Nursing Project Essay Example | Topics and Well Written Essays - 2750 words

Nursing Project - Essay Example The evidence definitely supports the use of this program and s presented in this paper. Continuous quality problems and spiraling costs in healthcare have lead to widespread interest in solutions that are effective and well supported. Evidence based practice has taken hold as an answer to the problem that makes sense (Coleman, 2003) EBP is sometimes viewed as an ideology, however, as far as practice goes it's goal is to supplement professional decision making with the latest research. It is sometimes argued today that to treat someone with a practice that the efficacy has not been shown is not ethical (Kind,2007). That would leave many healthcare treatments today as unethical. This paper will discuss nursing transition to evidence based practice in the realm of patients and transitioning. The question would be, "What are the most effective interventions for improving care coordination" Many Medicare dollars are spent on a small percentage of beneficiaries with chronic conditions and those people are in and out of the hospital many times, many within short periods of time. The causes of this are numerable but some of them are inadequate care, poor communication among primary caregivers, specialists, and patients, weak adherence by patients, and failure to catch problems early. There are three types of intervention being looked at closely at this time to try to solve these problems. Transitional Care, self managed education intervention, and coordinated care interventions are being considered as effective but requiring further study (Coleman, 2003). Transitional care is first engaged in the hospital, followed intensely post-discharge and receives comprehensive post discharge instructions on medications, self care and symptom recognition. Reminder calls are made to assure that the patients follow up with primary care providers as required. Effective transitional care is targeted for patients with specific diseases such as CHF. This is guided by APN's and is usually a twelve week intervention that is highly structured with protocols (ncga.gov.) It requires a one year post discharge follow-up. Statistically it has shown to reduce hospitalizations by 34% and lower overall costs by 39%. APN's in this case are the transitional coaches and there are tools given for cross site communication. Self management education is a term used for collaboration with patients and families to identify patient goals, improve self management, expand sense of self efficacy, and assess mastery of skills (ncga.gov). Much of this is done in group sessions of limited duration. The targeted patients are usually forty or older and have heart disease, lung disease, stroke or arthritis. There are usually seven weekly group sessions on exercise, symptom management, techniques, nutrition, fatigue and sleep management, use of medications, dealing with emotions, communication and problem solving. Statistics show that these patients have 1/3rd fewer hospital stays. Coordinated care on the other hand is considered teaching patients about self care, medications, how to communicate with problems, monitor patients symptoms, well-being, and adherence between office visits and advise patient on when to see their physician. A full report is given to the patient's physician (ncga.gov). This would also include arranging for social support