NURS 8002 Week 7 Discussion: The Doctorally Prepared Nurse: Community of Practice
Sample Answer for NURS 8002 Week 7 Discussion: The Doctorally Prepared Nurse: Community of Practice Included After Question
What is meant by a community of practice?
A community of practice represents a group of individuals who share a common purpose and desire to positively impact their practice and share ideas, perspectives, and lessons learned to enhance the proficiency with which to engage in practice.
Not surprisingly, as a profession, nursing already represents a critical community of practice. Moreover, DNP-prepared nurses are uniquely poised to lead and install changes of a transformative capacity within a community of practice due to their skill set of understanding and engaging in evidence-based practice. As a future DNP-prepared nurse, how do you see yourself engaging with or leading a community of practice?
This week, you will examine community and organizational needs, challenges, and issues. You will analyze the role of the DNP-prepared nurse in addressing these needs, challenges, and issues in your Blog Assignment. You will also consider and recommend practice changes that will meet community and organizational needs, challenges, and issues.
Learning Objectives
Students will:
- Evaluate community and organization needs, challenges, and issues
- Analyze the role of the DNP-prepared nurse in addressing community and organization needs, challenges, and issues
- Recommend practice changes and interventions that address community and organization needs, challenges, and issues
Learning Resources
Required Readings (click to expand/reduce)
Blog: The DNP-Prepared Nurse and Their Community
Vaccine and immunization legislation.
Nutritional assistance programs for school youths.
Diabetes education for elderly outpatients in a community health clinic.
Reducing the number of re-admits of patients who have had outpatient procedures.
Reducing the number of patient falls on a medical/surgical hospital floor.
Photo Credit: Getty Images/iStockphoto
These represent a few community and organizational needs, challenges, and issues that may require and merit the advocacy, skill set, and knowledge of the DNP-prepared nurse. In your role as a DNP-prepared nurse, you may find yourself the champion and advocate for improved health outcomes both at a local and individual patient level to one of a national or global and population-based level. The DNP-prepared nurse is well poised to address and advocate changes not only in a healthcare setting but in a community context to promote positive social change and positive health-based outcomes.
For this Discussion, reflect on those needs, challenges, and issues that may be most important for your community or organization. Why do these needs, challenges, and issues merit the attention of a DNP-prepared nurse?
To prepare:
- Review the Learning Resources for this week and consider those local issues/topics that are most important for your community or organization. Find articles about your community or organization that reflect the need for intervention by a doctorally prepared nurse.
- Reflect on why these local issues/topics merit addressing from your perspective as a DNP-prepared nurse.
- Reflect on your role as the DNP-prepared nurse to address these local issues/topics and consider what type of practice changes or interventions you might recommend to bring about needed change for your community or organization.
By Day 3 of Week 7
Post a response to your Blog in which you describe at least two of the most important needs/challenges/issues in your community or organization. Why are these needs/challenges/issues important? Be specific. Then, recommend at least two practice changes or interventions you would suggest to address these needs/challenges/issues in your community or organization. Be sure to align your role as the DNP-prepared nurse to the competencies identified in the AACN Essentials.
By Day 5 of Week 7
Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days by suggesting additional strategies your colleague could implement to bring about needed change in their community.
Submission and Grading Information
Grading Criteria
To access your rubric:
Week 7 Blog Rubric
Post by Day 3 of Week 7 and Respond by Day 5 of Week 7
To Participate in this Blog:
Week 7 Blog
What’s Coming Up in Module 4?
Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images
In the next module, you will explore and analyze approaches for summarizing peer-reviewed research. You will also contrast which approaches are most helpful in summarizing peer-reviewed research.
Next Module
A Sample Answer For the Assignment: NURS 8002 Week 7 Discussion: The Doctorally Prepared Nurse: Community of Practice
Title: NURS 8002 Week 7 Discussion: The Doctorally Prepared Nurse: Community of Practice
Needs, Challenges, and Issues Within Community
Throughout my career in the Orlando, Florida area, I have noticed several needs, challenges, and issues within healthcare. One of those issues I have noticed frequently is adherence to dialysis schedules. In the perioperative area, we regularly have dialysis patients who require surgeries or procedures. When interviewing these patients during the preoperative phase, I have noticed several of these patients do not adhere to a dialysis schedule. They miss dialysis frequently, for a variety of reasons. Missing a dialysis appointment can have several adverse effects. The patients may experience dyspnea, pulmonary edema, and stress on their cardiovascular system from missing sessions (Alikari et al., 2019). Skipping dialysis sessions can also lead to increased mortality rates (Alikari et al., 2019). Therefore, it is extremely important for the patient to adhere to their dialysis schedules. This is a worrisome trend that could benefit from a practice change or intervention.
Another issue I have noticed recently within my own organization is the elopement of involuntary psychiatric hold patients. As a charge nurse, I attend a daily safety meeting that includes all the departments of the hospital. Recently, there have been several instances of psychiatric patients with sitters who have eloped and have not been returned. This is a huge safety issue. The psychiatric patient who is under an involuntary hold is placed on this hold because they have been assessed as a threat to themselves or others. To keep the patient from harming themselves or others, they are watched 24/7 by a patient sitter. To have several episodes of these patients eloping and not being returned is troublesome. If these patients elope, there is an increased risk of an adverse safety event happening.
