EVIDENCE BASED PRACTICE PROPOSAL – PROBLEM DESCRIPTION 5
Institutional AffiliationEvidence Based Practice Proposal – Problem Description
Background
Death is a natural occurrence, but healthcare professionals have the role in reducing mortality rate to their best more so in the surgical field where the outcomes of the process are determined by the decision of the surgeon. Surgical care is performed daily in our communities, and it is an integral part of care globally. Mortality in surgery is inevitable since it can be caused by medical or surgical errors, delayed treatment, poor infrastructure and limited resources in a facility. Among the estimated 234 million operations performed annually, the rate of deaths is approximated to be 9.14% which is quite alarming (Chukuezi & Nwosu 2010). Deaths in surgical wards are more prevalent and have been increasing yearly, causing alarm. Research by Krishnamurthy et al., (2015), which involved 8962 patients in the ward reported the death of 585 overall between 2011 and 2015. The results had a crude rate of 6.5% which is high to be experienced in surgical wards. Although deaths are common in medical-surgical wards, the reduction in deaths has been due to preventable causes such as sepsis, GIT and trauma. The efficiency of healthcare practitioner though working in multidisciplinary teams rounds has been proposed as the way to reduce the mortality rate in medical-surgical units.
Stakeholders
The stakeholders responsible for implementing the change include all healthcare practitioners, administrators, nurse educators, staff nurses, patients, and any other medical organization. The passive stakeholders in this project include a chief nursing officer, risk management, finance department, Chief executive officer and education department. All these are at one point affected by the proposal since their participation will determine the success of the EBP project. Non-governmental organizations and granters can form part of the stakeholder’s team where they will fund the healthcare systems for successful implementation of the project. The interested parties in this project include students, medical organization, education institutions, and research institutions.
PICOT Question
For registered nurses, does the use of evidence-based practice as compared to not using EBP reduce the mortality rate for medical-surgical unit patients during hospitalization?
Purpose
The significance of this project will be to determine if the use of evidence-based practice can help reduce the mortality rate among medical-surgical unit patients.
Objectives
To find out the significance of EBP in reducing the mortality rate for medical-surgical unit patients
To determine the knowledge of registered nurses on evidence-based practice
To evaluate the effectiveness of multidisciplinary team round in evidence-based practice
To estimate registered nurses involvement in the multidisciplinary team rounds
The project success will be measured by its ability to reduce mortality rate which has been prevalent in medical-surgical
The information about the cause of death is important in any health care system as it guides possible intervention strategies. The increasing mortality rate in medical-surgical Unit is alarming where among all the hospitalized patients in these wards, 9.14% of them die yearly. Mortality rates in critically ill patient and patients from surgery depend on the mix case and are assumed to range from 5 to 40% (Li et al., 2016). The understanding of mortality rates is important as it helps in the determination of best strategies to solve the condition. Also, increased collaboration between healthcare workers and those in medical-surgical Units improves care, reduces a length of stay as well as mortality rates.
Research by Brown et al., (2014) illustrate the importance of continuous monitoring for average-risk patients with the belief that delayed or suboptimal intervention could increase morbidity and mortality rates. The study wanted to establish the significance of continuous heart rate and respiratory rate monitoring for patients in the medical-surgical unit. The study reviewed 7643 patient chats, and among these, 2314 were continuously monitored using available interventions while the rest were controls. The finding of the study was that continuous monitoring of a medical-surgical unit could lead to a significant decrease in total length of stay both in hospital and intensive care unit (Brown, 2014). Another research by Chukuezi & Nwosu (2010) aimed to uncover the number of deaths reported yearly in medical-surgical units. Records from theatre register were used in the study, and the findings revealed an increased mortality rate in those wards. The researcher affirmed that strategies to improve care and reduce medical mortality rates were necessary.
Among the operative procedures conducted in the United States yearly, 40% of them are incurring complication which can lead to deaths or infections. A collaboration of nurses and other medical practitioners and the use of multidisciplinary team rounds can help in reduction of such infections and deaths. What is more, the use of evidence-based practice by registered nurses can have a significant impact on the reduction of mortality rate (ANA, 2015). Nurses have close contact with patients; therefore they can identify patient’s needs quickly for a quick address. The use of evidence-based practice in the medical-surgical unit by registered nurses will reduce the risk of the increased mortality rate for hospitalized patients.
References
American Nurses Association. (2015). Optimal nurse staffing to improve quality of care and patient outcomes. Silver Spring, MD: Author.
Brown, H., Terrence, J., Vasquez, P., Bates, D. W., & Zimlichman, E. (2014). Continuous monitoring in an inpatient medical-surgical unit: a controlled clinical trial. The American journal of medicine, 127(3), 226-232.
Chukuezi, A. B., & Nwosu, J. N. (2010). Mortality pattern in the surgical wards: A five year review at Federal Medical Centre, Owerri, Nigeria. International Journal of Surgery, 8(5), 381-383.
Krishnamurthy, V. R., Ishwaraprasad, G. D., Rajanna, B., Samudyatha, U. C., & Pruthvik, B. G. (2016). Mortality pattern and trends in surgery wards: a five year retrospective study at a teaching hospital in Hassan district, Karnataka, India. International Surgery Journal, 3(3), 1125-1129.
Li, G., Thabane, L., Cook, D. J., Lopes, R. D., Marshall, J. C., Guyatt, G., … & Taylor, R. (2016). Risk factors for and prediction of mortality in critically ill medical–surgical patients receiving heparin thromboprophylaxis. Annals of intensive care, 6(1), 18.