nursing

Reply to classmates post, at least 125words each reply and 1 scholarly reference within last 5 yeach for each

Post 1

Healthcare workers are dedicated professionals and their purpose is to care for patients to the best of their ability. I feel as if it is common for healthcare workers to forget to take a step back and try to understand why theyre doing what theyre doing. They know the basic why, but its not often thought about the extended reason why. Most of the time, working as a bedside RN, youre given the essential information about the topic and told to do it. In reality, there is much more to know. Healthcare workers do what they do because of translational research.

Translational research takes what healthcare science has discovered and puts the findings into action (Grady, 2010). It goes through a rigorous process before it can be utilized in patient care, however. There are several stages where the research is tested in clinical trials. If it passes, it is then put into the dissemination phase. This is where it is sent to healthcare providers (Grady, 2010). From there, it can remain as is or changes can be made to further advance healthcare science (Grady, 2010). A perfect example of this is the treatment of HIV. Healthcare science has worked tirelessly to create drugs to battle HIV. Multiple drug classes have been utilized and if there has been a drug failure, there is attempts to create something better or more effective (Boynton & Elster, 2012). Because of this effort, other diseases are benefiting as well (Boynton & Elster, 2012). That science is translational.

POST 2

In using the GCU Library I located an article that discussed translational research which focused on readmissions to a different hospital (nonindex) than the original hospital (index) where the patient received treatment. The goal of the research was to determine if readmission to a nonindex facility within 90 days after a subarachnoid hemorrhage can compromise quality of care resulting in increased morbidity (Tang, et al., 2019). The study was conducted on from 2010 2014 on 9254 patients who were treated for ruptured aneurysm. 1985 which is about 21.5% were readmitted within 90 days of which 17.9% were admitted into a nonindex facility. The results of the study determined that patients readmitted to non index hospitals post treatment of subarachnoid hemorrhage were at greater risk of developing complications or subsequent readmissions. The belief is care may be fragmentated. The study determined that interventions aimed at improving continuity of care may decrease high morbidity associated with nonindex readmissions.

The type of translational researched used for this study is T1 basic to clinical. The information from this research can continue to enhance clinical trials leading to change in practice and quality of care. Based on evidence yielded from studies and clinical trials how nurses practice can be determined and enhanced. I believe that translational research is the best for subarachnoid aneurysm treatment because rate of hospital readmissions and patient decline could possibly be lessened by providing continuity of care and changing how patients are treated post procedure.

POST 3

As we all know healthcare is ever changing and evolving. The recent shift to value-based health care and its impact on the roles and responsibilities of the advanced registered nurse in the healthcare field has transformed to meet the needs of the healthcare industry. The advanced registered nurse has different roles and responsibilities with the shift to value-based health care. The advanced registered nurse will evolve to have a bigger scope of practice. The advanced registered nurse will do more than assessment and nursing diagnoses including working with the physician. They are expected to have clinical judgement and skills beyond that of a regular registered nurse. The advanced registered nurse will have a bigger scope not only assessing and diagnosing patients but also prescribing medications. The healthcare system continuously changes and the role and scope of the advanced registered nurse also changes to meet these demands. There are many benefits to having advanced practice nurses including improving costs, registered nurses (RN) roles and scope of practice have been expanded in many countries and the quality and cost-effectiveness of healthcare systems have improved (Fagerstrm, 2012). The advanced registered nurse is necessary to assist the physician and reduce the workload. According to a fact sheet published by Nurse Journal, nurses have a long history of being subservient to the doctors or healthcare systems under which they work, advanced practice nurses have a chance to break this glass ceiling and become significantly more autonomous in their scope of practice and their ability to rely on their own knowledge to make decisions about patient health (Nurse Journal, 2019). The major evolving trend in the health care delivery system is the increase in advanced practice nurses. This will improve practices and give nurses a lot more independence and ability to make judgement calls.

POST 4

While value-based health care may superficially seem income driven, it is primarily based upon patient safety. Prior to the initiation of value-based health care, hospital acquired conditions were common. A patient would expect that a hospitalization would end in a cure and better health. However, it may have included a central line infection as well as a catheter associated urinary tract infection. Ultimately, it was patient harm acquired on hospital time.

Currently, hospitals covered under Centers for Medicare and Medicaid Services (CMS) must meet benchmark criteria for bundles to prevent hospital acquired conditions (HAC). If these criteria are not met and HAC scores are greater than the 75th percentile, CMS payments to hospitals are reduced (CMS, 2020). In efforts to obtain as much reimbursement as possible, hospitals have taken to following bundles and creating protocols to prevent and minimize HACs. RNs are a crucial part of this process, being the bedside caretakers of patients.

Advanced registered nurses may not typically spend much time at the bedside, but their involvement in value-based health care is critical. Nurse managers are involved in the protocol process and bundle compliance audits. Nurse Practitioners must initiate orders for DVT prophylaxis and assess for central line and Foley necessity. Nurse educators must relay proper bundle technique and compliance to new hires and update current employees.

In my current (and new) role as Sepsis Program Coordinator, I will be greatly affected by the current CMS guidelines for patient safety indicator 13, postoperative sepsis rates. The role I will fill was created upon CMS FY 2020 measures. Sepsis is not a condition solely acquired within a health care facility, but its management upon diagnosis is critical for survival. Post-operatively, patients are at higher risk for developing sepsis. When bundle compliance is high, mortality rates are low (CMS, 2019). As the program coordinator, it will be my job to ensure that bedside nurses are following electronic prompts, that physicians are following bundle compliance within timely fashion, and that patients are educated and ready for discharge.

 

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