Practice Changes and Interventions
To assist with dialysis patient’s adherence to their dialysis schedules, the DNP-prepared nurse could suggest implementing an educational program. This approach was suggested by Alikari et al. (2019). During their study, they found patients greatly benefitted from educational programs (Alikari et al., 2019). These nurse-led educational programs focused on the patient being a “partner” in their health care, as opposed to just being told what to do (Alikari et al., 2019). I believe implementing such a program with the dialysis patients at my organization would be extremely beneficial.
To decrease the number of involuntary psychiatric hold patient elopements, the implementation of a “behavioral response team (BRT)” may be beneficial. Bravo (2017) describe the focus of the team, which is “to respond, de-escalate disruptive behaviors, educate less experienced nursing units and increase safety.” These teams could intervene in an escalating patient behavior situation and perhaps diffuse the situation, thus preventing patient elopement. Implementation of these teams could increase the safety of both the patients and the staff in these situations.
Alignment with AACN Essentials
Addressing these issues within my organization and community, along with implementing practice changes is a major role of the DNP-prepared nurse. The practice changes outlined in this blog post align with the American Association of Colleges of Nursing (AACN)’s DNP Essentials. The implementation of a nurse-led educational program for dialysis patient aligns with DNP Essential VII, which is Clinical Prevention and Population Health for Improving the Nation’s Health (AACN, 2006). This essential focuses on “health promotion and risk reduction” for populations (AACN, 2006). By assessing the needs of dialysis patients, the DNP-prepared nurse can implement ways to reduce the risk of missing dialysis sessions and the adverse outcomes that can be a result. The implementation of BRT in a hospital algins with the DNP Essential II, which is Organizational and Systems Leadership for Quality Improvement and Systems Thinking (AACN, 2006). This essential states DNP-prepared nurses must be able to “focus on the needs of a panel of patients, a target population” and “conceptualize new care delivery models” (AACN, 2006). By implementing a BRT as a standard of practice with involuntary psychiatric holds, this is creating a new delivery of care for this target population. DNP-prepared nurses are expected to assess the needs of an organization or population and implement new ways to achieve quality care.
References
Alikari, V., Tsironi, M., Matziou, V., Tzavella, F., Stathoulis, J., Babatsikou, F., Fradelos, E., & Zyga, S. (2019). The impact of education on knowledge, adherence and quality of life among patients on haemodialysis. Quality of Life Research, 28(1), 73-83. https://doi.org/10.1007/s11136-018-1989-y
American Association of Colleges of Nursing. (2006). The essentials of doctoral education for advanced nursing practice. https://www.aacnnursing.org/Portals/42/Publications/DNPEssentials.pdf
Bravo, J. (2017). The behavioral response team: building a safer hospital. Journal of Healthcare Protection Management, 33(1), 113-117. Retrieved from the Walden University Library databases.
A Sample Answer 2 For the Assignment: NURS 8002 Week 7 Discussion: The Doctorally Prepared Nurse: Community of Practice
Title: NURS 8002 Week 7 Discussion: The Doctorally Prepared Nurse: Community of Practice
Thank you for your excellent main post addressing the needs, challenges, and issues with your community, along with some appropriate practice changes and interventions based on specific essentials. You choose to address the following: 1) dialysis scheduling and 2) elopement of involuntary psychiatric hold patients. Both of these were addressed with practice changes such as 1) dialysis patients – staff educational program aligned with DNP Essential VII, and 2) for involuntary psychiatric hold patient elopements, the implementation of a “behavioral response team (BRT)” aligned with DNP Essential II. You seem to have a keen eye when evaluating your community health needs and have proporsed appropriate solutions.
I agree something needs to be done for both those issues. Essential II: Organizational and Systems Leadership for Quality Improvement and Systems Thinking allows the DNP graduate nurse to review and help amend policy within the system (American Association of Colleges of Nursing, 2006). For those eloping patients, there has to be a whole in the system of the organization that is allowing them to leave. At my current facility, there are different levels of sitters. For those that are at an elopement risk, they would require a higher level sitter, trained to handle these types of psych patients. Security is also notified for those who are not assigned to the psych unit. The security would round on those who have been placed on a regular Med-Surg floor because those floors are not locked down. We also have a behavior health code. Our employees have a button on our badge that when pressed sends out an alert. It knows our location based on the position of our badge and will echo the call to that area. The facility that I work at now has a great number of patients going through withdrawal. The changes to their system were necessary for this population of patients. Your facility will have to change its system thinking to prepare for this new population of patients.
Reference
A Sample Answer 3 For the Assignment: NURS 8002 Week 7 Discussion: The Doctorally Prepared Nurse: Community of Practice
Title: NURS 8002 Week 7 Discussion: The Doctorally Prepared Nurse: Community of Practice
I agree dialysis is a hard commitment for a lot of patients to uphold. According to Medline plus (n.d.) patients have three treatments a week, takes 3-4 hours each time, and appointments are scheduled same time, same days a week. I would implement a questionnaire to see why are patients not able to adhere to the schedule. Then based on the answers from the questionnaire offer resources.
Education is a huge piece as well. It’s important to educated and re-educate on a consistent basis. The AANC essentials speak about using technology to support and improve patient care and health care system, and provide leadership within health care systems like a dialysis clinic using web-based learning or intervention tools to support and improve patient care (ANCC, 2006).
Resource:
U.S. National Library of Medicine. (n.d.). Dialysis centers – what to expect: Medlineplus medical encyclopedia. MedlinePlus. https://medlineplus.gov/ency/patientinstructions/000706.htm#:~:text=What%20to%20Expect%201%20Your%20access%20area%20will,to%20the%20dialysis%20machine.%20…%20More%20items…%20.
