Essay Instructions: Nursing Research Utilization Project Proposal
The Department of Health and Human Services?the Center for Medicare and Medicaid
Services (CMS) and the Agency for Healthcare Research and Quality (AHRQ) partnered together in developing a comprehensive survey for ?Hospital Consumer Assessment of Healthcare Providers? known as ?HCAHPS?. The purpose of this survey is to collect patients? reports and perspectives that they developed while being in the hospital. The public is encouraged to express their feelings and concerns about hospitals and to rate their hospital experience. National healthcare quality surveys have found that noise in hospitals is an urgent concern. Noise level is among the physical environment factors that influence the ?healing environment? of any health care (Reiling, Huges, & Murphy, April 2008).
Problem statement:
The Coronary Care Unit of North Shore University Hospital, Manhasset, New York a 12-bed unit has seen a 20% increased in hospital complains about the noise level over the last three quarters of the year. Make sure you know the baseline (so you will be able to measure a difference)
Solution statement:
The Coronary Care Unit of North Shore University Hospital will implement a noise reduction protocol that will include the following evidence based (EB) elements:
A. manage noise level ??
B. reducing staff conversations
C. exterior noises ? be specific
D. overall hospital sound ? what does this mean? (Xie, Kang, and Mills, 2009).
You must propose an EB solution and I can?t see that this is without references (I see they are below ? but you need them here too?
Project objective
It is the management?s job to address the fact that noise became an issue on the patient?s survey. The goals in the Critical Coronary Care of North Shore Hospital are patient?s satisfaction and obtaining financial retribution for the services rendered. Getting a clear understanding of an organization?s business or performance goals is the practitioner?s first step in setting measurable objectives for a communications program. All we need here is your goal
The Critical Coronary Care of North Shore Hospital launched this project of reducing the noise level in the unit, which will be measured by no complains marked on patients? surveys, by July 1, 2013. Go back to your problem ? make sure this objective measures for an improvement. Was your problem based on the survey (it was unclear)
Solution Description:
A. staff education and new employee orientation will mandate staff awareness of managing noise, including use of personal phones, monitor noise levels, and IV pumps, as sound control needs to be regarded with accountability in maintaining an appropriate sound environment (Mazer, 2006).
B. reducing staff conversation and overhead voice paging by introducing the electronic documentation and collaboration via emails, electronic messaging, and electronic orders will improve the quality of noise levels in the unit (Solet, Buxton, Ellenbogen, Wang, & Carballiera, 2010).
C. exterior noises, coming from outside the hospital building (road traffic) will be counteracted by the installation of double window glass is this feasible?, which is soundproof and insulates around the window frames. The exterior noises were found to be the least arousing stimuli, as opposed to other stimuli (towel dispenser, door close, toilet flush, ice machine) that tended to be more arousing (Solet, Buxton, Ellenbogen, Wang, & Carballiera, 2010). These ?sources? of noise are addressed, and being aware of them gives the staff the power of control.
D. installation of the sound waves blocking generators near the nursing station, and in the patients? rooms. Sound masking appears to be the most effective technique for improving sleep, decrease the noise level and promote healing((Xie, Kang, and Mills, 2009). There for, creating small pilots of stations at both ends of the corridors will decongest the main nursing station. Doctors? station is created on a side so they can seat quietly, and be able to concentrate on the patients? charts.
Proposed solution is consistent with current research knowledge
?Unnecessary noise is the most cruel abuse of care which can be inflicted on either the sick or the well,? Florence Nightingale wrote in her 1859 book, Notes on Nursing (Miller, 2006). Sleep disturbance is a factor in the development of delirium, as well as producing specific effects the respiratory, cardiovascular and immunological systems. Critical care patients are especially prone to delirium, better known as ?sundown syndrome? as their normal circadian pattern of adrenocorticotropic hormone and melatonin levels is changed markedly by sepsis, and the change in white blood count due to heart attacks (Xie, Kang, and Mills, 2009). The impact of noise on patients' sleep and the effectiveness of noise reduction strategies is part of the safety program implemented by hospitals to decrease the effects of sundown syndrome. Higher blood pressure leads to a higher risk of cardiac problems as Berlin hospitals found that chronic noise in hospital environment, where people are already ill and psychologically stressed, unnecessary noise can be very harmful leading to heart attacks (Miller, 2006).
The ?sources? of noise are of interior and exterior causes. The phones, the beepers, the cardiac monitors, and IV pumps were found to alter the noise level in critical care units. Other stimuli, such as towel dispenser, closing doors, toilet flush, and ice machine tended to be even more arousing (Solet, Buxton, Ellenbogen, Wang, & Carballiera, 2010). The impact of noise on patients' sleep and the effectiveness of noise reduction strategies in ICUs have shown that staff conversation and alarms are generally the most disturbing noises for patients' sleep in ICUs. Literature explains that working with the staff on reducing the level of noise generated by these sources will become part of the personnel training (Mazer, 2006).
The built of the hospital itself, with hard long lasting materials will contribute in addition to the human and machinery sound emanating in a working environment to monitor and promote patient health. The reason that hospital interiors and furnishings are made of reflective materials is to avoid pathogens to adhere to surfaces. They are easily cleaned and cannot harbor infections. Housekeeping caddies, X ray machines, electrocardiograms and echo machines rolling on a hard surface are causing sounds enhancement, overlapping and lingering longer than normal. Adding to them are the pneumatic tube system, automatic doors, and the rolling ventilators and IABP (Miller, 2006). Controlling noise involves actually adding sound to the environment with a series of speakers installed in the ceiling that distributes electronically a background sound, unperceived by humans that serve to cover or reduce the impact of noise spikes. It is a specially engineered sound creating an ambient environment that is quieter and that enhances speech privacy in healthcare facilities (Xie, Kang, and Mills, 2009). Dispersing the main nursing station by adding small cells of nursing station at the ends of the corridor is beneficial in dispersing the activity horizontally on the floor.
