Please reply to each discussion below with positive feedback (peer to peer) Disc

Please reply to each discussion below with positive feedback (peer to peer)
Discussion 1-
RR
My small-scale change is to increase the knowledge of infection control discharge instructions for patients that are at risk of or those that have current infections to assist in decreasing admission and re-admission rates into the hospital.
For my capstone project my short-term goal is to implement an educational in-service on healthcare acquired infections related to infection control to our emergency room staff which includes 35 Registered Nurses, 7 CNA/TECHs, 2 paramedics, 2 managers, and one CNO to decrease readmission rates to the hospital, by the end of week 4.
As an emergency room nurse, I have seen many people come into the department with various complaints, in recent months I have noticed a trend of readmissions that are linked to infection. When speaking to the patients they have stated that they either didn’t get the medications needed to get rid of what infection they had, or they have been discharged prematurely from the hospital off of IV antibiotics. We also see a large population of transients that are unable to get medications due to lack of funds.
Internally with the help of my preceptor I have been able to pull reports from 72-hour readmissions from the last four months at the hospital through the emergency department. The report shows twenty-six readmissions within four months. Thirteen of those readmissions have an infection from multiple sources. This is a staggering 50% of readmissions to the hospital being from infections.
Readmissions to a hospital are both unwanted by the provider as well as the patient. Improving quality patient care and outcomes are one of the most integral parts of healthcare now. Yearly readmissions across the United States are at 2 million patients a year, with 17 billion dollars spent by Medicare alone (Kauffman et al., 2016). With implementation of increased education and patient care it improves the patients’ outcomes as well as decreases the readmission risk. In a study done in Poland they were able to link improved care coordination and communication with patients’ education through increased time with providers and nurses (Wieczorek-Wójcik et al., 2022).
The data collection plan I am implementing is the use of a pre and posttest/survey to see what the nurses currently know and what education is needed to help decrease readmissions related to infection. After receiving the pretest back this week I will be able to start the education process with staff. I plan on using PowerPoint as well as a handout with the staff in my unit. Increasing the knowledge base on infection control at discharge is my desired outcome. If we can increase our knowledge together the patients will benefit as well.
Regards,
Rachal
References:
Kauffman, B., About the AuthorBill KauffmanSenior Principal Bill Kauffman works with the research team in providing research and analysis in various areas including sales transactions and skilled nursing. He has lead roles in creating new and enhanced products and impl, Bill KauffmanSenior Principal Bill Kauffman works with the research team in providing research and analysis in various areas including sales transactions and skilled nursing. He has lead roles in creating new and enhanced products and implementation of ne, & View all posts by Bill Kauffman. (2016, March 23). Readmissions & medicare: What’s the cost? National Investment Center. Retrieved May 17, 2022, from https://www.nic.org/readmissions-medicare-whats-the-cost/
Wieczorek-Wójcik, B., Gaworska-Krzemińska, A., Owczarek, A., Wójcik, M., Orzechowska, M., & Kilańska, D. (2022, March 31). The influence of Nurse Education Level on hospital readmissions-a cost-effectiveness analysis. MDPI. Retrieved May 17, 2022, from https://www.mdpi.com/1660-4601/19/7/4177/htm
Discussion 2-
CI
Small scale project change – implementing a protocol amongst the the staff of the emergency room, 20 ER room nurses, 5 paramedics, and 6 ER tech those ensures that all patient rooms are thoroughly stocked before the next patient is triaged, or change of shift, in the patient room to decrease any delay in patient care due to lack of supplies.
Short term goal – Implement a checklist or count sheet that staff members of the ER (listed above) that ensures that the room is always stocked with the necessary or regularly used equipment and supplies in patient room before new patient arrives or before the change of shift
Short term outcome – By the end of week 5, team members of the emergency room will routinely stock and ensure rooms are properly set up before new patients are triaged in the care rooms by following the checklist set and developed.
What internal and external data shows this is an issue.
Delay in care during medical alerts such as sepsis alert, chest pain, or stroke alerts, were certain procedures and test must be completed in a timely manner to ensure that adequate pace and effectiveness of ER staff providing patient care. These delays in care can put staff outside the window for these procedures to be completed resulting in events or increase in means times of the unit during these heart events. Emergency rooms are tracked on how fast EKG are completed and done following the room stocking checklist.
Internal factor can include the seriousness or severity in the change of patients in each room. If the patient is not a trauma, all patient rooms can be used for patients amongst any severity or acuity levels of patients arriving to the ER.
Emergencies room can be places that are constantly changing and facing timing restraints based on patient acuity or changes in health status when patient arrive to the emergency room. When facilities use standardized stocked procedural carts, there was a 26.5 second decrease in the overall timeframe of patient care techniques and interventions. (Furstenburg, 2018) This small decrease in patient care times can add up to overall decrease in total per patient total wait time and procedures implementation per patient rate in the emergency room.
In order to determine the degree of of the short term goal outcomes, check list will be monitored and staff rounding and questionnaires will be completed amongst all ER staff including ER nurses, paramedics, and tech to ensure the effectiveness of the protocol implementation. Rounding with unit leadership to to discuss intervention times such as EKG times or stroke workup times amongst medical alerts called in the ER.
Furstenburg, P., Oosthuizen, A., & Wallis, L. (2018). Purpose-orientated stocking of procedure trolleys saves time in busy emergency centres. South African Medical Journal, 108(12), 1024-1026.