American Association of Colleges of Nursing. (2006). The essentials of doctoraleducation for advanced nursing practice. https://www.aacnnursing.org/Portals/42/Publications/DNPEssentials.pdf
A Sample Answer 4 For the Assignment: NURS 8002 Week 7 Discussion: The Doctorally Prepared Nurse: Community of Practice
Title: NURS 8002 Week 7 Discussion: The Doctorally Prepared Nurse: Community of Practice
Hi Tiffany, great post. You are definitely correct that dialysis patients are at serious risk of adverse effects when they do not commit to dialysis. You brought up some great points about how to encourage them to make their visits. Educational programs are a great idea, and can lead to being inspirational for the patient. Sulka, as cited by Wilkins (2021) points out that when we look at overall health in the community, you really have to go beyond the clinical picture. She makes a great point considering how important it is to get to the root of why patients are missing dialysis appointments. To your point regarding making them a partner in their own healthcare, this is definitely key. White et al. (2021) notes with respect to patients and their families, accountable care changes clinicians and systems with keeping patients and their goals in the center of all planning and caregiving. Making them a partner while making them accountable is a great way to help them better understand the significance of the care. Great plans!
References
Wilkins, T. (2021). Gwinnett’s health department shares data on health and community
Disparities. Data dashboard: Gwinnett, Newton and Rockdale counties: Community
Health. Retrieved October 12, 2021, from https://www.ajc.com/neighborhoods/gwinnett/
gwinnetts-health-…h-and-community-disparities/K5GSI6IZFREONGQIXPNQTDEHWI/
White, K. M., Dudley-Brown, S., and Terhaar, M. F. (2021). Translation of evidence into nursing
And healthcare (3rd ed.). Education:An enabler of translation. Springer Publishing
Company.
A Sample Answer 5 For the Assignment: NURS 8002 Week 7 Discussion: The Doctorally Prepared Nurse: Community of Practice
Title: NURS 8002 Week 7 Discussion: The Doctorally Prepared Nurse: Community of Practice
I am speaking about CPI in my blog post as a way to address lack of appropriate care for psych patients but I have of course heard of the Behavioral Response Team. I actually wrote about it quite awhile back as (before this course) an evidence based intervention and what I found was it did reduce behavioral incidents in all of the studies that I looked at. With that being said, there was limited data. The same could be said about the research around implementing CPI outside of psych and all other behavioral interventions outside of mental health. The reason for this is sad and it is that most staff outside of that specialty need help in that area so I think it is great that we have multiple people in this group who care about it.
This is insightful Tiffany. There are different problems faced by healthcare institutions in different communities. These problems/challenges are always unique depending on the methods of treatments and types of complications that are under consideration (Alikari et al., 2019). Adherence to dialysis schedules often become a challenge for most healthcare institutions. Given the long distance that patients have to travel to get dialysis, some people may miss the stated deadlines required (Liu et al., 2021). Missing a dialysis appointment can have several adverse effects. The patients may experience dyspnea, pulmonary edema, and stress on their cardiovascular system from missing sessions (Tohme et al., 2017). One of the best approach to manage the increasing cases of missed dialysis is to create reminders for the patients; this is possible through the use of the modern technologies that can be installed in the Smartphones. From the research studies, missed dialysis often interfere with the quality treatment outcomes. Most of the patients who miss dialysis often experience further complications in the process of treatment.
References
Alikari, V., Tsironi, M., Matziou, V., Tzavella, F., Stathoulis, J., Babatsikou, F., Fradelos, E., & Zyga, S. (2019). The impact of education on knowledge, adherence and quality of life among patients on haemodialysis. Quality of Life Research, 28(1), 73-83. https://doi.org/10.1007/s11136-018-1989-y
Liu, M. W. C., Syukri, M., Abdullah, A., & Chien, L. Y. (2021). Missing In-Center Hemodialysis Sessions among Patients with End Stage Renal Disease in Banda Aceh, Indonesia. International Journal of Environmental Research and Public Health, 18(17), 9215. https://www.mdpi.com/1660-4601/18/17/9215
Tohme, F., Mor, M. K., Pena-Polanco, J., Green, J. A., Fine, M. J., Palevsky, P. M., & Weisbord, S. D. (2017). Predictors and outcomes of non-adherence in patients receiving maintenance hemodialysis. International urology and nephrology, 49(8), 1471-1479. https://link.springer.com/article/10.1007/s11255-017-1600-4
A Sample Answer 6 For the Assignment: NURS 8002 Week 7 Discussion: The Doctorally Prepared Nurse: Community of Practice
Title: NURS 8002 Week 7 Discussion: The Doctorally Prepared Nurse: Community of Practice
Great ideas for practice problems that need to be addressed. The issue of assisting dialysis patients on the importance of not skipping treatment is of high importance. I have worked as a dialysis nurse and definitely understand this issue. You are correct in stating that they miss appointments for different reasons. It is important for the nurse to educate the patient on the importance to adhering to their schedule treatment time. I worked in outpatient dialysis, and called EMS many times for patients who were receiving treatment after skipping treatment. The DNP Essential, Clinical Prevention and Population Health for Improving the Nation’s Health aligns perfectly with this practice problem, as it focuses on health promotion and risk reduction (AACN, 2006).
