Assignment: financial aspect account for developing the evidence-based practice project
Assignment: financial aspect account for developing the evidence-based practice project
Assignment: financial aspect account for developing the evidence-based practice project ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON Assignment: financial aspect account for developing the evidence-based practice project please respond to the main discussion DQ1 and DQ2 with reference and also respond to the peer discussions Assignment: financial aspect account for developing the evidence-based practice project DQ1 After discussion with your mentor, name one financial aspect, one quality aspect, and one clinical aspect that need to be taken into account for developing the evidence-based practice project. Explain how your proposal will directly and indirectly impact each of the aspects. DQ2 Now that you have completed a series of assignments that have led you into the active project planning and development stage for your project, briefly describe your proposed solution to address the problem, issue, suggestion, initiative, or educational need and how it has changed since you first envisioned it. What led to your current perspective and direction? Peer DQ1 As per conversation with my mentor, one financial aspect that needs to be taken into account for developing the evidence-based project is the estimated budget that has to be approved by the management of the organization. While a quality aspect should always be to improve the current organizational rate. The clinical aspect is the improvement of patient care that is the main reason behind this evidence-based project. According to Sipes (2016), one of the primary responsibilities of a project manager is to successfully execute a project within the estimated budget, time, and quality standards. The budget is that backbone of every project. If the project manager does not have the necessary amount of money and a properly estimated budget, then the project will result in a failure. My mentor has taught me that a project manager has to fully understand the importance of cost estimation and budgeting from the initiation phases of the project. The amount of financial resources will dictate the duration and type of available operation and activities in the realm of a project. My project proposal will include an estimated budget, will be free of miscalculations, and will have a complete breakdown of the necessary budget. One quality aspect of my hand hygiene compliance improvement project is to increase the compliance rate of proper hand hygiene techniques in the department. According to my mentor, even though all the healthcare providers are aware that they have to wash and sanitize their hands throughout the shift, many of them do not use proper hand hygiene techniques or forget to wash their hands. Currently, the hand hygiene compliance rate in my healthcare organization is decreasing, as the rate of healthcare-associated infections has increased. In observational studies conducted in local city hospitals, direct healthcare providers washed or sanitized (with alcohol-based sanitizer) their hands on average from 5 to as many as 42 times per shift (World Health Organization, 2018). If the average shift is 8-12 hours that means that many direct care providers only washed/sanitized their hands between 1 and four times. These numbers are very low for a healthcare facility. The average shift of the direct patient care provider in my healthcare facility is 8 hours, and the average number of hand washing procedures performed during the shift has decreased from 5 per shift to 2.5 in the past year, which is half of the previous numbers. Assignment: financial aspect account for developing the evidence-based practice project One clinical aspect that needs to be taken into account when developing the evidence-based project is how the project will affect the delivery of patient care. The introduction of hand hygiene compliance monitoring badges is meant to improve the hand hygiene of the healthcare providers, but will it negatively impact the patient care? As a project manager, it is imperative to understand and try to predict the positive and negative clinical aspect that these monitoring badges will have on the delivery of patient care. Will it take time away from patient care? Will it decrease the number of hospital-acquired infections? My proposal of the hand-hygiene monitoring badges will not take time away from patient care because proper hand washing takes one minute, but the number of hospital-acquired infections can be significantly decreased. In American hospitals alone, the Centers for Disease Control (CDC) estimates that healthcare-associated infections (HAI) account for an estimated 1.7 million infections and 99,000 associated deaths each year (2018). Using proper hand washing and hand sanitizing techniques throughout the shift can decrease the number of HAIs in the healthcare organization. Hand washing is the fundamental way to prevent and reduce HAIs in hospital patients ( McCalla, Reilly, Thomas, McSpedon-Rai, 2017 ). David Centers for Disease Control and Prevention. (2018). Hand hygiene in healthcare settings. Retrieved from https://www.cdc.gov/handhygiene/index.html McCalla, S., Reilly, M., Thomas, R., & McSpedon-Rai, D. (2017). Major Article: An automated hand hygiene compliance system is associated with improved monitoring of hand hygiene. AJIC: American Journal of Infection Control , 45 (1), 492497. https://doi-org.chamberlainuniversity.idm.oclc.org Sipes, C. (2016). Project management for the advanced practice nurse. Retrieved from https://online.vitalsource.com World Health Organization. (2018). WHO guidelines on hand hygiene in health care: First Global Patient Safety Challenge . Clean Care is Safer Care . Retrieved from http://www.who.int/gpsc/5may/tools/9789241597906/e Peer DQ2 Evidence based health practices are often available for a various condition like asthma, heart failure, and diabetes. The practices are not always implemented in any care delivery. It is a problem-solving approach which incorporates the careful use of up to date, quality data in decisions regarding care of patients (Vaidya et al., 2017). Financial aspect Evidence based practice is an approach which involves many stages that require thorough check and finances to function well. A financial manager makes a detailed budget of how the method will work. Everything should be planned within the budget made by the financial manager. Every step is taken keenly for the practice to function well. Public authorities and professional organizations have tried to promote evidence-based practice to provide standard health services not leaving out national and international organizations (Melnyk et al., 2017). Since my project is on staffs or nurse turnover in nursing home or a long term care facility, the finances of the evidence-based practice will be very high. A lot of money is needed to set up a facility which is conducive for the patients and nurses who use the area. The finances may come from donors, well-wishers, investors and the government. Also, the place will be a nursing home for those patients with diabetes especially type two diabetes. It will provide kits for the patients to measure their blood glucose level even at the comforts of their homes. Nurse turnover is an undesirable trend for health care employers since it is expensive, disruptive and threatens the quality of care and patients safety (Vaidya et al., 2017). The nurses who are not performing well are assessed and released, and new ones who act are hired. It also requires the nurses satisfaction with the salary paid and the environment they work in. Finances for the nurses payroll and finances for hiring them are provided too (Vaidya et al., 2017). One quality aspect Evidence-based practice project requires a high percentage of quality for it to perform correctly. It is considered as a one quality point of developing the practice. Every step should be designed correctly to avoid non quality practice. Nurse turnover is one problem that can threaten the quality of care and patient safety in the facility. It should be taken care of since it is a sensitive matter (Melnyk et al., 2017). The quality of the nursing facility depends on the services the patients receive since t is the main agenda of the program. The practice should work to improve the quality of the nursing care facility every time for the patients to receive high standard services with high quality. Clinical aspect My project on staffs or nurse turnover in nursing home or long term care facility, clinical matters, and care will be handled with a lot of keenness. The patients will be taken care of in a right way and ensured proper services for them. The facility will be clean every time to avoid infections and diseases, have medical equipment that will help in testing and treat patients. They will be there to prevent issues of patients coming to the facility and dont receive any medication. It will directly have an impact on the practice because providing evidence before diagnosis, and the patients will be treated well (Melnyk et al., 2017). References Melnyk, B. M., Fineout?Overholt, E., Giggleman, M., & Choy, K. (2017). A Test of the ARCC© Model Improves Implementation of Evidence?Based Practice, Healthcare Culture, and Patient Outcomes. Worldviews on Evidence ? Based Nursing , 14 (1), 5-9. Vaidya, N., Thota, A. B., Proia, K. K., Jamieson, S., Mercer, S. L., Elder, R. W., & Zaza, S. (2017). Practice-Based Evidence in Community Guide Systematic Reviews. American journal of public health , 107 (3), 413-420. Peer DQ3 Evidence-based practice has become an important tool for enhancing healthcare outcomes. My topic is more concerned with the development of an evidence-based practice project aimed at reducing staff turnover rates in health care settings. Statistics have indicated that an estimated 15 to 36% turnover rate is experienced each year in hospitals across the United States (Stone, Hughes & Dailey, 2008). Increased turnover cause increases the cost of hiring and poor health outcomes. The process of developing an evidence-based project requires putting into consideration factors such as finances, quality and clinical factors. Financial factors indicate that the project should reduce the cost incurred by the health care systems in addition to requiring low implementation cost. For this project, the evidence-based practice will help to reduce the turnover rates hence saving on the finances of the health care system, which are incurred even by the patients. The project will make sure that the implementation does not exceed the expected cost-benefit of implementing the project. Assignment: financial aspect account for developing the evidence-based practice project Evidence-based practice should also be able to improve the quality