Nursing Practice Practice Problem Proposal Comprehensive Nursing Essay Example
Part 1: Propose a relevant nursing practice problem for an evidence-based practice project. Explain why you selected this topic and how it is relevant to advance nursing practice. Include one research article that demonstrates support for the nursing practice problem.(Nursing Practice Practice Problem Proposal Comprehensive Nursing Essay Example)
Overcrowding in the Emergency Department and delays lead to significant consequences related to public health. In most hospital settings across the US, this systemic issue is widely acknowledged to negatively impact boarding in the ED, increased left without being seen rates, inability by the public to enjoy timely access to care, and ambulance diversion. Most importantly, managing overcrowding in the ED requires a multimodal approach to addressing this multifaceted problem. Several measures and strategies have been implemented, including triage of critical care patients, constant relay of information concerning the influx of patients, and assigning and identifying bed availability across the hospital to secure optimal throughput. In the selected site of the proposed PICOT-based evidence-based project, a novel bed traffic control was implemented to manage bed utilization and placement to facilitate even distribution of patients premised on their medical needs. The proposed project site is a California community hospital offering acute care located in a rural county of this state. Before outlining the proposed intervention, it is essential to look at the negative consequences of overcrowding in the ED.(Nursing Practice Practice Problem Proposal Comprehensive Nursing Essay Example)
According to Stahley et al. (2020), ED overcrowding translates to extended wait times in the ED and long visit lengths, both of which lead to decreased quality of care and increased incidence of adverse events among patients who are critically ill. On the other hand, long wait times make some patients leave the ED without being seen. Suffice it to say that increased LWBS rates compromise patient safety, the quality of care and mean decreased hospital revenue. The list of adverse effects of ED overcrowding spill over to high rate of staff turnover, an overburdened hospital workforce, inability by the healthcare organization to offload emergency medical services to patients on time, increased medical errors, poor patient outcomes, poor patient satisfaction scores, and high hospital operating costs to mention just but a few. Subsequently, the successful implementation of the proposed intervention would help resolve these consequences in a significant way.(Nursing Practice Practice Problem Proposal Comprehensive Nursing Essay Example)
Digiacomo et al. (2018) opine that adopting a be bed ahead in a hospital system would resolve the delay in transferring patients from one point of care to the next necessary point through effective utilization of bed traffic control (BTC). It would, for example, move the patient from the ED to the inpatient. Therefore, the proposed intervention is an EBP process change that alters the existing method of bed assignments. Under the bed ahead concept, the movement of inpatients admitted to the medical-surgical unit using appropriate change implementation principles. Adopting a bed ahead concept for assigning beds would eliminate several steps present in the existing process and therefore proactively lead to a decrease in delays at the time of admission and ED length of stay (LOS).(Nursing Practice Practice Problem Proposal Comprehensive Nursing Essay Example)
In summary, the proposed EBP ptoject is expected to be guided by a PICOT based question that states ‘For ED patients aged 18 years or more and admitted to the medical- surgical unit of a healthcare organization offering acute care (Population-P), does the implementation of bed ahead concept- based system(Intervention-I) compared to the current system system of bed assigning (Comparison-C) lead to decreased delays at the time of admission and subsequent LOS (Outcome-O) within 4 months of the project’s implementation? Time-T)’(Nursing Practice Practice Problem Proposal Comprehensive Nursing Essay Example)
Part II: In the table below, describe the population and the intervention. (You will continue drafting the PICOT, completing the shaded areas in Topic 3.)(Nursing Practice Practice Problem Proposal Comprehensive Nursing Essay Example)
PICOT Question | ||
P | Population | Adult patients admitted in the medical- surgical unit of the proposed site of the EBP project implementation |
I | Intervention | Adoption of ‘ be a bed ahead concept’ to the hospital system |
C | Comparison | Compared to the current system system of bed assigning |
O | Outcome | Lead to decreased delays at the time of admission and subsequent LOS |
T | Timeframe | Within 4 months of the project’s implementation |
PICOT | For ED patients aged 18 years or more and admitted to the medical- surgical unit of a healthcare organization offering acute care (Population-P), does the implementation of bed ahead concept- based system(Intervention-I) compared to the current system system of bed assigning (Comparison-C) lead to decreased delays at the time of admission and subsequent LOS (Outcome-O) within 4 months of the project’s implementation? Time-T)(Nursing Practice Practice Problem Proposal Comprehensive Nursing Essay Example) | |
Problem Statement |
References
Stahley, L., O’Brien, P. B., Lowe, M., Porteous, P., & Austin, S. (2020). The impact of bed traffic control and improved flow process on throughput measures in a metropolitan emergency department. Journal of emergency nursing, 46(5), 682-692.(Nursing Practice Practice Problem Proposal Comprehensive Nursing Essay Example)
DiGiacomo, J. C., Angus, L. G., Wallace, R., Cardozo-Stolberg, S., Gerber, N., Munnangi, S., … & Skarka, K. (2020). The Impact of an ICU “Bed Ahead” Policy on ED Length of Stay and Patient Outcomes. Annals of surgery, 271(2), 303-310.(Nursing Practice Practice Problem Proposal Comprehensive Nursing Essay Example)