The described scholarly activity is concerned with designing, implementing, and evaluating a patient experience initiative in the hospital. The project is based on the results of the HCAHPS scores and domains. The initiative focuses on three primary issues that the facility has to reform. The first one is the communication with patients about medications. The second identified problem is the interaction between nurses and patients. Finally, the staff’s responsiveness is the third issue that needs improvement. The target market for this activity includes facilities where nurses actively engage with patients who stay at the hospital. Thus, patient data allows the participants of the program to develop and introduce a program for nurses. This activity is beneficial to me because it provides an opportunity to contribute to nursing education as well as create practical initiatives to increase the quality of patient experiences.
Overall, the initiative is designed to improve the quality of care for patients. Currently, the present hospital has HCAHPS scores of 22% of VBP (Value-based Purchasing). This rate affects other indicators of quality such as CMS Star Rating and Hospital Leapfrog Grade. Therefore, one can see that the problem of nurses’ communicative skills persists in the facility. The data collected from HCAHPS shows that, out of five impactful domains of quality, three can be targeted with the designed program. The first issue lies in the fact that nurses may fail to talk to patients about the medications that they later have to take. Thus, patients may not know about the possible side effects or outcomes of using medication improperly which increases the risk of noncompliance.
Secondly, communication between nurses and patients is lacking in other areas such as respect, attentive listening, participation in decision-making processes, and others. Here, the problem also affects patients and nurses as well as the hospital in general. For patients, this lack of communication means that their needs are neglected. The hospital, in turn, can be affected by negative reviews and the loss of clients which can subsequently lead to decreased quality of performance and limited resources. As a result, nurses and other medical workers are also affected by the lack of communication. The third area of concern reflects reveals outcomes, as it deals with personnel’s responsiveness to patients. In this case, however, nurses may face accusations of neglectful care if they do not respond to patients’ calls.
The DNP-prepared nurse can use the knowledge and experience to design and implement the initiative. As a result, many competencies may be challenged and achieved as the nurse synthesizes academic knowledge in order to provide practical solutions. This project allows DNP-prepared nurses to show that the preparation of a plan and its introduction to the facility leads to increased quality of care – a goal that can be considered vital in the industry.
The solution, similar to the problem’s description, is divided into three sets of actions, each of which addresses the particular issue that the hospital faces.
- The first group of activities targets nurses’ explanation of medications to patients:
- A nurse interacts with patients to learn about medications that are new for them. Then, the nurse places an “M” on the board to remember to explain this medication’s specifications to the patient (purpose, side effects).
- Classes that discuss patient-specific medications are reviewed every day during the patient’s stay in the hospital.
- Nurses should use additional information about the medications during teach-back sessions.
- The second set of practices deals with other types of nurse-patient conversations:
- Nurses must engage patients and their loved ones in the process of care through bedside shift reports (BSR). Here, the hospital’s workers emphasize safety and quality in the delivery of care.
- Nurses should employ specific concepts during a conversation with a patient such as Acknowledge, Introduce, Duration, Explanation, Thank you (AIDET).
- Nurses should create daily plans and display them on the board so that the staff would engage in meaningful reporting of activities.
- Nurses should use “Laymen’s Terminology” – simple language that is easy to understand for non-medical workers. For example, specific terminology and abbreviations should be excluded from patient conversations and replaced with words that the patient will understand.
- Nurses should describe each action that they are going to perform while working with a patient. Finally, they should also use the whiteboard to check their plans.
The final group of changes is focused on increasing responsiveness:
- Nurses should conduct hourly rounding during which they should address four P’s – Pain, Potty, Position, and Personal Items.
- The hourly rounds are performed during the day (from 6 AM to 10 PM). At night, the rounds can be completed every two hours.
- Nurses should engage with patients whenever they are in the room.
- Nurses are to always respond to patient calls in a timely manner. If a nurse is near the patient who requires assistance, he/she should help the patient or contact another professional.
Participation in the described initiative offers experience in using patient data as a source of project development and quality improvement. In this case, nurses focus on the analytic foundations of professional practice and population management. In particular, the utilization of the HCAHPS scores and their evaluation lead a DNP-trained nurse in this assignment. Moreover, DNP-prepared nurses educate themselves on the basics of systems management and leadership. Participation requires one to produce, implement, and evaluate multiple practices. By integrating nursing science and patient population data into the creation of solutions, nurses marry their theoretical knowledge with real-life situations, applying competencies and gathered information to serve their population. This program allows one to demonstrate leadership and collaboration with nurses since all interventions need the staff’s understanding and compliance. Finally, a nurse should recognize contemporary scientific research in creating the procedures for other personnel members to employ. For instance, the proposed solutions may not be effective if a contributing nurse fails to assess their usability and create appropriate goals.
Program Competencies Addressed
The program allows one to achieve multiple competencies that pertain to domains of scientific underpinnings, transformational leadership, population management, and analytic foundations. The list of addressed competencies includes:
- The project integrates nursing, psychosocial, and organizational sciences to provide patients with care and attention.
- The initiative requires the DNP-prepared nurse to exercise leadership and advocacy skills in order to implement the change on an institutional level.
- The program includes monitoring outcomes of care through HCAHPS and quality improvement activities.
- By inspecting and improving nurse-patient communication, the project advocates for ethical and social justice.
- The initiative needs one to design practices that promote safe and efficient health care.