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NURS FPX 4020 Assessment 4: Improvement Plan Tool Kit

NURS FPX 4020 Assessment 4: Improvement Plan Tool Kit

Improvement Plan Tool Kit

The serious problem of delayed responses to deteriorated patient circumstances in healthcare is best dealt with with the help of the improvement plan toolkit. With this toolbox, healthcare institutions can easily identify, evaluate, and address the factors contributing to delayed responses in an organized and user-friendly manner. NURS FPX 4020 Assessment 4: Improvement Plan Tool Kit: Staff classroom instruction, standard communication protocols, and proactive tracking are all components of an extensive structure, provided that cutting-edge technology, such as patient monitoring systems, is used. resubscribe: It is crucial for maintaining patient safety in addition to reducing mortality rates and raising the standard of healthcare providers generally (Ali et al., 2023). This assessment’s fundamental objective is to present a toolkit for improvement plans in healthcare to account for delays in responding to patients’ worsening instances.

Annotated Bibliography

General Organizational Safety and Quality Best Practices

Curtis, K., Munroe, B., Fry, M., Considine, J., Tuala, E., Watts, M., Alkhouri, H., Elphick, T., Ruperto, K., Barrass, J., Balzer, S., Chisholm, B., Van, C., & Shaban, R. Z. (2021). The implementation of an emergency nursing framework (HIRAID) reduces patient deterioration: A multi-centre quasi-experimental study. International Emergency Nursing, 56(56), 100976. https://doi.org/10.1016/j.ienj.2021.100976

The main objective of the research was to gauge the effects of using the HIRAID  methodology on patient security in two ambulance services in Australia. We collected and reviewed data from 920 patients who decreased within 72 hours after departing the emergency department (ED). The results of the study revealed that while patients in the post-implementation group had higher multiple conditions, their deterioration following ED treatment decreased from 27% to 13%. Delays in intervention (from 28.3% to 15.1%) and in escalating attention when problematic vital signs have been identified (from 20.2% to 6.9%) were also substantially reduced. The amount of isolated nursing-related challenges that contributed to the decline dropped from 21% to 8%. NURS FPX 4020 Assessment 4: Improvement Plan Tool Kit: To sum up, the adoption of the HIRAID framework in emergency nursing has been linked to a decrease in clinical deterioration regarding emergency care, demonstrating its potential for improved patient safety in the hospital’s emergency room (Curtis et al., 2021).

Walshe, N., Ryng, S., Drennan, J., O’Connor, P., O’Brien, S., Crowley, C., & Hegarty, J. (2021). Situation awareness and the mitigation of risk associated with patient deterioration: A meta-narrative review of theories and models and their relevance to nursing practice. International Journal of Nursing Studies, 124(104086), 104086. https://doi.org/10.1016/j.ijnurstu.2021.104086  

The critical role of being aware of circumstances in healthcare is discussed in the writing, especially as it relates to patient safety and the practice of nursing. It highlights just how important it is to comprehend how people, groups, and healthcare systems adapt to worsening patient conditions while keeping awareness in changing task environments. The definition, theoretical terms, and research of situation awareness in inpatient hospital settings were all investigated by the study authors as part of their meta-narrative assessment of the material on healthcare. After studying 120 publications, they were able to identify three main narratives: the use of technology, communication tools, and education to enhance situation consciousness; the individual, team, and systems views on situation understanding; and the relationship connecting situation awareness and the protection of patients. Based on an optimistic research methodology and the legacy of cognitive engineering, the majority of the published work originated in operating rooms and anesthetic departments. NURS FPX 4020 Assessment 4: Improvement Plan Tool Kit: The research emphasizes how critical it is for nurses to recognize failing patients and escalate their treatment. It also underscores the need to take into consideration the intricate sociocultural facets of healthcare teams and the rise of awareness of situations in highly developed technology medical facilities. This study may help guide subsequent studies and organizational nursing practice settings (Walshe et al., 2021).

