DN 723 Written DNP Proposal Paper
DN 723 Written DNP Proposal Paper
Introduction ● Project purpose/aims of the project The purpose of this project is to enable the implementation of a clinical intervention to ensure a reduction in the return visits to the emergency department. The proposed intervention is to implement a discharge checklist tool that when patients are going to be released from the emergency department, they can check mark boxes of what they understood from the discharge instruction packet. Then patient will need to sign affirming that providers discussed what is on the agenda with the patients before they leave the emergency department. The provider will verify what topic the patient did not understand and go over it once again and provide literature of the material given. The provider will be required to also sign this tool, stating that patient understood discharge instructions and that all topics were covered. This checklist tool will be place in patient’s chart. The expected outcome and evaluation of this activity will be determined by the extent to which the patients understand the instructions. The effectiveness of this intervention will be manifested in the improvement of service delivery. The strategy is expected to reduce the overcrowding at the emergency department and improvement of the patient outcome. Additionally, nurses are they key for this tool since they are in direct contact with patients. They, subsequently, have specific errands, which are the main drivers of overcrowding. The issue of the patients to comprehend release guidelines can be tended effectively by nurses (Sayah et al., 2014). They handle all the vital techniques of guaranteeing that patients are released from the hospitals, which incorporates all the desk work that should be shown to the patients, their parents, or relatives. Nurses can grasp this opportunity to clarify in detail every one of the inquiries that the patients of guardians pose and, in any event, asking them questions to guarantee that they understand the data they are given in detail. They can also step up to the plate by ensuring the transportation of the patients from the ED to their destinations, particularly when utilizing the ambulatory services. Nurses are in a better position to partake in clarifying the concerns of the patients as well as their diseases. DN 723 Written DNP Proposal Paper
This intervention can guarantee that patients stick to every one of the mandates of the directives of the care providers to maintain a strategic distance from occurrences arising from wrong medication. It should be fortified with legitimate ED training on patient management to prevent future returns. Intensive training can improve the role of nurses and incorporating patient engagement. These efforts can guarantee that providing a high-quality discharge process, it initiates the preparations for patients to return home and can properly manage their recovery without having the necessity of returning to the ED, thus reducing congestion. ● Expected project outcomes By educating doctors, mid-levels providers and nurses on how to utilize the discharge tool they should be able to provide a high-quality discharge instruction to the patients. Most importantly, once individuals have been educated on the appropriate way to discharge a patient from the ED, it can be assumed these patients will continue to seek care accordingly. The implementation of the strategies above is expected to achieve the following outcomes. 1. Reduce or possibly eliminate unnecessary returns visits to the emergency department. 2. Improve the quality of care being offered at the emergency department. 3. Improve patient satisfaction. 4. Improve the competence of the doctors, mid-levels providers and nurses. ● Background and significance of problem to health care/nursing. Discuss from a general perspective and progress to the specific. Add your problem statement in this section Although hospitals have been striving to cut the cost, the problem of return visits to the emergency department has not been completely addressed. 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 [CDC], 2017). In Florida, it is estimated that 28% of the acute care visits and half of the hospital admissions emerge from the Emergency Department (ED) per the CDC (2017). The authorization of 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 plausibility of future return, and the recurrent return can be obtained from the administrative information. Some basic variables have been related with high rates of readmission of patients to the ED. They incorporate low follow up care and language boundary that bars patients from understanding the discharge guidelines. DN 723 Written DNP Proposal Paper
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 hospitals ED constantly face the issue of restricted assets, high rates of patient admissions, aging populace, and deficiency of human services suppliers. Majority of the ED have gotten amazingly overcrowded leading to long delays in care which contributes negatively to the patients’ outcomes since they cannot get 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 unscheduled return visits to the emergency department is very important to healthcare or nursing since it provides the healthcare personnel with essential information regarding their performance or health output. A reduction in the rate of 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. Hospital emergency departments (ED) continuously face the problem of limited resources, increased patient presentation, aging population, and shortage of healthcare providers. Most EDs have, become among the most overcrowded sections of any healthcare facility. They are characterized by long waiting time that contributes negatively to the patients’ outcome as well as low family experiences. However, ideal nursing interventions can play a central role in preventing the overcrowding of the ED. Although hospitals have been striving to cut the cost, this goal has not been satisfactorily addressed because of the challenge of patients returning to emergency departments. Most hospitals in the state of Florida have been focusing on reducing 30-day readmission with several initiatives and interventions (CDC, 2017). In Florida, it is estimated that 28% of the acute care visit and 50% of the hospital admissions arise from ED per Center of Disease and Control (2017). The enactment of Patient Protection and Affordable Care Act and has demonstrated the need for integrating patient care voice in designing the delivery of healthcare (Rising et al., 2014). The explanations for patients to return to the ED, the possibility of future return, and the repeated return can be examined from the administrative data.DN 723 Written DNP Proposal Paper
Some common factors have been associated with high rates of readmission of patients to ED. They include low follow up care and language barrier that limits patients from understanding the discharge instructions. Other factors can be old age, no ambulatory status, and lack of family support. ● Relationship of project to advanced nursing practice and DNP Essentials This project has a close connection with Advanced Nursing Practice in that it provides nurses with an opportunity to perform their duties regarding patient discharge and patient care. Nurses assume a key role in transforming care. They can offer nitty gritty clarifications concerning patient discharge to the patients. It will involve the factors that will emerge while the patient will be 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 patients from heading off to the ED once more. Another transient arrangement includes the doctors examining itemized data about the diseases affecting their patients. The doctors can likewise appropriately address worries that their patients may need to lessen their vulnerability. Over the long haul, the doctors and attendants ought to guarantee they make an ED-based care program that will integrate the care teams in the ED. The program should offer more trainings on taking care of patients at the ED including the parts of release to prevent the return cases (Rushforth, 2015). Intensive training should point towards upgrading the nurses and doctor roles that incorporates patient engagement. Developing a discharge checklist that when patients are going to be released from the ED they can check out and sign affirming that providers examined what is on the agenda with the patients before they leave the ED. Doctors can fill in as a contact to different partners who practice by helping them discover the patients fittingly. Doctors ought to likewise work intimately with distinguished drug specialists associated to the hospital, to offer medication counselling. This will cultivate patient self-management and diminish vulnerability from patients (Schrader et al., 2019). The DNP Essential Aligned with The Project. (PLEASE ADD THE DNP ESSENTIALS IV, V, VI, VII and VIII) INTEGRATE THEM WITH THIS PROJECT. This DNP Project is supported by the DNP Essentials I, II and III. 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). DN 723 Written DNP Proposal Paper