Reference
American Association of Colleges of Nursing. (2006). The essentials of doctoral education for advanced nursing practice. https://www.aacnnursing.org/Portals/42/Publications/DNPEssentials.pdf
COLLAPSE
Dear Class:
Look forward to a ROBUST discussion and sharing of your community knowledge and experience during Week 7! Please think about the following:
- Reflect on unique community needs, challenges, and issues
- Reflect on why these local issues/topics merit addressing from your perspective as a DNP-prepared nurse.
- Reflect on your role as the DNP-prepared nurse to address these local issues/topics and consider what type of practice changes or interventions you might recommend to bring about needed change for your community or organization.
Look forward to your posts soon!
A Sample Answer 7 For the Assignment: NURS 8002 Week 7 Discussion: The Doctorally Prepared Nurse: Community of Practice
Title: NURS 8002 Week 7 Discussion: The Doctorally Prepared Nurse: Community of Practice
Reducing the number of re-admits of patients who have had outpatient procedures.
Working in the transitional care unit hospital, I have witnessed numerous of re-admissions from outpatient procedures and inpatient. Re-admit issues are patients not adhering to discharge plans, medication adherence, and not showing up to follow-up appointments. Lack of not adhering to discharge plans patients sometimes develop an infection at the procedure sites, which causes longer recovery time for patients. Also, not adhering to medication regimens could lead to adverse drug events. Hospital re-admit is associated with adverse patient outcomes and results in high financial costs. Due to the increased cases of hospital re-admit for both inpatient and outpatient procedures, Medicare and Medicaid Services have penalties hospitals/providers for their 30-days re-admit rates based on reimbursement fees.
Some intervention that could help reduce re-admit of patients and aligning the AACN Essentials of DNP are:
Essential II: Organizational and Systems Leadership for Quality Improvement and Systems Thinking – DNP-prepared nurses could help reduce re-admit of patients by employ principles of business, finance, economics, and health policy to develop and implement effective plans for practice-level and system-wide practice initiatives that will improve the quality-of-care delivery. Analyze the cost-effectiveness of practice initiatives accounting for risk and improvement of health care outcomes (AACN, 2006). An example of essential II, DNP-prepared nurses could implement a transitional care process adhering to Medicare and Medicaid concerns about re-admit and hospital/provider penalties cost. Transitional care processes are designed to prevent re-admit by conducting teach-back methods (checking comprehension of information learned). The patient or caregiver demonstrates what they have learned in their plan of care information to the nurse. Another intervention is the implementation of a discharge checklist- this is where nurses go over with patients before discharging a patient’s living situation, need for prosthetic items, need for home health, availability of a caregiver, transportation needs to go to follow-up appointments. Also, medication reconciliation before discharge- this is where medications are reviewed before discharge to ensure that all medication changes (new medication, dose change on previously prescribed medication, and elimination of medication) are accurate in patient’s medical records (Pugh et al., 2021). These interventions could help reduce the cost of re-admit issues in outpatient procedures and inpatient.
Essential VI: Interprofessional Collaboration for Improving Patient and Population Health Outcomes Employ effective communication and collaborative skills to develop and implement practice models, peer review, practice guidelines, health policy, and standards of care (AACN, 2006). An example of essential VI is where DNP- prepared nurses collaborate with other team members to help prevent patients re-admit. Some interventions include communicating medical plans in front of patients during physician team rounds. Discussions are held in the patient rooms and engaging patients regarding discharge treatment plans involving physician teams, nurses, and other team members. Another intervention is collaborating with staff routinely to assess patients for rehabilitation services during discharge planning to PT/OT at home, PT/OT outpatient, inpatient rehabilitation, or SNF (Pugh et al., 2021).
Reducing the number of patient falls on a medical/surgical hospital floor.
Other issues that I have witnessed in the hospital are high fall incidence in the med surg floors. Patient falls and re-admit are two of the biggest Centers for Medicare and Medicaid Services list of non-reimbursable events in the hospital. Patient falls on the hospital floors are problematic safety concerns that can be prevented with the correct intervention protocol. Falling can range from minor bruises and abrasions to more severe results such as fractures, lacerations, head injuries, and even death. Some patients are not even aware of being identified as fall risk patients while in the hospital (Cuttler et al., 2017). Fall risk identification should be placed on patients’ communication board in the room, place a yellow wristband on patients, and place a fall risk sign on the outside door of patients to help prevent falls on the hospital floor. Also, making sure on staff shift, patients bed exit alarm are turned on.
Some intervention that could help reduce patient falls in hospital floor and aligning the AACN Essentials of DNP are:
Essential IV: Information Systems/Technology and Patient Care Technology for the Improvement and Transformation of Health Care. Design, select, use, and evaluate programs that evaluate and monitor outcomes of care, care systems, and quality improvement, including consumer use of health care information systems (AACN, 2006). Using essential IV to prevent patient falls in the hospital setting is critical. DNP-prepared nurses could implement fall risk interventions such as using the bed exit alarm alerting nurses when a patient attempts to get out of bed. While the bed exit alarm is integrated into the patient’s bed, staff can ensure the patients belonging are at arm’s reach. Also, using the patient’s electronic health records (EHR) to document fall risk intervention conducted on staff shift. Implementing bed alarms on, offering toileting, and remaining with the patient when they are out of bed can help reduce falls in the hospital setting
Essential VI: Interprofessional Collaboration for Improving Patient and Population Health Outcomes. DNP-prepared nurses could collaborate with staff and patients on the importance of adhering to fall intervention in the hospital. Some interventions to help prevent falls in the hospital are having in place a fall safety agreement. This agreement included the patient being educated on fall risk prevention strategies and acknowledging that falling can cause serious injuries. Also, conducting an in-service staff safety huddle during shift change. In safety huddles, the staff are instructed to ensure all patients receive the fall prevention education, fall risk health assessment, and documented and a signed patient fall safety agreement upon admission or transfer to the unit. Also, collaborating with staff to ensure high-risk fall patients are provided with nonskid socks, gait belts, and yellow wrist bands are all safety interventions to reduce patient fall risk on the hospital floor (Bargmann & Brundrett, 2020).
