I’m working on a nursing discussion question and need support to help me learn.

Step 1: Consider what change you would like to initiate that will benefit the healthcare community.

Discuss how you plan to facilitate making contact with a nurse leader and post a draft change project that willl impact quality improvement as a narrative for students and faculty to review.

Step 2: Read other students posts and respond to at least two of them. Respond by posting two suggestions, strategies, or ideas that could be useful in assisting your peers with their project plan.

Response 1 John

The change I would initiate is the use of more telehealth and video appointments. Our clinic currently does both on a limited basis due to lack of funding to pay for video and telehealth equipment. I work in a rural outpatient clinic. Many of our patients even live far from us. Patients living in rural communities don’t want to drive all the way to the clinic for appointments. They’re often only seen occasionally by visiting nurses. Their chronic conditions often go unchecked leading to complications and a greater cost and challenge for our healthcare community.

Approaching Nurse Leadership

Nurse leaders are constrained by budget(Izquierdo, 2021) therefore, my proposal must make financial sense. Quality improvement will be made by monitoring these patients and helping them manage their chronic conditions reducing complications and strain on healthcare providers. In this way my proposal benefits the healthcare community. In the long run savings will result in both the reduction of patient suffering and financially saving the cost of acute medical care due to complications. Further savings would be the side effect of visiting nurses not having to drive to patient’s rural locations. Investigations would have to be made to determine the cost of patient’s acute hospitalizations as well as the costs of in person nurse visits. Hopefully savings would more than offset the cost of tablets for those without cell phones and time in educating patients (which would be minimal) on the use of equipment. With my change plan making both patient healthcare quality improvement as well as making financial sense it may be considered for discussion(Izquierdo, 2021).

Reference:

Izquierdo, Robert (2021) How to Create and Run a Change Management Plan, THE BLUEPRINT, 5 Steps to Creating a Change Management Plan | The Blueprint (fool.com)

Response 2 Danielle

Proposed change I am considering in the occurrence of hospital acquired pressure injuries. “A hospital-acquired pressure injury (HAPI; formerly known as a pressure ulcer) is a localized injury to the skin and/or underlying tissue during an inpatient hospital stay.” (Rondinelli, et al, 2018). Our hospital does the use the braden scale on each patient in order to assess each patient’s risk of developing a pressure ulcer. While this scale in great I think it leaves out some important information such as do they currently have an ulcer or a history of them & therefore putting them at a higher risk for more. We use this stratagy in the use of the BMAT for falls in that if a patient has a history of falls they are deemed a higher risk for falls. When assessing our patients for risk of pressure injuries if they score an 18 or lower there are steps to be taken in order to prevent them. In my assessments I have noticed more often that we have been seeing an increased number of hospitals occurred pressure injuries. ” HAPIs can be associated with a longer hospital stay, pain, infection, and even death” (Rondinelli, et al, 2018).

The nursing leader I am approaching with my quality improvement proposal is my current unit manager. She is very involved in the day to day activities with upper managements & quality improvements measures such as CAUTI & CLABSI preventions. I have already been able to approached her & ask if she was willing to let me interview her for a quality improvement project for this class & she agreed to do so. I feel it is important to interview someone that has a relationship with those that make they quality improvement changes.

References

Rondinelli, J., Zuniga, S., Kipnis, P., Kawar, L. N., Liu, V., & Escobar, G. J. (2018). Hospital-Acquired Pressure Injury: Risk-Adjusted Comparisons in an Integrated Healthcare Delivery System. Nursing research, 67(1), 16–25. https://doi.org/10.1097/NNR.0000000000000258