NUR 495 ASU Strategic Planning in Nursing Environment Paper

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Assignments View Feedback Feedback for 6.3 Assignment: Strategic Plan Paper • Add to ePortfolio Submission Feedback Overall Feedback Please review the instructions in the module and the comments. You have good information and background as to what a strategic plan is, who would be stakeholders etc. However, I can not discern the specific problem you would be dealing with, what is your SMART outcome and plan including how you would evaluate.? Rubric Name: 6.3 Assignment Rubric (4 criteria)(5 levels)(Content; Critical Analysis; College-Level Writing; APA Citing and Referencing)(200pts) EXLE #2 of Discussion Post Rodriguez-Discussion 1.2 Contains unread posts Candice Rodriguez posted Nov 16, 2021 7:32 PM Subscribe Delirium- “a disturbed mental state in which the patient cannot sustain attention, the environment is misperceived, and the stream of thought is disordered. The individual may experience changes in cognition (which can include disorientation, memory impairment, or disturbance in language), perceptual disturbances, hallucinations, illusions, and misinterpretation of sounds or sights. The episode develops quickly and can fluctuate over a short period. Delirium may be caused by various conditions, such as infections, cerebral tumors, substance intoxication and withdrawal, head trauma, and seizures.” (APA Dictionary of Psychology). Delirium is often seen within the intensive care unit (ICU), especially among ventilated patients. It can harm our patients in a multitude of ways. We can often see increased time on the ventilator, prolonged stays in the ICU, and longer overall hospital stays. There are marked increased care costs for these patients due to their medical state and the longer duration of stay. Studies have suggested patients who suffer from ICU delirium have a higher mortality rate –both in-hospital and after discharge. There may also be an increased risk of long-term cognitive dysfunction among survivors (Cavallazzi et al., 2012) It is unknown how long a stay will make illicit the onset of delirium among intensive care patients. Studies suggest that a modest projection of the incidence of delirium in the ICU ranges from 45% to 87%. It may be much higher than that due to inconsistency due to lack of knowledge of the variety of assessment tools available and overlooking the early signs among high-risk individuals. To counter these roadblocks, we need to screen consistently and screen early to recognize the risks of delirium and prevent it from occurring. Through education of staff and families of ventilated patients, we can spread awareness of this phenomenon and recognition of patients at risk and the signs of delirium. Nursing education is essential to appropriately screen, identify, and implement care plans in patients with ICU delirium. Bedside critical nurses need to be prompt in their assessments as we are in close contact with our patients at all times. Thus we are best equipped to respond, detect, prevent and even treat delirium. If you’re working in an ICU, you likely discovered no specific educational training designed for nurses to respond to ICU delirium issues. The objective here is to identify new educational ways to increase our knowledge on the delirium in ICU topic, enhance our patient care skills, and boost our confidence level over the next six weeks. Being aware that ICU delirium is an issue in our environment is the first step towards better bedside care. Studies show that although reversible, ICU delirium can affect patient outcomes. (Marino et al., 2015). References Cavallazzi, R., Saad, M., #038; Marik, P. E. (2012). Delirium in the ICU: an overview. Annals of intensive care, 2(1), 49. https://doi.org/10.1186/2110-5820-2-49 Marino, J., Bucher, D., Beach, M. , Yegneswaran, B. #038; Cooper, B. (2015). Implementation of an Intensive Care Unit Delirium Protocol. Dimensions of Critical Care Nursing, 34(5), 273–284. DOI: 10.1097/DCC.0000000000000130 11/17/21, 6:04 AM 1.4 Assignment – 4WI2021 Bacca Capstone: Synth/Evaluat (NUR-495-01A) – Indiana Wesleyan University 1.4 Discussion Rubric (8 criteria)(5 levels)(varying points)(80pts) Course: 4WI2021 Bacca Capstone: Synth/Evaluat (NUR-495-01A) Criteria Level 5 Level 4 Level 3 Level 2 Level 1 Criterion Score Statement of Need or Problem to Be Addressed 10 points 9 points 7 points 5 points 3 points / 10 Accurate, specific, and succinct statement of need or problem statement is provided to guide the strategic plan. (8-9) points (6-7) points (4-5) points (0-3) points Accurate, specific statement of need or problem statement is included, but lacks succinct phrasing. Statement of need or problem statement is included, but lacks specificity to serve as foundation for the strategic plan. Statement of need or problem statement is included, but lacks succinct phrasing and specificity to