NR 351 Week 5 Discussion Topic, Leadership to Improve Quality in Diverse Situations

NR 351 Week 5 Discussion Topic, Leadership to Improve Quality in Diverse Situations

NR 351 Week 5 Discussion Topic, Leadership to Improve Quality in Diverse Situations

There are many challenging nursing care issues in the medical field today. There are also solutions to many of these problems that can be found through researching evidence-based practice. One of the nursing care issues I would like to see improvement in is the lack of patient education. Patient education is extremely important to the health care field for many reasons. According to DeMarco (2011), “Health care consumers educated about a health condition are more likely to adhere to the health professional’s guidelines for disease management, treatment plan, and care at home for themselves or a loved one after being discharged from the hospital” (p. 23).

To research different ways to improve patient education I would start with the PICOT process. According to Hood (2018), PICOT stands for population, intervention, comparison, outcome, and optional timing. In order to accomplish effective research, I would have to come up with a question that involved those areas. The question I would insert into CINAHL is; In patients 30 years and older, does patient education compared to no education influence positive outcomes in their care throughout their lifetime? PICOT questions need to be extremely specific, so I’d have to refine it a few times to find the best evidence-based practice (EBP). After finding enough EBP, I’d incorporate it into my own experiences and determine whether my intervention of patient education affects patient care the way I believe it does.

References:

Hood, L. J. (2018). Leddy & Pepper’s professional nursing (9th ed.). Philadelphia, PA: Wolters Kluwer.

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Nystrom, M., Demarco, J., & Salvatore, K. (2011). The importance of patient education throughout the continuum of health care. Journal of Consumer Health on the Internet, 15(1), 22-31. https://doi-org.chamberlainuniversity.idm.oclc.org/10.1080/15398285.2011.547069

According to Rowlands, incorrect surgical counts are a common occurrence after surgery.  In reviewing incident reports from six hospitals during a three-year period, researchers found that incorrect surgical counts (25%) were the most frequently reported event.  Despite the availability of AORN standards and recommended practices and hospital policies, this type of error continues to occur (2012).

Rowlands also states, “the OR is a highly complex, error-prone environment characterized by nonstop activity, specialization, and intricate interdisciplinary processes.  The complexity is manifested not only in the patient and his or her condition but also in the sophistication of instrumentation and technology, which may increase the risk for error”.  “From the stories of preoperative personnel involved in incorrect surgical counts, three distinct themes emerged: bad behavior, general chaos, and communication difficulties”.

Working in the OR first hand I deal with the three themes mentioned.  I find it difficult to have everyone participate in the correct sequence as well as visualizing each item counted.  When I correct someone, I receive “looks”, hissing and a feeling that I am being too strict while I feel that other are too lax and do not take into consideration that policies dictate our process.  The patient and their safety, following policies and maintaining my licensure are the core of my practice.  Recently, I had a surgical technologist berate me for correcting a new surgical technologist in the way they were performing the count.  I received attitude from the new employee and was berated by the preceptor during the procedure.  I structure my counting based on the policy and so I know that I am performing my count according to AORN standards.  

Moving forward in my practice, I will continue my counts as outlined in our policy.  I will continue to correct others when necessary and I will hold others accountable to follow the policy.  I do not play into unprofessionalism in my OR and I will address each situation as it arises.  When others disrupt the OR with unprofessionalism, I simply explain that we can discuss the situation at a later time.   

Researching in the Chamberlain Library for information regarding surgical counts, I began my search in the CINAHL complete tab, entered surgical counts on the first line and extended my search further with “risk factors associated with incorrect surgical counts”. I found a great journal article and used it along with my experience to complete my week 5 assignment.   

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References

Hood, L. J. Leddy and Pepper’s Professional Nursing (9th ed.).  Philadelphia, PA Wolters Kluwer 

Rowlands, A. (2012). Risk Factors Associated with Incorrect Surgical Counts.  https://doi.org/10.1016/j.aorn.2012.06.012Links to an external site.

I feel the same way about my nurse leader. He is a ‘nurses nurse’ — he truly does advocates for us and rolls up his sleeves to help when needed. He is our floor manager but also works as a per diem staff nurse at another hospital, which I think helps keep his perspective. The hospital implemented the “GetWell Network” as a form of education for patients — daily medication education pops up, services can be requested, surveys can be filled our and diagnosis specific education can be assigned through the network. It’s a great tool but it just added another thing to our already long list of things to do, with too little personnel. Of course, the hospital is implementing the use of the network into our unit satisfaction scores to gauge how well we are doing as a unit. As a staff nurse, it was entirely unrealistic for us to complete and a lot of the education being provided we were already doing. Our manager took it upon himself to fully take on that responsibility, which lifted a huge load off of us. He takes a chunk of his morning, every morning, to go through the network with each patient. He’s a great leader in that sense and in return he gains our support as staff and upper management is happy because the network is being used as intended.