Improving Skilled Nursing Facilities Emergency Preparedness to a Pandemic Crisis

Subject: Nursing
Pages: 8
Words: 2576
Reading time:
11 min
Study level: PhD

The Social Change

Recognizing a lack of awareness about effective methods of addressing the global pandemic in a skilled nursing facility is vital. More consistent levels of consciousness will positively contribute to the emergence of change on multiple societal levels. COVID-19 directly impacts all health care consumers due to the extreme level of contingency that results in a high daily number of patients. Therefore, the advanced quality of nursing practices can positively influence social change, as appropriate care might significantly improve each individual’s personal experience in the hospital setting.

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Furthermore, various governmental organizations and stakeholders may also positively contribute to a social change brought by the research outcomes. Organizations can be compared to machines in the sense that they consist of interconnected parts (McHugh, 2010). Thus, when one component fails, it negatively affects other parts of the structure. Nurses are an essential part of the health care system; therefore, this research will have a beneficial effect on the proper functioning of organizations within which they operate. Lastly, nurses are a necessary part of emergency responses required to staff beds, triage new patients, and manage medicines, including vaccines. Overall, this DNP project can have a substantial impact on nursing practices during the pandemic, which will crucially impact social change.

Moreover, understanding Walden University’s mission and vision for encouraging social change through research, training, and knowledge, this DNP project will focus on improving the theoretical and practical levels of the facility. In doing so, this study’s findings can increase the quality of nursing staff response to national health emergencies. The COVID-19 pandemic has revealed partial unpreparedness for similar diseases. Therefore, improving the awareness of the crisis response through analyzing the existing literature can productively add to the following improvement in nursing practice, which will lead to positive social change.

Overall, various segments of society may benefit from the research project, as, first, the well-being and safety of patients is crucial for all members of a health care setting. Moreover, the government and other organizations, including stakeholders, will gain from the analysis because these institutions are only able to prosper within a stable environment. Lastly, the nursing setting can benefit from this research, as it is vital to continually improve essential skills that are involved in providing high-quality care for individuals during and after the global pandemic. In general, the study will bring an important contribution to all levels of population, which will result in community development.

Context for the Doctorate Project

This DNP project is not based on intervention, as it implies individual research of evidence-based strategies. The project will be implemented at the student’s place of employment. The facility is Water’s Edge Healthcare and Rehab Center. This organization is the choice of various doctors, clinics, and patients. The Water Edge is proficient in customer assistance as it highly values patient satisfaction. The nursing team assures that residents feel safe and comfortable in the facility, as it strives to provide them with the best care possible. The DNP project can be accomplished through the implementation of evidence-based strategies, providing higher-level emergency preparedness. The primary purpose of the research is to improve the quality of nursing and care management, which resonates with the mission of Water’s Edge Healthcare and Rehab Center. Therefore, this project can be fully achieved in this setting.

Sources of Evidence

Relevant evidence confirming the necessity to approach the recognized practice problem incorporates:

  • “Life in the Pandemic: Some Reflections on Nursing in the Context of COVID‐19” (Jackson et al., 2020).
  • “American Geriatrics Society Policy Brief: COVID-19 and Nursing Homes” (American Geriatrics Society, 2020)
  • “”We Are Alone in This Battle”: A Framework for a Coordinated Response to COVID-19 in Nursing Homes” (Behrens & Naylor, 2020)
  • “Reflections on Nursing Ingenuity During the COVID-19 Pandemic” (Newby et al., 2020)
  • “Oncology Nursing During a Pandemic: Critical Reflections in the Context of COVID-19” (Paterson et al., 2020)
  • “Nurse Expertise: A Critical Resource in the COVID-19 Pandemic Response” (Schwerdtle et al., 2020)
  • “Implications for COVID-19: a systematic review of nurses’ experiences of working in acute care hospital settings during a respiratory pandemic” (Fernandez et al., 2020).

