Findings Presentations & Publications While Conducting DNP Project Discussion

Findings Presentations & Publications While Conducting DNP Project Discussion ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON Findings Presentations & Publications While Conducting DNP Project Discussion Topic: Reflection and Next Steps Synthesize a plan for dissemination of your DNP Project outcomes and recommendations and share your plan with your classmates. Findings Presentations & Publications While Conducting DNP Project Discussion dissemination plan: Poster and podium presentations throughout the organization. Presentation of a written or verbal executive summary to stakeholders and the practice site organization leadership. Development of a webinar presentations. Development and presentation of a digital poster, a grand rounds presentation, and a PowerPoint presentation. Providing financial and production resources. I need minimum 350 words with 3 peer reviewed references from 2017-2020. Attached my DNP project. dnp_project_final_version.docx Running head: IMPROVING DISCHARGE PROCEDURES Improving Discharge Procedures to Reduce Unnecessary Emergency Department Return Visits IMPROVING DISCHARGE PROCEDURES 1 Abstract Unnecessary return visits to the emergency department (ED) has prevailed as a critical problem for patients, healthcare workers, and healthcare providers. While the hospitals might spend a significant amount of money and resources in caring for patients who return to the ED, patients often accrue increasing costs of healthcare. To address this issue, this project explores the implementation of a discharge tool that will help medical staff to better communicate with the patients resulting in patients’ better understanding of the discharge instructions and procedures. This project is expected to educate doctors and nurses on how to provide patients with high quality discharge instructions that will enable the elimination of unnecessary return visits, improve quality of care, and reduce costs. The target population will be Florida’s Celebration community, and since it is estimated that 28% of the acute care visits and half of the hospital admissions emerge from the ED, using this populous community will yield more reliable results. Even though the project has not been implemented in the target facility in Florida due to the COVID-19 pandemic that has resulted in several layoffs and a significant drop in ED visits, it is already in use in the New York City (NYC) healthcare facilities. Findings Presentations & Publications While Conducting DNP Project Discussion The project has increased patient satisfaction levels to 80%, producing positive results in patient outcomes, and great compliance with follow up procedures such as outpatient care after being discharged from the ER, among others. Results of this project which uses EPIC electronic medical record system has been proven to be working in New York, and promises to yield similar results when it is eventually implemented in Florida after the state’s health system recovers from the adversities of the pandemic. Keywords: Unnecessary return visits, EPIC electronic medical record system, patient satisfaction IMPROVING DISCHARGE PROCEDURES 2 Table of Contents Improving Discharge Procedures to Reduce Unnecessary Emergency Department Return Visits 4 Purpose …………………………………………………………………………………………………………………………………. 4 Expected Outcomes………………………………………………………………………………………………………………… 4 Negative Outcome ………………………………………………………………………………………………………………….. 5 Background …………………………………………………………………………………………………………………………… 5 Advanced Practice Relationship ……………………………………………………………………………………………… 6 DNP Essentials ………………………………………………………………………………………………………………………. 7 Population and Setting …………………………………………………………………………………………………………… 9 Project Alignment with Practice Site Mission and Goals ………………………………………………………… Findings Presentations & Publications While Conducting DNP Project Discussion 10 Target Population ………………………………………………………………………………………………………………… 11 Key Stakeholders …………………………………………………………………………………………………………………. 11 Benefit of Project………………………………………………………………………………………………………………….. 12 Needs Assessment …………………………………………………………………………………………………………………. 12 Literature Review ………………………………………………………………………………………………………………… 13 Literature Synthesis ……………………………………………………………………………………………………………… 14 Causes of Unnecessary ED Return Visit ………………………………………………………………………………… 14 Impacts of Unnecessary ED Return Visits ……………………………………………………………………………… 16 Reducing Rates of Unnecessary ED Return Visits ………………………………………………………………….. 17 Theoretical Framework ………………………………………………………………………………………………………… 18 Rationale for Conceptual Framework Choice………………………………………………………………………… 18 Relationship of the Theory/Framework …………………………………………………………………………………. 19 Identify Change Theory ……………………………………………………………………………………………………….. 20 Project Implementation Plan ………………………………………………………………………………………………… 20 Preparation ………………………………………………………………………………………………………………………….. 20 Protection of Human Subjects ………………………………………………………………………………………………. 21 Project Budget ……………………………………………………………………………………………………………………… 21 Implementation ……………………………………………………………………………………………………………………. 21 Data Collection …………………………………………………………………………………………………………………….. 22 Pretest for providers …………………………………………………………………………………………………………….. 23 Posttest for providers ……………………………………………………………………………………………………………. 23 Project Timeline …………………………………………………………………………………………………………………… 24 Data Analysis ……………………………………………………………………………………………………………………….. 24 Project Evaluation ……………………………………………………………………………………………………………….. 25 Formative Evaluation …………………………………………………………………………………………………………… 26 IMPROVING DISCHARGE PROCEDURES 3 Summative Evaluation………………………………………………………………………………………………………….. 26 Project Sustainability……………………………………………………………………………………………………………. 27 ConclusionFindings Presentations & Publications While Conducting DNP Project Discussion …………………………………………………………………………………………………………………………… 27 References ……………………………………………………………………………………………………………………………. 