NR 392 Week 3 Course Project Milestone 2 | Already Graded A

Course Project Milestone 2 Template Directions: Prior to completing this template, carefully review Course Project Milestone 2 Guidelines paying particular attention to how to name the document and all rubric requirements. After saving the document to your computer, type your answers directly on this template and save again. This assignment is due by Sunday end of Week 3 by 11:59 p.m. Mountain Time. Your Name: Assignment Criteria Answers: (NOTE: See Milestone 2 Rubric for details required in each area.) Define: Delirium in ICU patients due to sleep deprivation. Approved QT (quiet time) implementation in ICU can help decrease the number of delirium Nursing Issue and increase the score in Quietness (HCAHPS score) from Milestone 1 25 points Measure: Identify Measures (Indicators) to Support the Issue 75 points ▪ The ICU had 3 patients affected with delirium in the last quarter and it prolonged their ICU days and delayed their recovery. ▪ ICU delirium patients will be decreased by 75% by implementing QT in ICU during the night from 10PM to 5 AM. ▪ Quietness score in HCAHPS score in ICU was 58% last quarter, while national score was 63%. The quietness score will reach at national goal or above after 3 months of implementing QT in ICU. • Units: ICU only • Populations: ICU patients age 18 years and older • QT implementation: Decrease alarm sound in patients’ room. Deeming the light in the hall way. Closing patient’s doors. Silencing phones. Hushing staff conversation. Huddle Vital signs, bath, and lab work at 6 AM. Distribute ear plug on patients’ request • Need education session held by quality improvement department and education department for night shift staff including nurses, Phlebotomist, X ray technician, Respiratory therapist regarding the implementation of QT and their cooperation • Families’ cooperation is important and each nurse should educate the family regarding QT plan and get their cooperation and consent • Sign posted in front of nurses’ station alerting all night staff in QT in progress Measure: List Stakeholders (important persons) in Improving this Nursing Issue 50 points • Nurse manager: Implementing QT in ICU needs manager’s approval and policies should be written under the supervision of unit manager • Night staff nurses: Night shift nurses are in charge of controlling the noise decrease to promote the patients’ rest during the night by being in charge of each patient assigned to them • Quality improvement: Quality department will collect the data from hospital surveys regarding the quietness score and can suggest any measures can be added to promote the QT plan in ICU • Phlebotomist: Arrange to draw blood after 5AM unless it is not stat, so NR392 Course Project Milestone 2 T March 2018 CJM that patients can sleep more without interruption. • X-ray technician: Morning X ray can be arranged after 5 AM • Respiratory therapist: Daily ABG and breathing treatment can be done after 5 AM and bundle the two together for less interruption of sleeping • Family members: Family members and visitors should leave after visiting hours are over and some families should be arranged to stay depending on the patient’s needs and requests to promote rest. Without the family’s help and agreement, QT cannot be successful. Analyze: Patients in ICU often suffer from ICU delirium due to sleep deprivation from Analyze the noises, lights, visitors especially at night. Patients’ activity is very limited while in Causes of the ICU due to acuity of illness and limited interaction with surroundings and people. Nursing Issue These can cause delirium to the patients and delirium can cause a delay of care 50 points and patient can have some long-term problems after being discharged from hospital. By Implementing quiet time during the night, patients can rest and sleep better, therefore decreasing the chance of delirium and better outcomes. When the patients rest well, patients’ satisfaction is increased thus hospital will reach the national score in quietness (HCAHPS score) The reason that patients experience sleep deprivation at night is due to the high noise level such as alarm sounds, telephone rings, staff conversations, and continuous disturbances from vital signs check-ups, blood drawings, X-rays, and respiratory treatment. Patients don’t get enough sleep and sleep deprivation can cause delirium to the patents. It is imperative to educate the staff about noise and disturbance reductions throughout the night in order to allow the patients to get longer uninterrupted sleep. NR392 Course Project Milestone 2 T CJM Show Less