of care or services offered to the people. It can be identified that having an adequate number of motivated staffs will help provide high-quality care to the patients. The provision of quality care plays an essential role in improving the wellbeing, promoting patients satisfaction and outcomes. Additionally, it is important to put clinical considerations in place when designing evidence-based practice. The project should meet the clinical needs and improve the overall healthcare outcomes. The nursing care homes have increased the need to have an adequate number of employees to provide quality acre thereby improving the health care outcomes of the people. Increased turnover reduces the clinical competence of promoting the safety of patients, which results in increased cost for insurers, family, care providers, and the patients thus should be avoided (Stone et al., 2008). References Stone, P. W., Hughes, R., & Dailey, M. (2008). Creating a safe and high-quality health care environment. Peer DQ4 Direct expenses are those that directly effect the operation of the hospital. Examples of direct expenses would be Nursing; staffing nurses are completely dependent upon the number of patients on the unit. Other examples of direct expenditures would be supplies needed to care for said number of patients. Indirect expenses are not a direct increase or decreasing item combined with patient count, things like facility monthly rent, salaries for upper management, and maintenance (Gartenstein, Devra., 2018, June 26). My capstone project is correctly utilizing the CIWA-ar scale and alcohol withdraw protocol to reduce morbidity/mortality and shorten length of stay. Education will be the primary way of implementing this evidence-based project (EBP) through having volunteer nurse champions to help educate staff, educational poster boards placed in staff rooms, and 2-minute presentation with educational fliers given at all huddles for a 7-10 period. Secondary execution would be to create a mandatory educational computer-based program, part of an e-learning video and quiz. Financial Aspects We hear the term value equation in our work area whether it be in cost control concerning staffing or proper utilization of the many different items needed for patient care (lines, iv start kits, products for ADLs, dressing materials, etc.). Improving our patients health by providing the best care through EBP is all healthcare providers goal. The cost of providing EBP must be considered in the value equation to be implemented. The steps for implementation start with; 1) determining the cost avoided 2) determining the cost of implementation 3) examining the return on investment (ROI) (Cullen, Laura, DNP, RN, and Hanrahan, Kirsten, DNP, ARNP, Jan. 9, 2018). My primary method of implementation requires the volunteered time by staff nurses to be champions for education presentations. These nurses would also be resources for staff to ask questions of while on shift. This primary method to help reduce morbidity/mortality and shorten length of stay would not negatively affect the financial aspects for the corporation, it would help it through shortened hospital stays. This EVP does not affect the indirect financial aspect to any degree as it is education driven. If my secondary method for implementation was to move forward that would affect the direct financial aspect through time and money put forward for the creation of my e-learning video and for all nursing staff to take. Indirectly it would affect the IT department and electricity expenditure for implementation. Quality Aspect Quality improvement utilizes systematic-reviews and data-guided methods to improve patient outcomes or processes. Clear definition of the processes or outcome need to be clearly defined, identify the measurement technique used, develop a plan for execution of said intervention while incorporating data collection before and after (Conner, Brian, T., June, 2014). My EBP has the potential to affect quality directly through correctly utilizing the CIWA-ar protocol which would improve the quality at which patients withdrawing from alcohol by experiencing better controlled symptoms and shortening length of stay. This can be measured through electronic health records of previous adult patients admitted to the hospital as primary or secondary diagnosis of alcohol withdraw assessing the average length of stay before implementation and 3-month period after implementation to determine average length of stay and any adverse effects of treatment. The indirect aspect of this proposal could affect patient satisfaction scores from those patients that were correctly treated under the CIWA-ar protocol. Clinical Aspects One major clinical aspect to be considered is finding the support staff to become the champions for the implementation of educating staff nurses. The desire to best address this type of patient will further the cause for additional help. I will present this EBP to the clinical directors and charge nurses for each floor and explain I am looking for volunteers to learn the importance of this EBP and further educate staff. I will also post education fliers with my contact information explaining the need for further support. The direct impact would be the time the clinical director and charge nurses will spend listening to the proposal. Staff nurses assisting this project will be volunteer basis and this will clinically advance all staff to properly