29 Appendix ……………………………………………………………………………………………………………………………… 33 List of Figures Figure 1: Andersen framework of health utilization …………………………………………………………… 37 Figure 2: Questionnaire for patients upon discharge ………………………………………………………….. 38 Table 1: Discharge checklist tool…………………………………………………………………………………….. 39 IMPROVING DISCHARGE PROCEDURES 4 Improving Discharge Procedures to Reduce Unnecessary Emergency Department Return Visits Unnecessary return visits to the emergency department are a problem that most healthcare facilities face across Florida and other states. Unnecessary return visits are indicators of poor care quality. Numerous studies have demonstrated emergency departments’ discharge procedures are a significant contributor to unnecessary return visits (Taylor, 2000). This issue creates gaps in continuity of care for patients resulting in an inadequate or incomplete emergency department discharge. Healthcare providers must realize that inadequate discharge negatively impacts patient compliance with care, treatments and follow-ups. Providing verbal and preformatted written discharge instructions to the patient does not guarantee that the patient understands the information provided. The patient must understand the medical information given and participates in their care. The best way to achieve patient understanding is communicating, and reinforcing while acknowledging culture, beliefs and language barriers. Purpose The purpose of this project is to implement a discharge tool that will help healthcare providers to better communicate with patients and better achieve patient understanding. Findings Presentations & Publications While Conducting DNP Project Discussion The proposed intervention is to implement a discharge checklist tool that enables patients to document their understanding of discharge instructions by marking and answering questions about the discharge instructions packet. The patient and the provider will document the exchange by both signing the discharge tool. The tool will remain in the patient’s medical records. Expected Outcomes After educating doctors, mid-levels providers and nurses on how to utilize the discharge tool they should be able to provide patients higher quality discharge instructions. Most IMPROVING DISCHARGE PROCEDURES 5 importantly, once individuals have been educated on the appropriate way to discharge an ED patient, it can be assumed these patients will continue to seek care accordingly. The implementation of this tool is expected to achieve the following outcomes. • Reduce or possibly eliminate unnecessary ED returns visits. • Improve the ED quality of care. • Increase patient satisfaction. • Strengthen providers’ competence. Negative Outcome Negative outcomes can occur with the implementation of the discharge tool. The providers will need to take time to explain and make sure the patient understands discharge material. This can cause a delay in discharges that will lead to an increase in discharge time. The issue can be resolved by delegating specific discharge topics between doctors and nurses. For example, the doctors will discuss diagnosis, test results and treatments with the patient, while nurses will discuss treatment side effects, follow-up care and reinforce all material given. Background Although hospitals strive to cut costs, this goal has not been satisfactorily addressed due to unnecessary return ED visits. Most hospitals in the state of Florida have been concentrating on reducing 30-day readmission with a few activities and intercessions (Centers for Disease Control and Prevention, 2017). In Florida, it is estimated that 28% of the acute care visits and half of the hospital admissions emerge from the ED (Center for Disease Control and Prevention, 2017). The authorization of the Patient Protection and Affordable Care Act 2010 has shown the requirement for coordinating patient care voice in structuring the conveyance of social insurance (Rising et al., 2014). The clarifications for patients to come back to the ED, the possibility of future return, IMPROVING DISCHARGE PROCEDURES 6 and the recurrent unnecessary return visits can be obtained from administrative data. Some common factors have been associated with high rates of readmission of patients to ED. They include low follow up care and any language barrier that limits patients from understanding the discharge instructions. Other variables include old age, non-ambulatory status, and absence of family support. These visits are not only cumbersome to the healthcare personnel, but also an important indicator of the quality of care. The EDs constantly face the issue of limited resources, high rates of patient admissions, aging population, and deficiency of human services suppliers. The majority of the ED has gotten amazingly overcrowded leading to long delays in care which contributes negatively to the patients’ outcomes since they cannot be treated on time. Patients returning to the emergency department have medical issues that have either failed to go away or improve or have gotten worse. Being an important metric to measure the quality of healthcare, the problem of unnecessary return visits to the ED is very important to healthcare providers since it provides essential information regarding their performance. A reduction in the rate of unnecessary return visits to the ED is a marker of high-quality care, while an increase in the rate signifies poor healthcare performance and poor patient outcomes. Findings Presentations & Publications While Conducting DNP Project Discussion Advanced Practice Relationship The nurse practitioners possess a deep level of knowledge in health care that allows managing a broad spectrum of clinical problems that ends with positive outcomes. Nurses assume a key role in transforming care. They can offer cross-cultural competencies and proficiency in care that leads to clear clarifications concerning patient discharge which involve the factors that emerge while the patient is at home, and how to move toward circumstances that may force them to return to the ED (Rafnsson & Gunnarsdottir, 2010). This will help keep the IMPROVING DISCHARGE PROCEDURES 7 patients from heading off to the ED once