The examined literature suggests that even though public health emergencies, such as the global pandemic, are rare, nurses are on the front line across the world. Currently, governments and medical facilities worry as nurses’ ability to provide care will reach its limits due to the rising workload and the quantities of nurses that are assumed to be influenced by the global health crisis (Jackson et al., 2020; American Geriatrics Society, 2020). Thus, the hiring of new nurses is inevitable. However, this requires specialized training, the renewing of knowledge, and supplementary information about care in the time of an epidemic. While some features of nursing do not change over time, the discipline of healthcare is fast-evolving, especially in the case of COVID-19 (Jackson et al., 2020). Nurses are obligated to be innovative; they attempt to discover ways to make the care experience better at every moment (Newby et al., 2020). Therefore, learning is a crucial process, which justifies that this project is particularly useful.

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Furthermore, the literature indicated both the need and the importance of the development of a renewed management manual for nurses during the situation of crisis (Jackson et al., 2020). Despite being actively involved in the battle against the global pandemic, nursing staff represent one of the professions that must be concerned with mitigating unpredictable circumstances (Jackson et al., 2020). Their combined fear is often in regard for themselves, vulnerable patients, co-workers, and loved ones (Jackson et al., 2020). Therefore, apart from caring for cases of COVID-19 at work, the safety of their own families weighs massively on nurses at these difficult times of uncertainty (Jackson et al., 2020). It is also essential to present a new educational program for nurses that would address the ways to manage stress during emergencies. Currently, the existing nursing manual does not correctly address these global fears, as nurses are putting their families and friends in potential danger after being exposed to infected individuals.

Moreover, the literature provides evidence that there is a lack of appropriate preparations in this ongoing situation. Nursing home residents account for a disproportionally high one-third of deaths from the global pandemic in the United States (Behrens & Naylor, 2020). This crisis has led to the emergence of unusual obstacles in providing high-quality care even in the most skilled nursing facilities. Thus, the situation requires effective action in the generating of solutions for the unique risks in care delivery during COVID-19. Therefore, learning more about management and care nursing methods within health emergencies is essential, as the current lack of appropriate practices justifies it.

Additionally, the study states that particular actions nurses take in the past have a high potential to inform preparations for a crisis today (Paterson et al., 2020). This is mainly possible by presenting historical evidence to notify emergency practices for the future. The article notes that nurses engage in all phases of the crisis response, including timely evacuation, both psychological and physical care, case detection, patients’ assessment measures, vaccinations, and more (Paterson et al., 2020). Therefore, training nurses is particularly important, as they are essential workers during the situation of crisis and have to be fully prepared. Moreover, some similarities exist between the Influenza pandemic and the COVID-19 crisis. Both viruses are rapidly spread through close contact and characterized by a rapid increase. Thus, conducting a comprehensive analysis of the most suitable nursing facilities’ approaches while managing a pandemic crisis throughout history can help contemporary health care specialists learn useful skills while handling COVID-19.

Furthermore, about five percent of infected individuals currently require critical care, and thirty percent of those expecting admission in intensive care (Schwerdtle et al., 2020). Thus, COVID-19 is putting tremendous stress on the essential services of care around the world. Various health systems are changing quickly by developing exceptional and new care workforce standards. Overall, health care professionals, retiree nurses, practicing nurses, and undergraduate students need to comprehend that essential knowledge, clinical abilities, and practice has to be renewed or are yet to be received. The research presents that for nurses in clinical practice, a noticeable influence from the pandemic correlates to the psychosocial consequences (Fernandez et al., 2020). Nurses experience pressure and anxiety connected with long-lasting separation from family, lack of sleep, massive workloads generated by demand in the medical system, and high staff shortages. Thus, the current system cannot provide a comfortable working environment for nurses. Therefore, a literature review can lead to an alternative management manual with improved practices that decrease stress levels among health specialists.

Health-care workers exhibiting symptoms of COVID-19 are isolated immediately. Contact tracing is used to identify any possible individuals the infected worker may have met (Ng et al., 2020). Rigorous testing is done to determine any outbreak of the disease among staff. The selected testing method has to have a fast turnaround time of 24 hours at maximum to minimize the risk of spreading the disease. In general, the staff should be checked for symptoms, and temperature should be measured upon arrival to work. The CDC recommends testing every 3 or 7 days and isolating the staff and patients who were in contact with the infected individual.