apply the CIWA-ar protocol. This project in its primary function does not impact the company from the indirect aspect. References Conner, Brian, T., (June, 2014), Differentiating research, evidence-based practice, and quality improvement. Retrieved from: https://www.americannursetoday.com/differentiating Cullen, Laura, DNP, RN, and Hanrahan, Kirsten, DNP, ARNP, (Jan. 9, 2018), Evidence-Based Practice and the Bottom Line: An Issue of Cost, Retrieved from: https://www.hfma.org/Content.aspx?id=58754 Gartenstein, Devra. (2018, June 26). Examples of Direct and Indirect Costs. Small Business Chron.com. Retrieved from http://smallbusiness.chron.com/examples-direct-ind Peer DQ5 In the initiation phase of the project, it is imperative to plan the project and include the proposed solution to the identified issue. Direct patient care providers in the surgical department will be required to wear and activate their hand hygiene monitoring badges at the beginning of their shifts. The data will be analyzed on a daily, weekly and monthly basis for the first six months in a specific department. The data collected will be for each employee and will need to be statistically analyzed using a computer software program. When the staff member uses the hand washing station, the monitoring badges records the event and sends it to the computer software for analysis (Hygreen, 2011). Each staff member will have a unique identification number which will be recorded in the computer application, so that data for each staff member in the department is collected separately. ID number, time and date will be recorded and sent for analysis. Mandatory training sessions on proper hand hygiene procedures will be created and presented for the nursing staff of the surgical department. Posters on the proper hand hygiene techniques will be clearly displayed in all the patient rooms and hallways of the surgical department. The statistical analysis program will review the collected data and create plot charts, graphs and descriptive statistical data such as mode, median and mean for each staff members hand washing compliance and the overall compliance for that specific department. Compliance reports can be reviewed to see if the improvement project is working, whether or not there are any problems with equipment, if any employee has a high non-compliance with hand hygiene (so they can be interviewed) techniques. The data collected will allow the healthcare facility to determine if the hand hygiene monitoring systems should be implemented throughout the entire facility. My proposed solution to the poor hand hygiene compliance in the organization did not change over the course of this semester. Evidence shows that direct observation is not the most effective method to monitor hand hygiene compliance in the organization. However, scholarly literature shows that automatic monitoring badges are a much more effective than direct observations. David Hygreen. (2011). Hand Hygiene Recording and Reminding System. Retrieved from http://hygreen.com/ Peer DQ6 The increased challenge of hospital readmission of patients with heart failure has become a topic of concern. Prevention of hospital admission for heart failure patients has become a priority for clinicians, researchers, and stakeholders in the systems. According to Bergethon et al. (2014), the issue is sensitive because one in four heart failure patients is hospitalized thirty days following the discharge. The topic attracted me because if not controlled it will continue to affect the people and contributed to increased cost for the providers, insurers and the patients. Therefore, the primary purpose of my study was to identify the intervention that can be used to reduce the readmission rates. The interventions suggested may include planning for discharge and scheduling for follow up to keep track of the medical progress of these patients Additionally, it is important to offer patient education to allow the patients to beware of their condition and encourage them to take an active role in self-care, which may help reduce the readmission rates.The increased readmission has been attributed to lack of proper link up of the patients with the outpatient providers. The outpatient providers should be provided with adequate information regarding the discharged patients to ensure a good transition from inpatient to outpatient care. Therefore, it will become possible to administer the required medication and help to the patients, which reduces the risk of readmission. From the studies, it has been observed that although the reduction of admission rates can be hard to achieve, it is attainable. Development of effective strategies will greatly contribute to the reduction of readmission rates. Therefore, all the stakeholders in the healthcare system should collaborate to establish an evidence-based practice that will eliminate the issue. Nursing practitioners will need to conduct more research to come up with more strategies that can be utilized to solve the issue. Assignment: financial aspect account for developing the evidence-based practice project References Bergethon, K. E., Ju, C., DeVore, A. D., Hardy, N. C., Fonarow, G. C., Yancy, C. W., & Hernandez, A. F. (2016). Trends in 30-day readmission rates for patients hospitalized with heart failure: findings from the Get With the Guidelines-Heart Failure Registry. Circulation: Heart Failure , 9 (6), e002594. Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10
