While the implementation plan prepares students to apply their research to the problem or issue they have identified for their capstone change proposal project, the literature review enables student

PICOT Statement

Grand Canyon University

July 1, 2018

PICOT Statement

P- Elderly patients (aged 65 years and above)

I.- Improving workflow and use of health information technologies

C- Home-based care

O- Improved quality of care and increased patient safety

T- Two months

Patient Population and Problem

Elderly patients (aged 65 and above) face many health problems within the primary care setting. Consequently, nurses and other health care professionals normally grapple with the challenge of improving quality of care and patient safety for this population (Boltz et al. 2016). Elderly patients are often vulnerable to many health hazards that might affect the quality of care and their safety. For instance, their cognitive functioning reduces as their age progress. In addition, they normally have a high propensity to avoid taking prescriptions and medications. Furthermore, elderly patients normally register high rates of allergic responses, coupled with falls and inability to request for assistance from nurses. Improving workflow within nurses’ working environments can help to reduce these health problems (National Council of State Boards of Nursing,2010). The work processes for nurse and physicians in primary healthcare settings might not be effective in taking preventive measures to ensure that elderly patients’ quality and safety are guaranteed. These include protection form hazards such as immobility, muscle atrophy, falls, and contractures.

Intervention

The utilization of evidence-based practice can support nursing interventions to improve workflow and quality of care. The task of improving workflow should focus on integrating technologies into the existing nurses’ work environments such as people, roles, and work procedures. Nurses and other healthcare team should complete tasks by adhering to the appropriate work procedures. Healthcare institutions should introduce health information systems such as EHRs in order to optimize the benefits to nursing care (Grain et al. 2014). There is need to introduce systems that support nurses in the delivery of their duties and responsibilities. For instance, technological systems should be introduced to support nurses in their efforts to complete the tasks of documentation of vital signs of elderly patients, as well as ability to develop charts of vital signs and search functions (Isono et al. 2017). In addition, nurses who operate in busy environments should develop a work breakdown sheet that identifies the details of their tasks. Training programs should also be introduced to enhance performance and satisfaction.

Comparison

As an alternative, home-based care can be provided to elderly patients. However, when compared to use of evidence-based practice in primary care, home-based interventions may be associated with various potential adverse effects. For instance, many health professionals are often inaccurate in presuming that home-based care does not come with economic and emotional costs. In most situations, home-based interventions are associated with considerable emotional and financial burden. Most caregivers are often women, and they have a propensity to have minimal access to or control of resources required to assume this responsibility. Sometimes, they are not often available to prevent patients from falling, or avoiding medications.

Outcomes

The utilization of technology and workflow process improvement initiatives can help to improve safety and quality of care among elderly patients. The outcomes of these nursing interventions are far and wide. This is because they result in reduced cases of falls among elderly patients. In addition, they help to constantly keep records of medications that are taken by the patients and quick detection of the potential problems that might hinder the patients from recovery. Improvements in workflow have the potential to enable nurses and physicians to get important information about patient disease status and healthcare processes. Healthcare agencies that embrace health information systems and improve workflow are able to keep track of progresses being made by many elderly patients within primary care settings.

Time

These evidence-based interventions can be implemented within a span of two months. Their successes can result in positive health outcomes for elderly patients immediately. In addition, workflow improvements can yield the desired fruits both in the long-term and long-run. In the short-run, nurses are most likely to improve their productivity.

References

Boltz, M., Capezuti, E., Fulmer, T. T., & Zwicker, D. (Eds.). (2016). Evidence-based geriatric

nursing protocols for best practice. New York: Springer Publishing Company.

Grain, H., Martin-Sanchez, F., & Schaper, L. K. (Eds.). (2014). Investing in E-health: People,

Knowledge and Technology for a Healthy Future: Selected Papers from the 22nd

Australian National Health Informatics Conference (HIC 2014) (Vol. 204). IOS Press.

Isono, H., Suzuki, S., Ogura, J., Haruta, J., & Maeno, T. (2017). Improving the workflow of

nursing assistants at a general hospital in Japan. BMJ Open Qual, 6(2), e000106.

National Council of State Boards of Nursing. (2010). Nursing Pathways for Patient Safety E-

book. New York: Elsevier Health Sciences.