Feb 23, 2024 Blog: The DNP-Prepared Nurse and Their Community NURS 8200
A Sample Answer For the Assignment: Blog: The DNP-Prepared Nurse and Their Community NURS 8200
One of the issues in my organization is the long length of hospital stay with patients. This was an important issue as it does not only affect the increase in cost, it also affects the patient’s health. Unnecessary days in the hospital may lead to increase hospital-acquired patient complications (e.g., healthcare-associated infections, falls) and increased costs for patients and healthcare systems (Tipton, 2021). One of the practice changes that we adopted was the throughput method to help with this issue.
According to CenTrak (2023), the throughput method is described as the movement of patients from arrival to discharge. This method involves the care, resources and the decision that is being made to move patients through the hospital. When this method is implemented well, it improves the quality-of-care patients receive as well as their level of satisfaction with their experience. Another practice change that was helpful was the adoption of interdisciplinary rounds. This helped with communicating the plan for the patient’s care which in turn improves patient’s outcome.
According to Reduced Hospital Days and Dollars With Interdisciplinary Rounds (2018b), according to a study, when compared, the outcome for patients receiving interdisciplinary rounds as opposed to traditional rounds found that length of stay was reduced from 6.1 to 5.5 total days, for an overall cost reduction of 17%. Communication is important with both the throughput method and interdisciplinary rounds.
The use of technology is very important in other to get a faster and more reliable result from both. DNP graduates are distinguished by their ability to use information systems/technology to support and improve patient care and healthcare systems and provide leadership within healthcare systems and/or academic settings (AACN, 2006).
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Another issue that the organization is facing is staffing shortages. With these shortages, we are witnessing healthcare workers at the bedside with less knowledge and experiences. Prognosis based on knowledge and experience and multidisciplinary treatment and care may not only save lives of ICU patients with severe and complex conditions but may also influence their subsequent activities of daily living and quality of life (Fukuda et al., 2020).
Blog The DNP-Prepared Nurse and Their Community NURS 8200
With this issue, continuous education was implemented to help with the constant change in healthcare. According to Green (2022), continuous education is important because it helps ensure that medical professionals are up to date on the latest treatment and procedures. It also helps healthcare providers maintain their licenses and sharpen their skills. Another change that was implemented was incentives for healthcare employees.
Some incentives might require employers to dig a bit deeper into their annual budgets to help attract and retain valuable staff (Walid & Walid, 2023). This helps staff feel as they valuable and paid for their worth. It also helps retain experienced nurses with greater knowledge. Knowledge of the disease process and how patient’s respond to the treatment is very important when it comes to healthcare providers.
DNP graduates possess a wide array of knowledge gleaned from the science and have the ability to translate that knowledge quickly and effectively to benefit patients in the daily demands of practice environment (AACN, 2006).
Reference
Tipton, K. (2021, September 1). Introduction. Interventions to Decrease Hospital Length of Stay – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK574438/#:~:text=Unnecessary%20days%20in%20hospital%20may,for%20patients%20and%20healthcare%20systemsLinks to an external site..
CenTrak. (2023, January 19). How Busy Hospitals Can Increase Patient Flow: 6 Tips. CenTrak. https://centrak.com/resources/blog/increase-patient-flowLinks to an external site.
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
Fukuda, T., Sakurai, H., & Kashiwagi, M. (2020). Efforts to reduce the length of stay in a low-intensity ICU: Changes in the ICU brought about by collaboration between Certified Nurse Specialists as head nurses and intensivists.Links to an external site.Links to an external site. PLOS ONE, 15(6), e0234879. https://doi.org/10.1371/journal.pone.0234879Links to an external site.
Green, E. (2022). The Importance of Continuous Education in Healthcare. Caregiver Support Services. https://www.caregiversupportservices.com/the-importance-of-continuous-education-in-healthcare/
Walid, & Walid. (2023). Incentives For Healthcare Employees: Retention Strategies (Healthcare Reward). Conference Source. https://conference-source.com/nursing-incentive-programs/
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.
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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
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.
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
Falkenberg-Olson, A. C. (2019). Research translation and the evolving PhD and DNP practice roles: A collaborative call for nurse practitioners. Journal of the American Association of Nurse Practitioners, 31(8), 447–453. https://doi.org/10.1097/JXX.0000000000000266
Ortiz, M. (2021). Best Practices in Patient-Centered Care: Nursing Theory Reflections.Nursing Science Quarterly, 34, (3), 322-327. DOI 10.1177/08943184211010432.
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
To go to the next module:
Module 4
Week 7: The Doctorally Prepared Nurse: Community of Practice
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)
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
Andrew, N., Tolson, D., & Ferguson, D. (2008). Building on Wenger: Communities of practice in nursing. Nurse Education Today, 28(2), 246–252. https://doi.org/10.1016/j.nedt.2007.05.002
Cook, D. A., Pencille, L. J., Dupras, D. M., Linderbaum, J. A., Pankratz, V. S., & Wilkinson, J. M. (2018). Practice variation and practice guidelines: Attitudes of generalist and specialist physicians, nurse practitioners, and physician assistants. PLOS ONE, 13(1), e0191943. https://doi.org/10.1371/journal.pone.0191943
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