Pimentel, M. A., Redfern, O. C., Malycha, J., Meredith, P., Prytherch, D., Briggs, J., Young, J. D., Clifton, D. A., Tarassenko, L., & Watkinson, P. J. (2021). Detecting deteriorating patients in hospital: Development and validation of a novel scoring system. American Journal of Respiratory and Critical Care Medicine, 204(1). https://doi.org/10.1164/rccm.202007-2700oc

The development and implementation of an Electronic Noticeboard (HAVEN)-based hospital-wide alerting program to detect hospitalized patients at risk of reversible deterioration is covered in this piece of writing. The study was focused on outcomes like heart attacks or unexpected ICU hospitalizations and employed a previous group of patients from four UK hospitals. Using an automated learning model, the HAVEN system was trained with patient data, which included vital signs, laboratory results, multiple conditions, and frailty. The findings showed that HAVEN outperformed other scoring infrastructures, outperforming those with a preexisting range of 0.700 to 0.863 with a discrimination rate of 0.901 within 24 hours after evaluations. Furthermore, HAVEN outperformed the next best approach, which was able to foresee 22% of cardiac arrests or unscheduled hospitalizations in intensive care units with a lead time of up to 48 hours in advance. It also suggests that when compared to the present methods, especially the National Early Warning Score, HAVEN might considerably enhance early identification of in-hospital worsening (Pimentel et al., 2021).

Environmental Safety and Quality Risks

Burke, J. R., Downey, C., & Almoudaris, A. M. (2020). Failure to rescue deteriorating patients. Journal of Patient Safety, 18(1), 140–155. https://doi.org/10.1097/pts.0000000000000720

The premise of “Failure to Rescue” (FTR), which denotes the incapacity to avert a patient’s death as the consequence of problems that result from medical treatment, fundamental disease, or surgery, is explored in the remainder of the paper. The main objective of the investigation was to find out the causes of FTR and possible treatments that would improve the institution’s FTR rates. A thorough evaluation was carried out, examining several digital repositories throughout 2006 and 2018. Fifty-two of the original 1486 items were rigorously evaluated. The six areas to be addressed with particular suggestions were divided into three strategic arms, “acknowledge,” “relay,” and “responded,” for these articles. In medical institutions, complications are frequent and cause great consequences for patients, healthcare workers, and systems. FTR is used to evaluate an organization’s capacity to handle these kinds of crises. In their “The 3 Rs of Failure to Rescue” approach, the contributors highlight the necessity of quickly identifying, interacting with one another, and responding to issues. This paradigm might assist institutionalized quality improvement efforts for effectively dealing with complications by helping to identify those places where patient resuscitation failures occur (Burke et al., 2020).

O’Neill, S. M., Clyne, B., Bell, M., Casey, A., Leen, B., Smith, S. M., Ryan, M., & O’Neill, M. (2021). Why do healthcare professionals fail to escalate as per the early warning system (EWS) protocol? A qualitative evidence synthesis of the barriers and facilitators of escalation. BMC Emergency Medicine, 21(15), 1–19. https://doi.org/10.1186/s12873-021-00403-9

In order to comprehend why healthcare professionals (HCPs) sometimes ignore early warning system (EWS) protocols when faced with circumstances of acute deterioration, a qualitative synthesis of evidence was carried out to be addressed in this study. The investigation sought to identify barriers and catalysts to escalation in accordance with EWS standards in order to advise on the enhancement of the Irish National Early Warning System (INEWS). The study included eighteen investigations with a variety of HCPs from a total of seven different nations. The analyses revealed five broad themes: administration, clinical experience, professional boundaries, rapid response team (RRT) response, and EWS defining features. These themes are associated with the obstacles and enablers of escalation. The shortage of standards, materials, responsibility, fear, hierarchy, and overconfidence were all regarded as barriers to escalation. Accountability, consistency and resources, medical knowledge, and empowerment were among the factors that contributed. The investigation clarifies the practical difficulties HCPs have while using EWSs and underlines the need to remove these impediments in order to raise patient safety and treatment quality. Government officials, executives at hospitals, and medical professionals may use this information in order to enhance emergency response systems (O’Neill et al., 2021).

