rate of sepsis and septic shock and when I first placed it in my PICOT-D Dr. Etheridge suggested that it will be difficult to just concentrate with it and I agree with her feedback.Per Dr. Etheridge feedback it is important that I have correct data and I should include statistics to show. My proposed project is implementing sepsis bundle for early identification for severe sepsis and septic shock. Sepsis is a huge problem in our organization and we don’t have any protocol to follow and guide us when it comes to Sepsis. It is important to identify septic patients in ICU and optimal treatment should be performed immediately. The goal of my proposed project is better outcome and bundle compliance of patients with severe sepsis and septic shock. Early detection and early management in sepsis patients will improve and compliance should be included,

If my proposed DPI project is not feasible I would suggest if patient flow from ED to their respective unit will be acceptable. Delays in patient flow and a shortage of bed are common in a hospital. Improving patient flow in any organization is important for patient outcome and patient satisfaction. Crowding can negatively affect patient and staff performance and this leads to problems. Patient flow is a problem in our facility and I am a part of the patient flow committee and I see it everyday. I am very passion in making sure that patient needs to be boarded as soon as bed is available for patient comfort and for staff role as well. To improve patient flow it includes removing unnecessary testings, duplicate orders and identifying what the problem really is, I think that this will be a good project too if I will not be able to do my first proposed project.

 

 

References:

 

Levy, M. M., Rhodes, A., Phillips, G. S., Townsend, S. R., Schorr, C .A. Surviving sepsis campaign: Assocition between performance metrics and outcomes in a 7.5year study. Intensive Care Med. 2014; 40:1623-1633. doe: 10.1007/s00134-014-3496-0.

 

Rojas-Garcia, A., Turner, S., Pizzo, E., Hudson, E., Thomas, J., Raine, R.; Impact and experience of delayed pdischarge: A mixed studies systematic review; Health Expect, vol. 21, no. 1, pp41-56; 2018.