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Introduction
The problem of the lack of effective discharge planning, as practice shows, negatively affects patient outcomes and adversely influences recovery rates. As a solution to the issue, a special plan will be analyzed where the intervention model will be presented with its full justification and a description of all the necessary nuances. Detailed planning can help change the readmission rates of children with asthma for the better and achieve more successful treatment.
Change Model Overview
As one of the ways to solve the current problem, an integrated model of discharge planning can be used. According to Wells, LeClerc, Craig, Martin, and Marshall (2016), this approach involves not only nursing staff but also other healthcare professionals, including the management of a particular clinic. However, junior medical personnel should pay special attention to this model and adhere to its conditions so that the outcome of the intervention process could be positive and children with asthma could experience less discomfort after discharge.
Scope of the EBP
The practice issue that has a direct bearing on the problem of young patients readmission rate is not efficient discharge planning. Insufficiently competent work in this area leads to the fact that patients have to return to clinics for additional treatment, which adversely affects both the health of children and the reputation of a certain medical institution (Hesselink et al., 2014). Also, according to Parikh et al. (2018), 3.9% of readmissions were the lowest indicator after a one-month intervention (p. 175). The problem affects not only a single clinic but the whole healthcare system since in the case of an inadequately designed discharge policy, problems will arise periodically in various patients with different diseases.
Stakeholders
As the members of the intervention group, the pulmonologist as the main specialist can be recruited. A health visitor will monitor the status of the trustees in order to monitor changes in the state of their health. Also, three change nurses should be on duty at the hospital, controlling the condition of the children.
Responsibility of Team Members
The main role of the pulmonologist is a competent assessment of the patients conditions and the development of a treatment plan. The health visitor will be engaged in regular visiting already discharged patients and monitor their health indicators. Change nurses will be on duty at the hospital, working each in their shift, and monitoring the condition of those who are in the wards under the doctors supervision.
Evidence
Different authors consider the problem of discharge planning as one of the serious issues concerning nursing practice. For example, Kuethe, VaessenVerberne, Elbers, and Van Aalderen (2013) consider this problem from the point of view of a global scale, explaining the necessity of urgent interventions by the complexity of consequences in case of incompetent treatment. The research in this area is significant and useful, and one of its primary advantages is the improvement of young patients treatment indicators, which automatically raises the status of a particular medical institution. Certain guidelines, for example, manuals on the rules of patient discharge will be useful for nurses.
Evidence Summary
According to the authors opinions, interventions are necessary; for instance, Hesselink et al. (2014) recommend changing attitudes toward patient discharge policy and monitoring their condition when they are at home. Parikh et al. (2018) claim that nursing training should be improved to achieve better labor performance. According to Kuethe et al. (2013), the treatment of asthma requires increased attention and the use of modern methods, especially when it comes to children. Wells et al. (2016) suggest using an integrated model that implies uniting the efforts of scholars and physicians to find the most effective solution to the problem. Patients parents can be satisfied only if obvious effective measures are applied to children, and the number of readmissions will be significantly less.
Recommendations for Change Based on Evidence
The recommendation for improvement is that it is necessary to substantially review the system of discharge planning and to resort to the help of modern methods and approaches. The active intervention will certainly improve the situation for the better, and nurses need to understand the importance of innovations. The use of information from other sources is welcomed.
Translation
Action Plan
To begin with, it is required to collect a group of researchers, which will include a doctor and nurses. Further, it is necessary to obtain consent from the parents of those children who will participate in the study. Probably, there will not be any problems with it since the main goal is to help young patients in recovery. The minimum time frame required to implement the plan is one month. During this time, it will be possible to draw competent conclusions about whether the interference in personnels work of personnel is effective or not, and whether the rate of readmission decreases. The report on the work done can be presented in the form of a statistical analysis and data obtained in the process of interviewing children and their parents.
Process, Outcomes Evaluation, and Reporting
It is planned that the results of the study will make it possible to reduce the readmission rate among the number of children with asthma who go to medical institutions for treatment. The evaluation will be based on statistical data, as well as feedback from patients themselves and their parents. The results will be transferred to stakeholders in the form of a report sheet where the statistics will be displayed reflecting indicators before and after the research.
Next Steps
In order to implement an intervention plan not only in a single clinic but also on a larger scale, it is essential to popularize the idea of the need for careful discharge planning, for example, by publishing a printed version of the study. This type of work is good for any medical institution, regardless of its size. In order for the implementation to be permanent, it is required to keep records of patients opinions about the work done, for instance, by communicating on a special forum on the Internet or through online surveys.
Findings Dissemination
The information on findings within the target healthcare institution can be distributed at special separate meetings for junior and senior staff. As a report to other facilities, it is possible to use specialized Internet portals or social networks. Also, the publication of the article may be of interest to a certain circle of readers, and in the future, the data will be able to spread.
Conclusion
Thus, the problem of high readmission rates among children with asthma is a relevant issue, and detailed discharge planning can be of great help in its solving. The background of the issue is the necessity to find a method to change the current situation. The evidence is the statistics provided in the scientific literature. The translation provides for developing an action plan by involving stakeholders and implementing the steps of the intervention. The integration into practice can be achieved through the dissemination of the obtained information among medical personnel in the target clinic and on the Internet. The evaluation of the outcomes can give a clear picture of the studys success. The change plan can be maintained by publishing the results of research and posting the data online.
References
Hesselink, G., Zegers, M., Vernooij-Dassen, M., Barach, P., Kalkman, C., Flink, M.,& Suñol, R. (2014). Improving patient discharge and reducing hospital readmissions by using Intervention Mapping. BMC Health Services Research, 14(1), 389-399.
Kuethe, M. C., VaessenVerberne, A. A., Elbers, R. G., & Van Aalderen, W. (2013). Nurse versus physicianled care for the management of asthma. Cochrane Database of Systematic Reviews, 2(1), 1-35.
Parikh, K., Hall, M., Kenyon, C. C., Teufel II, R. J., Mussman, G. M., Montalbano, A.,& Shah, S. S. (2018). Impact of discharge components on readmission rates for children hospitalized with asthma. The Journal of Pediatrics, 195, 175-181.
Wells, D. L., LeClerc, C. M., Craig, D., Martin, D. K., & Marshall, V. W. (2016). Evaluation of an integrated model of discharge planning: Achieving quality discharges in an efficient and ethical way. Canadian Journal of Nursing Research Archive, 34(3), 103-122.
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