Transforming Nursing

Individual evidence resources

The title for the planned DNP project is ‘Tangible Virtual Treatment’ and the setting will be at the private practice Virtual Consult MD in Norcross, Georgia, USA. The private practice offers telepsychiatry to individuals across the lifespan. Physical monitoring before recommending and prescribing medication for various mental health conditions is not required. This quality improvement practice gap is an issue in my organization. For instance, research indicates that less than 50% of patients on prescription drugs in mental care settings undergo critical monitoring when they seek care in England (Ayre, Lewis, and Keers, 2023). Physical monitoring of vital signs and other areas such as weight and blood level for illicit drugs is critical for mental health patients. Furthermore, it guides the characteristics of the health condition and the patient’s body's ability to acclimate to the resulting stress on the well-being of their various physiological components (Sapra, Malik, and Bhandari, 2020).

The proposed type of project is a quality improvement initiative. This initiative is in line with the practice gap in my healthcare organization. A quality improvement initiative seeks to improve the identified practice gaps in an organization by implementing the related interventions. For instance, a quality improvement initiative for medication administration without consideration for patient monitoring will also educate staff within the organizational setting. Therefore, reiterating the basics tenants of patient care promotes -evidence-based practice in healthcare organizations while closing practice gaps.

References

Ayre, M. J., Lewis, P. J., & Keers, R. N. (2023). Understanding the medication safety challenges for patients with mental illness in primary care: a scoping review. BMC Psychiatry, 23(1), 1-17. clinical services (No. WHO/CDS/HIV/19.17). World Health Organization.

Sapra, A., Malik, A., & Bhandari, P. (2020). Vital sign assessment.

· The practice gap, in this case, is the administration of medication without prior physical monitoring of vital signs, weights, and blood levels for illicit drugs. The lack of such assessments negatively impacts nurses' responsiveness to critical solutions. Research carried out on 48,864 patients admitted in general wards between 2015 and 2018 reveals that early warning scores assessments such as vital signs were undermined in one-quarter of measurements (Elliott and Endacott, 2022). Clinical deterioration goes undetected when protocols like physical monitoring before medicine administration have low compliance rates in organization settings including mental health care organizations. This lack of compliance is persistent in health care provision, with the assessment of vital signs being often neglected in clinical practice despite them being a critical part of care provision. According to Eddahchouri, et al. (2021), the factors contributing to negligence in vital signs assessment include the nurse’s experience, the absence of formal guidelines, and the idea that vital signs assessment is neglectable in low-risk patients. The lack of physical patient monitoring is a problem in nursing and healthcare in general as it undermines the lives of patients resulting in avoidable deaths.

References

· Eddahchouri, Y., Koeneman, M., Plokker, M., Brouwer, E., van de Belt, T. H., van Goor, H., & Bredie, S. J. (2021). Low compliance to a vital sign safety protocol on general hospital wards: a retrospective cohort study.  International Journal of Nursing Studies,  115, 103849.

· Elliott, M., & Endacott, R. (2022). The Clinical Neglect of vital signs’ assessment: an emerging patient safety issue?.  Contemporary Nurse,  58(4), 249-252.