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D031 Ev idence-Based Innovation Plan - Constipation Management In Hospice Care |
Questions And Answers, Latest Update | 100% Correct Answers | Graded
Management of Constipation in Hospice and Palliative Care Patients
Traci Ann Boyles
College of Health Professions, Western Governors University
D031: Advancing Evidence-Based Innovation in Nursing Practice
Deb Williams
February 11, 2023
, 2
Management of Constipation in Hospice and Palliative Care Patients
Disruptive Innovation in Healthcare
In healthcare, nurses are at the forefront of the patient experience and care provided. The
patient’s experience with their nursing staff determines their satisfaction, quality of life
experienced, and the overall patient outcome. For this reason, nurses such as staff nurses, nurse
leaders, and advanced professional nurses need to embrace evidence-based innovation, be
familiar with different models of gathering, analyzing, and utilizing evidence such as the Stetler
Model or the Iowa Model, and feel confident in initiating innovative ideas. (Polit & Beck, 2019).
Hospice and Palliative care nurses are not excluded from this need. Hospice/Palliative nurses
focus on symptom management and end-of-life care. Often these patients come onto the hospice
service with symptoms that have not been managed because of a lack of education and a lack of
resources. Constipation is one of the many troubling symptoms that plague hospice and palliative
patients of all ages. The Centers for Medicare & Medicaid Services (CMS) which is a major
payor source for hospice patients, has been utilizing the Consumer Assessment of Healthcare
Providers and Systems (CAHPS) Hospice Survey to monitor the patient/family experience as
part of their Hospice Quality Reporting Program (HQRP). (Parast et al., 2021).
To manage constipation in hospice and palliative patients, several disruptive innovations
could be utilized to help alleviate discomfort or prevent constipation if initiated. The disruptive
innovations that would most benefit a symptom like constipation would be improving the initial
comprehensive assessment completed by the admission nurse and initiating preventive measures
or treatment within the first patient encounter and offering a way for the nurse, patient, and
family to monitor and track bowel habits. 40% of palliative patients report constipation on their
initial comprehensive assessment with this increasing to 66% of patients reported in palliative
care centers. (McIlfatrick et al., 2019). One problem McIlfatrick and her team found was that
, 3
there is an inconsistency in the nursing bowel assessments of the patients included in their
review. (McIlfatrick et al., 2019). This review also highlighted that the treatment of constipation
is undermanaged with nonpharmacological methods and medications, often with the result of
worsening of the patient’s discomfort. (McIlfatrick et al., 2019). By initiating standard nursing
assessments with monitoring/tracking through web-based apps and algorithms for the initiation
of both nonpharmacologic and medication treatment, quality of life and comfort can be
improved.
Within the healthcare system and hospice, there are two disruptive innovations that have
improved patient outcomes. The first disruptive innovation that has improved outcomes is the
electronic medication administration records (eMAR). The use of eMAR systems has decreased
the number of errors in medication administration and also improved documentation times. By
providing real-time documentation using eMAR documentation, the nurses and physicians are
able to monitor medication administration and ensure that patients do not miss medications or
needed care which is a time saver as well as a safety improvement because prior to eMAR use,
staff had to search through paper charting to find appropriate orders and documentation.
(Covetus Technologies Pvt Ltd., 2020). The use of eMAR systems improves the efficiency of
nursing care with the use of alerts and maintains improved patient confidentiality by requiring
users to have personal login access. (Covetus Technologies Pvt Ltd., 2020).
The next innovation that has improved healthcare is the use of communication platforms
such as Zoom to conduct telehealth visits. The use of Zoom to complete telehealth visits has
worked remarkably in psychiatry, psychotherapy, nutritionists, and with dermatology visits.