serve as foundation for the strategic plan. Statement of need or problem statement is lacking focus or is omitted. https://brightspace.indwes.edu/d2l/lms/dropbox/user/folder_submit_files.d2l?ou=155809#038;db=424486 1/6 11/17/21, 6:04 AM 1.4 Assignment – 4WI2021 Bacca Capstone: Synth/Evaluat (NUR-495-01A) – Indiana Wesleyan University Criteria Level 5 Level 4 Level 3 Level 2 Level 1 Criterion Score Background of the Problem 20 points 19 points 15 points 11 points 0 points / 20 Exemplary analysis of literature to support the need/problem to be addressed. (16–19) points (12-15) points (8-11) points (0-7) points Satisfactory analysis of literature to support the need/problem to be addressed. Limited analysis of literature to support the need/problem to be addressed. Limited analysis of literature to support the need/problem to be addressed. Analysis of literature to support the need/problem is scant or omitted. Minimum of three pertinent, scholarly sources are used to validate the need. Fewer than three current, pertinent, scholarly sources are used to validate the need. Fewer than three current, pertinent, scholarly sources are used to validate the need. Minimum of three current, pertinent, scholarly sources are used to validate the need. Project Outcome Minimum of three pertinent, scholarly sources are used to validate the need. 10 points 8 points 6 points 5 points 3 points Expertly crafted project outcome is specific, measurable, realistic, with a timeline, and accurately conveys the intended outcome of the planned change project. (8-9) points (6-7) points (4-5) points (0-3) points Adequately phrased project outcome is specific, measurable, realistic, with a timeline, and accurately conveys the intended outcome of the planned change project. Project outcome is phrased incorrectly by conveying an activity, output or intervention, and includes limited SMART goal criteria. Project outcome is phrased incorrectly by conveying an activity, output or intervention, and does not include SMART goal criteria. Project outcome is omitted or is phrased incorrectly and loosely related to plan by conveying an activity, output or intervention rather than an outcome statement. https://brightspace.indwes.edu/d2l/lms/dropbox/user/folder_submit_files.d2l?ou=155809#038;db=424486 / 10 2/6 11/17/21, 6:04 AM 1.4 Assignment – 4WI2021 Bacca Capstone: Synth/Evaluat (NUR-495-01A) – Indiana Wesleyan University Criteria Level 5 Level 4 Level 3 Level 2 Level 1 Criterion Score Activities and 10 points 9 points 7 points 5 points 0 points / 10 Includes comprehensive, specific activities to facilitate achievement of the stated outcome, along with a specific timeline congruent with the project scope. (8-9) points (6-7) points (4-5) points (0-3) points Includes specific activities to facilitate achievement of the stated outcome, along with an estimated timeline congruent with the project scope. Includes an overview of activities loosely related to the stated outcome, along with an estimated timeline that demonstrates limited congruence with the project scope. Includes an overview of activities weakly related to the stated outcome, along with an estimated timeline that demonstrates weak congruence with the project scope. Activities and timeline are not congruent with the stated outcome or with the project scope, or are omitted. 10 points 9 points 7 points 5 points 3 points The evaluation plan specifically aligns with the project outcome and accurately describes how the outcome will be measured or evaluated. (8-9) points (6-7) points (4-5) points (0-3) points The evaluation plan aligns with the project outcome and adequately describes how the outcome will be measured or evaluated. The evaluation plan loosely relates to the project outcome and minimally describes how the outcome will be measured or evaluated. The evaluation plan is weakly related to the project outcome or fails to describe how the outcome will be measured. The evaluation plan is unrelated to the project outcome, fails to describe how the outcome will be measured, or is missing altogether. Timeline Evaluation Plan https://brightspace.indwes.edu/d2l/lms/dropbox/user/folder_submit_files.d2l?ou=155809#038;db=424486 / 10 3/6 11/17/21, 6:04 AM 1.4 Assignment – 4WI2021 Bacca Capstone: Synth/Evaluat (NUR-495-01A) – Indiana Wesleyan University Criteria Level 5 Level 4 Level 3 Level 2 Level 1 Criterion Score Online 5 points 4 points 3 points 2 points 0 points /5 Posting is made by the end of the fifth day of the workshop. Posting is made by the end of the sixth or seventh day of the workshop. Posting is made by the end of the sixth or seventh day of the workshop. (1-2) points Posting is made after the seventh day of the workshop or is missing altogether. Well–developed post that fully addresses assignment and provides strong evidence of critical thinking. Satisfactorily developed post that addresses the majority of the assignment and provides some