Bachelor of Science in Nursing Capstone

Bachelor of Science in Nursing Capstone Bachelor of Science in Nursing Capstone Opportunities should be content that can be added to the policy to assist in reducing CAUTI, According to AHRQ these are some of the possible opportunities based on the AHRQ guidelines. Included a list a list for when catheters are deemed medically necessary for the following reasons such as: Urinary retention including obstruction and neurogenic bladder: The patient is unable to pass urine because of an enlarged prostate, blood clots, or an edematous scrotum/penis or unable to empty the bladder because of neurologic disease/medication effect. Bachelor of Science in Nursing Capstone Short perioperative use in selected surgeries (less than 24 hours) and for urologic studies or surgery on contiguous structures. NUR 4922 Rasmussen College Bachelor of Science in Nursing Capstone Need for accurate hourly output measurements to manage treatment in intensive care units . Assistance with healing of perineal and sacral wounds in incontinent patients to avoid further deterioration of wound and skin when alternative methods are ineffective. Required strict immobilization for trauma or surgery. Hospice/comfort care or palliative care, if requested by patient. Reduction in the use of catheters will reduce the chance of a CAUTI and positively impact the patient outcome. Provide a list of alternative devices prior to catheter insertion. Include a nurse driven protocol to assist in removing catheters when no longer medically necessary Implement a bladder scan/ straight cath guidelines for patients that are unable to void post catheter removal.Opportunities should be content that can be added to the policy to assist in reducing CAUTI, According to AHRQ these are some of the possible opportunities based on the AHRQ guidelines. Included a list a list for when catheters are deemed medically necessary for the following reasons such as: Urinary retention including obstruction and neurogenic bladder: The patient is unable to pass urine because of an enlarged prostate, blood clots, or an edematous scrotum/penis or unable to empty the bladder because of neurologic disease/medication effect. Short perioperative use in selected surgeries (less than 24 hours) and for urologic studies or surgery on contiguous structures. Need for accurate hourly output measurements to manage treatment in intensive care units . Assistance with healing of perineal and sacral wounds in incontinent patients to avoid further deterioration of wound and skin when alternative methods are ineffective. Required strict immobilization for trauma or surgery. Hospice/comfort care or palliative care, if requested by patient. Reduction in the use of catheters will reduce the chance of a CAUTI and positively impact the patient outcome. Provide a list of alternative devices prior to catheter insertion. Include a nurse driven protocol to assist in removing catheters when no longer medically necessary Implement a bladder scan/ straight cath guidelines for patients that are unable to void post catheter removal. deliverable_1_updated_versionkikelomo12.14.20__3_.docx ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS 1 SWOT Analysis of policy Kikelomo Adenekan Rasmussen College NUR4922CBE: Bachelor of Science in Nursing Capstone Professor Leigh Trujillo December 3, 2020 2 SWOT Analysis of policy Providing patients with a documented catheter insertion policy is one of the most recommended procedures for all hospitals. The policy provides a framework upon which nurses provide their undisputed care to patients. The policy also allows for accountability among the nurses by providing a standard procedure through which all insertions should be done. Here is a SWOT analysis of the Rasmussen hospital policy on catheter insertion, which states that: It is the policy of Rasmussen Hospital to ensure that all urethral catheter insertions are completed under sterile technique. Two Registered Nurses are to be present for each insertion and document according to the policy’s proceeds. Accurate documentation plays a pivotal role in health services, it is an indicator of nurse performance and the nursing service quality in a hospital. Documentation provides details of patient condition, nursing interventions that have been provided, and patient response to the intervention (Asmirajanti et al., 2019). However, the hospital is experiencing financial repercussions due to the high rates of CAUTI. In light of this, I will review the policy using SWOT analysis. The analysis will outline the strengths, opportunities, as well as its weaknesses, and threats. Importantly, I will provide recommendations for change to ensure CAUTI rates are reduced in Rasmussen Hospital. S: Strengths of policy Competent staff: One strength identified in the Rasmussen hospital policy is promoting teamwork and competent staff in executing nursing duties (Tang et al., 2018). As stated in the policy, the procedure requires two nurses for any ureteral catheter insertion procedure in the hospital. This policy reflects the confidence the hospital has in its staff to 3 complete all catheter insertion procedures using sterile techniques as stipulated in the organization policy. According to Needleman and Hassmiller (2009), competent staff plays a crucial role in improving healthcare efficiency and quality in hospitals. Therefore, since Rasmussen hospital has a competent staff, CAUTI infections under the new policy can be tremendously decreased. Another strength advocated by the policy is inter-professional communication; the policy allows professional nurses to communicate with each other and with the patient in a responsible way (Tang et al., 2018). This