(Siwicki, 2021). Siwicki reports that the use of zoom in these areas is forecasted to continue and
possibly increase over the coming years. (Siwicki, 2021). During the recent COVID pandemic,
telehealth Zoom meetings ensured that needed physician visits were attended as well as other
D031 Ev idence-Based Innovation Plan - Constipation Management In Hospice Care |
Questions And Answers, Latest Update | 100% Correct Answers | Graded
Management of Constipation in Hospice and Palliative Care Patients
Traci Ann Boyles
College of Health Professions, Western Governors University
D031: Advancing Evidence-Based Innovation in Nursing Practice
Deb Williams
February 11, 2023
, 2
Management of Constipation in Hospice and Palliative Care Patients
Disruptive Innovation in Healthcare
In healthcare, nurses are at the forefront of the patient experience and care provided. The
patient’s experience with their nursing staff determines their satisfaction, quality of life
experienced, and the overall patient outcome. For this reason, nurses such as staff nurses, nurse
leaders, and advanced professional nurses need to embrace evidence-based innovation, be
familiar with different models of gathering, analyzing, and utilizing evidence such as the Stetler
Model or the Iowa Model, and feel confident in initiating innovative ideas. (Polit & Beck, 2019).
Hospice and Palliative care nurses are not excluded from this need. Hospice/Palliative nurses
focus on symptom management and end-of-life care. Often these patients come onto the hospice
service with symptoms that have not been managed because of a lack of education and a lack of
resources. Constipation is one of the many troubling symptoms that plague hospice and palliative
patients of all ages. The Centers for Medicare & Medicaid Services (CMS) which is a major
payor source for hospice patients, has been utilizing the Consumer Assessment of Healthcare
Providers and Systems (CAHPS) Hospice Survey to monitor the patient/family experience as
part of their Hospice Quality Reporting Program (HQRP). (Parast et al., 2021).
To manage constipation in hospice and palliative patients, several disruptive innovations
could be utilized to help alleviate discomfort or prevent constipation if initiated. The disruptive
innovations that would most benefit a symptom like constipation would be improving the initial
comprehensive assessment completed by the admission nurse and initiating preventive measures
or treatment within the first patient encounter and offering a way for the nurse, patient, and
family to monitor and track bowel habits. 40% of palliative patients report constipation on their
initial comprehensive assessment with this increasing to 66% of patients reported in palliative
care centers. (McIlfatrick et al., 2019). One problem McIlfatrick and her team found was that
, 3
there is an inconsistency in the nursing bowel assessments of the patients included in their
review. (McIlfatrick et al., 2019). This review also highlighted that the treatment of constipation
is undermanaged with nonpharmacological methods and medications, often with the result of
worsening of the patient’s discomfort. (McIlfatrick et al., 2019). By initiating standard nursing
assessments with monitoring/tracking through web-based apps and algorithms for the initiation
of both nonpharmacologic and medication treatment, quality of life and comfort can be
improved.
Within the healthcare system and hospice, there are two disruptive innovations that have
improved patient outcomes. The first disruptive innovation that has improved outcomes is the
electronic medication administration records (eMAR). The use of eMAR systems has decreased
the number of errors in medication administration and also improved documentation times. By
providing real-time documentation using eMAR documentation, the nurses and physicians are
able to monitor medication administration and ensure that patients do not miss medications or
needed care which is a time saver as well as a safety improvement because prior to eMAR use,
staff had to search through paper charting to find appropriate orders and documentation.
(Covetus Technologies Pvt Ltd., 2020). The use of eMAR systems improves the efficiency of
nursing care with the use of alerts and maintains improved patient confidentiality by requiring
users to have personal login access. (Covetus Technologies Pvt Ltd., 2020).
The next innovation that has improved healthcare is the use of communication platforms
such as Zoom to conduct telehealth visits. The use of Zoom to complete telehealth visits has
worked remarkably in psychiatry, psychotherapy, nutritionists, and with dermatology visits.
(Siwicki, 2021). Siwicki reports that the use of zoom in these areas is forecasted to continue and
possibly increase over the coming years. (Siwicki, 2021). During the recent COVID pandemic,
telehealth Zoom meetings ensured that needed physician visits were attended as well as other