Assignment: financial aspect account for developing the evidence-based practice project
Assignment: financial aspect account for developing the evidence-based practice project ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON Assignment: financial aspect account for developing the evidence-based practice project please respond to the main discussion DQ1 and DQ2 with reference and also respond to the peer discussions Assignment: financial aspect account for developing the evidence-based practice project DQ1 After discussion with your mentor, name one financial aspect, one quality aspect, and one clinical aspect that need to be taken into account for developing the evidence-based practice project. Explain how your proposal will directly and indirectly impact each of the aspects. DQ2 Now that you have completed a series of assignments that have led you into the active project planning and development stage for your project, briefly describe your proposed solution to address the problem, issue, suggestion, initiative, or educational need and how it has changed since you first envisioned it. What led to your current perspective and direction? Peer DQ1 As per conversation with my mentor, one financial aspect that needs to be taken into account for developing the evidence-based project is the estimated budget that has to be approved by the management of the organization. While a quality aspect should always be to improve the current organizational rate. The clinical aspect is the improvement of patient care that is the main reason behind this evidence-based project. According to Sipes (2016), one of the primary responsibilities of a project manager is to successfully execute a project within the estimated budget, time, and quality standards. The budget is that backbone of every project. If the project manager does not have the necessary amount of money and a properly estimated budget, then the project will result in a failure. My mentor has taught me that a project manager has to fully understand the importance of cost estimation and budgeting from the initiation phases of the project. The amount of financial resources will dictate the duration and type of available operation and activities in the realm of a project. My project proposal will include an estimated budget, will be free of miscalculations, and will have a complete breakdown of the necessary budget. One quality aspect of my hand hygiene compliance improvement project is to increase the compliance rate of proper hand hygiene techniques in the department. According to my mentor, even though all the healthcare providers are aware that they have to wash and sanitize their hands throughout the shift, many of them do not use proper hand hygiene techniques or forget to wash their hands. Currently, the hand hygiene compliance rate in my healthcare organization is decreasing, as the rate of healthcare-associated infections has increased. In observational studies conducted in local city hospitals, direct healthcare providers washed or sanitized (with alcohol-based sanitizer) their hands on average from 5 to as many as 42 times per shift (World Health Organization, 2018). If the average shift is 8-12 hours that means that many direct care providers only washed/sanitized their hands between 1 and four times. These numbers are very low for a healthcare facility. The average shift of the direct patient care provider in my healthcare facility is 8 hours, and the average number of hand washing procedures performed during the shift has decreased from 5 per shift to 2.5 in the past year, which is half of the previous numbers. Assignment: financial aspect account for developing the evidence-based practice project One clinical aspect that needs to be taken into account when developing the evidence-based project is how the project will affect the delivery of patient care. The introduction of hand hygiene compliance monitoring badges is meant to improve the hand hygiene of the healthcare providers, but will it negatively impact the patient care? As a project manager, it is imperative to understand and try to predict the positive and negative clinical aspect that these monitoring badges will have on the delivery of patient care. Will it take time away from patient care? Will it decrease the number of hospital-acquired infections? My proposal of the hand-hygiene monitoring badges will not take time away from patient care because proper hand washing takes one minute, but the number of hospital-acquired infections can be significantly decreased. In American hospitals alone, the Centers for Disease Control (CDC) estimates that healthcare-associated infections (HAI) account for an estimated 1.7 million infections and 99,000 associated deaths each year (2018). Using proper hand washing and hand sanitizing techniques throughout the shift can decrease the number of HAIs in the healthcare organization. Hand washing is the fundamental way to prevent and reduce HAIs in hospital patients ( McCalla, Reilly, Thomas, McSpedon-Rai, 2017 ). David Centers for Disease Control and Prevention. (2018). Hand hygiene in healthcare settings. Retrieved from https://www.cdc.gov/handhygiene/index.html McCalla, S., Reilly, M., Thomas, R., & McSpedon-Rai, D. (2017). Major Article: An automated hand hygiene compliance system is associated with improved monitoring of hand hygiene. AJIC: American Journal of Infection Control , 45 (1), 