Foundations and Essentials for the Doctor of Nursing Practice

BLOG: THE DNP-PREPARED NURSE AND THEIR COMMUNITY

respond to two of your colleagues by suggesting additional strategies your colleague could implement to bring about needed change in their community.

PEER #1

Chikita Domonique Smith

As a nurse with a doctorate degree, I have a keen understanding of the various problems and opportunities that face my organization and society. The following are two of the most pressing issues that need advocacy:

Vaccine and Immunization Legislation:

The ongoing pandemic of COVID-19 highlights the significance of vaccination and immunization. Nonetheless, issues of vaccine hesitancy, accessibility, and awareness persist in my community. Since immunization not only safeguards individual health but also contributes to public health outcomes, it is vital for a DNP-prepared nurse to address this issue (Bowles, 2020). We may strengthen community immunity and stop the spread of vaccine-preventable diseases by campaigning for policies and programs that promote vaccination based on evidence. In terms of advancing population health and lobbying for policy shifts, this is consistent with AACN Essentials.

How to Reduce Patient Falls at a Medical/Surgical Hospital:

Patient falls are a major issue in hospitals because they frequently lead to serious injuries, extended hospital stays, and higher healthcare expenditures. The DNP-prepared nurse's focus on patient falls is in line with AACN Essentials for enhancing healthcare quality and patient safety (Wright et al., 2022). Reducing the number of injuries caused by falls on the medical/surgical ward requires the implementation of fall prevention techniques and staff education programs supported by scientific data. This can be done by conducting regular risk assessments, installing bed alarms, improving patient education, and establishing a safety culture within the healthcare facility.

Recommended Practice Changes/Interventions

Vaccine and Immunization Legislation:

· Together with local politicians, public health agencies, and community groups, come up with and support laws that require eligible people to get vaccines while also allowing medical exemptions.

· To help underprivileged groups and fight vaccine doubt, it is important to set up immunization clinics and training programs in the community (Gonzales et al., 2021).

· Use social media, talks, and partnerships with local businesses and schools to spread the word about the benefits of vaccinations and bust myths about them.

Reducing the Number of Patient Falls:

· All hospitalized patients should be provided the same fall risk assessment tools upon their arrival and at regular intervals throughout their stay.

· Some of the fall prevention measures that should be addressed in continuous staff training programs include patient location, the use of assistive devices, and medication management.

· To keep track of fall risk alerts and interventions in real time, employ electronic health records and other technological tools such as bed alarms and pressure-sensitive mats (Oh-Park et al., 2021).

· Encourage the development of a system in which near calls with falls are documented and studied so that safety measures can be enhanced over time.

As a nurse with a Doctor of Nursing Practice, I want to improve health outcomes and bring about social change by solving these important needs and problems in my community and at work. These projects are in line with the AACN Essentials because they focus on patient safety, improve healthcare quality, and push for policies that are backed by evidence to make the health of the whole community better.

Reference:

Bowles, A. (2020). Methods to Reduce Vaccine Errors in Primary Care and Pediatric Clinical Setting (Doctoral dissertation, Bradley University).

Gonzales, A., Lee, E. C., Grigorescu, V., Smith, S. R., De Lew, N., & Sommers, B. D. (2021). Overview of barriers and facilitators in COVID-19 vaccine outreach. US Department of Health and Human Services.

Oh-Park, M., Doan, T., Dohle, C., Vermiglio-Kohn, V., & Abdou, A. (2021). Technology utilization in fall prevention. American Journal of Physical Medicine & Rehabilitation, 100(1), 92-99.

Wright, R., Lee, Y. J., Yoo, A., McIltrot, K., VanGraafeiland, B., Saylor, M. A., ... & Han, H. R. (2022). Doctor of nursing practice project: Key challenges and possible solutions. Journal of Professional Nursing, 41, 53-57.