promotes respectful relationships and trust amongst the nurses, patients, and family members. With mutual respect, inter-professional communication fosters a positive environment in which shared goals are achieved (Tang et al., 2018). Another strength to draw from this policy is promoting the effective use of Electronic Medical Record systems (Balestra, 2017). As stated, once the procedure is completed, the registered nurses who performed the procedure are expected to document the procedure followed in an electronic health records system (Balestra, 2017). This allows for the safe storage of patient’s data and promotes accountability for every action taken. Evidence-Based Practice EBP involves the use of current techniques and evidence to make a well-informed decision about patient care (Balestra, 2017). The hospital policy supports evidence-based practice by the documentation of the procedure. It can also be considered a strength since the documented procedures can be used for future references to improve patient outcomes. More importantly, nurses can use the documented procedures to avoid making past mistakes in 4 treating CAUTI. In doing so, the hospital will achieve better results, reducing the hospital’s financial costs. NUR 4922 Rasmussen College Bachelor of Science in Nursing Capstone W: Weaknesses of Policy The success of implementing this policy depends on the availability of several resources to oversee its deployment. However, one of the cited weaknesses associated with the policy is the lack of financial resources to acquire needed resources. This, in turn, hinders the acquisition of necessary resources that are critical for the procedure (Sarah & Puput, 2018). Lack of financial support can be attributed to either lack of or inadequate policies on financial guidelines to support the policy (Ford-Gilboe et al., 2018). Another weakness that the policy might encounter will be staff reluctance to accept the new policy. Since the new policy was introduced last year, convincing the staff that the proposed policy could be more effective will be daunting. Research indicates that staff resistance could hinder the implementation of legislation (Sarah & Puput, 2018). Another notable weakness of the policy is the acquisition of alloy catheters. Inadequate quality supplies can adversely affect the health of the patients, eventually complicating their quality of life. Again, due to a lack of appropriate regulatory policies, the hospital might acquire low-quality catheters, increasing health risk for the patients (Vokes et al., 2018). O: Opportunities (Increase in revenue) One identified opportunity associated with the procedure is improved patient outcomes (Shamout et al., 2017). The new policy was implemented to ensure reduced CAUTIs in the hospital; proper adoption of the policy will ensure CAUTI rates decrease, which present the hospital with an opportunity to increase its revenues. According to Assadi (2018), 5 hospitals’ improved delivery efficiency reduces their operational costs while increasing their revenues. Therefore, proper adoption of the policy will allow Rasmussen hospital to reduce CAUTI rates and, at the same time, increase their revenues. Improved Patient Outcomes The new policy aims to reduce the CAUTI rate. The policy emphasizes patient assessment and staff education, which are critical in person-centered care. In doing so, the hospital will be improving patient outcomes by preventing infections and decreasing mortality and morbidity rate (Boev & Kiss., 2017). Hence, the new policy presents Rasmussen Hospital with an opportunity to increase patient outcomes. However, to achieve CAUTI reduction at the Rasmussen hospital, some content that would be added to the policy will include continuous staff education that will address the general culture and clinical practice of the Rasmussen Hospital and specific information would be added to the policy that addresses the need for nurses to ensure to identify appropriate catheter use, proper catheter insertion, maintenance and prompt catheter removal. The success of the policy could result in reduced cases of CAUTIs at the Rasmussen Hospital. The policy emphasizes patient assessment and staff education which are critical in person-centered care. Therefore, patients will be more satisfied with the routine checks and removal of the indwelling catheters before they cause infections (Vokes et al., 2018). Consequently, higher satisfaction scores will result in better compensation for value-based care. The costs associated with management of CAUTIs will reduce, resulting in fewer hospital-stay days. As the staff receives more training on infection reduction, they will increase their competencies and help new hires in adapting them (Kingsberry, 2019). 6 Therefore, the policy will become part of the units’ culture leading to a continuous trend in infection reduction T: Threats Even though the policy is straightforward in its set guidelines, there is still the threat of non-compliance from staff as they adapt to proposed changes. Resistance to change presents a significant problem among healthcare organizations and could result in poor patient outcomes (Noritomi et al., 2017). Some staff may be resistant to change, which may derail the expected outcomes. Another threat that the policy might encounter that might be difficult to change would be the public’s negative perception stemming from the increased cases of CAUTI in the hospital in the recent past. Thirdly, increased resistance by staff members to evidence-based practice changes (Ramadan et al., 2020). For instance, nurses might be overwhelmed by the intensive care required for the patient in the unit and underestimate the patient need for catheterization. These