evidence of critical thinking. Weakly developed post that addresses less than the majority of the assignment and provides the beginnings of critical thinking. Response to at least one peer is posted before the end of the workshop. Response to at least one peer is posted before the end of the workshop. Timeliness (Onsite students are assessed on responsiveness in class discussions) Response to at least one peer is posted before the end of the workshop. https://brightspace.indwes.edu/d2l/lms/dropbox/user/folder_submit_files.d2l?ou=155809#038;db=424486 Posting is made on the seventh day of the workshop. Weakly developed post that addresses less than the majority of the assignment and provides the beginnings of critical thinking. Response to at least one peer is posted before the end of the workshop. 4/6 11/17/21, 6:04 AM 1.4 Assignment – 4WI2021 Bacca Capstone: Synth/Evaluat (NUR-495-01A) – Indiana Wesleyan University Criteria Level 5 Level 4 Level 3 Level 2 Level 1 Criterion Score Online Forum Engagement 5 points 4 points 3 points 2 points 0 points /5 Response to one peer is substantive, adds significant depth and meaningful insights to the discussion, and is at least six sentences in length. Response to one peer is substantive, adds reasonable depth and insight to the discussion, and is at least six sentences in length. Response to one peer adds limited depth and insight to the discussion, or falls short of the six sentence length requirement. (1-2) points No response to a peer. Response includes analysis of information presented with strong suggestions to enhance the plan. Response includes weak analysis of information presented, with limited suggestions to enhance the plan. 10 points 9 points 7 points 5 points 3 points Spelling, grammar, punctuation, sentence and paragraph structure are correct. (8-9) points (6-7) points (4-5) points (0) points One or two errors in APA and/or college-level writing style. Three or four errors in APA and/or college-level writing style. Five to ten errors in APA and/or college-level writing style. More than ten errors in APA and/or college-level writing style. (Onsite students are assessed on responsiveness in class discussions) Response includes critical analysis of information presented and creative, constructive suggestions to enhance the plan. APA and College-level Writing Style Response to one peer adds no depth or insight to the discussion, or falls short of the six sentence length requirement. Response includes no analysis of information presented, with limited suggestions to enhance the plan. / 10 Sources are cited and referenced in correct APA format. https://brightspace.indwes.edu/d2l/lms/dropbox/user/folder_submit_files.d2l?ou=155809#038;db=424486 5/6 11/17/21, 6:04 AM 1.4 Assignment – 4WI2021 Bacca Capstone: Synth/Evaluat (NUR-495-01A) – Indiana Wesleyan University Total / 80 Overall Score Level 1 0 points minimum https://brightspace.indwes.edu/d2l/lms/dropbox/user/folder_submit_files.d2l?ou=155809#038;db=424486 6/6 EXLE #1 OF DISCUSSION POST 1.2 Discussion Contains unread posts Devon Hanson posted Nov 16, 2021 9:41 PM Subscribe Definition of the Problem: Present a detailed description of the elements of the problem. Nurses play critical roles in relaying and making information understandable for their patients. Nurses can be very busy during their shifts, especially during the current pandemic. They sometimes forget or deprioritize taking the time to get to know their patients and their needs. When patients are confused or overwhelmed about their care and feel alone, they tend to give poor scores on their Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. Currently, at OSF St. Francis Hospital in Escanaba, MI, there is no “commit to sit” program or service available to inpatients on the medical-surgical unit. OSF St. Francis Hospital HCAHPS survey scores for “Overall Rating of Hospital” is at a 43 percentile with a target percentile of 77. More specifically, the “Nurses Listen Carefully to You” section of the HCAHPS survey scores has also significantly declined since October of 2020. With the implementation of the commit to sit program, patients’ anxiety and confusion will decrease, resulting in better patient outcomes, mentally and physically. With better patient outcomes come better HCAHPS survey scores. Development of Solution Options: Identify the desired future state/conditions that would ideally solve the problem. Include the actions that would be required to achieve the desired change. The “commit to sit” program is when a nurse commits to sit, ideally at eye level, with their patient to engage in a 5-10-minute conversation about the nurse and patient’s goals, concerns, and plan for the shift. The goal is to increase the medical-surgical patients’ HCAHPS survey scores at OSF St. Francis Hospital after implementing the “commit to sit” strategic plan. An action that could be implemented to achieve this outcome