Identifying a Target Population
Based on the information provided in Unit 7 discussion, identify the target population of your DNP project, why you selected this target population, and analyze the cultural and psychosocial dimensions; environmental factors; demographic descriptors; health literacy; and if appropriate, the bio-statistical data for the specific target population. Include in the scholarly paper, a strategy for implementation of the project, potential outcomes, and an evaluation strategy.
Unit 7 discussion was the following:
The Problem is patient returning to the ED because of the alleged inability to understand discharge instructions, access follow- up care, their concerns on the medical problem, and its progression. Most patients require resources for completing care that would get accessed timely through their return to the ED which creates one of the biggest problems in United States hospitals which is the overcrowded ED. The revisiting of the ED is now a measure of the adequacy of Emergency Department discharge practices. The short return to the Emergency Department closely gets monitored. This metric also reflects the emergency care quality, especially in cases where patients need hospitalization in their return to the ED. Many of the patients get discharged home after treatment without proper education or instructions. This investigation identified the issue associated with the adult population and also the language barrier.
There are emerging measures seeking to minimize the number of readmissions to the Emergency Department. Policymakers and relevant stakeholders who want to reduce costs, improve outcomes, and promote improved patient experience regard safe transition as an essential goal. The hospital readmissions are regarded as tools that capture the transition of care deficits in hospital settings (Cheng et al., 2016). It is now a measure of quality that is now linked to penalties for poor-performing medical institutions. Several studies group the return visit rate as poor in marking quality. A study concerning return visits emphasized on patient-driven aspects. The study also revealed that patients utilize the ED according to their perception of value. They returned because of the alleged inability to understand discharge instructions, access follow- up care, their concerns on the medical problem, and its progression.
Proposed clinical intervention or system change
Intervention effort is to involve nurses that can offer detailed explanations concerning patient discharge to the patients. It will entail the factors that will arise while the patient will be at home, and how to approach situations that may compel them to go back to the ED. This will help prevent the patients from going to the ED again. Another short-term solution involves the physicians discussing detailed information about the illness involved with their patients. The physicians can also properly address concerns that their patients may have to reduce uncertainty from them and utilize interpreters if patient speaks foreign language for proper understanding. In the long run, the physicians and nurses should ensure they create an ED-based care program that will integrate the care teams in the ED. The program should offer more trainings on handling patients at the ED including the aspects of discharge to prevent the return cases. Intensive training should aim towards enhancing the nurses and physician role that includes patient engagement. Developing a discharge checklist that when patients are about to be discharge from the ED they can check mark and sign confirming that providers discussed what is on checklist with patients before they leave the ED. Alternative intervention is to establish a reliable way of contacting providers after the discharge period via telemedicine. Such methods can assist patients in managing their concerns without the need to return to the hospital.
Demonstrate how evidence from the literature search ties the problem or clinical inquiry to practice.
For over 20 years, physicians in the ED are under programs that report the visits back to the ED within 72 hours. Several studies group the return visit rate as poor in marking quality. A study concerning return visits emphasized on patient-driven aspects. the CDC data offered insights on this issue. For instance, in 2014, close to 5.7% of the ED visits involved patients who were previously in the ED in the last three days. Approximately 4.8% of the visits were due to follow-up. Also, close to 3% of the ED visits were previously there 72 hours before. The revisiting of the ED is now a measure of the adequacy of Emergency Department discharge practices. The short return to the Emergency Department closely gets monitored.
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