PEER # 2

Lizette Girado

Week 7 Blog - Addressing Crucial Challenges in Healthcare

     In today's healthcare arena, ensuring patient safety and reducing costs are pivotal objectives that significantly impact the quality of care delivered. The two pressing issues that warrant immediate attention are reducing the incidence of patient falls in the medical-surgical unit and standardizing perioperative care through Enhanced Recovery After Surgery (ERAS) protocols.

Reducing Patient Falls in the Medical-Surgical Units

     Patient falls are a critical safety concern, contributing to increased morbidity, extended hospital stays, and elevated healthcare costs (LeLaurin & Shorr, 2019). Falls can also affect patient satisfaction and have legal repercussions for the healthcare facility.

Interventions

· Establishing a Fall Prevention Tool Kit

· Creating and utilizing a fall prevention toolkit can provide a structured and standardized approach to assessing fall risks and implementing prevention strategies. A study conducted by Dykes et al. (2020) found that a nurse-led toolkit that engaged the patient and their family significantly decreased the rate of patient falls per 1000 patients days.

· Utilizing Technology

· Implementation of bed alarms and fall detection systems can act as a crucial layer of protection, alerting staff in real-time should a fall occur (Cuttler et al., 2017).

Standardizing Perioperative Care Through ERAS Protocols

     Inconsistent perioperative care can lead to postoperative complications, extended hospital stays, and delayed patient recovery. ERAS protocols are evidence-based and multidisciplinary perioperative care pathways that aim to reduce surgical stress, promote patient mobilization, and expedite recovery, thus enhancing overall patient outcomes while being cost-effective (Altman et al., 2019).

Interventions

· Multidisciplinary Training and Education

· Conducting regular training sessions on ERAS protocols for all perioperative staff ensures consistency and adherence to standardized procedures, promoting a unified approach to patient care (Altman et al., 2019).

· Continuous Monitoring and Evaluation

· Establishing a system for ongoing monitoring and evaluation of ERAS protocol implementation can identify areas of improvement, ensuring that the desired outcomes in reducing complications and expediting recovery are achieved (Blumenthal, 2019).

     Aligning with the American Association of Colleges of Nursing (AACN) Essentials, a Doctor of Nursing Practice (DNP) prepared nurse is uniquely positioned to lead these initiatives. Leveraging competencies in organizational leadership, quality improvement, and evidence-based practice can significantly address these challenges. By promoting a culture of safety, interdisciplinary collaboration, and data-informed decision-making, substantial strides can be made in enhancing patient care and organizational excellence.

References

Altman, A. D., Helpman, L., McGee, J., Samouëlian, V., Auclair, M.-H., Brar, H., & Nelson, G. S. (2019). Enhanced recovery after surgery: Implementing a new standard of surgical care. Canadian Medical Association Journal, 191(17), E469–E475.  https://doi.org/10.1503/cmaj.180635 Links to an external site.

Blumenthal, R. N., MD. (2019, June). ERAS: roadmap for a safe perioperative journey. Anesthesia Patient Safety Foundation. Retrieved October 9, 2023, from  https://www.apsf.org/article/eras-roadmap-for-a-safe-perioperative-journey/#:~:text=ERAS%20protocols%20provide%20transformative%20plans,opioid%20usage%20in%20surgical%20patients Links to an external site.

Cuttler, S. J., Barr-Walker, J., & Cuttler, L. (2017). Reducing medical-surgical inpatient falls and injuries with videos, icons and alarms. BMJ Open Quality, 6(2), e000119.  https://doi.org/10.1136/bmjoq-2017-000119 Links to an external site.

Dykes, P. C., Burns, Z., Adelman, J., Benneyan, J., Bogaisky, M., Carter, E., Ergai, A., Lindros, M., Lipsitz, S. R., Scanlan, M., Shaykevich, S., & Bates, D. (2020). Evaluation of a patient-centered fall-prevention tool kit to reduce falls and injuries. JAMA Network Open, 3(11), e2025889.  https://doi.org/10.1001/jamanetworkopen.2020.25889 Links to an external site.

LeLaurin, J. H., & Shorr, R. I. (2019, March 1). Preventing falls in hospitalized patients: state of the science. National Library of Medicine.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6446937/ Links to an external site.