NR631 Nurse Executive Concluding Graduate Experience - I
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Course
NR631
Institution
NR631
Week 8: CGE Project Portfolio - Part 1 Diego Bustillo
Chamberlain Collage of Nursing December 2020
Week 8: CGE Project Portfolio - Part 1
Project PICOT question
For patients presenting in the ED, does implementing purposeful rounding and bedside reporting improve the Le...
For patients presenting in the ED, does implementing purposeful rounding and bedside reporting improve the Left Without
Being Seen rate?
Abstract summary of project topic
Within the Chamberlain Hospital ER scenario, problems can be noted in many areas. Among the main problems is the high rate
of Left Without Being Seen (LWBS). Currently, the rate of LWBS is at 4.6 % considering that the national benchmark is 2%. There is
a lack of effective communication along the care delivery process starting from triage to discharge. Nurses give reports at the nursing
station and do not round on patients. They are on their mobiles phones, texting most of the time and are reluctant to discharge patients
to avoid admissions at end of shift.
To address these problems, the current project focuses on the implementation of bedside reporting and purposeful rounding
among patients presenting to the ED as key strategies to reduce the rate of LWBS. The information collected from a review of the
literatures clearly demonstrates the effectiveness of the proposed intervention in addressing the problems that Chamberlain Hospital is
facing. For example, Sayah et a (2014) conducted a study to evaluate the effectiveness of process improvement/bedside reporting in
reducing the Left Without Being Seen (LWBS) rate. Study findings showed that bedside reporting helped to reduce the mean rate of
patients in the ED who left without being seen.
, NR631 Nurse Executive Concluding Graduate
Reflection on course outcomes, I am happy about the current progress in achieving
Experience - I course outcomes. For example, being able
to identify literature on bedside reporting and purposeful rounding from different databases has facilitated the achievement of course
outcome #2. The existence of an effective communication plan is one of the ways through which project managers ensure the
existence of effective communication. For the current project, the communication plan includes key stakeholders, an assessment of
the type of information required, and signoff from stakeholders.
Following a successful implementation of the proposed change, I hope to achieve the key project deliverables that include a
reduction in the rate of Left Without Being Seen for patients presenting in the ED, an improvement in patient satisfaction scores, and
appropriate response to the issue of lengthy waits for patients presenting to the ED. I believe that utilizing a range of tools including
the Work Breakdown Structure, Risk Register, and Gantt chart increases the chance that the project will be a success and will be
completed within schedule.
Literature review
Sayah et al (2014) conducted a study to evaluate the effectiveness of process improvement/bedside reporting in reducing Left
Without Being Seen (LWBS) rate at the Cambridge Hospital Emergency Department (ED). In their findings, the authors established
that bedside reporting helped to reduce the mean rate of patients in the ED who left without being seen. The intervention allowed the
hospital to increase the volume of patients in the ED while improving the quality of care and level of satisfaction. In a study by
, NR631 Nurse Executive Concluding Graduate
Daniels (2016) on purposeful and timely nursing rounds, the authors established that purposeful
Experience -I rounding is one of the best
intervention practices that can be effectively implemented in the ED to ensure that they meet their patients’ needs and satisfaction
hence reducing the rate of LWBS. Purposeful rounding should involve the nurses and all staff working within the ED. This ensures
that there is effective communication of the patient’s needs and enhances staff interventions or responsiveness to meet their needs.
In another conducted by Freibott (2017), the researchers sought to examine whether applying best practices such as bedside
reporting could help improve patient flow and optimize ED. The initiative also focused on reducing time stamps for patients
presenting in the ED. Their findings revealed a considerable reduction in the time frame for arriving patients and LWBS rates. In the
study carried out by Cabilan and Eley (2015) seeking to examine how to examine efficiency at the ED, findings showed that using
technology for instance implementing a computerized system with the ED boosts the number of early discharges and improve the
patients’ admission rate. Through this, the ED will be able to serve more patients and reduce the number of Left without Being Seen
(LWBS) patients. Tidwell (2011) conducted a study to examine the effectiveness of best practices/bedside reporting. Research data
were analyzed using chi-square and paired t-test. Findings revealed that bedside reporting improves nurse and patient satisfaction and
is a comprehensive approach to reducing LWBS. In another study by Johnson (2015), the purpose was to assess the impact of
bedside report implementation to transition patients in different hospital units. In their findings, the authors established that the
utilization of standard bedside reporting resulted in a significant improvement in care and a reduction in LWBS particularly for
patients presenting
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