a biopsy andor used to identify cardiac problems including blocked valves andor

A biopsy andor used to identify cardiac problems

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a biopsy and/or used to identify cardiac problems including blocked valves and/or blocked coronary arteries. However, the facility is not equipped to perform cardiac interventions such as placing cardiac stents and/or replace heart valves. Another weakness within the facility is the outdated EHR. Multiple different systems are used to chart which often results in duplicate charting and nurses are not notified or aware when new orders are added. Evidence-based practice activities Evidence-based practice (EBP) is a systematic approach used to ensure the best possible outcomes. Used to guide nursing practice, evidenced-based practice is an integration of evidence, the best available, to improve patient outcomes. One EBP activity currently
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INNOVATIONS 11 being utilized by the Huntington VA involves surgical patients and urination. Post-surgical patients are required to void prior to being discharged. This requirement was put into effect after so many patients were returning to the ER during the first 24 hours post-operatively (post-op) due to urinary retention. This activity has greatly reduced the amount of urinary catheterizations and post-op ER visits. Quality improvement projects Quality improvement (QI) projects are essential to ensuring that a facility is improving patient safety, efficiency, and/or clinical outcomes. Like EBP, a quality improvement project is also a systematic approach used to analyze performance, practice, and ways to improve performance. The Huntington VA has recently implemented a new QI project in an effort to reduce the number of missed appointments. The VAMC has recently initiated system generated reminder calls, secure messaging, and reminder texts in an effort to reduce the amount of no- shows for clinic appointments. As this project is still in its infancy, effectiveness has not yet been determined. Recommendation for Organization Change Recommendation After interviewing leaders within the facility and reviewing practices, the organization could benefit from additional changes. A recommended practice change for the Huntington VA is the implementation of order sets or protocols. An order set is a standardized set of predefined templates. It is a set or group of related orders which allows physicians and/or nurses to act within their scope to improve patient outcomes. Order sets/protocols can be initiated for infusions, including heparin and insulin and/or infection control such as Methicillin-resistant Staphylococcus aureus. One of the concerns at the Huntington VA, is the lack of appropriate
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INNOVATIONS 12 titration of heparin and insulin drips, by nurses, which results from the lack of communication from physicians. For example, heparin drips should be titrated based upon patient diagnoses and lab results, particularly the partial thromboplastin time (PTT). Due to the lack of communication within the facility, providers were/are initiating rate changes on heparin drips but the changes were not being processed because the nurses were not being notified of the orders to change the rates. This effected/effects patients and patient care as heparin drips are not being titrated in
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