Reference
American Association of College of Nursing. (2006). The esstenial of doctoral education for advanced nursing practice. https://www.aacnnursing.org/Portals/42/Publications/DNPEssentials.pdf
Bargmann, A. L., & Brundrett, S. M. (2020). Implementation of a Multicomponent Fall Prevention Program: Contracting With Patients for Fall Safety. Oxford University Press, 185(2), 28-34. https://doi.org/10.1093/milmed/usz411
Cuttler, S. J., Barr-Walker, J., & Cuttler, L. (2017). Reducing medical-surgical inpatient falls and injuries with videos, icons and alarms. BMJ open quality, 6(2), e000119. https://doi.org/10.1136/bmjoq-2017-000119
Pugh, J., Penney, L., Noel, P., Neller, S., Mader, M., Finley, E. P., Lanham, H. J., & Leykum, L. (2021). Evidence based processes to prevent readmissions: more is better, a ten-site observational study. BMC Health Serv Res, 29(89). https://doi.org/10.1186/s12913-021-06193-x
A Sample Answer 8 For the Assignment: NURS 8002 Week 7 Discussion: The Doctorally Prepared Nurse: Community of Practice
Title: NURS 8002 Week 7 Discussion: The Doctorally Prepared Nurse: Community of Practice
I enjoyed reading your post this week regarding the community needs you identified and possible interventions. Preventing falls within the inpatient care setting is a challenge for healthcare providers. In your post, you mainly discussed interventions for the adult patient on a medical-surgical unit. Falls are also experienced within pediatric units. The pediatric patients that may be at higher risk for falls while in the hospital are patients less than 3 years old and adolescents with a neurological diagnosis (Stubbs & Sikes, 2017). These authors identified the need to implement a fall prevention program, which they named “Red Light, Green Light” (Stubbs & Sikes, 2017). This program used the terms red light and green light to determine if the patient was unsafe or safe during “activities such as transfers, ambulation, bathing, showering” (Stubbs & Sikes, 2017). If the patient was indicated as a “red light,” the physical therapy staff would educate the patient and family members on how to safely transfer or ambulate the patient (Stubbs & Sikes, 2017). Although this fall prevention program focused on pediatric patients, something similar could be implemented with adult inpatients.
This program is an example of the DNP Essential VI, which is Interprofessional Collaboration for Improving Patient and Population Health Outcomes (American Association of Colleges of Nursing, 2006). The DNP-prepared nurse is prepared to contribute to interprofessional collaboration by being able to “facilitate collaborative team functioning” (American Association of Colleges of Nursing, 2006). The intervention described by Stubbs and Sikes (2017) involves teamwork from the nursing staff, physical therapy, and patient’s family. These individuals need to work together to successfully implement the fall prevention program. The DNP-prepared nurse can take the initiative as a leader and implement such interprofessional collaborations.
Thanks for a great post!
References
American Association of Colleges of Nursing. (2006). The essentials of doctoral education for advanced nursing practice. https://www.aacnnursing.org/Portals/42/Publications/DNPEssentials.pdf
Stubbs, K. E., Sikes, L. (2017). Interdisciplinary approach to fall prevention in a high-risk inpatient pediatric population: Quality improvement project. Physical Therapy, 97(1), 97-104. https://doi-org.ezp.waldenulibrary.org/10.2522/ptj.20150213
A Sample Answer 9 For the Assignment: NURS 8002 Week 7 Discussion: The Doctorally Prepared Nurse: Community of Practice
Title: NURS 8002 Week 7 Discussion: The Doctorally Prepared Nurse: Community of Practice
Thank you for your excellent main post addressing the needs, challenges, and issues with your community, along with some appropriate practice changes and interventions based on specific essentials. You choose to address hospital re – admission challenges related to outpatient procedures (non- adherence to discharge recommendations) and hospital falls. You discussed the challenges of these issues and the impact on hospital care, quality, and safety. Respectively, your selection of DNP Essentials II and VI for the hosptial re-admissions; and the DNP Essentials IV and VI seems very appropriate to align your practice engagements and implementation plans as a DNP student.
You seem to have a keen eye when evaluating your community health needs and have proposed appropriate solutions.
Great post. I agree that a Lack of not adhering to discharge instructions may result in poor health maintenance which may predispose the patient to infection leading to prolong recovery time and possible death. Surgical site infections (SSIs) are among the most common healthcare-associated infections. It accounts for 20% to 31% of healthcare-associated infections in hospitalized patients. Reducing SSIs is a national priority, as reflected in the US Department of Health and Human Services’ National Action Plan to Prevent Healthcare-Associated Infections (Owens et., al 2014).