Family visits generally had to be limited to minimize risk of an outbreak, hence, family members visiting inpatients have to postpone their visits. While this could cause psychological stress to the patient, it is a necessary measure (Paterson et al., 2020). If needed, family members could provide technological devices such as iPad to help the patient communicate with them remotely. To limit any chance of spread, private rooms are best if available instead of semi-private rooms. However, private rooms lead to patients feeling helpless and isolated, indicating that nurses must be present and attentive to their needs (Liu et al., 2020). Overall, private rooms provide more protection for medical staff than semi-private rooms.

Lastly, nursing staff can be checked upon arrival for work; however, even if they pass obligatory symptoms and temperature screening policies, nurses can still be infected (American Geriatrics Society, 2020). Consequently, carrying the virus and affecting patients and other medical professionals. Evidence-based development plans for cleaning the patients’ environment include a mixture of deep cleansing with disinfection of surfaces and ultraviolet light use (UV-C) (Dexter et al., 2020). However, the lack of personal protective equipment or staff might prevent successful and thorough cleaning leading to further infections. The study suggests that former operating room administration statements have not determined the most suitable approach for assigning staff and cases to professionals during the global pandemic, hence the most appropriate way of managing patient assignment is yet to be determined (Dexter et al., 2020). Thus, the abovementioned imperfections in current management should be addressed in the study.

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The Approach or Procedural Steps

Procedural steps for answering the practice-focused question include conducting an extensive review of the literature on best approaches utilized by skilled nursing facilities for managing a pandemic crisis. An additional step consists of the development of a pandemic crisis management manual. The last step is the implementation of an education program for nursing staff on managing a pandemic crisis. One possible strategy to obtain data includes the use of various academic databases that will be able to provide the most relevant research presenting evidence-based nursing strategies. This analysis enables the utilization of resources from both online and offline libraries. The DNP project is acceptable, as it requires secondary-source research.

Ethical

This project will provide protection for human subjects by providing them with personal protective equipment (PPE) that can shield them from the virus. The primary purpose of this PPE is to ensure that no droplets of coughs, sneezes, or other body fluids are in contact with the personnel. Currently, the protective gear that is considered suitable for contacting with patients includes masks, gloves, coveralls, goggles, or other equivalent equipment. Sources of information that help determine the best suitable equipment are articles by Jackson et al. (2020) and Schwerdtle et al. (2020) that outline the essential safety measures for nurses working in dangerous conditions. In general, there are no ethical issues associated with the completion of this project since the project will focus on the review of literature that can help enhance the existing practices.

The research method is designed to not interfere directly with human subjects; therefore, the DNP provides full protection for patients. Secondary-data analysis is considered one of the most ethical methods, as it ensures the safety of information about individuals because it refers to already existing data (Jol & Stommel, 2016). However, to improve the quality of ethics throughout the study, it is essential to use peer-reviewed academic sources. This way, the project will use only scientifically approved data. Moreover, such a type of analysis requires appropriate citing, in order to give credit to all scholars whose works are used in the project. The data sources’ regions are unlimited, as the emergency instances can occur all over the globe. Therefore, the data will not be chosen primarily based on one country. The study will be handled carefully and impartially without prejudice or bias. The literature will be examined carefully and objectively. Form A will be presented to the Walden University Institutional Review Board for approval. Overall, the central possible ethical dilemma that might occur during the study is transparency, where the secondary source research uses a primary source of questionable ethicality. Thus, the research must thoroughly investigate the findings and methodology of the works used for the study to avoid this issue.

Alignment

All aspects of the research study align together to create a successful DNP project. The methodology based on secondary-data research is suitable for analyzing the most prominent strategies to manage a pandemic in skilled nursing facilities. The study directly influences social change among all the levels of the population, including patients, organizations, and nursing staff. Moreover, the research will be implemented within the context of Water’s Edge Healthcare and Rehabilitation Center. The philosophy of the center aligns with the primary goals of the study, which facilitates the accomplishment of the DNP project. Finally, the study is intended to be ethical and transparent with the full protection of patients’ identities and private information.

