ESSENTIALS OF ADVANCED NURSING PRACTICE FIELD EXPERIENCE 8 the unit however; the nursing staff is not assessing the patients for these needs or not providing these resources. Rationale for Recommended Change The rationale for the recommended change of requiring all nursing staff to assess the patient for adequate sleep, and to also document this assessment; this recommended change will help to improve patient outcomes, patient satisfaction, and will address community needs. The University of Kansas Hospital prides itself on being the Number One Hospital in Kansas and Kansas City, in order to continue to be the best at patient outcomes, patient satisfaction, and ensuring that community needs are being met. Although the University of Kansas Hospital still ranks high on HCAHPS scores, the Cardiac ICU HCAHPS specific scores have been decreasing; because of this, a change must be made in order to ensure the unit is providing the best care possible. The importance of sleep in the ICU is crucial for these patients. According to a study regarding sleep deprivation and sleep interruptions in the ICU stated “an increased number of awakenings may have similar consequences as sleep deprivation” (Medrzycka-Dabrowska, Lewandowska, Kwiecien-Jagus & Czyz-Szypenbajl, 2018); this included “weakening of the immunological system leading to an increased risk of infections, reduced respiratory parameters, increased perception of pain, reduced glucose tolerance, increased sympathetic activity and increased protein catabolism” (Medrzycka-Dabrowska, Lewandowska, Kwiecien-Jagus & Czyz- Szypenbajl, 2018). As previously stated, the primary health risks in this area are the aging population, high poverty rates, prevalence of diabetes and obesity, and a high percentage of uninsured. Because of these risks, the patients in this population are less likely to seek preventative services, which then leads to more complex illnesses and sicker patients once they
ESSENTIALS OF ADVANCED NURSING PRACTICE FIELD EXPERIENCE 9 seek medical attention. By improving the quality and quantity of sleep that critically ill patients receive will have a direct effect on the patient's outcome, and could help to reduce other complications. Measures to Evaluate In order to evaluate the recommended change of requiring all nursing staff to assess the patient for adequate sleep and document the assessment each shift; the University of Kansas Hospital will look at benchmarks and hospital goals. The national benchmark that will be used to evaluate the change will be HCAHPS, and the University of Kansas Hospital will set the goals; the goals that are set by the hospital will be followed to evaluate for compliance, consistency, and effect. Firstly, the benchmarks will be evaluated by using HCAHPS, which sets national standards. As previously stated, the Cardiac ICU's HCAHPS scores decreased by 10%, with patient statements confirming noise to be a major factor; this score is also lower than several other intensive care units in the hospital. The University of Kansas Health System will have the
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