Walker, R. M., Boorman, R. J., Vaux, A., Cooke, M., Aitken, L. M., & Marshall, A. P. (2021). Identifying barriers and facilitators to recognition and response to patient clinical deterioration by clinicians using a behaviour change approach: A qualitative study. Journal of Clinical Nursing, 30(5-6), 803–818. https://doi.org/10.1111/jocn.15620  

The reasons for doctors’ procrastination or lack of responsiveness to patients’ decline in health in hospital settings are addressed in this piece of writing. Semi-structured interviews have been carried out at two hospital locations with doctors, health consumers, and members of the family using their Theoretical Domains Foundation. Information dissemination, taking responsibility for patient care, responding with confidence, expertise and abilities, culture, sentiments, and the surrounding context, as well as assets, are the seven main elements that have been identified as both facilitators and challenges that get to clinicians’ reactions. Research findings showed that interprofessional recognition and productive interactions among professional groups have been limited by conventional social and professional hierarchies as well as natural resource limitations. These restrictions hampered communication procedures, which were made worse by insufficient policy formulation and insufficient team-based coaching. NURS FPX 4020 Assessment 4: As a result, there was a compromise in patient safety, which disappointed the doctor. According to the investigations, in order to overcome these obstacles and encourage prompt chemical reactions to patients’ clinical deterioration, changes in behavior treatments are necessary. The results also highlight how crucial it is to question established hierarchies as well as processes in order to promote multidisciplinary healthcare worker decision-making and collaboration (Walker et al., 2021).

Staff-Led Preventive Strategies for Delayed Response

Warren, T., Moore, L., Roberts, S., & Darby, L. (2021). Impact of a modified early warning score on nurses’ recognition and response to clinical deterioration. Journal of Nursing Management, 29(5). https://doi.org/10.1111/jonm.13252

The research implemented the Modified Early Warning Score (MEWS) assessment, which attempted to increase nurses’ trust and expertise in acknowledging and managing clinical deterioration in patients in the hospital. MEWS aids in the prompt identification of patient deterioration. Eighty-five nurses from a rural hospital participated in the trial and were offered a simulation-based solution. Both individual simulations with high-fidelity and group sessions in the classroom were a part of this intervention. The findings revealed that nurses’ knowledge and confidence had significantly risen. Furthermore, a 34.1% increase in nurse interventions in response to clinical deterioration warning signs was seen in chart reviews. The research comes to an agreement that teaching MEWS via patient scenarios is a useful way to stop unnoticed degeneration. Implications for nursing management indicate that post-licensure nurses’ capacity to manage emergent clinical problems in inpatients may be efficiently taught and assessed by employing simulation-based treatments (Warren et al., 2021).

Chua, W. L., Rahim, N. R. B. A., McKenna, L., Ho, J. T. Y., & Liaw, S. Y. (2021). Intraprofessional collaboration between enrolled and registered nurses in the care of clinically deteriorating ward patients: A qualitative study. Australian Critical Care, 35(1). https://doi.org/10.1016/j.aucc.2021.01.009

The investigation looked at how trainee nurses (ENs) and registered nurses (RNs) worked cooperatively to identify and address medical decline in typical ward situations. It was performed at a tertiary hospital in Singapore with 12 ENs and 11 RNs, and the outcome showed three primary topics. The separation of ENs during transference resulted in an insufficient understanding of patients at risk. Firstly, nurse shift handovers are crucial as a means of interchange. It was also made clear that both groups valued mutual support in nursing working together and that they had different expectations for each other’s duties. Lastly, it was observed that decision-making was done in a top-down manner, with ENs being left out of decision-making regarding patient care. This investigation showed that there was subpar communication between ENs and RNs, which periodically resulted in delays in detecting patients who were worsening. It emphasizes how crucial interprofessional education is to strengthening EN-RN cooperation in nursing training and the workplace. Fostering collaboration and guaranteeing regular education on nursing teamwork skills are critical responsibilities of nurse leaders and trainers (Chua et al., 2021).

Lynch, J., Cope, V., & Murray, M. (2020). The Intensive Care Unit Liaison Nurse and their value in averting clinical deterioration: A qualitative descriptive study. Intensive and Critical Care Nursing, 63, 103001. https://doi.org/10.1016/j.iccn.2020.103001

            The investigation looks at ward nurses’ viewpoints on the job of the intensive care unit interface nurse and how it affects patient care. Ward nurses in a metropolitan acute care hospital were questioned using a qualitative analytical technique and semi-structured interviews. The interviews focused on their interactions with the emergency medicine Team/Code Blue calls, requesting technical or clinical assistance, and post-ICU discharge assessments. The results of this study show that there are four main areas in which the role of the Intensive Care Unit Liaison Nurse improves the treatment of patients: fewer Code Blue calls and increased critical care knowledge through schooling—more ward nurses’ confidence in managing consumers who are deteriorating, and the giving of technical support. Overall, Intensive Care Unit Liaison Nurses play an essential function in improving clinical patient results and strengthening ward nurses’ confidence in managing patients with worsening illnesses (Lynch et al., 2020).

