Prject Proposal

History of Law Enforcement

Your Name (First M. Last)

Date

Nurse Leader Rounding and HCAHPS score

Organization Approval Letter

April 16, 2019

Name of Principal, Director, Person-in-Charge

Western Governors University

1000 School Street

Dear Human Subjects Committee:

It is my understanding that Student Researcher Name will be conducting a research study at Winchester Hospital on “Nurse Leadership rounding and HCAHPS score”. Ms./Mr. Student has informed me of the design of the study as well as the targeted population.

I support this effort and will provide any assistance necessary for the successful implementation of this study. If you have any questions, please do not hesitate to call. I can be reached at (000) 000-0000.

Sincerely,

Name of Principal/Director/Person-in-charge

Title, name of school/agency/center/etc.

Preceptor Agreement Form

I agree to serve as a clinical preceptor for a Western Governors University nursing student currently completing coursework in Associate Degree in Nursing. I understand that I will work with this student during the stated academic year by providing guidance, direction and support appropriate to the clinical situation. As the assigned preceptor I shall provide supervision, in accordance with this chapter and/or the rule and law associated with my current state of practice, and I agree to the following:

I have completed the Preceptor Qualification form and I have a valid registered nurse license in the state in which I will be the acting preceptor. I will be precepting in________ Western Governors University.

I have 24 months of experience, or more, as a registered nurse or advanced practice nurse and I am competent in my clinical practices. ADN BSN MSN/APN/ CNP

I understand my role, as the assigned preceptor, and have been given applicable instructions and all forms necessary for this experience.

I have been given a copy of the clinical objectives/course syllabus.

I agree to evaluate the student’s experiences, achievements, and outcomes, as directed, using the tools provided.

I will not supervise any more than two nursing students at any one time per OBN code 4723-5-20(G)

Preceptor:

Printed Name: Signature: Date:

1708150-635004128770-63500(*This is the email I agree to check weekly for communication from the Supervisor and/or Course Coordinator)

Preceptor current place of employment:

Agency Name: Unit:Shift:

Address: Telephone

***********************************************************************

To be completed by Western Governors University Course Coordinator:

Course Coordinator:

Printed Name: Signature: _Date:

Contact number: Email:

Students and clinical instructors shall be assigned by the Course Coordinator.

Clinical Instructor: Contact number: email:

Student(s) 1)

2)

Clinical/Organizational Problem

HCAHPS is a publically available data set which can be used to evaluate the quality of the hospital. There exist limited nurse to nurse communication and patients in plan care discussions. Winchester hospital located in Winchester, Massachusetts is providing healthcare services to the population. The behavior of nurses with the patients and their families is sometimes unsatisfactory which is catastrophic for an organization’s HCAPHS.

Causes of problem

It is notable to mention that the performance of Winchester hospital is less than the average performance of the majority of healthcare centers in the US. Due to the lack of effective communication in the hospitals, there is a significant increase in poor health care services, which is crucial for not only the patients but also for the health care organization as well. The lack of communication between physicians and nurses, physicians and physicians, and nurse and patients are catastrophic for quality care. Furthermore, the communication between healthcare practitioners and patients and their families is unsatisfactory. Hospital Consumer Assessment of Healthcare Providers and System (HCAHPS) survey in healthcare facility reveals with evidence that there is a need to improve communication between nurses and patients.

Stakeholders

Clinical Nurse Leaders need to improve the health care services in the organization so that they can meet the objectives of higher HCAHPS score. Patients and their advocates are willing to obtain better health care services. Therefore, they often tend to get medical services for hospitals who have higher HCAHPS score. The medical staff such as health care practitioners and nurses have a major role in providing medical effective medical services to patients. If they enhance their skills and communication abilities, then they can easily improve their capabilities to provide effective health care services.

