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    Problem--Patient Rounding

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    Topic of Paper: Problem--Patient Rounding

    Please assist me with the following paper

    The paper (excluding the title page and references page) should be 8-10 pages

    The following objectives are to be addressed under these headings


    2. Problem Area of Impact
    Describe how the problem area impacts the three system levels within the organizational structure—microsystem, mesosystem, and macrosystem. (1 page)
    a. At what system level will change be most required to address the problem area—microsystem, mesosystem, or macrosystem level?
    b. Will the problem be addressed by focusing on only one of the system levels?
    c. Will all system levels be included when addressing the problem area?

    3. Strategies and Techniques

    Identify and describe the financial techniques or strategies that will be used to address the problem area. Use a systems thinking approach in order to address the problem area as thoroughly and efficiently as possible. (2 pages)
    a. Identify the most optimal strategy in addressing the problem area such as conducting a throughput analysis and identifying the various bottlenecks within the system, SWOT analysis to discover the range of staffing matrices used by competing hospitals, using a strategic process and identifying key stakeholders when creating a new culture of safety.
    b. Will other strategies need to be used to address the problem area or will one strategy suffice at this point in time?
    c. Will strategies cross over all three system levels?

    4. Implementation Plan

    Describe the implementation plan to address the problem area. (2 pages)
    a. Who needs to be involved in creating change; list the key stakeholders that need to be involved in this project.
    b. Document the steps of the process as it currently exists using a flow chart; perform a gap analysis, and design the steps of the new process that will address the gaps and improve the problem area.
    c. Design a timeline for completing the steps of the new process.

    5. Your Role as a DNP-Prepared Leader

    Describe the role as the DNP leader in supporting the change process. (2 pages)
    a. What leadership skills will you utilize to lead the change effort?
    b. How will you deal with individuals at the three levels of the system, as well as stakeholders with differing opinions?
    c. How will you assure there is reawakened passion for the change effort to be sustained?

    6. Measurable Outcomes

    Identify and define three measurable outcomes (e.g., patient satisfaction scores, nurse engagement scores, clinical outcomes) to measure the success of your implementation plan. (1 page)
    a. Will the measurable outcomes be measured at the three system levels—micro, meso, and macrosystem levels?
    b. What are the expectations of the customers and patients?
    c. What is in the literature about this particular indicator and outcome?


    Please include references

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    Solution Preview

    Evaluation of a standardized hourly rounding process (SHaRP). Academic Journal (English) By: Krepper R; Vallejo B; Smith C; Lindy C; Fullmer C; Messimer S; Xing Y; Myers K, Journal For Healthcare Quality: Official Publication Of The National Association For Healthcare Quality [J Healthc Qual], ISSN: 1945-1474, 2014 Mar-Apr; Vol. 36 (2), pp. 62-9;

    Introducing intentional rounding: a pilot project. Academic Journal (includes abstract) Dewing, Jan; O'Meara, Brenda Lynes; Nursing Standard, 2013 Oct 9; 28 (6): 37-44.

    The implementation of intentional rounding using participatory action research. Academic Journal By: Harrington, Ann; Bradley, Sandra; Jeffers, Lesley; Linedale, Ecushla; Kelman, Sue; Killington, Geoffrey. International Journal of Nursing Practice. Oct2013, Vol. 19 Issue 5, p523-529. 7p.

    DuPree, E., Fritz-Campiz, A., & Musbeno, D. (2014). A new approach to preventing falls with injury. Journal of Nursing Quality Care, 29(2), 99-102.
    Patient Rounding
    The following objectives are to be addressed under these headings

    Hospitals must adhere to new regulations and improvement outcomes after the passage of the Affordable Care Act. One of the primary areas of reform is patient safety while in the hospital as many patients suffer injuries and death as a result of the quality of care or lack thereof provided by healthcare providers. One of the main causes of injury is falls, which occur at shockingly high rates, and will result in a lack of reimbursement for services from Medicaid and Medicare under the ACA. Therefore, hospitals must implement new strategies to address this issue based upon evidence-based research. The primary strategy for reducing patient falls is patient rounding that the research literature has shown to tacitly be associated with improvements in care delivery and in patients' perception of care. In addition, and most importantly for this "summary" for (your) paper is that patient rounding has been positively associated with reduction in patient safety events such as falls.

    This summary will provide an overview of the challenges associated with hospitals implementing hourly rounding protocol as this implementation will require an entire organizational change within the nursing staff workflow and must first entail a visionary leader such as a DNP educated nurse who is capable of democratic and transformative leadership. This leader must be able to elicit support from the primary stakeholders in this strategic change, who are not in unison regarding patient rounding as many nurses are opposed to this practice while many researchers have also found no statistically relevant impact in hospitals using patient rounding. Therefore, the DNP leader will need to ensure that through evidence-based research, nurses are able to focus on the benefits instead of the extra work and disruption to nurse workflow that accompanies patient rounding.

    To ensure that patient rounding is embraced by nurses, effective and substantial training programs must be provided along with evidence-based research and education program that clearly and concisely prove the effectiveness of patient rounding. Patient rounding' that is successfully implemented will entail regular checks of individual patients carried out primarily by nurses using set intervals rather than a response to a summons via a call bell. The objective of patient rounding is to put patients needs and healthcare at the center of the nursing ward by acknowledging differences in patient preferences, which enables nurses to better meet their individualneeds.

    2. Problem Area of Impact
    Describe how the problem area impacts the three system levels within the organizational structure—microsystem, mesosystem, and ...

    Solution Summary

    The expert examines patient rounding in a hospital. How patient area impacts the three system levels (microsystem, mesosystem, and macrosystem) within the organizational structure are examined.