Impact on Patient Outcomes Essay

Directions
Please review the infographic as way to guide you in getting started with your assignment: Developing an Assignment with Integrity (Links to an external site.)
View a short tutorial with tips for completing this assignment: iCARE Paper Tutorial (Links to an external site.)
Getting Started: Interprofessional teams are part of practice trends we see developing in all aspects of care delivery. Consider you own work environment (or recent clinical setting).
For this assignment, consider the concept of interprofessional teamwork and patient outcomes.
Look to your current workplace as an example. (If you are not currently employed, look to a past workplace or clinical practice area.)Impact on Patient Outcomes Essay

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Apply the components of the iCARE concept to interprofessional teams in a short paper. (Body of the paper to be 3 pages, excluding the title page and references page)
iCARE components are:
C ompassion
A dvocacy
R esilience
E vidence-Based Practice (EBP)
How could you contribute to an interprofessional team and patient outcomes through nursing actions of: compassion, advocacy, resilience, and evidence-based practice?
Select one scholarly nursing article from CINAHL as a resource for your paper.
Additional scholarly sources can be used but are optional.
When searching in the CINAHL database, please limit your search word to one component of the paper you wish to emphasize, such as ‘Resilience’. Searching for the term iCARE will not produce the results you need.Impact on Patient Outcomes Essay
Elements of iCARE paper
Title page
Below are the headings to be used for this assignment.
Introduction: (No heading needed here in APA) Explain the type of work setting you are discussing and whether interprofessional teams are currently present. If interprofessional teams are present, indicate a team function that could be improved. If interprofessional teams are NOT present, indicate what type of team you think might be possible in the setting.
Describe a nursing action item for each component below that could contribute to: interprofessional team support; how this might impact the culture of your unit or organization; and possible impact on patient outcomes.Impact on Patient Outcomes Essay
Compassion
Advocacy
Resilience
Evidence-Based Practice
Summary: Include a summary statement of how iCARE components can support interprofessional teams and patient outcomes. Address how you may be able to influence this process of support for interprofessional teams overall in your unit or organization.
References: List any references used in APA format.
Templates
The prepared paper template is RECOMMENDED for this assignment.

iCare Assignment Template (Links to an external site.) – APA 6th edition

iCare Assignment TemplatePreview the document – APA 7th edition

Introduction:

It has been determined that communication is a major factor regarding health care and spiritual care among our patients/customers. Cone Health in Greensboro, North Carolina boasts the tenth busiest emergency department (ED)in the country. Patients accessing Cone Health speak a variety of languages other than English. Currently, 23 different cultures side with the city limits of Greensboro. Staff and patients often times find it necessary to access interpretive services. However, many times, particularly in the ED, patient care is control by time- restraints and those interpretative services are not access appropriately. Impact on Patient Outcomes Essay

The problem identified, is that while Cone Health experiences diversity, as practitioners, providers of care often experience difficulty in communicating with patients who speak languages other than English. Thus, either communication is truncated or other nonconventional interventions are used. This communication misstep often occurs not because Cone Health does not have the necessary resources for translation/interpretation services, but oftentimes because of education or awareness and access to said services. The initial question regarding this project is: Will offering an Educational HLC on Interpretive Services improve the compliance in utilizing these services for our customers/patients/families? The burning question was triggered by observations of three tragic circumstances where interpretive services should/could have been initiated. The three instances are as follows: One, a teenage shot in the mouth having to interpret for his parents. Two, patient’s deaf wife was whaling loudly after her husband had passed away in the during a procedure. The family was hearing impaired and were utilizing minor children for interpret services (ASL Interpreter called to comfort her, but it was a 2-hour delay in providing appropriate interpretative services). Finally, children who spoke English over heard the request for an interpreter to communicate that their mother had died. Impact on Patient Outcomes Essay

The three instances that trigged this study identified areas for improvements in utilizing interpretative services during opportunities in crisis situations/interventions. In the case of the hearing-impaired family, the mobile device could have been accessed when the family arrived and prepared prior to. The staff did not know such a device was available until the chaplain arrived and suggested it be borrowed from another department. The device itself was easy to navigate and once the ASL interpreter appeared on screen and introduced herself, the loud whaling stopped and all seemed to be intently listening with their eyes and ears.