Purpose of the Project

The purpose of this project is to highlight the challenges that are facing by Winchester hospital. Lack of communication between nurses and patients is hindering the process of quality health care services. The behavior of health care practitioners and nurses is not satisfactory with the patients and their families. Unsatisfactory health care services are deteriorating the overall HCAHPS score of Winchester hospital which is significantly impacting its profit margin.

Proposed Solution

There is an immense need to implement effective practices in the health care organization in order to improve the quality of health care. Nurse leader rounding is one of the most effective strategies that help to highlight the areas of improvement in the hospital. Nurse leader rounding is beneficial to understand the concerns of patients and their family. By understanding the problem, nurse leaders can easily propose solutions to improve the overall health care services in the organization. It is notable to mention that nurse leader rounding promote the sense of satisfaction in patients which can ultimately improve the overall HCAHPS score of Winchester hospital.

Evidence Summary

Nurse leader round with patients is an effective strategy that improves the overall satisfaction of patients with a nurse leader. Nurse leadership rounding involves direct observation and evaluation of the patient, staff, global view of patient status, clinical environment and unit functioning. Nursing leadership rounding provides opportunities to excel patients’ life expectancy by listening to their concerns. Day to day nurse leader rounds are valuable for proactive assessment of nursing quality regarding their care to the patients. This assessment of quality helps in providing immediate feedback to particular nurses. Nurse leader rounding provides these patients with the chance to share their concerns in an appropriate way. The presence of a nurse leader on the floors helps in encouraging and motivating patients that higher management is concerned about their health. Patients tend to share their feelings in an appropriate manner when they believe that nursing leadership is concerned about their healthcare in the hospital. A nurse leader needs to pay attention to better care of patients in order to successfully obtain a high rating in the HCAHPS score. Nurse leader needs to practice rounding in the hospital in order to integrate effective communication skills among staff members.

Implementation plan

In order to improve the health care services of the Winchester Hospital, it is necessary to implement the practice of nurse leader rounding. For this purpose, the hospital management needs to increase the workforce so that the routine nursing leadership practices may not get disturbed. Hourly nurse leader round must be implemented to identify the areas of improvement in the Winchester Hospital. After that, possible solutions must be proposed to improve the health care services in order to get better HCAHPS score.

Actions

1st week

2nd week

3rd week

4th week

Feasibility of plan

Conduct meeting

Alignment of all the stakeholders

Accessibility of resources

Approval of plan

Implementation of plan

For this purpose, Clinical Nursing Leadership, higher management and medical staff of Winchester Hospital are required. These individuals will help to implement the practice of Nurse Leadership rounding in Winchester Hospital to improve the HCAHPS score.

Previously, there was no concept about nurse leadership rounding in the Winchester Hospital. There was a lack of effective communication between nurses and patients that hindered the process of quality health care services. Now, the implementation of nurse leadership rounding will help to improve the overall health care services in the organization. It will also help to improve areas of improvement which will ultimately increase the overall HCAHPS score of Winchester Hospital.

Non-collaboration of medical staff with the objectives of the health care organization, unrealistic targets and lack of effective communication is a potential barrier to implement the nurse leadership rounding.

References

Dempsey, C., Reilly, B., & Buhlman, N. (2014). Improving the patient experience: real-world strategies for engaging nurses. Journal of Nursing Administration, 44(3), 142-151.

Merrifield, J., Frier, R., Lewis, L., & Walker, E. J. (2016). Improving care and accountability in a busy Emergency Department through the use of intentional rounding: The journey so far.

Morton, J. C., Brekhus, J., Reynolds, M., & Dykes, A. K. (2014). Improving the patient experience through nurse leader rounds. Patient Experience Journal, 1(2), 53-61.

Reimer, N., & Herbener, L. (2014). Round and round we go: rounding strategies to impact exemplary professional practice. Clinical journal of oncology nursing, 18(6).

Walker, K., Duff, J., & Fitzgerald, K. (2015). ‘Rounding’for better patient care: An evaluation of an improvement intervention implementation. International journal of nursing practice, 21(2), 207-213.