492497. https://doi-org.chamberlainuniversity.idm.oclc.org Sipes, C. (2016). Project management for the advanced practice nurse. Retrieved from https://online.vitalsource.com World Health Organization. (2018). WHO guidelines on hand hygiene in health care: First Global Patient Safety Challenge . Clean Care is Safer Care . Retrieved from http://www.who.int/gpsc/5may/tools/9789241597906/e Peer DQ2 Evidence based health practices are often available for a various condition like asthma, heart failure, and diabetes. The practices are not always implemented in any care delivery. It is a problem-solving approach which incorporates the careful use of up to date, quality data in decisions regarding care of patients (Vaidya et al., 2017). Financial aspect Evidence based practice is an approach which involves many stages that require thorough check and finances to function well. A financial manager makes a detailed budget of how the method will work. Everything should be planned within the budget made by the financial manager. Every step is taken keenly for the practice to function well. Public authorities and professional organizations have tried to promote evidence-based practice to provide standard health services not leaving out national and international organizations (Melnyk et al., 2017). Since my project is on staffs or nurse turnover in nursing home or a long term care facility, the finances of the evidence-based practice will be very high. A lot of money is needed to set up a facility which is conducive for the patients and nurses who use the area. The finances may come from donors, well-wishers, investors and the government. Also, the place will be a nursing home for those patients with diabetes especially type two diabetes. It will provide kits for the patients to measure their blood glucose level even at the comforts of their homes. Nurse turnover is an undesirable trend for health care employers since it is expensive, disruptive and threatens the quality of care and patients safety (Vaidya et al., 2017). The nurses who are not performing well are assessed and released, and new ones who act are hired. It also requires the nurses satisfaction with the salary paid and the environment they work in. Finances for the nurses payroll and finances for hiring them are provided too (Vaidya et al., 2017). One quality aspect Evidence-based practice project requires a high percentage of quality for it to perform correctly. It is considered as a one quality point of developing the practice. Every step should be designed correctly to avoid non quality practice. Nurse turnover is one problem that can threaten the quality of care and patient safety in the facility. It should be taken care of since it is a sensitive matter (Melnyk et al., 2017). The quality of the nursing facility depends on the services the patients receive since t is the main agenda of the program. The practice should work to improve the quality of the nursing care facility every time for the patients to receive high standard services with high quality. Clinical aspect My project on staffs or nurse turnover in nursing home or long term care facility, clinical matters, and care will be handled with a lot of keenness. The patients will be taken care of in a right way and ensured proper services for them. The facility will be clean every time to avoid infections and diseases, have medical equipment that will help in testing and treat patients. They will be there to prevent issues of patients coming to the facility and dont receive any medication. It will directly have an impact on the practice because providing evidence before diagnosis, and the patients will be treated well (Melnyk et al., 2017). References Melnyk, B. M., Fineout?Overholt, E., Giggleman, M., & Choy, K. (2017). A Test of the ARCC© Model Improves Implementation of Evidence?Based Practice, Healthcare Culture, and Patient Outcomes. Worldviews on Evidence ? Based Nursing , 14 (1), 5-9. Vaidya, N., Thota, A. B., Proia, K. K., Jamieson, S., Mercer, S. L., Elder, R. W., & Zaza, S. (2017). Practice-Based Evidence in Community Guide Systematic Reviews. American journal of public health , 107 (3), 413-420. Peer DQ3 Evidence-based practice has become an important tool for enhancing healthcare outcomes. My topic is more concerned with the development of an evidence-based practice project aimed at reducing staff turnover rates in health care settings. Statistics have indicated that an estimated 15 to 36% turnover rate is experienced each year in hospitals across the United States (Stone, Hughes & Dailey, 2008). Increased turnover cause increases the cost of hiring and poor health outcomes. The process of developing an evidence-based project requires putting into consideration factors such as finances, quality and clinical factors. Financial factors indicate that the project should reduce the cost incurred by the health care systems in addition to requiring low implementation cost. For this project, the evidence-based practice will help to reduce the turnover rates hence saving on the finances of the health care system, which are incurred even by the patients. The project will make sure that the implementation does not exceed the expected cost-benefit of implementing the project. Assignment: financial aspect account for developing the evidence-based practice project Evidence-based practice should also be able to improve the quality of care or services offered to the people. It can be identified that