You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts.
Assignment # 6

Zelene Harding

St. Thomas University

NUR 416 AP 5

Kathleen Price

February 17

The decision to change procedure or practice

According to healthcare code of conduct, a case manager is responsible to advocate for patient’s benefit (Armold, 2019). Even though the process is not easy, they strive to make probable decisions meant to secure patients satisfaction and safety for their clients. In my occupation within the health sector working as a health plan managerial role there are instance where one chooses the best option while forgoing healthcare protocol. For instance, while working I disregard a health insurance organization in respect elderly patient’s chronic condition. In this scenario, the presented patient was suffering from a preexisting condition that forced him to wait for three years in order to have a coverage ready. However, in regard to the patients condition a decision was made that countered the coverage guideline to be done within the first year.

Steps

The idea to adjust the policy and favor the patient condition was not easy since changing the set protocol need to be followed. As well, the steps to arrive at the decision revealed to be an evidence based. The steps involved making an identification for the applicable decision that was worth addressing chronically patient’s condition in the near future. Notably, relevant information was collected in order to accommodate the preexisting condition for the patient. Then, putting in place relevant options that could mitigate the health concern was identified. As well, this entailed holistic measures that could cater for the chronically patient condition. This was followed by a review for al presented options that could be best for the presented client. Finally, an alternative is chosen aimed at addressing geriatric patients with such conditions.

Evidence

considered According to research, there is an increased number of chronically ill patients in the United States (Zang et al., 2020). However, this statistic is arriving after considering Center for Disease Control and Prevention as well as application healthcare centers data. It is clear that majority of chronically ill patients needs a serious attention within a short period of time. This evidence supports the idea to disregard the time the chronic patient would return for treatment but cutting the timeframe. More so, it was revealed that the patient will get satisfied from the services acquired from healthcare providers since they will have a minimal medical cost for the services rendered.

Effectiveness

The presented medical change was effective to such patient with similar conditions. In this case, the patient received treatment timely and stopped experiencing pain. On the other hand, such a patient with similar issues will be timely handled in future thus attracting patients to healthcare facility since they will develop trust with the services rendered. In this case, such a case provides the patient with the required results hence attracting large number of patients visiting the facility. Lastly, the provided changes provide nursing field with ideas that are capable of improving patients condition collaboratively since they get motivated while treating patient using effective remedy.

Feb 17 at 3:17pm

Manage Discussion Entry

Policy Changes in Hospital Setting

Yadam Conde

St. Thomas University

NUR 416-AP5

Prof. Price

Feb 17, 2022

Policy Changes in Hospital Setting

Policy change rarely seems to happen in the hospital environment. More often than not, policies exist due to previous sentient events that need immediate corrective action. Besides the preexisting policies, infectious disease nurses and epidemiologists also make many changes in the procedures carried out by nurses. These changes are meant to decrease the biggest problem that plagues the hospitalized patient population. Infection. These policies primarily affect invasive lines and procedures and can include IV catheter length of placement, IV tubing shelf life, indwelling catheter removal options, and many more.

Recently, the hospital where I work has adopted a new policy regarding the allowed length of IV placement. Initially, the policy was to change IV sites every 96-hours or four days. This policy was replaced by one that increased the length of placement for IVs till necessary for change. Along with this new change in policy, we received new IV sets that included a completely new system, product, and manufacturer. This policy was adopted to reduce the number of cases of infiltrations as well as decrease the negative patient emotions towards continual invasive procedures. Although patent IVs are necessary for the hospital setting so that healthcare professionals can be ready for any sort of emergency, they also cause patients to become increasingly uncomfortable. Often, patients would ask me why I would be removing their IV if it was in perfect working condition. Once I educated patients regarding the risks for an infection that prolonged IVs have, they would still opt to keep their IV in place to save themselves from being “pinched” again.

A study conducted by Rickard et al. was a multicenter, non-blind randomized trial that included a 3283 inpatients population. The participant population must be patients that were hospitalized within a medical-surgical unit and were hospitalized for a minimum of 4 days. Any individual whose IV catheter had been placed in the emergency department was immediately excluded alongside individuals with known bloodstream infections. The results from this study showed that individuals who were a part of the routine replacement group had double the risk of developing a catheter-related bloodstream infection as opposed to the clinically indicated group. Although this study showed a significant data correlation between periodic catheter changes and adverse health outcomes, it was not the only research article regarding this issue.

In another study conducted by Sangtaeck et al. in 2019, a much larger study using patient discharge data, similar outcomes were noted. The population for this study was 588,375 inpatient scenarios that included patients hospitalized for more than four days. Of this population, about 1.75% had some sort of peripheral intravenous-related complication, which increased the mean length of hospitalization for these patients by 5.9 days and increased the cost of care by roughly $4,000.00. PIV-associated adverse healthcare outcomes significantly correlated routing PIV insertion and multiple diagnosis groups. This data is consistent with prior research as well as firsthand experience. The overwhelming data from various research studies proved what we nurses knew all along and eventually led to a positive policy change.

References

Brown, D., & Rowland, K. (2013). PURLs: optimal timing for peripheral IV replacement?. The Journal of family practice, 62(4), 200–202.

Lim, S., Gangoli, G., Adams, E., Hyde, R., Broder, M. S., Chang, E., Reddy, S. R., Tarbox, M. H., Bentley, T., Ovington, L., & Danker, W., 3rd (2019). Increased Clinical and Economic Burden Associated With Peripheral Intravenous Catheter-Related Complications: Analysis of a US Hospital Discharge Database. Inquiry : a journal of medical care organization, provision and financing, 56, 46958019875562. https://doi.org/10.1177/0046958019875562