Evaluation Of A Patient Clinical Pathway

The problem in this scenario is the challenges faced with trying to implement a new clinical pathway. This particular clinical pathway trying to be implemented is concerning ventilator-dependent patients who are discharged to home with home health care needs. These patients tend to have multiple health care needs beyond the ventilator and the new clinical pathway will establish a smooth transition from hospital to home, allowing for all the patient’s needs to be met. The challenges arise when trying to get all areas of the health care team to get involved. This especially includes the physicians that seem reluctant to follow a nurse’s guidelines. Not only are the physicians reluctant, the home health care representative will not be available to attend team meetings for a while. The new clinical pathway is due to be started in one month, so there is little time to get all parties on board.

Cook County was having more patients than it could handle complaining about chest pain. Also, determining if the pain could be a heart attack was a very inefficient and a long process with too much information. So they streamlined the process, mainly considering 4 things which were the EGG, fluid in lungs, systolic pressure, and unstable angina. The results were more accurate and saved time. This showed that, sometimes with too much information, there is too much of the complicaticated information and an answer can’t be reached and with less information a correct answer can be reached quickly.

The process of using Evidence Based Practice in a patients care plan consists of five key stages. Asses the patient and formulate the problems from this you will then need to access the relevant clinical articles. Using this information you should then be able to assess which is the best method of treatment discarding any misleading or ambiguous articles. You then need to incorporate this knowledge into the patients care plan. Finally you need to evaluate and assess the patient during treatment to ensure effectiveness.

Evidence Based Practice is a principle that is centered on the improvement of patient care and outcomes, by introducing and researching current based evidence when making decisions for that patient. According to Johnston (2016), “Health-care practitioners are increasingly being encouraged to implement research evidence into practice in order to ensure optimal patient outcomes and provide safe, high-quality care”. Throughout the course of this class, whether it be from researching about Evidence Based Practice, or the implementation of nursing care delivery models, patient care and the way we treat our patients is at the forefront of change. We know that change is necessary, now it is just a matter of how to implement that change into the healthcare

The goal of this assignment is to define the diverse forms of integrated care and to provide evidence on their impact both on the patient and also the future of the registered nurse. An integrated care pathway contains many elements in order to make it function. There must be a clear declaration of the aims, objectives and key elements of care founded by evidence, the best practice available and a consideration of patient expectations. The records, 24-hour care and assessment of changes and outcomes must be monitored. The assistance of communication, good organisation of people’s roles and sequencing the actions of the relatives, multidisciplinary team, and most importantly the patients. For an integrated care pathway to be truly multidisciplinary, it should never be developed by one staff group. At the outset, all staff groups involved in the patient journey should be identified. A typical working group should include doctors, nurses and allied health professionals, with input from administrative and managerial staff where it is necessary. If the pathway exceeds boundaries of care, such as, discharging patients to services outside the hospital or healthcare setting, reps of these groups should be involved with their integrated care plan. It is the integration of health care, social care, and other external agencies such as voluntary groups and private sectors that impact on the patients care and health professional’s quality of care giving. It does not need all

The importance of evidence based practice ( EBP ) is to enable nurses to provide high quality care, improve outcomes for patient and families and to run a more efficient health service. Therefore other agencies within the health service will benefit when interventions and care is based on research (Burns & Grove 2007). According to the (Nursing and Midwifery Council 2004)(NMC) nurses are accountable to society to provide a high quality of care so therefore it is important that nurses reflect, evaluate the care and keep abreast of new knowledge and evidence that is available (Burns & Grove 2007). Providing a streamlined service, which is cost effective and based on current evidence based practice has shown to reduce cost but also to enhances

Facilities, performing coronary CTA, should develop and adhere to evidence based coronary CTA protocols for optimal, high quality, cost-effective, patient-centered care. A comprehensive review of the literature was performed using CINAHL, PubMed, MEDLINE, and Medscape search engines, and with the terms ?coronary CTA?, ?protocols?, ?guidelines?, ?radiation?, ?contrast?, ?beta-blockers?, and ?radiology nursing?.