threats interfere with the policy’s effectiveness and, consequently, could be a threat to Rasmussen hospital if not well implemented. Recommendations The proposed policy will focus on actions that could reduce CAUTIs at the Rasmussen Hospital. NUR 4922 Rasmussen College Bachelor of Science in Nursing Capstone The first recommendation would be educating staff on the effect of CAUTIs on the quality of care given and how implementing the new policy could promote patient outcomes (Shaver et al., 2018). Part of evidence-based practice involves the proposal of policies that focus on patient safety and quality of care. Therefore, in meeting this goal, 7 training using PowerPoint presentations will help surgical nurses understand their role in reducing CAUTIs. The education program will target re-education on Foley catheters, their administration, routine checks, and how their management contributes to CAUTIs (Kingsberry, 2019). The training program would also include education on catheter routine checks to lead to more nurse competencies that will be utilized throughout patient care. Lastly, a recommendation would be to ensure staff practice effective and proper hygiene before any catheter procedure to minimize infection rates. I also recommend looking for other alternatives to Foley catheterization that could help in the reduction of CAUTIs. For instance, research has shown Tamsulosin’s effectiveness, especially in men after surgery, to reduce urine retention, which contributes to CAUTIs (Hamad et al., 2016). Administration of the medication as the catheter is inserted ensures that cases of postoperative urinary retention are reduced. Further, reducing Foley days can be implemented through other passing urine methods such as bladder scanners (Shaver et al., 2018). The implementation of alternative of alternative measure can be part of the education for nurse to promote us of evidence based methods in addressing the situation References Aldosari, B. (2017). Patients’ safety in the era of EMR/EHR automation. Informatics in Medicine Unlocked, 9, 230-233. https://doi.org/10.1016/j.imu.2017.10.001 8 Asmirajanti, M., Hamid, A.Y.S. & Hariyati, R.T.S. Nursing care activities based on documentation. BMC Nurs 18, 32 (2019). https://doi.org/10.1186/s12912-019-0352-0 Assadi, F. (2018). Strategies for preventing catheter-associated urinary tract infections. International Journal of Preventive Medicine, 9, 50. https://dx.doi.org/10.4103%2Fijpvm.IJPVM_299_17 Balestra, M. L. (2017). Electronic health records: patient care and ethical and legal implications for nurse practitioners. The Journal for Nurse Practitioners, 13(2), 105-111. https://doi.org/10.1016/j.nurpra.2016.09.010 Boev, C., & Kiss, E. (2017). Hospital-acquired infections: Current trends and prevention. Critical Care Nursing Clinics, 29(1), 51-65. https://doi.org/10.1016/j.cnc.2016.09.012 Ford-Gilboe, M., Wathen, C., Varcoe, C., Herbert, C., Jackson, B., Lavoie, J., Pauly, B., Perrin, N., Smye, V., Wallace, B.B., Wong, S., & Program, A.J. (2018). How equity?oriented health care affects health: key mechanisms and implications for primary health care practice and policy. The Milbank Quarterly, 96, 635 – 671. https://doi.org/10.1111/14680009.12349 Ramadan, E. S. F., Elsabahy, H. E. S., & El-shaer, A. M. (2020). Nursing Staff Awareness about evidence-based practice: Facilitations, barriers, and beliefs. Egyptian Journal of Health Care, 11(4), 96-120. https://dx.doi.org/10.21608/ejhc.2020.124850 Sampathkumar, P. (2017). Reducing catheter-associated urinary tract infections in the ICU. Current Opinion in Critical Care, 23(5), 372-377. https://doi.org/10.1097/mcc.0000000000000441 Sarah, F., & Puput, O. (2018, August). Cost and financial, economic impact in catheterassociated urinary tract infection (CAUTI): A systematic review. In Proceedings of the 9 International Conference on Applied Science and Health (No. 3, pp. 257-265). https://publications.inschool.id/index.php/icash/article/download/240/201 Shamout, S., Biardeau, X., Corcos, J., & Campeau, L. (2017). Outcome comparison of different approaches to self-intermittent catheterization in neurogenic patients: NUR 4922 Rasmussen College Bachelor of Science in Nursing Capstone A systematic review. Spinal Cord, 55(7), 629-643. https://doi.org/10.1038/sc.2016.192 Shaver, B., Eyerly-Webb, S. A., Gibney, Z., Silverman, L., Pineda, C., & Solomon, R. J. (2018). Trauma and intensive care nursing knowledge and attitude of Foley catheter insertion and maintenance. Journal of Trauma Nursing, 25(1), 66-72. https://doi.org/10.1097/jtn.0000000000000344 Sulmasy, L. S., López, A. M., Horwitch, C. A., & American College of Physicians Ethics, Professionalism, and Human Rights Committee. (, 2017). Ethical implications of the electronic health record: in the service of the patient. Journal of General Internal Medicine, 32(8), 935-939. https://doi.org/10.1007/s11606-017-4030-1 Tang, C. J., Zhou, W. T., Chan, S. W. C., & Liaw, S. Y. (2018). Interprofessional collaboration between junior doctors and nurses in the general ward setting: A qualitative exploratory study. Journal of Nursing Management, 26(1), 11-18. https://doi.org/10.1111/jonm.12503 Vokes, R. A., Bearman, G., & Bazzoli, G. J. (2018). Hospital-acquired infections under pay-forperformance systems: an administrative perspective on management and change. Current Infectious Disease Reports, 20(9), 35. https://doi.org/10.1007/s11908-018-0638-5 … Purchase answer to see full attachment Student has agreed that all tutoring, explanations, and answers provided by the tutor will be used to help in the learning process and in accordance with Studypool’s honor code & terms of service . Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10