NR 505 Week 7: Exploring Research Results Discussion

NR 505 Week 7: Exploring Research Results Discussion

NR 505 Week 7: Exploring Research Results Discussion

The whole goal of my study is to determine what behaviors, if any, can improve patient experience or satisfaction with their inpatient hospital stay. The research article that I am referencing is titled, “Using the evidence-based practice service nursing bundle to increase patient satisfaction”. In the article, the results that I could use in my practice setting would be Table 3 Service nursing bundle: staff audits. In this table the results reveals that the bundle was put in place from 08/03/15 to 09/21/2015. During that time frame the survey results increased as the weeks went by from 65% to 100% (Skaggs, Daniels, Hodge, & DeCamp, 2018). Showing that consistency of using the nursing bundle of communication, hourly rounding, and bedside shift report resulted in improved scores. This study seems to be a perfect fit; it is practical and very appropriate to achieve the goal of increased patient satisfaction.

To implement this research data, there would be a planning phase to determine staff education outline and to inform them of the need for change. During the Do phase we would actually carry out educating the staff and making sure that they know the importance of the changes. Then, study the best time frame and evaluation methods once the implementation is started. Lastly, act on any changes that need to occur to make these new changes last and remain effective. The resources needed for a successful implementation would be education, rounding sheets to hang in the room for hourly rounding, consistent audits of bedside shift report by charge nurses and myself and computer to create a log to capture all the data collected and to look up survey results from Press Ganey. Press Ganey is the tool that my facility uses to collect patient survey results. Monitoring these results will help to evaluate if the new interventions are successful or not over a set period of time.

A future study for this same topic would look at different interventions that make patients happy during their stay. These things could be as simple as food services or environmental services. Changes that are discovered through research should be realistic, measurable and easy to maintain to ensure that they last.

Reference

Skaggs, M. K., Daniels, J. F., Hodge, A. J., & DeCamp, V. L. (2018). Using the evidence-based practice service nursing bundle to increase patient satisfaction. Journal of Emergency Nursing, 44(1), 37-45. doi: 10.1016/j.jen.2017.10.011

Using the following steps found within the translation phase of the Practice Evidence Translation (PET) model developed by Johns Hopkins, select a research result reported in a journal article that supports your PICOT/PICo question. Please respond to the following steps. Please note that wording of the steps may have been modified slightly from the PET so that they help with this posting. Include the permalink at the end of your posting.

• Using references, identity the research result that you could use in your practice setting.
• Determine fit, feasibility, and appropriateness of the result for your practice setting.
• Using Plan-Do-Study-Act (PDSA), outline an action plan.
• Identify the resources (physical, personal, technology) needed to implement your action plan.
• Determine the criteria that you would use to determine whether the implementation of your project was successful.
• Identify one future research study that would be useful in extending knowledge of your selected project result.

PICo questions: How do nurses in an inpatient setting perceive the value of bedside shift report?

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Completing last week’s research, it is apparent that bedside shift report adds a layer of safety for the patients. A qualitative study in an inner-city, acute care teaching hospital, was done to gain insight on what experiences nurses had with BSR. Jeffs et al. (2013) interviewed 43 female nurses from various clinical specialties. The participants were asked to list the positive and the negatives about BSR. Topics that were covered included describing the positives and negatives of face to face interactions with nursing colleagues; the negative outcomes associated with the interactions and involvement of patients in care planning; and if they felt that the care was more patient-centered and safer. Over six months, the nurses took in observations and found that they could identify, intercept and correct potential errors. In addition, they could clarify the care plan and patient needs. The nurses were also able to prioritize care with a quick assessment. The results may be affected by the limitation of the study only taking place in one hospital. The study was well rounded to include nurses from different units.

My plan in implementing a change to bedside shift report is to improve patient safety by improving nurse to nurse communication and reducing hospital events including patient falls. I would gather the baseline quality data for the hospital units involved in the study. Once the plan is discussed with all members involved and the education on how to conduct the BSR is provided to the nurses involved in the implementation the next step is to do. Set the date and start monitoring and evaluating the new process of BSR. Conducting interviews with nurses at the beginning and several weeks later to understand barriers and successes from the new process. The length of time to conduct interviews can be difficult to determine in a qualitative study. In this process change scenario, I would continue to conduct interviews until I started to receive redundant responses to questions multiple times. Next, I will study the data obtained through the interviews and the quality data collected over that same time period. I should be able to determine if I reached the outcome I predicted and if the implementation went as I planned. This is a good time to evaluate any barriers or challenges encountered during the implementation. The step in the PDSA is act. Taking the information learned during the implementation and ensuring that the solutions remain sustainable.