References
Anderson, F. W., & Hardley, L. (2009). Guidelines for Setting Measurable Public Relations Objective. Retrieved from http://www.instituteforpr.org/wp-content/uploads/Settings_PR_Objectives.pdf
Miller, H. (2006). Sound Practices Research Summary. Retrieved from
http://www.hermanmiller.com/content/dam/hermanmiller/documents/research
Mazer, S. (March-April, 2006). Stop the Noise: Reduce Errors by Creating A Quieter Hospital, Environment. Biomedical Instrumentation & Technology, 40(2): 145-6 doi# or journal url
Reiling, J., Huges, R. G., & Murphy, M. R. (2008, April). The Impact of Facility Design on Patient Safety. An Evidence-Based Handbook for Nurses, 28(4), 1.
Solet, J.M., Buxton, M.O., Ellenbogen, M.J., Wang, W., Carballiera, A., (2010), Acoustic
Guidelines For Healthcare Facilities. Retrieved from http://www.healthdesign.org
Xie, H., Kang, J., Mills, G.H., (2009), Clinical review: The impact of noise on patients' sleep and the effectiveness of noise reduction strategies in intensive care units, Critical Care; 13(2): 208, Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles
I started to write this paper myself, but the teacher corrected it and I am confused what to keep and what not. It continues in more sections down, as per instructions. Please build on my idea about the level of noise in a nursing station, and how this will afect the patients' staying.
Individual
Nursing Research Utilization Project Proposal:
Complete Section A: Problem Identification.
? Use the problem (with corrections from feedback) identified in week 1 to begin your proposal.
? Describe the problem or issue.
? Provide support that the problem or issue is an important one to solve (significance of the problem).
? State a project objective that is specific, realistic, and measureable.
Complete Section B: Solution Description.
? Describe the proposed solution (with corrections from week 1 feedback).
? Describe the way(s) in which the proposed solution is consistent with current research knowledge.
? Discuss the feasibility of implementing the proposed solution in the work setting.
? Discuss the way(s) in which the proposed solution is consistent with organization or community culture and resources.
Format your paper consistent with APA 6.0 guidelines.
Submit the assignment in the assignment section.
Complete Section C: Research Support.
? Develop a research base for the proposed solution that is sufficient to support its use.
o Provide a sufficient and compelling research base for the proposed solution (3-5 articles).
o Summarize all research reports used in a concise manner and provide acceptable internal and external validity.
o Describe the essential components of each study so readers can evaluate its scientific merit.
Individual
Nursing Research Utilization Project Proposal: Section D Draft Proposal and Assignment Grading Criteria: Nursing Research Utilization Project Proposal
Complete Section D: Implementation Plan.
Describe the methods to be used to implement the proposed solution.
? Describe the overall plan for implementing the proposed solution.
? Identify resources needed for the proposed solution?s implementation.
? Describe the methods for monitoring solution implementation.
? Describe the way(s) in which a theory of planned change was used to develop the implementation plan.
? Discuss the feasibility of the implementation plan.
Individual
Nursing Research Utilization Project Proposal: Sections E & F Drafts
Proposal and Assignment Grading Criteria: Nursing Research Utilization Project Proposal
Complete Section E: Evaluation Plan.
Describe the methods to be used to evaluate the solution.
Outcome Measure:
? Develop or revise an outcome measure that evaluates the extent to which the project objective is achieved. A copy of the measure must be included in the appendix.
? Describe the ways in which the outcome measure is valid, reliable, sensitive to change, and appropriate for use in this proposed project.
Evaluation Data Collection:
? Describe the methods for collecting outcome measure data and the rationale for using those methods.
? Identify resources needed for evaluation.
? Discuss the feasibility of the evaluation plan.
? Identify two possible grant funding sources and why your proposal would be a good fit for these sources.
Complete Section F: Decision Making.
Describe the methods to be used to decide the future of the solution.
? Discuss methods and specific plans to maintain a successful project solution.
? Discuss methods and specific plans to extend a successful project solution.
? Discuss methods and specific plans to revise an unsuccessful project solution.
? Discuss methods and specific plans to terminate an unsuccessful solution.
? Describe specific plans for feedback in the work setting and for communicating the project and its results to professional groups external to the project.
Individual
Nursing Research Utilization Project Proposal Proposal and Assignment Grading Criteria: Nursing Research Utilization Project Proposal. This is the entire paper (all sections) put together with all corrections made.
Put all sections of your proposal/paper together; add an abstract, introduction and conclusion. It should not to exceed 5,000 words.
Note. The cover sheet, abstract, references page, and appendices are not included in the word limit.
Include the following content which should incorporate all faculty, class and learning team feedback:
? Abstract, between 250 and 400 words
? Introduction
? Section A: Problem Identification ? Identify a work-setting problem.
? Section B: Solution Description ? Develop a description of the proposed solution.
? Section C: Research Support ? Develop a research base for the proposed solution that is sufficient to support its use.
? Section D: Implementation Plan ? Describe the methods to be used to implement the proposed solution.
? Section E: Evaluation Plan ? Describe the methods to evaluate the solution.
? Section F: Decision Making ? Describe the methods to be used to decide the future of the solution.
? Conclusion
Incorporate all faculty, class, and Learning Team feedback.
Format the paper consistent with APA 6.0 guidelines.
Submit the Research Utilization Project Proposal Paper via the assignment section.