RESPONSE TO ORDER 907617 /AN

You are required to make a minimum of one response to the initial post of at least one other student. In your responses to your peers’ posts you must provide constructive and insightful comments that go beyond that of agree or disagree. plus ask a question off their work to one the conversation forward

1st classmate
1. How can nurses contribute to decreasing variation in their professional practice? Give some examples of how you have seen this accomplished in your healthcare experiences.

`One way to decrease variations in the nursing professions is by digitizing healthcare and making health information for a patient readily available and by standardization of evidence-based best practice that would require administrators and doctors to utilize the best practice. It should not be up to the PMD to take care of each and ever patient IF, their is an evidence-based best practice,( Ferguson, 2018). An example of the nurse decrease a variation is a myself and I go to my PMD with varies ailments. As I get older I notice that I have more increased skin sensitivity and allergies. I am referred to specialist like Dermatology and an Allergist. After my consults and f/u appointments. All information is reviewed by my PMD because it is uploaded to the Northwell Health portal that connects the physicians within that hospital based group. I am also able to access all my medical information from all physicians.

Another way is prior to a procedure such as colonoscopy or a hernia repair at he LTC I work in. Medical clearance is needed, however other disciplines are needed to be cleared first. Such as cardiac clearance, lab work up is needed, and sometime a psychiatric evaluation. 3 other disciplines are needed before the PMD would grant the Medical clearance.

2. Give one example of how you think a standard approach to an aspect of patient care might decrease variation and improve quality.

A standard approach may be Telehealth visit with a licensed, board certified clinician that would give you the same standard of care as being seen in person by your PMD. It would be cost effective for a $59 visit via video versus waiting for an appointment for your PMD and insurance is billed $400 for a routine visit. I assisted my grandfather on a Telehealth visit during the COVID pandemic and all the questions that his PMD and cardiologist were asking were f/u questions from previous visits. All information I had in front of me and he was able to give them a full description of his daily routine.

3. Describe the barriers that exist for professional nurses to promote standardization of care practices to decrease variability?

The barriers that exist are Digitization- not having full access to patient information interdisciplinary, Evidence -based best practice – should be required by doctors and administrators IF available. The PMD should have the patient consult with a specialist in that disease.ex. New onset of DM type 2. The patient should be set up with a Diabetic nurse., Commoditization- or race to bottom meaning healthcare is way too expensive and we need o lower cost effectively for all people, and Globalization – Medical tourism which is for Americans to get treatment in other countries that are 90% cheaper and the person will not go bankrupt from costly medical bills.( Ferguson, 2018).

Reference:

Burroughs, J. (2018, June 11).
How To Understand U.S. Healthcare? Follow The Money. https://www.youtube,com/watch?v=mTXVcmVVjoQLinks to an external site.

Classmate 2
How can nurses contribute to decreasing variation in their professional practice? The short answer to me would be a standardization of treatments for diseases based on evidence-based practice rather than a provider preference, as stated in the video (Burroughs, 2018). But, the issue is not that simple. From the nursing level, I think it requires an expansion of our role in healthcare. In our required reading, this week covered developments in nursing practice. The one that stood out to me was that of the case manager, which includes advocating for the patient, being a liaison between them and the healthcare team, preventing fragmentation and replication of treatments, and focusing on high-quality, cost-effective care (Catalano, J.T., 2020, p. 706). With the proper utilization and incorporation of case managers into the care plan, it Is assuring we are pursuing evidence-based practice to serve our patients best. This would lead to a standardization of treatment and decreases in variations once facilities could start reviewing cases and seeing a correlation showing what they are doing is working both for the patient in aspects of treatment and finically for the corporation.

Examples of how I have seen this accomplished are simply through the use of care managers. At the level one facility I work at, care managers are a routine thing for patients. Their utilization has shown that with a high-level nurse involved in the treatment process and care plan, the care was more effective, had better patient outcomes, and was cost-effective for the facility.

One example of how I think a standard approach to an aspect of care might decrease variation and improve quality is simple. It would be the implementation of check sheets during patient handoffs. The SBAR would be a great example. Through this standardized form for we can give effective detailed information to the oncoming staff. This is a standardized process that happens every shift change and ensures good communication and understanding of a patient’s situation and care currently being delivered, thus improving outcomes and reducing variability after shift change.

The Barriers that exist for professional nurses to promote standardization of care practices to decrease variability are immense. The two main barriers I will focus on are providers who render treatments based on personal experience instead of evidence-based practice and interoperability. As nurses, we need a greater scope of practice to influence the physicians we work alongside as part of the healthcare team. Once we can put more emphasis on providers following evidence-based practices, this will be a huge stride towards cutting down variability due to the standardization of treatments for conditions following a current evidence-based practice. The second issue is that of interoperability. The need for advances in technology is growing every day. We need many more nurses to pursue informatics nurse specialists’ roles to meet the rapidly increasing demands as the healthcare field becomes more integrated and reliant on technology.