Ways to reduce post-surgical site infection include, Empowering patients with the information needed to fully engage in infection prevention, for instance, the use of an aseptic technique during dressing change at home. The health care system needs to engage home health wound care nurses to make frequent visits to the patients after discharge. The wound care nurses will engage in performing dressing changes, assess the wounds for potential infection. Also, they will be able to identify any issues and will intervene swiftly. Additionally, patients should be educated on the need to adhere to their follow-up appointment as scheduled by their surgeon.
In conclusion, post-surgical infection has a profound negative impact, both on patients and healthcare organizations hence it is vital to diverse multidisciplinary prevention strategies to foster healing and improve outcomes.
Reference
Owens PL, Barrett ML, Raetzman S, Maggard-Gibbons M, Steiner CA. Surgical Site Infections Following Ambulatory Surgery Procedures. JAMA. 2014;311(7):709–716. doi:10.1001/jama.2014.4
A Sample Answer For the Assignment: NURS 8002 Week 7 Discussion: The Doctorally Prepared Nurse: Community of Practice
Title: NURS 8002 Week 7 Discussion: The Doctorally Prepared Nurse: Community of Practice
This is insightful Oluwakemi. Cases of re-admissions are common in the healthcare systems. Re-admission often occurs as a result of the further complications causes by healthcare acquired infections, fall, and wrong prescription of different medications (Bargmann & Brundrett, 2020). Re-admissions are always conducted to ensure that patients are given quality medication and treatment processes for effective outcomes. Re-admit issues may also result from patients not adhering to discharge plans, medication adherence, and not showing up to follow-up appointments. There are different interventions that can be undertaken to reduce the cases of re-admissions. Some of the measures that can be undertaken include reducing the cases of medication errors, reducing the cases of healthcare acquired infections through enhance of quality healthcare delivery services (Cuttler et al., 2017). Integration of technology in the provision of healthcare services is also necessary in ensuring that discharge and readmission processes are undertaken within the set procedures (Liu et al., 2018). Finally, there is the need for training of healthcare professionals to ensure that all the procedures are undertaken within the set standards.
References
Bargmann, A. L., & Brundrett, S. M. (2020). Implementation of a Multicomponent Fall Prevention Program: Contracting With Patients for Fall Safety. Oxford University Press, 185(2), 28-34. https://doi.org/10.1093/milmed/usz411
Cuttler, S. J., Barr-Walker, J., & Cuttler, L. (2017). Reducing medical-surgical inpatient falls and injuries with videos, icons and alarms. BMJ open quality, 6(2), e000119. https://doi.org/10.1136/bmjoq-2017-000119
Liu, V., Lei, X., Prescott, H. C., Kipnis, P., Iwashyna, T. J., & Escobar, G. J. (2018). Hospital readmission and healthcare utilization following sepsis in community settings. Journal of hospital medicine, 9(8), 502-507. https://onlinelibrary.wiley.com/doi/abs/10.1002/jhm.2197
A Sample Answer For the Assignment: NURS 8002 Week 7 Discussion: The Doctorally Prepared Nurse: Community of Practice
Title: NURS 8002 Week 7 Discussion: The Doctorally Prepared Nurse: Community of Practice
Falls during hospitalizations can increase the length and cost of a hospital stay (Bargmann & Brundrett, 2020). Fall prevention bundles such as nonskid socks, bed alarms, safety contracts, and education are incredible to help reduce hospital falls. However, I believe 15mins safety rounding is a crucial tool because, in my experience, I have noticed that by the time the bed alarm goes off, the patient is either already out of bed and on the fall or sitting at the edge of the bed in the process of getting up.
Another instance is post-discharge fall. In my experience, I have seen a patient that was in the process of discharging home fall and breaking her hip bone. The excitement prompted her to get up and start dressing because she wanted to get ready for her daughter, who called her on the phone that she was being discharged. This led to unwarranted emergency surgery and more extended hospital stay. We need to educate our patients and family about safety measures until discharge to prevent falls.
Reference
Bargmann, A. L., & Brundrett, S. M. (2020). Implementation of a Multicomponent Fall Prevention Program: Contracting With Patients for Fall Safety. Oxford University Press, 185(2), 28-34. https://doi.org/10.1093/milmed/usz411
A Sample Answer For the Assignment: NURS 8002 Week 7 Discussion: The Doctorally Prepared Nurse: Community of Practice
Title: NURS 8002 Week 7 Discussion: The Doctorally Prepared Nurse: Community of Practice
Informative post regarding re-admissions and fall in the hospital. Approximately 30-35% of falls occurring in healthcare facilities result in injury that can cost over 14,000 per incident adding, 6.3 days to an individual’s length of stay. Adverse outcomes associated with inpatient falls include bruising, and fractures, depression and anxiety, prolonged length of stay, and even death. Some fall-related incidents may lead to medical lawsuit; therefore, fall risk reduction via implementing monitoring and analyzing systems along with nursing care improvement and patients’ education have become one of the most important issues in medical safety (Mikos et al., 2021).
Reference
Mikos, M., Banas, T., Czerw, A., Banas, B., Strzępek, Ł., & Curyło, M. (2021). Hospital Inpatient Falls across Clinical Departments. International Journal of Environmental Research and Public Health, 18(15). https://doi-org.ezp.waldenulibrary.org/10.3390/ijerph18158167
A Sample Answer For the Assignment: NURS 8002 Week 7 Discussion: The Doctorally Prepared Nurse: Community of Practice
Title: NURS 8002 Week 7 Discussion: The Doctorally Prepared Nurse: Community of Practice
The two challenges I have noticed in my organization are similar issues, which are lack of communication with family or support partners as well as lack of communication with our patients. These challenges have been around for a long time, and although great strides have been made in correcting the problems we have not completely corrected the issues. My role as a DNP graduate nurse is to ensure continued research to improve patient outcomes (Falkenberg-Olson, 2019).