more. Moreover, the nurse practitioner’s relationship with patients is built on working together to achieve a positive outcome which helps with care compliances. Nurse practitioners are proven to decrease patients ED visits, hospital admissions, and healthcare costs (Rushforth, 2015). The nurse practitioner can provide training that points towards upgrading the nurses and doctor roles that incorporates patient engagement. DNP Essentials This DNP project is supported by the eight DNP Essentials. The essential I is the scientific underpinnings of this education which reflect the complexity of practice at the doctoral level and the rich heritage that is the conceptual foundation of nursing (AACN, 2006). The educational part of this project will assist healthcare providers to understand the patterning of human behavior in interaction with the environment in normal life events and critical life situations after being discharged from the ED. This will help improve science discipline by understanding the nature and significance of health and health care delivery phenomena. This essential also maintains that the extensive understanding of the nursing theory ensures that advanced nursing practice is built upon a solid foundation. Graduates can, therefore, integrate nursing practice with organizational or analytical sciences (AACN, 2006). These science-based concepts can, therefore, be used to improve the quality of healthcare. Essential II is the organizational and systems leadership to improve quality and systems thinking meaning that doctoral-level knowledge and skills in these areas are consistent with nursing and health care goals to eliminate health disparities and to promote patient safety and excellence in practice (AACN, 2006). This essential helps in transforming research into practice. Findings Presentations & Publications While Conducting DNP Project Discussion The project is based on quality improvement by making changes to current discharge policies by providing the best practice to discharge a patient. This will improve patient outcomes after being IMPROVING DISCHARGE PROCEDURES 8 out of the ED and prevent them from returning because they did not understand discharge/after care instructions. Essential III states scholarship and research are the hallmarks of doctoral education (AACN, 2006). This essential mainly focuses on the complex issues that face modern health. It further focuses on the medical dilemmas that physicians face in patient care, as well as shaping the evidence-based initiatives in the agenda of healthcare. The project uses analytic methods to critically appraise existing policies and other evidence to determine and implement the best practice to discharge a patient from the ED. Essential IV allows the DNP prepared nurse to design by selecting, utilizing, and evaluating the programs that monitor outcomes of care, care system, and quality improvement including consumer use of health care information system (AACN, 2006). This project contains a significant analysis that involved a patient’s quality of care and the utilization of patient care technology. Findings represent an opportunity to evaluate the return visits to the ED for inappropriate discharge. Essential V refers to engagement with policy development by identifying the problem and creating a healthcare system that meets the needs (AACN, 2006). This project helps the DNP prepared nurse to educate others such as policy makers regarding patient outcomes, policy change, and the correct way of discharging a patient from the ED. Additionally, it would address and facilitate health care needs in the acute care setting. Essential VI states the importance of effective communication and collaborative skills in the development and implementation of practice models (AANC, 2006). The project demonstrates collegiality within the community of knowledgeable people from different IMPROVING DISCHARGE PROCEDURES 9 professions in the health care system with endeavors to serve the population by utilizing healthcare resources.Findings Presentations & Publications While Conducting DNP Project Discussion Essential VII DNP prepared nurses is expected to evaluate care delivery models and the utilization of using concepts related to community, environment and occupational health, and cultural and socioeconomic dimensions of health (AACN, 2006). The project embraces the community to the extent of knowledge by supporting strategies directed to improve all dimensions of health. Additionally, it supports the theoretical framework that is utilized to guide the project in the community as a whole. Essential VIII the DNP prepared nurse is expected to design, implement, and evaluate therapeutic interventions based on nursing science and other sciences (AACN, 2006). This project focuses on the established strengths and knowledge of the NP by applying them to the ability of the researcher of effectively evaluate, teach, and educate individuals on the correct alternative provision of health care. This Essential shows DNP prepared nurse ability to demonstrate advanced levels of clinical judgment such as systems thinking, accountability in designing, evaluating evidence-based care to improve patient outcomes. Population and Setting Florida’s Celebration community is populous, which makes it an ideal area to create and execute the intervention. The population for this DNP Project is located in an acute care hospital in rural Central Florida. They have varying cultural backgrounds, which are mainly determined by race. Local residents can be categorized into whites, African Americans, Hispanics, Asians, Native Americans, and people with a combination of two races. The culture of the target population impacts their health, beliefs about diseases and death, lifestyles as well as health promotion. The psychosocial dimensions include can be categorized into three. Medical IMPROVING DISCHARGE PROCEDURES 10 dimensions relate to the type of treatment, the perception of suffering, and the cl … Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10

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