would be to create a dialogue for the nursing staff to follow for their 5-10-minute conversations. This will help to lessen any anxiety or uncertainty about what to speak with the patients about. These conversations could be done while doing required tasks such as administering medication or administering blood products during their shift. To sit with the patient at eye level, chairs must be present for the nurse to sit by the patient’s side. If no chair is available, the nurse may sit on the patient’s bed if appropriate. Nurses would have to be willing to participate in and implement the commit to sit program. An important step is to have specific nurses be strong advocates to ensure the sit-down conversations are being done on each patient to create accountability for each shift. These chosen nurses could be the charge nurse for each shift. A form should be filled out or signed by each nurse that the sit-down was completed and reported in the weekly newsletters by the unit manager. Feasibility of Planned Change: Evaluate the feasibility of your planned change by addressing physical resources, time resources, financial resources, and stakeholder involvement. Refer to Figure 1.4 on p. 15 in the textbook, Fundamentals of Project Management (Heagney, 2016) and address the questions listed under “Plan the Project.” “What must be done?” The goal is to increase the medical-surgical patients’ HCAHPS survey scores from the current 43 percentile ranking to at least a 50 percentile at OSF St. Francis Hospital within eight weeks after implementing the “commit to sit” strategic plan. The nursing staff needs to be educated on the commit to sit program before initiating the program for eight weeks. The nurses must then have 5-10-minute conversations with their patients during their shift. “Who will do it?” The nurse/unit manager, the nursing staff, charge nurses, and nursing supervisors will need to work together to implement the program. The Chief Nursing Officer, Lacey Crabb, has already been notified of the desire to implement this program on the medical-surgical unit and has granted permission to do so. In addition, Merrisa Macgregor, a nursing supervisor at OSF St. Francis Hospital, has experience implementing the commit to sit program at facilities she previously worked at. She will be an important resource during the 8-week implementation period. The patient safety coordinator, Megan Maki, should also be involved to help with survey results. The patients also need to be compliant and willing to have conversations with the nursing staff. The nursing staff will have to determine what patients are appropriate to have these conversations with. This program also relies on patients completing their surveys for accurate results. “How will it be done?” Every nurse in the unit needs to be provided information and education on the commit to sit program and how to implement it with their patients. This project will be done by the nursing staff having 5-10minute conversations with their patients during their shift. HCAHPS scores from the medical-surgical unit patients’ surveys would be collected before and after implementing the commit to sit plan. The data collected would have to be compared and analyzed. “When must it be done?” This must be done within 8-weeks to get accurate results. If this program was completed sooner, there might not be enough data, patients, nursing staff, or time to evaluate the results of the surveys. Patient census, acuity, and appropriate staff need to be accounted for. Ideally, the program’s implementation would be done as soon as possible, seeing as the current survey results are significantly lower than the desired target percentile. “How much will it cost?” This program should not cost the staff or facility any money. This program needs commitment from the nursing staff and other stakeholders involved. “What do we need to do it?” To implement this program, commitment, accountability, communication, determination, and hard work must be involved. Most importantly, we need the willingness and compliance from the nursing staff to initiate the conversations. We also need patients to complete their HCAHPS surveys. Problem Statement: In two to three concise sentences, list the problem statement you have developed from this analytical exercise. OSF St. Francis Hospital does not have a “commit to sit” program within their facility, specifically the medical-surgical unit. Implementing the commit to sit program over eight weeks can positively impact the patients’ experience, which can result in higher Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey scores. OSF St. Francis Hospital HCAHPS survey scores for “Overall Rating of Hospital” currently rank at a 43 percentile with a target percentile of 77. Running Head: Strategic Planning 1 Strategic Planning in Nursing Environment Hope J. Chung School of N…

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