Family-centered Care
Family-centered care is a necessary part of nursing practice that requires establishing a connection with all parties involved in patient care. The emotional support that families provide is essential to patient care, so much so that a mass amount of research has been provided focusing on improving family-centered care (Akram et al., 2021).
Intervention
The interventions I suggest both require time. For our families, I think it is important to dedicate a set time during the shift to reach out to those family care partners interested in being contacted. The set time will be agreed upon by a designated family member and will be passed on as part of the handoff.
Patient-centered Care
Achieving the optimal outcome for the patient is the goal of every healthcare worker involved in the patient’s care. To achieve this, it is crucial to design a care plan centered around the patient. There are a number of theories that can help positively influence patient outcome. Patient-centered care allows the patient control of a situation that can be chaotic. The sudden change in a person’s health can be terrifying and can make the patient feel helpless. Patient-centered care gives the patient control of the fight by organizing the care around the individual. This is done by partnering with patients and their families, identifying the patient’s needs and preferences regarding care. Therefore, there has to be communication to establish this connection(Ortiz, 2021).
Intervention
The intervention here will be the same, the devotion of time. It is important to spin time with the patient. Ortiz’s (2021) article pointed out the amount of time nurses spent with their patients. The article suggested that nurses spend more time on the computer (technology) that it becomes easy for them to forget about communicating with the patient. After this finding, nurses were required to spend five minutes with each patient at the beginning of the shift. During this time, they would sit and talk with their patients, making sure to establish eye contact, listen to any questions they may have, and answer the questions completely. This would be the intervention I would suggest for this practice problem.
Conclusion
Communication is key in getting to know the needs of the patients and producing a positive outcome. You have to communicate with all parties involved to make sure everyone is on the same page related to the patient’s care. Time must be allotted for communication with both the patient and the care partners to reach optimal results.
References
Akram, R., Huda, M., Dao’od, A., Basel, A. & Mohammad, A. (2021). Enhancing family-centered care in the ICU during the COVID-19 pandemic. Nursing Management, 52, (8), 34-38. DOI: 10.1097/01.NUMA.0000758684.16364.F6
Ortiz, M. (2021). Best Practices in Patient-Centered Care: Nursing Theory Reflections. Nursing Science Quarterly, 34, (3), 322-327. DOI 10.1177/08943184211010432.
A Sample Answer For the Assignment: NURS 8002 Week 7 Discussion: The Doctorally Prepared Nurse: Community of Practice
Title: NURS 8002 Week 7 Discussion: The Doctorally Prepared Nurse: Community of Practice
Thank you for your excellent main post addressing the needs, challenges, and issues with your community, along with some appropriate practice changes and interventions based on specific essentials. You choose to address the lack of communication in some settings among the parties such as staff and patients. You are advocating for both patient-centered and family-centered care focus in our health care arena. This is admirable!
Have you identify which DNP Essentials would best be aligned with your concern of lack of communication? As you know aligning your interventions/actions with the appropriate DNP Essentials will guide you toward your intended outcomes.
I look forward to hearing more from you regarding your plans
The challenges you presented in your discussion post are important. I have also noticed a lack of family-centered care and lack of communication with patients within my organization. I think the interventions you suggested, devoting more time to listening the family and patient’s needs, is important. In addition to devoting more time to spend with the patients, I would suggest implementing communication strategies to enhance the quality of communication. Kwame and Petrucka (2021) suggest the use of chit-chatting, humor, and silence “are essential in enhancing person-centered care and communication.” Implementing these strategies during the time spent with the patient can improve the relationship between the patient and the nurse, while also increasing the quality of communication.
Quality patient communication can lead to health promotion and risk reduction. This aligns with the DNP Essential VII, which is Clinical Prevention and Population Health for Improving the Nation’s Health (American Association of Colleges of Nursing, 2006). When the nurse establishes a good, communicative relationship with the patient, they may be able to help the patient understand their health better. This can lead to the education, and hopefully implementation, of health care strategies to improve and maintain the patient’s health. Since most nurse-patient conversations occur when the patient is facing a health issue, this is an essential time to emphasize the importance of health promotion.
Thanks for a great post!
References
American Association of Colleges of Nursing. (2006). The essentials of doctoral education for advanced nursing practice. https://www.aacnnursing.org/Portals/42/Publications/DNPEssentials.pdf
Kwame, A., & Petrucka, P. M. (2021). A literature-based study of patient-centered and communication in nurse-patient interaction: barriers, facilitators, and the way forward. BMC Nursing, 20(1), 1-10. https://doi.org/10.1186/s12912-021-00684-2
A Sample Answer For the Assignment: NURS 8002 Week 7 Discussion: The Doctorally Prepared Nurse: Community of Practice
Title: NURS 8002 Week 7 Discussion: The Doctorally Prepared Nurse: Community of Practice
Hi Latara, awesome post. Your message about both family centered-care and patient care are important, and true. It is necessary that the patients support system is involved. Patients do best when they have a great support system, and the family is involved in what may be going on. Also, patient centered care just makes sense. When the patient feels as though they have a sense of control, it encourages them to do what is necessary to improve their care. Communication and time is key for everyone. I have seen the effects of nurses focusing on the computer, when admitting patients. They can miss key elements of an assessment, and the patient feels ignored to top it off. White et al. (2021) notes translation of research into practice must be guided by the models and frameworks that include the process of change and the identification of critical elements or variables in the organization that affect and determine whether the new knowledge fits the organization and will be feasible to implement. The other dynamic to making changes to allow for more direct communication is finding the time. The start of a shift can be unpredictable, I would be interested in seeing your ideas become reality.