NR 505 Week 7: Exploring Research Results Discussion

Jeffs, L., Acott, A., Simpson, E., Campbell, H., Irwin, T., Lo, J., Beswick, S., & Cardoso, R. (2013). The value of bedside shift reporting: Enhancing nurse surveillance, accountability, and patient safety. Journal of Nursing Care Quality, 28(3), 226-232. doi:10.1097/NCQ.0b013e3182852f46

A Dedicated Education Unit is a recent concept which has been effectively used in university hospital systems, such as University of Portland in Oregon.  The unit is staffed by staff nurses in a clinical instructor role.  Nursing faculty are on hand to provide effective teaching methods to the clinical instructors, but otherwise they are not part of the learning process for the students.  The DEU allows for nursing students to gain practical knowledge; therefore, helping the student to gain confidence in their skills prior to graduating.  In my EBP, I suggest the use of such a unit for new graduate RN’s.  I have read many articles pertaining to this subject ranging from the student to the patient perspective.  One specific article, written by Nishioka, Coe, Hanita, and Moscato in 2014 focuses on the student perspective on a DEU.  In this article, the writers conducted a mixed-methods study to compare the use of a DEU and traditional 1:1 precepting (Nishioka, Coe, Hanita, and Moscato, 2014, p.  301). They wanted to know the thoughts of the students.  There were many good results of this study, but the one I shall focus on is the consistency of teaching in the DEU.  This area is extremely important for a future nurse educator.  The students felt the learning environment on the DEU was very fluid and high quality (Nishioka et al., 2014, p.  306).  Because of this positive environment, students were more at ease, able to learn, and felt part of the team.  A couple of students reported the DEU clinical instructors taught the more practical side of nursing, not just the theory (Nishioka et al., 2014, p. 303).  These areas are frequently areas of dissatisfaction for new graduates. How many times have you heard a new RN say, “I don’t feel part of the team”, “No one wants to help me or teach me.” So, with the use of a DEU, these areas of dissatisfaction could be relieved leading to overall increased retention of nurses.  This type of unit can be costly to the facility at first, but with increased retention of nurses, this will decrease costs overtime.  Implementing such a unit requires structure.  One way in which healthcare institutions implement change is through a change model, such as PDSA.  

This acronym stands for Plan-Do-Study-Act.  The goal of any change is to be cost effective, safe, timely, efficient, equitable, and sustainable (Reed & Cord, 2015, p. 147).  By using PDSA, the dynamic nature of healthcare can be enhanced. Planning of any change will require buy-in and support from administration, management, staff, education department, and the community.  This concept is no different.  The hospital will need to have overtime and a lot of manpower to make this unit work.  The next phase the actual implementation of the plan.  This would be the doing part of PDSA.  I randomly assign the new graduates to two groups.  One group is the study group, which will receive their formal education on the DEU.  Whereas the second group will receive only traditional 1:1 training.   As the study coordinator, I would be observing interactions between new grads and clinical instructors, as well as conducting surveys and interviews with the study participants.  Next, is the study part of the action plan.  This requires data collection from the participants and analyzing this data. Finally, after all the data is analyzed I shall take time to reflect on the study and see if changes should have been made, or if my implementation was flawed.  My goal would be greater retention after one year of the DEU group compared with the traditional 1:1 group.  I would like to see a retention rate of greater than 19% of the DEU group. As for a future research study on DEU usefulness, I would like to follow these initial two groups over a five- year period, to see how they continue to adjust to the professional world, as well as if the DEU group continues to further their education to advanced degrees.

Thanks,

References:

Nishioka, V.M., Coe, M.T., Hanita, M., & Moscato, S.R.  (2014). Dedicated Education Unit:  Student Perspectives.  Nursing Education Perspectives, 35(5), 301-307.  Retrieved from:  http://dx.doi.org/10.5480/14-1380Links to an external site.

Reed, J.E. & Cord, A.J.  (2015).  The problem with Plan-Do-Study-Act cycles.  BMJ Quality & Safety, 25(3), 147-152.  Retrieved from:  http://dx.doi.org.chamberlainuniversity.idm.oclc.org/10.1136/bmjqs-2015-005076Links to an external site.