This type of intervention is easily applied when proper knowledge and education exists to assist staff in accessing interpretative services. Even though, this happened on a weekend, it is feasible to imply that this event could have occurred at any time of day. Every employee and volunteer of Cone Health need to be made aware of the legal ramifications and potential negative patient/customers outcomes. Cone Health must stress the importance of knowing the procedure on how to access needed interpretive services for patients and families in crisis at any time. Impact on Patient Outcomes Essay

Background

Approximately 57 million people, or 20% of the US population, speak a language other than

English at home, and approximately 25 million, or 8.6% of the U.S. population are defined as Limited English Proficiency (LEP). The Pew Research Center reported that approximately 50% of the newly insured will be minorities, and less likely to speak English. It should be noted that LEP have Longer Hospital Stays, greater risk for surgical delays due to lack understanding surgical instructions, and greater risk for readmission due to not understanding discharge instructions. It is important to remember that there are also legal requirements of hospitals to provide access to interpretive services. Title VI of the Civil rights Act mandates the interpreter services be provided for patients with limited English proficiency who need this service despite the lack of reimbursement. Thus, when staff does not initiate the use of interpretive services there can be legal liability and impacts to patient health.

Our goal for this quasi-longitudinal study was to identify if offering an Educational HLC on Interpretive Services would improve the compliance in utilizing these services for our customers/patients/families?” Impact on Patient Outcomes Essay

Methods

A survey monkey was utilize to identify any gaps in knowledge about the process Cone employee and volunteers assess interpretive services for non-English speaking patients, clients or guardians. Staff were contacted via email to participate in a survey about interpretive services. After reviewing the results, an educational power point, which contained the official Cone policy, was devised to address any gaps in knowledge. A post survey was delivered via email to assess any changes in practice.

The pre-survey consisted of fourteen questions. A total of 1778 employees and volunteers completed the pre-survey. Four demographic questions were used to identify roles, departments and campus location. The survey contain questions requesting the employees and volunteers to share their purpose for using interpretive services and how frequently. Based on a Likert scale, staff was asked about how comfortable were they requesting interpretive services. The roles or position a staff member is placed will highly affects this question. Employees were asked to identify the appropriate situations for requesting interpretive services and provide any barriers that affected their request. Impact on Patient Outcomes Essay

After ( weeks) an educational PowerPoint was delivered via email to all the staff and volunteer personnel at Cone hospital. The power point explained everyone roles for communicating with Non-English speaking patients. The power point identified the official resources that are to be used for interpretive services such as face-to face interpreters that have completed the requirements designated by Cone Hospital, language line telephone service, and/or mobile notepad/screen. Family members and co-workers are not acceptable replacement for interpretive services. A patient may choose to decline interpretive services by signing a waiver, which is placed in the patient’s chart. The patient may decide at any time to use interpretive services in the future if they chose. The location of the official policy for Cone Health hospital was also available in the power point. Impact on Patient Outcomes Essay

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The post survey composed of ten questions which was delivered via email (? week after the educational power point. The post survey was developed to explore any practice changes throughout the hospital. The survey inquired about any barriers the employees and volunteers may have encountered while accessing volunteer services. How comfortable staff felt about contacting interpretive services for the patient, guardian or visitor. Since the pre-survey how many times did that staff member or volunteer utilized interpretive services. The final question was used to identify any recurrent responders. Impact on Patient Outcomes Essay

Results:

A total of 1778 employees and volunteers completed the pre survey within a two weeks span. About 65% percent of the respondents were using interpretive services for direct patient care. Face to face interpreters was the most common type of interpretive services used by staff and volunteers at 73.36%. 88% of the Cone health members felt comfortable utilizing interpretive services. 92 percent of the respondents are aware that any employee or volunteer can request an interpreter if services are needed. Over 97 percent of the respondents will consider using interpretive services for any patient that does not speak English. There was an increase of 2% of the respondents that recognize that any role/position is at liberty to contact interpretive services. 85% of the respondents stated that family and co-workers are not acceptable forms on interpretive services. Impact on Patient Outcomes Essay

There were many barriers voiced by staff and volunteers that made it difficult to provide interpretive services to their clients. Most respondents determined the length of the time to obtain an interpreter was the greatest barrier. Some languages, such as Vietnamese, various African dialects and Montagnard dialects were not languages offered within the facility services. Many staff members were lacked the information required to access interpretive services. New employees are given badges with the most up-to-date information about interpretive services, but seasoned employees and volunteer workers were not provided with this information annually. The hospital also had a limited number of equipment staff and volunteers could utilize. Locating these devices made it more difficult for the members of the facility to perform their role efficiently. Impact on Patient Outcomes Essay

Discussion/Implications

Effective communication has a profound impact on patient outcomes. As the community demographics changes so does the variety of languages spoken. Healthcare workers are mandated by title IV of the civil right (Juckett and Unger)to provide medical information to the patient and/or caregivers in the manner in which they comprehend. This study has revealed that employees and volunteers want to provide the best care available but at times encounters barriers that prevent the best method of communication for the patient. Any member of healthcare is responsible for advocating for the patient. The institution should provide the resources the staff need, such as in house interpreters, remote interpreters that can be contacted via phone or streaming devices in addition to a wide variety of language options. Impact on Patient Outcomes Essay

Many staff members felt time was a major drawback to seeking interpretive services. As healthcare providers, managing one’s time efficiently is paramount, but when short cuts are taken to save time then patient care is compromised. To truly understand, the non-English speaking patients, all efforts must be made to have interpretive services available to assist staff in providing optimal care.

Staff members must also be able to identify the type of interpretive services resources that are available to them. Facilities should require annual update educational sessions to keep staff and volunteers informed about any changes to interpretive services. The education may include the why, when and how to use interpretive services; the variety of options of resources and locations of the resources. Impact on Patient Outcomes Essay

The Impact of Nurse Staffing on Patient Outcomes
Kelly Adams McCann
Drexel University

The Impact of Nurse Staffing on Patient Outcomes
When my daughter was in the Neonatal Intensive Care Unit (NICU) 11 years ago, I was I was blissfully ignorant of patient-to-nurse ratios and budget constraints. I had confidence in the competence of the nurses and believed that they had the time and the tools necessary to care for my child. Now that I’m a nurse myself and I see my support staff numbers cut and my patient load rise, I wonder what my patients and their families think of me.
In an age when we are all being asked to do more with less, nurse staffing levels are no different. The business of medicine is just that, a business, and…show more content…
Multiple studies demonstrate a relationship between lower patient-to-nurse ratios and improved patient outcomes (Garrett, 2008; Penoyer, 2010; Unruh, 2008). Patient outcomes addressed in the various studies included falls, infections, length of stay, mortality, patient safety, patient satisfaction, postoperative complications, pressure ulcers, quality of care and unplanned extubation with reintubation. A 2004 report from the Agency for Healthcare Research and Quality (AHRQ) stated that adverse events can increase the cost of a total treatment by 84%, length of stay by 5.1 to 5.4 days and probability of death by 4.67% to 5.5% (Garrett, 2008).
This is a sobering statistic: “the odds of a patient dying in hospitals with an average workload of 8 patients per nurse are 1.26 times greater than in hospitals where the mean workloads of 4 patients per nurse” (Aiken, Clarke, Sloane, Lake & Cheney, 2008). A rubber band can only stretch so far before it breaks. Impact on Patient Outcomes Essay