Reference
White, K. M., Dudley-Brown, S. and Terhaar, M. F. (2021). Translation of evidence into nursing and healthcare (3rd ed.).
Change theory and models: Framework for translation. Springer Publishing Company.
A Sample Answer For the Assignment: NURS 8002 Week 7 Discussion: The Doctorally Prepared Nurse: Community of Practice
Title: NURS 8002 Week 7 Discussion: The Doctorally Prepared Nurse: Community of Practice
Lack of communication is a huge practice problem in many hospital/clinic settings. The patient and Family Engagement module of the Comprehensive Unit-based Safety Program (CUSP) Toolkit focuses on an important topic:: Making sure patients and their family members understand what is happening during the patient’s hospital stay, are active participants in the patient’s care, and are prepared for discharge.
In my clinic, after the patient is seen my the provider, the nurse will go in and explain any changes made to the plan of care, any new orders such as labs or referrals, cover new and old medications, and any upcoming appointments.
Resources:
Patient and family engagement. AHRQ. (n.d.).
https://www.ahrq.gov/hai/cusp/modules/patient-family-engagement/notes.html.
A Sample Answer For the Assignment: NURS 8002 Week 7 Discussion: The Doctorally Prepared Nurse: Community of Practice
Title: NURS 8002 Week 7 Discussion: The Doctorally Prepared Nurse: Community of Practice
One would agree communication is crucial at all levels of healthcare. According to Kwame & Petrucka (2021), effective communication between patients and healthcare providers is essential for patient care and recovery. Furthermore, nurses and healthcare providers must identify situations affecting a patient’s overall health and the external factors that can impede them from early recovery. Also, community outreach programs regarding diabetic care may provide activities associated with diabetic prevention and management. Suppose an individual does not have the necessary support to attend the workshops. In that case, they are often unable to benefit from the outreach, which can affect their overall health outcomes and affect healthcare providers and institutions from creating that awareness. Diabetes and diabetes-related complications may significantly affect the healthcare delivery system, and one can consider it a significant public health concern (Youn, Lee, & Park, 2020). For example, diabetic retinopathy may be the leading cause of visual impairment and blindness. If diabetic education at the community level is focused on educating patients to identify signs and symptoms associated with diabetic retinopathy, they can appropriately be screen and adequately managed. Therefore, what was mentioned regarding the patient-centered approach and the necessary interventions to create awareness can commence at health screening prevention programs that cater to the disease condition. While creating awareness and education for screening, they contribute to the overall health care continuum and strive to improve patient outcomes.
References
Kwame, A., & Petrucka, P. M. (2021). A literature-based study of patient-centered care and communication in nurse-patient interactions: barriers, facilitators, and the way forward. BMC Nursing, 20(1), 1–10. https://doi-org.ezp.waldenulibrary.org/10.1186/s12912-021-00684-2.
Youn, H. M., Lee, D. W., & Park, E.-C. (2020). Association between community outpatient clinic care accessibility and the uptake of diabetic retinopathy screening: A multi-level analysis. Primary Care Diabetes, 14(6), 616–621. https://doi-org.ezp.waldenulibrary.org/10.1016/j.pcd.2020.02.010.
NURS 8002 Week 7 Discussion: The Doctorally Prepared Nurse: Community of Practice Grading Rubric Guidelines
| Performance Category | 10 | 9 | 8 | 4 | 0 |
| Scholarliness
Demonstrates achievement of scholarly inquiry for professional and academic decisions. |
|
|
|
|
|
| Performance Category | 10 | 9 | 8 | 4 | 0 |
| Application of Course Knowledge –
Demonstrate the ability to analyze, synthesize, and/or apply principles and concepts learned in the course lesson and outside readings and relate them to real-life professional situations |
|
|
|
|
|
| Performance Category | 5 | 4 | 3 | 2 | 0 |
| Interactive Dialogue
Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days. (5 points possible per graded thread) |
|
Summarizes what was learned from the lesson, readings, and other student posts for the week. |
|
|
|
| Minus 1 Point | Minus 2 Point | Minus 3 Point | Minus 4 Point | Minus 5 Point | |
| Grammar, Syntax, APA
Note: if there are only a few errors in these criteria, please note this for the student in as an area for improvement. If the student does not make the needed corrections in upcoming weeks, then points should be deducted. Points deducted for improper grammar, syntax and APA style of writing. The source of information is the APA Manual 6th Edition |
|
|
|
|
|
| 0 points lost | -5 points lost | ||||
| Total Participation Requirements
per discussion thread |
The student answers the threaded discussion question or topic on one day and posts a second response on another day. | The student does not meet the minimum requirement of two postings on two different days | |||
| Early Participation Requirement
per discussion thread |
The student must provide a substantive answer to the graded discussion question(s) or topic(s), posted by the course instructor (not a response to a peer), by Wednesday, 11:59 p.m. MT of each week. | The student does not meet the requirement of a substantive response to the stated question or topic by Wednesday at 11:59 pm MT. |