Capstone course week1 peer responses

Respond to your peer in one paragraph. These posts should be thoughtful, respectful, and add value to the discussion. This response could include relating your experience to whatever they initially posted. Use a different scholarly source, reference it using APA format, and include in-text citations when using the referenced material in your post.

You must use DIFFERENT resources, in-text citations, and APA references in your response than your peers used. Use current resources. Please do not routinely cite outdated (no greater than five years old) sources of information. Do NOT use the exact in-text citations or references for your peers in THE INITIAL POST.

Respond to peers thoughtfully, add value to the discussion, and apply ideas, insights, or concepts from scholarly sources, such as: journal articles, assigned readings, textbook material, lectures, course materials, or authoritative websites.

1st peer post

Barbara Huskins

May 6, 2024 at 6:24 PM

Increased alarm fatigue related to nuance alarms from telemetry boxes are a significant issue on the unit at this time. The central monitoring unit where these are being monitored is constantly calling the unit about probes off, poor telemetry readings, battery changes and even poor Wi-Fi connections. All these calls are directed at the primary nurse, causing increased mental workload related to increased interruptions, as well as alarm fatigue. If there was a process that could be implemented related to the call tree, then potentially we could reduce this increased nurse burn out as well as address the issues at hand. Making those aware of the type of alarm and the education that will be needed for all healthcare professionals involved is a big change. This will help with the alarm fatigue and increase alarm awareness. (Shaoru et al., 2023). By not addressing the opportunities we will just continue to run into increased nurse mental workload, nurse burn out and alarm fatigue. These are already major threats within the health care system. Having another team member responsible for these interruptions will allow the nurses to continue to provide the necessary care that only nurses can provide. Anyone can change a battery but only nurses can medicate patients. Week one will consist of data collection and problem identification. Week 2 will be planning of education needed based on data collected. Week 3 will be education role out. Week 4 will be data collection of how well education was received and process change implementation. Week 5 will be data review of education process change and collection of decreased alarm notification to primary nurse versus unit secretary. Week 6 will be process fine tuning of any identified fall outs from week 5 review. Week 7 will be finalized process, and evaluation of improved communication via telemetry notifications to primary nurse and decreased mental workload during shifts. 

References

Shaoru, C., Hui, Z., Su, W., Ruxin, J., Huiyi, Z., Hongmei, Z., & Hongyan, Z. (2023). Determinants of medical equipment alarm fatigue in practicing nurses:  A systematic review. 
SAGE Open Nursing
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2nd peer post

Dionne Dow

May 7, 2024 at 4:33 PM

What problem or issue are you seeking to improve? 

 My aim is to reduce RN anxiety in and avoidance of leading other staff in the charge nurse capacity during the night shift within a behavioral health unit. 

How did you identify or recognize the problem or issue (i.e., inclusion of internal data)? 

I have often overheard nurses say, “As long as I don’t have to be the charge nurse, I don’t mind what I do here.” I have noticed that some staff have called out if they believe they will have to be the charge nurse for the night and be responsible for giving report in the morning to the oncoming shift staff (includes the unit manager, clinical nurse coordinator, case management team, nurse staff, and mental health technicians). Other nurses find float nurses to work their first 4 hours so that they miss the evening report and medication pass (attendance to both is critical for giving the morning report), thus avoiding the charge nurse role. 

What evidence from the research supports the existence of the problem or issue (i.e., include external data)?  Include supportive rationale for your evidence from a peer-reviewed journal using APA in-text citation and a full reference. 

Charge nurses can be unprepared to tackle their duties, experience anxiety, and fear when they are not certain of what their duties are, and when they must lead other staff. “The role of the charge nurse is to ensure duties are accomplished, issues are resolved, and patients are appropriately cared for.” (Spiva et al., 2020). Double-checking the work of a registered nurse can seem redundant to another nurse and this is a duty expected of the charge nurse. Additionally, some nurses have expressed a dislike for public speaking (during the morning report). Additionally, the oncoming shift staff have bountiful energy which can be considered obnoxious to the night shift charge nurse who is in their 12th hour of work. 

Discuss the strategy you plan to implement as your change component and how your chosen strategy will be effective in addressing your problem or issue (education policy, protocol, or technology). 

I plan to fully prepare registered nurses to undertake the charge nurse role by providing education via precepting, shadowing, and guiding them in the position. I will ensure that they have the written tools needed to fulfil the complete role of charge nurse and utilize their existing critical thinking skills to develop a manual for the role. My goals are to reduce anxiety, call outs, and partial shift completion due to fear of undertaking the role.

Create a timeline for your project’s implementation beginning in Week 1 and ending in Week 7 of the course. 

Week 1 – determine and seek approval of strategy and topic 

Week 2 – revise the strategy (and incorporate professor feedback) and outline my short and long-term goals 

Week 3 – create an evidence table (using required resources), determine how to collect data, and plan the implementation phase 

Week 4 and 5 – implementation of education to achieve the long-term goal/desired outcome 

Week 6 – summarize the collected data and provide statistics, evaluate all findings, submit poster 1 

Week 7 – submit poster 2 

Thank you,

Dionne 

Reference: 

Spiva, L., Davis, S., Case-Wirth, J., Hedenstrom, L., Hogue, V., Box, M., Berrier, E., Jones, C., Thurman, S., Knotts, K. & Ahlers, L. (2020). The effectiveness of charge nurse training on leadership style and resiliency. 
JONA: The Journal of Nursing Administration, 50(2), 95-103.

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