Chest pain is a frequent cause of emergency department presentation. Many times, chest pain can be an indicator of myocardial infarction. Yearly, about 600,000 people die of heart disease in the United States, with a total of about 700,000 having a myocardial infarction. The leading source of death for both men and women is heart disease ("Heart disease facts," 2014). Managing the challenging clinical problems of those presenting with chest pain can be demanding. While clinical judgment is imperative in managing these patients, rapid treatment protocols to evaluate risk

Aveyard and Sharp (2013, citing Sackett et al. 2000) interpret evidence-based practice as the reliable and sensible use of the most recent evidence together with clinical knowledge and patient values to guide health care decisions. This suggests that we must use the best up-to-date evidence to make decisions about care delivery to patients, acknowledging individuals needs and preferences to optimised patient outcomes. By considering patient’s opinion and the clinician’s experience with the supporting significant evidence from research and expert report, we can give the best results for the patient () . However, nurses must always use their clinical judgement and decision making alongside with EBP as sometimes evidence may not applicable and

In both plans a physician advisor reviews cases but within HH the case manager compiles all the clinical data and reviews, seeking the advice of physician advisor if necessary. Equally, the plans provide for utilization review to be initiated within the first twenty-four hours of the patient’s admission, if not prior to admission. In addition, both plans provide opportunities for the admitting physician to provide proof or argument for discrepancies in treatments or length of stays. Although the UK HealthCare UR plan provides a single physician review of inadequate treatment or length of stay, HH UR plan stipulates a minimum of two physician members review additional information submitted via the admitting physician. Specifically, in the HH UR plan exists a component of a continuous medical care evaluation studies to provide provisions for the Continuous Quality Improvement Committee. In addition, physicians continually need to be educated on detail specific care in HH, as physicians occasionally do not want the prescribed orders challenged. Pre-printed patient progress notes with check boxes assist some of HH’s physicians in considering necessary or unnecessary treatments

Protocols and guidelines have been used for many years and has many advantages in ensuring unacceptable care is kept to a low if followed .One of the main advantages is patient saftey if protocols are put in place there is little room for error which is just as ressuring for the care giver to know

To monitor standards of clinical governance the government established the National Institute for Clinical Excellence (NICE) and commission for Health Improvement (CHI) (Department of Health, 1998). The purpose of clinical effectiveness is using the best available knowledge through research, clinical expertise and patient choice, applied to patient care. This can be achieved through training, education and change management (Muir Gray, 2001); evaluated through clinical guidelines and provision of evidence-based practice (Royal College of Nursing, 1996). 'Clinical effectiveness is the cornerstone of evidence-based practice' (Reagan, 1998 p245) Links between evidence based practice and clinical effectiveness are outlined by Dawson (2001). He suggests that evidence based practice cannot be achieved independently of clinical effectiveness. McSherry et al (2002) considered that the two are interdependent of each other with

Professionals: The department is opened twenty-four hours a day and seven days away. The team members of this unit is comprised of an advanced nurse practitioner (ARNP), a nurse manager (NM), four charge nurses (CN), twenty-six registered nurses (RN), ten patient care technicians (PCT) and four unit clerks(UC). Each clinical staff member works in shifts consisting of twelve hours during the day 7a-7p or night 7p-7a. Since the main focus of this unit is monitoring and stabilizing of patient’s conditions within the specific timeframe of twenty-three hours, the staff members are cohesive and deliver team oriented care.

Every industry consists of code and or indicator for certain level of references. When it comes to a patient’s health and or treatment strategy it’s important to make sure all parties understand the ultimate mission. For instance, risk red flag can conclude that advance measures should be taken based on one’s health circumstances. Best presented by, Kavaler & Alexandra (2014), “One or more “red flags” in connection with a patient’s care should alert healthcare providers to take actions to remedy the situation (p. 11).” It’s vital that, each patient has an update chart and remedy towards the given health condition. The doctors, nursing staff, and other medical professional should be knowledgeable on the patient health. For patients that have

Clinical practice guidelines (CPG) are used to guide the healthcare providers for specific clinical decision making. Researchers had proven that by using CPG it helps in reducing inappropriate variations in healthcare practice. In healthcare service the use of CPG had shown improvement in promoting the delivery of high quality care. CPG had been long develop and evaluated in the medicine field however, in nursing profession, nurses had shown a great interest in developing and using CPG as a means to facilitate evidence based nursing practices. Hospitals that had adopted CPG had shown a great reduction on inappropriate variations in clinical practice and prometed high quality care with evidence based health