NURS FPX 4020 Assessment 4:Technologies Solution for Delayed Response

Imran, Iqbal, N., Ahmad, S., & Kim, D. H. (2021). Health monitoring system for elderly patients using intelligent task mapping mechanism in closed loop healthcare environment. Symmetry, 13(2), 357. https://doi.org/10.3390/sym13020357

The piece of writing talks about how populations getting older affect socioeconomic systems and how resources for health monitoring are becoming more and more important. It draws attention to how the Internet of Things (IoT) might be utilized to monitor health, particularly for elderly people. A suggested architecture for tracking geriatric patient health in a closed-loop Internet of Medical Things system is presented in this research. The system, created as a case study, uses wearable biomedical sensors to detect measures including the temperature of the body, heart rate, glucose levels in the blood, and patient body positioning in order to monitor the wellness of patients in a variety of contexts, such as residences, ambulances, and hospitals. When deteriorating illnesses are identified, quicker treatments are possible because anomalies in health data are identified via the use of heuristic and machine learning-based techniques. The suggested architecture’s functionality in terms of round trip time, trustworthiness, task drop rate, and latency is assessed in the study, which shows how dependable and successful it is for crucial activities in IoT healthcare applications (Imran et al., 2021).  

Leonardi, L., Lo Bello, L., Patti, G., & Ragusa, O. (2021). A network architecture and routing protocol for the MEDIcal WARNing system. Journal of Sensor and Actuator Networks, 10(3), 44. https://doi.org/10.3390/jsan10030044   

For hospitalized patients receiving pre-intensive care, the MEDIcal WARNING (MEDIWARN) system continuously tracks key performance indicators. In units without an Ethernet infrastructure, gathering information is made simple with the use of a wireless network. The MultiPath Routing Protocol for MEDIWARN (MP-RPM) is a novel algorithm for routing that is part of the MEDIWARN communication system, which is introduced in this article along with its network creation. In order to decrease network overhead and enable dependable, low-latency data transfer over a dynamic internet, MP-RPM was developed. An experimental investigation into MEDIWARN’s use in a real-world case study is included in the paper. Additionally, it evaluates MP-RPM performance in comparison to two popular routing protocols, Destination-Sequenced Distance-Vector Routing (DSDV) and Ad-hoc On-demand Distance Vector (AODV), considering timeliness and dependability into considerations. With effective wireless exchange of information and sophisticated routing protocols, the MEDIWARN system improves clinical teams’ comprehension of patients’ scenarios and permits prompt reactions to changes in their psychological state (Leonardi et al., 2021).

Joshi, M., Ashrafian, H., Aufegger, L., Khan, S., Arora, S., Cooke, G., & Darzi, A. (2019). Wearable sensors to improve detection of patient deterioration. Expert Review of Medical Devices, 16(2), 145–154. https://doi.org/10.1080/17434440.2019.1563480 The article demonstrates how monitoring vital signs is a critical component of medical treatment that may help detect individuals who have become ill as well as enhance their results. There is still the possibility that hospital wards would overlook patient deterioration regardless of the use of paper-based track and trigger warning assessments for clinical assessment and monitoring operations. Wearable sensor technology is a possible way to deal with this particular issue. The ability to continually and in real-time monitor many vital signs of ward patients has been made feasible by the invention of lightweight, wireless sensors for clothing. By giving healthcare professionals rapid and reliable data for identifying and reacting to changes in a patient’s condition, portable technology is seen as a major step in improving patient care and lowering the risk of patients slipping through the security barrier (Joshi et al., 2019).

NURS FPX 4020 Assessment 4:Conclusion

In summary, the enhancement of the plan toolkit mentioned above provides a thorough method of tackling the vital issue of delayed responses to deteriorating patient scenarios in the medical field. Through the integration of discoveries from many research examinations, we have emphasized the worth of executing efficient frameworks, augmenting awareness of circumstances, and using innovative technology inside healthcare environments. Lowering fatality rates, raising overall service regulations, and ensuring patient safety may all be achieved by introducing these tactics into healthcare facilities management. In order to enhance patient care and provide a safer environment for patients, healthcare institutions may benefit from implementing the improvement plan tool kit to identify, evaluate, and eliminate the factors that cause responses to become tardy.