having an adequate number of motivated staffs will help provide high-quality care to the patients. The provision of quality care plays an essential role in improving the wellbeing, promoting patients satisfaction and outcomes. Additionally, it is important to put clinical considerations in place when designing evidence-based practice. The project should meet the clinical needs and improve the overall healthcare outcomes. The nursing care homes have increased the need to have an adequate number of employees to provide quality acre thereby improving the health care outcomes of the people. Increased turnover reduces the clinical competence of promoting the safety of patients, which results in increased cost for insurers, family, care providers, and the patients thus should be avoided (Stone et al., 2008). References Stone, P. W., Hughes, R., & Dailey, M. (2008). Creating a safe and high-quality health care environment. Peer DQ4 Direct expenses are those that directly effect the operation of the hospital. Examples of direct expenses would be Nursing; staffing nurses are completely dependent upon the number of patients on the unit. Other examples of direct expenditures would be supplies needed to care for said number of patients. Indirect expenses are not a direct increase or decreasing item combined with patient count, things like facility monthly rent, salaries for upper management, and maintenance (Gartenstein, Devra., 2018, June 26). My capstone project is correctly utilizing the CIWA-ar scale and alcohol withdraw protocol to reduce morbidity/mortality and shorten length of stay. Education will be the primary way of implementing this evidence-based project (EBP) through having volunteer nurse champions to help educate staff, educational poster boards placed in staff rooms, and 2-minute presentation with educational fliers given at all huddles for a 7-10 period. Secondary execution would be to create a mandatory educational computer-based program, part of an e-learning video and quiz. Financial Aspects We hear the term value equation in our work area whether it be in cost control concerning staffing or proper utilization of the many different items needed for patient care (lines, iv start kits, products for ADLs, dressing materials, etc.). Improving our patients health by providing the best care through EBP is all healthcare providers goal. The cost of providing EBP must be considered in the value equation to be implemented. The steps for implementation start with; 1) determining the cost avoided 2) determining the cost of implementation 3) examining the return on investment (ROI) (Cullen, Laura, DNP, RN, and Hanrahan, Kirsten, DNP, ARNP, Jan. 9, 2018). My primary method of implementation requires the volunteered time by staff nurses to be champions for education presentations. These nurses would also be resources for staff to ask questions of while on shift. This primary method to help reduce morbidity/mortality and shorten length of stay would not negatively affect the financial aspects for the corporation, it would help it through shortened hospital stays. This EVP does not affect the indirect financial aspect to any degree as it is education driven. If my secondary method for implementation was to move forward that would affect the direct financial aspect through time and money put forward for the creation of my e-learning video and for all nursing staff to take. Indirectly it would affect the IT department and electricity expenditure for implementation. Quality Aspect Quality improvement utilizes systematic-reviews and data-guided methods to improve patient outcomes or processes. Clear definition of the processes or outcome need to be clearly defined, identify the measurement technique used, develop a plan for execution of said intervention while incorporating data collection before and after (Conner, Brian, T., June, 2014). My EBP has the potential to affect quality directly through correctly utilizing the CIWA-ar protocol which would improve the quality at which patients withdrawing from alcohol by experiencing better controlled symptoms and shortening length of stay. This can be measured through electronic health records of previous adult patients admitted to the hospital as primary or secondary diagnosis of alcohol withdraw assessing the average length of stay before implementation and 3-month period after implementation to determine average length of stay and any adverse effects of treatment. The indirect aspect of this proposal could affect patient satisfaction scores from those patients that were correctly treated under the CIWA-ar protocol. Clinical Aspects One major clinical aspect to be considered is finding the support staff to become the champions for the implementation of educating staff nurses. The desire to best address this type of patient will further the cause for additional help. I will present this EBP to the clinical directors and charge nurses for each floor and explain I am looking for volunteers to learn the importance of this EBP and further educate staff. I will also post education fliers with my contact information explaining the need for further support. The direct impact would be the time the clinical director and charge nurses will spend listening to the proposal. Staff nurses assisting this project will be volunteer basis and this will clinically advance all staff to properly apply the CIWA-ar protocol. This project in its primary function does not