Journal Entries need to connect your previous professional experience with your practice, the Master’s-level specialty-area competencies/concepts in the program, the AACN 2021 Essentials and the information provided in your Practicum Experience. You will continue adding to your Journal, creating a cumulative log of your Practicum Experience as a whole. This comprehensive Journal will be submitted for each Journal Submission Assignment.
All Journal Entries are one page in length (250–300 words) and should adhere to scholarly writing. Below are 2 previous journals from Weeks 3 and 7 this journal should be continuous please see directions above and do accordingly, add references APA format.
Thank you
Journal 3
This week marks another insightful day on my assigned medical-surgical unit, where we have been focused on Hospital-acquired Infections (HAIs), improving patient experiences and fostering better collaboration among the nursing staff and physicians. One of the most pressing issues we are addressing is the reduction of HAIs, a significant challenge in hospital settings. According to the Centers for Disease Control and Prevention (CDC), HAIs affect approximately 1 in 31 hospital patients on any given day (CDC, 2020). My job is to help to implement a multifaceted approach to tackle this issue, including stricter adherence to hand hygiene protocols, the use of antimicrobial stewardship, and the regular audit of infection control practices. We are also educating the staff and patients about the importance of these measures. Studies have shown that consistent hand hygiene can reduce the incidence of HAIs by up to 40% (Allegranzi & Pittet, 2009), which underscores the critical nature of these efforts.
Improving patient experience is another crucial aspect of our quality improvement projects. We are focusing on enhancing communication between healthcare providers and patients, ensuring that patients feel heard and understood. Research indicates that effective communication can significantly improve patient satisfaction and health outcomes (Street et al., 2009). We are employing strategies such as bedside shift reports, which involve the patient in the care process, and regular patient satisfaction surveys to gather feedback and make necessary adjustments.
A significant challenge we are addressing is the collaboration between nursing staff and physicians. Historically, there has been a divide, often stemming from differences in training and perspectives. However, it is essential to recognize that we are all working towards the same goal: providing the best possible care for our patients. Effective teamwork and communication are paramount. As study by O’Daniel and Rosenstein (2008) highlights that interprofessional collaboration can lead to improved patient outcomes, reduced errors and enhanced job satisfaction among healthcare workers. To this end, we are organizing regular interdisciplinary meetings where nurses and physicians can discuss patient care plans, share insights, and resolve any conflicts that arise.
Our initiatives also include team-building exercises and workshops focused on communication skills and conflict resolution. These sessions are designed to break down barriers and build a culture of mutual respect and understanding. The positive impact of these initiatives is already becoming evident; there is a noticeable improvement in morale and cooperation within the team.
In summary, my practicum experience provides me with invaluable insights into the complexities of healthcare quality improvement. We are making strides towards creating a safer and more efficient healthcare environment. The team that I work with is great and very supportive and open-minded, my preceptor has opened her unit for me to navigate, work with the team on a few initiatives, extending from what I started which I great. The importance of these initiatives is supported by extensive research and best practices, so successful implementation holds great promise for the future of patient care.
References:
Allegranzi, B., & Pittet, D. (2009). Role of hand hygiene in healthcare – associated infection prevention. Journal of hospital infection, 73 (4), 305-315. https://doi.org/10.1016/j.jhin.2009.04.019
Centers for Disease Control and Prevention. (2020). Healthcare-associated infections (HAIs). https://www.cdc.gov/hai/index.html
O’Daniel, M., & Rosenstein, A.H. (2008). Professional communication and team collaboration. In R.G. Hughes (Ed.), Patient Safety and quality: An evidence-based handbook for nurses (pp. 2-271-2-284). Agency for Healthcare research and Quality.
Street, R.L., Makoul, G., Arora, N.K., & Epstein, R.M. (2009). How does communication heal? Pathways linking clinician-patient communication to health outcomes. Patient Education and counseling, 74(3), 295-301. https://doi.org/10.1016/j.pec.2009.08.015
Journal Week 7
It is unbelievable that it is week 7 of my practicum, as I inch closer to the end of my Doctoral degree. I continue my rotation on the medical surgical unit with my focus on keeping the engagement going on reducing and preventing Catheter Associated Urinary Tract Infections (CAUTI). Our focus for the last few weeks has been to focus on reinvigorating device rounds, specifically targeting the removal of Foley catheters. This initiative aims to prevent CAUTIs, a significant concern in patient care. The goal is to make the removal of Foley catheters a standard part of daily practice, ensuring that it is not solely driven by nurses but also integrated into the physicians’ routine.
Our strategy involves collaborating closely with physicians during these rounds. By doing so, we aim to embed this practice into the daily workflow, ensuring that it becomes a habitual part of patient care. This collaboration is crucial as it promotes a team-based approach to infection prevention, enhancing patient outcomes. Physicians’ involvement is essential in assessing the necessity of catheters and considering timely removal, which aligns with best practices and guidelines for reducing CAUTIs.
Furthermore, this collaboration encourages the team to explore alternatives to foley catheters. For patients who are ambulatory, anticipating their need to urinate can reduce the reliance on indwelling catheters. For bedridden patients, external urinalysis catheters are considered a viable option. These alternatives can significantly reduce the risk of infections and improve patient comfort and safety. By integrating these practices into the daily routine, we aim to establish a sustainable model for preventing CAUTIs, highlighting the importance of interdisciplinary teamwork in enhancing patient care.
According to the Centers for Disease Control and Prevention (CDC), CAUTIs account for approximately 75% of hospital acquired of hospital acquired infections, underscoring the importance of this initiative (CDC, 2021). The American Nurses Association (ANA) also emphasizes the need for comprehensive infection prevention strategies, including the judicious use of indwelling catheters and the promotion of alternatives (ANA, 2021). By adhering to these guidelines and fostering strong collaboration between nurses and physicians, our team is committed to reducing the incident of CAUTIs and improving overall patient outcomes. I feel a sense of pride when the staff included me in their meeting as it pertains to quality, Quality seems to be deal on this unit and everyone is engaged and goal oriented.
References
Center for Disease Control and prevention. (2021)/ Catheter Associated Urinary Tract infections (CAUTI). Retrieved from https://www.cdc.gov/hai/ca_uti/uti.html
American Nurses Association (2021). ANA CAUTI prevention toolkit. Retrieved from https://www.nursingworld.org/practice-policy/work-envirnment/health-safety /infection-prevention
Infectious Diseases Society of America (20220. Guidelines on the Diagnosis and Management of Catheter-Associated Urinary Tract Infection in Adults. Retrieved from https://www.idsociety.org/practice-guideline/cauti/
Lo, E., Nicolle, L.E., Coffin, S,E., Gould, C., Maragakis, L., Meddings, J., Pegues, D.A., Pettis, A.M., Saint, S., & Yokoe, D.S. (2021). Strategies to prevent catheter -associated urinary tract infections in acute care hospitals:2014 update. American Journal of Infection Control, 42(5), 557-570.