References

Ali, O., Abdelbaki, W., Shrestha, A., Elbasi, E., Alryalat, M. A. A., & Dwivedi, Y. K. (2023). A systematic literature review of artificial intelligence in the healthcare sector: Benefits, challenges, methodologies, and functionalities. Journal of Innovation & Knowledge, 8(1), 100333. https://doi.org/10.1016/j.jik.2023.10033

Burke, J. R., Downey, C., & Almoudaris, A. M. (2020). Failure to rescue deteriorating patients. Journal of Patient Safety, 18(1), 140–155. https://doi.org/10.1097/pts.0000000000000720

Chua, W. L., Rahim, N. R. B. A., McKenna, L., Ho, J. T. Y., & Liaw, S. Y. (2021). Intraprofessional collaboration between enrolled and registered nurses in the care of clinically deteriorating ward patients: A qualitative study. Australian Critical Care, 35(1). https://doi.org/10.1016/j.aucc.2021.01.009

Curtis, K., Munroe, B., Fry, M., Considine, J., Tuala, E., Watts, M., Alkhouri, H., Elphick, T., Ruperto, K., Barrass, J., Balzer, S., Chisholm, B., Van, C., & Shaban, R. Z. (2021). The implementation of an emergency nursing framework (HIRAID) reduces patient deterioration: A multi-centre quasi-experimental study. International Emergency Nursing, 56(56), 100976. https://doi.org/10.1016/j.ienj.2021.100976

Imran, Iqbal, N., Ahmad, S., & Kim, D. H. (2021). Health monitoring system for elderly patients using intelligent task mapping mechanism in closed loop healthcare environment. Symmetry, 13(2), 357. https://doi.org/10.3390/sym13020357

Joshi, M., Ashrafian, H., Aufegger, L., Khan, S., Arora, S., Cooke, G., & Darzi, A. (2019). Wearable sensors to improve detection of patient deterioration. Expert Review of Medical Devices, 16(2), 145–154. https://doi.org/10.1080/17434440.2019.1563480

Leonardi, L., Lo Bello, L., Patti, G., & Ragusa, O. (2021). A network architecture and routing protocol for the MEDIcal WARNing system. Journal of Sensor and Actuator Networks, 10(3), 44. https://doi.org/10.3390/jsan10030044

Lynch, J., Cope, V., & Murray, M. (2020). The Intensive Care Unit Liaison Nurse and their value in averting clinical deterioration: A qualitative descriptive study. Intensive and Critical Care Nursing, 63, 103001. https://doi.org/10.1016/j.iccn.2020.103001

O’Neill, S. M., Clyne, B., Bell, M., Casey, A., Leen, B., Smith, S. M., Ryan, M., & O’Neill, M. (2021). Why do healthcare professionals fail to escalate as per the early warning system (EWS) protocol? A qualitative evidence synthesis of the barriers and facilitators of escalation. BMC Emergency Medicine, 21(15), 1–19. https://doi.org/10.1186/s12873-021-00403-9

Pimentel, M. A., Redfern, O. C., Malycha, J., Meredith, P., Prytherch, D., Briggs, J., Young, J. D., Clifton, D. A., Tarassenko, L., & Watkinson, P. J. (2021). Detecting deteriorating patients in hospital: development and validation of a novel scoring system. American Journal of Respiratory and Critical Care Medicine, 204(1). https://doi.org/10.1164/rccm.202007-2700oc

Walker, R. M., Boorman, R. J., Vaux, A., Cooke, M., Aitken, L. M., & Marshall, A. P. (2021). Identifying barriers and facilitators to recognition and response to patient clinical deterioration by clinicians using a behaviour change approach: A qualitative study. Journal of Clinical Nursing, 30(5-6), 803–818. https://doi.org/10.1111/jocn.15620

Walshe, N., Ryng, S., Drennan, J., O’Connor, P., O’Brien, S., Crowley, C., & Hegarty, J. (2021). Situation awareness and the mitigation of risk associated with patient deterioration: A meta-narrative review of theories and models and their relevance to nursing practice. International Journal of Nursing Studies, 124(104086), 104086. https://doi.org/10.1016/j.ijnurstu.2021.104086

Warren, T., Moore, L., Roberts, S., & Darby, L. (2021). Impact of a modified early warning score on nurses’ recognition and response to clinical deterioration. Journal of Nursing Management, 29(5). https://doi.org/10.1111/jonm.13252

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