impact the company from the indirect aspect. References Conner, Brian, T., (June, 2014), Differentiating research, evidence-based practice, and quality improvement. Retrieved from: https://www.americannursetoday.com/differentiating Cullen, Laura, DNP, RN, and Hanrahan, Kirsten, DNP, ARNP, (Jan. 9, 2018), Evidence-Based Practice and the Bottom Line: An Issue of Cost, Retrieved from: https://www.hfma.org/Content.aspx?id=58754 Gartenstein, Devra. (2018, June 26). Examples of Direct and Indirect Costs. Small Business Chron.com. Retrieved from http://smallbusiness.chron.com/examples-direct-ind Peer DQ5 In the initiation phase of the project, it is imperative to plan the project and include the proposed solution to the identified issue. Direct patient care providers in the surgical department will be required to wear and activate their hand hygiene monitoring badges at the beginning of their shifts. The data will be analyzed on a daily, weekly and monthly basis for the first six months in a specific department. The data collected will be for each employee and will need to be statistically analyzed using a computer software program. When the staff member uses the hand washing station, the monitoring badges records the event and sends it to the computer software for analysis (Hygreen, 2011). Each staff member will have a unique identification number which will be recorded in the computer application, so that data for each staff member in the department is collected separately. ID number, time and date will be recorded and sent for analysis. Mandatory training sessions on proper hand hygiene procedures will be created and presented for the nursing staff of the surgical department. Posters on the proper hand hygiene techniques will be clearly displayed in all the patient rooms and hallways of the surgical department. The statistical analysis program will review the collected data and create plot charts, graphs and descriptive statistical data such as mode, median and mean for each staff members hand washing compliance and the overall compliance for that specific department. Compliance reports can be reviewed to see if the improvement project is working, whether or not there are any problems with equipment, if any employee has a high non-compliance with hand hygiene (so they can be interviewed) techniques. The data collected will allow the healthcare facility to determine if the hand hygiene monitoring systems should be implemented throughout the entire facility. My proposed solution to the poor hand hygiene compliance in the organization did not change over the course of this semester. Evidence shows that direct observation is not the most effective method to monitor hand hygiene compliance in the organization. However, scholarly literature shows that automatic monitoring badges are a much more effective than direct observations. David Hygreen. (2011). Hand Hygiene Recording and Reminding System. Retrieved from http://hygreen.com/ Peer DQ6 The increased challenge of hospital readmission of patients with heart failure has become a topic of concern. Prevention of hospital admission for heart failure patients has become a priority for clinicians, researchers, and stakeholders in the systems. According to Bergethon et al. (2014), the issue is sensitive because one in four heart failure patients is hospitalized thirty days following the discharge. The topic attracted me because if not controlled it will continue to affect the people and contributed to increased cost for the providers, insurers and the patients. Therefore, the primary purpose of my study was to identify the intervention that can be used to reduce the readmission rates. The interventions suggested may include planning for discharge and scheduling for follow up to keep track of the medical progress of these patients Additionally, it is important to offer patient education to allow the patients to beware of their condition and encourage them to take an active role in self-care, which may help reduce the readmission rates.The increased readmission has been attributed to lack of proper link up of the patients with the outpatient providers. The outpatient providers should be provided with adequate information regarding the discharged patients to ensure a good transition from inpatient to outpatient care. Therefore, it will become possible to administer the required medication and help to the patients, which reduces the risk of readmission. From the studies, it has been observed that although the reduction of admission rates can be hard to achieve, it is attainable. Development of effective strategies will greatly contribute to the reduction of readmission rates. Therefore, all the stakeholders in the healthcare system should collaborate to establish an evidence-based practice that will eliminate the issue. Nursing practitioners will need to conduct more research to come up with more strategies that can be utilized to solve the issue. Assignment: financial aspect account for developing the evidence-based practice project References Bergethon, K. E., Ju, C., DeVore, A. D., Hardy, N. C., Fonarow, G. C., Yancy, C. W., & Hernandez, A. F. (2016). Trends in 30-day readmission rates for patients hospitalized with heart failure: findings from the Get With the Guidelines-Heart Failure Registry. Circulation: Heart Failure , 9 (6), e002594. Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10
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