NR452 RUA Outline
· Introduction
· Purpose of the paper
· Priority topic:
a. Hypoglycemic protocol modification**
· Description of relationship between category from NCLEX-RN examination blueprint and priority concept
· Importance
· Importance of priority topic- reduce stay in the hospital, positive patient satisfaction (follow ethical “do no harm”), cost containment, early detection, promote patient outcomes
· Describe health of patient population- diabetic patients
· Potential negative effect to professional practice
· Adapting to the change of hypoglycemic protocol- if they don’t adapt or forge the protocol exists, patient harm could result
· Increased health care costs ( hospital pays out of pocket for healthcare acquired infections, increased length in the hospital is a financial burden for families)
· Potential negative effect to patient population
· Infections
· Poor healing
· Seizures
· Death
· Healthcare Disparities, Inequalities, and Interventions
· Patient populations that may be negatively influenced by the priority concept (topic) if unresolved
· Diabetic patients- also pts with other comorbidities
· Low socioeconomic status
· Undiagnosed diabetic patients
· Healthcare resources to support evidence-based professional practice related to the priority concept
· Hypoglycemic protocols
· Healthcare specific education
· Nutrition
· American diabetes association
· Summarize potential priority concept (topic) healthcare disparities and inequalities related to diverse populations.
· Propose an evidence-based solution for the priority concept (topic) related to healthcare disparities.
· Modify hypoglycemic protocol for all hospitals
· Identify three (3) evidence-based practice interventions.
1. Modify current parameters of hypoglycemic protocol
2. Begin protocol at admission for all patients at risk of hypoglycemia
3. Mandatory patient and caregiver education “check-off”
· Discuss two (2) patient education considerations related to the priority concept (topic).
1.
2.
· Legal and Ethical Considerations and Intervention Challenges
· Identify at least one (1) ethical and one (1) legal implication for addressing the priority concept (topic) in professional practice.
1. Ethical- cultural
2. Legal- “interfering” with physician scope of practice (nurse practicing “medicine” not practicing “nursing”)
· Discuss at least one (1) strategy in prevention of an ethical dilemma related to the priority concept (topic) in professional practice.
1. Availability of alternative insulin products to acknowledge cultural differences
· Discuss at least one (1) strategy in prevention of legal consequences related to the priority concept (topic) in professional practice.
1. Finalize the changes with the hospital board based on evidence-based practice etc.0
· Identify one (1) anticipated challenge to the success of preventing the priority concept (topic) in professional practice
1. Resistance to change
· Identify one (1) anticipated challenges to the success of resolving the priority concept (topic) in professional practice.
1. HCP’s attempting to “override” the protocol
2. Cost
· Participants and Interdisciplinary Approach
· Identify all the parties who will be involved in the implementation of the priority concept (topic) interventions
· Pharmacy- accessibility of medications in the appropriate time frame
· HCP’s- thorough diagnosis, standing orders, prescriptions, etc
· Nurses- thorough assessments, identify patient needs, communication to healthcare team
· Dietitian- provide nutritional support and education
· Risk reduction- provide statistics relating to the topic of concern and implement ways to improve
· IT- program and collaborate new advancements in technology to make patient documentation and medical care easy and efficient
· Hospital administration/board members.management- develop new policies/protocols and implement
· Social work- provide resources and make accommodations for patient care
· Financial team- ensure financial responsibility and capability
· Discuss the benefit of including the identified interdisciplinary member from disciplines outside nursing to promote evidence-based professional practice.
· Getting everyone on the same page
· Quality Improvement
· Provide at least one (1) benefit in patient outcomes from addressing the priority concept (topic) within the clinical environment.
1. Decreased mortality rate
2. Decreased length of stay → decreased healthcare cost
· Provide at least one (1) benefit to the nursing profession that will result from addressing this priority concept (topic) in clinical professional practice.
1. Makes it easier to provide more efficient and safe care due to availability of orders in the policies
2. Advocacy
· Discuss at least one (1) resource utilized to promote improved patient outcomes in the clinical environment.
1. EBP Article
· Discuss at least one (1) resource
1.
· Conclusion
· Provide a thorough recap of the purpose to promote increased evidence-based professional practice knowledge related to the priority concept (topic) deficiency.
· Summarize resources identified to support improved evidence-based professional practice related to the priority concept (topic).
· Include a complete statement describing why addressing the priority concept (topic) matters and to whom.
· Implementation of protocol for hypoglycemic patients is relevant to increase efficiency of nursing care and prevent decompensation of patients’ condition.
Outcomes
· Reduce length of stay
· Patient satisfaction
· Improve patient outcomes
Proposed Changes
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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3776519/
https://dtc.ucsf.edu/living-with-diabetes/complications/hypoglycemia/