NR 505 Using Evidence to Address Practice Issues SOLUTION
Revisit the practice-related issue of interest that you identified in the week one discussion posting, and respond to the following:
Describe the practice-related issue and its impact on the nursing profession and/or healthcare delivery.
How does this issue influence healthcare safety, quality, and/or health outcomes?
What nursing intervention would you recommend to improve the issue?
As you conduct a review of literature to better understand the issue and your proposed intervention, what search terms might be most helpful?
Based upon your responses to the above, develop a PICOT statement that conveys the following elements.
P-Population and Problem – What is the nursing practice issue or problem and who does it affect?
I-Intervention – What evidence-based solution for the problem would you like to apply?
C-Comparison – what is another solution for the problem? (Note that this is typically the current practice, no intervention at all, or alternative solutions.)
O-Outcome – Very specifically, how will you know that the intervention worked? What will be the indicator of success, and how will that outcome be measured?
T-Timeframe – Target date for outcome achievement.
Use a sentence format to construct your PICOT statement. Here is an example from the educational field (remember, your PICOT will address a nursing practice issue or problem):
Using Evidence to Address Practice Issues
Poor communication and lack of collaboration among the healthcare providers compromise the quality of healthcare service delivered to the patients. The Healthcare system involves various units working together, which must be adequately coordinate to achieve a seamless transition in the care delivery process among the patients. The purpose of this study is to explore how the lack of collaboration among the nurses and other healthcare providers impact the healthcare delivery process and the measures to address it.
Practice-Related Issue and Its Impact on the Nursing Profession and/or Healthcare Delivery
Many healthcare institutions struggle with collaboration, which influences more suffering and poor experiences among the patients, especially those with chronic illnesses. Lack of collaboration and constant conflict between the nursing department and other healthcare institutions compromises the quality of care delivery and limits the ability of the institution to promote evidence-based practices.
How the Issue Influence Healthcare Safety, Quality, and/or Health Outcomes
According to Rosen et al. (2018), collaboration is characterized by improved communication and allows healthcare providers to handle patients’ issues. Such an environment promotes transparency and the culture of quality care delivery. On the other hand, when people do not collaborate, it becomes easy to criticize and condemn one another. The healthcare providers will not be willing to own their mistakes in care delivery because of the created environment full of reproach. Failed communication between the healthcare providers causes direct harm to the patients. The other issues linked with poor collaboration include delayed intervention and admission of improper treatment to the patient. It becomes difficult for the pharmacists to consult with the clinicians and clarify the best medication to give the patient, leading to poor treatment outcomes.
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Nursing Intervention Would You Recommend to Improve the Issue
The introduction of telemedicine can help promote inter-professional collaboration and improve the quality of healthcare services delivered to patients. Telemedicine in nursing involves the use of telemedicine technology in the care delivery process. The technology allows the nurses to communicate with other healthcare practitioners and their patients, enhancing the interdisciplinary practice (“Revolutionizing Healthcare”, 2019). The healthcare system is made up of different units that operate from different locations though they work together. Therefore, the telemedicine technique allows the nurses to reach their colleagues regardless of geographical barriers. In such an environment, it becomes easy to execute the healthcare delivery roles and harmonize the relationship between the various units in the hospital (“Revolutionizing Healthcare”, 2019).
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Review of Literature to Better Understand the Issue and Your Proposed Intervention
In conducting the literature review to understand the issue and the proposed solution, the key terms to use will include telemedicine and safe medical practice, inter-professional collaboration, nursing communication with other departments and culture of collaboration.
PICOT Statement
The PICOT question guides the search strategies and the expected findings to help answer the research questions. Therefore, sources that directly answer the question will be used. The PICOT statement for the issues will be:
For nurses and other professionals, does implementing telemedicine technology, as compared to not, improve the collaboration between the nurses and other healthcare professionals in the hospital within six months?
Population: The nurses and other healthcare professionals
Intervention: Implementing the telemedicine
Comparison: No telemedicine
Outcome: Improved collaboration
Time: six months
Conclusion
Finally, the identified issue in this case was lack of collaboration among the healthcare providers. Collaboration among the healthcare providers promotes quality healthcare delivery to the patients. The research aimed at develop interventions that will help improve collaboration among healthcare providers and guarantee quality healthcare delivery to the patients. Implementing telemedicine could help bridge the gaps between the nurses and other healthcare providers and create a seamless and continuum care delivery environment.
References
Revolutionizing healthcare with IoT and cognitive, cloud-based telemedicine. (2019). Acta Polytechnica Hungarica, 16(2). https://doi.org/10.12700/aph.16.2.2019.2.10
Rosen, M. A., DiazGranados, D., Dietz, A. S., Benishek, L. E., Thompson, D., Pronovost, P. J., & Weaver, S. J. (2018). Teamwork in healthcare: Key discoveries enabling safer, high-quality care. American Psychologist, 73(4), 433-450. https://doi.org/10.1037/amp0000298
Your post regarding bedside shift report (BSR) is quite interesting. I believe there is a need for more data supporting the efficacy and benefits associated with bedside shift report. I have worked in facilities where the staff was transitioned to bedside shift report. For the most part, staff was extremely resistant to the idea for a myriad of reasons that varied from BSR extends the length of time it takes to report off to concerns regarding the risk of breaks in patient confidentiality to the staff just simply did not see a need to do so. Roslan and Lim (2016) conducted an interpretive, descriptive, qualitative study using focus group interviews with semi-structured questions. Twenty nurses were asked about their perception of bedside clinical handover. Results of this study concluded that the nurses found bedside clinical handover to be a possible cause of breaks in patient confidentiality, a source of interruption and distraction by patients and family members. On the other hand, research subjects also found bedside clinical handover to be a foundation for communication between patients and nurses.
As an acute care nurse, I know and understand the angst caused from bedside report. Despite this fact, I remain a staunch supporter of bedside shift report. When I was a manager, I cannot recall the number of times I received complaints from staff who complained because the patient in room 301 had an infiltrated IV at the start of the shift or the patient in room 345 was dirty at the beginning of the shift or the patient in room 320 was complaining because they have been asking for pain meds for over an hour. Each of the issues would have been known and could have been addressed during shift report. Most nurses do not intentionally leave work undone but there is the occasional unicorn who leaves work undone on a consistent basis. Although healthcare is a 24-hour rotation, no nurse wants to follow someone who consistently leaves a mess for the next shift. BSR hinders the possibility of this becoming a persistent issue.
I look forward to your continued research on this matter.
LaKrishia
Roslan, S. & Lim, M. (2016). Nurses’ perceptions of bedside clinical handover in a medical-surgical unit: An interpretive descriptive study. Retrieved from: http://journals.sagepub.com/doi/full/10.1177/2010105816678423