The contemporary academic literature reinforces the importance of developing new techniques for managing care settings in the case of emergencies. The articles suggest that nurses are essential workers during the COVID-19 pandemic; therefore, the development of new practices can lead to a more coordinated response (Jackson et al., 2020; American Geriatrics Society, 2020). The different aspects of the prospectus are aligned since the practice problem helps in managing a social change. Therefore, credible sources that support the discussed practice problem and the need to improve the existing practices of managing nurses’ work during the pandemic should be addressed. The practice-focused question and the approach will address the practice problem of not having an appropriate strategy for ensuring the safety of the nursing personnel when working during the times of the pandemic.

Overall, various academic journals, including the Journal of Aging & Social Policy and the Journal of the American Association of Neuroscience Nurses, indicate that the topic of the DNP project is relevant. The practice-based question will be successfully addressed through the procedural steps, including literature review, development of a manual, and the subsequent educational program. The practice-centered question of the study and the procedural steps align with the issues in practice. Overall, practice-based subjects and literature presented also correspond.

References

American Geriatrics Society. (2020). American geriatrics society policy brief: COVID-19 and nursing homes. Journal of the American Geriatrics Society, 68(5), 908–911. Web.

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Behrens, L. L., & Naylor, M. D. (2020). “We are alone in this battle”: A framework for a coordinated response to COVID-19 in nursing homes. Journal of Aging & Social Policy, 1–7. Web.

Dexter, F., Parra, M. C., Brown, J. R., & Loftus, R. W. (2020). Perioperative COVID-19 defense: An evidence-based approach for optimization of infection control and operating room management. Anesthesia & Analgesia, 131(1), 37–42. Web.

Fernandez, P. R., Lord, H., Halcomb, P. E., Moxham, P. L., Middleton, D. R., Alananzeh, D. I., & Ellwood, L. (2020). Implications for COVID-19: A systematic review of nurses’ experiences of working in acute care hospital settings during a respiratory pandemic. International Journal of Nursing Studies, 103637. Web.

Jackson, D., Bradbury‐Jones, C., Baptiste, D., Gelling, L., Morin, K., Neville, S., & Smith, G.D. (2020). Life in the pandemic: Some reflections on nursing in the context of COVID‐19. Journal of Clinical Nursing, 29, 2041-2043. Web.

Jol, G., & Stommel, W. (2016). Ethical considerations of secondary data use: What about informed consent? Dutch Journal of Applied Linguistics 5(2), 180–195. Web.

Liu, Q., Luo, D., Haase, J. E., Guo, Q., Wang, X. Q., Liu, S., Yang, J., Yang, B. X. (2020). The experiences of health-care providers during the COVID-19 crisis in China: A qualitative study. The Lancet Global Health, 8(6). Web.

McHugh, M. D. (2010). Hospital nurse staffing and public health emergency preparedness: Implications for policy. Public Health Nursing, 27(5), 442-449.

Newby, J. C., Mabry, M. C., Carlisle, B. A., Olson, D. M., & Lane, B. E. (2020). Reflections on nursing ingenuity during the COVID-19 pandemic. Journal of the American Association of Neuroscience Nurses. Web.

Ng, K., Poon, B. H., Puar, T. H. K., Quah, J. L. S., Loh, W. J., Wong, Y. J., Tan, T. Y., Raghuram, J. (2020). COVID-19 and the risk to health care workers: A case report. Annals of Internal Medicine, 172(11), 766–767. Web.

Paterson, C., Gobel, B., Gosselin, T., Haylock, P. J., Papadopoulou, C., Slusser, K., Rodriguez, A., & Pituskin, E. (2020). Oncology nursing during a pandemic: Critical reflections in the context of COVID-19. Seminars in Oncology Nursing, 36(3), 151028. Web.

Schwerdtle, P., Connell, C. J., Lee, S., Plummer, V., Russo, P. L., Endacott, R., & Kuhn, L. (2020). Nurse expertise: A critical resource in the COVID-19 pandemic response. Annals of global health, 86(1), 49. Web.