Respond to the following 2 posts separately.
Length: A minimum of 150 words per post, not including references
Citations: At least one high-level scholarly reference in APA per post from within the last 5 years
1. Wk2 PICO(T) Question
My clinically relevant question deals with APRNs functioning as Hospitalists. My Patient Population would be those patients that are admitted to the hospital with low acuity scores or those admitted to observation units. The Intervention or Issue of Interest would be that these two patient populations are admitted to the care of an APRN. The Comparison/Control would be comparing like admitted patients against those admitted to MDs and Dos. The Outcome would be equitable Press Ganey/Patient Satisfaction scores. and equal length of stays with no adverse patient outcomes. The Timeframe I would like the research to be a 3-month window. So my question: Over the span of 3-months, would there be any treatment differences received by Low Acuity or Observation patients cared for by either APRNs or MD/DOs.
A journal article I found suggested that those that replied to a survey questionnaire “viewed Adult NPs (ANPs) as more favorable hires for hospitalists than Acute Care NPs (ACNPs)” (Klein et al., 2020). This article also went on to state that Chief Nursing Officers (CNOs) viewed ACNPs in a more favorable light simply based on their title over ANPs versus those that gave credentials to Hospitalists (Klein et al., 2020). “Hospitalists feel Nurse Practitioners (NPs) and Physician Assistants (Pas) that are on Hospitalist teams positively impact clinical care and efficiency” (Pino-Jones et al., 2019). This second article found that Hospitalist Physicians viewed NPs and PAs quite favorably with benefits realized in clinical care provided to patients, the efficiency of practice and working differentials, and in patient satisfaction scores (Pino-Jones et al., 2019). NPs have been functioning in the role of Hospitalist going on 20 years. This 3rd journal article surveyed NPs and found out that 366:880 respondents were working in a Hospitalist capacity and that “most respondents (n=275 74.7% of 366) were certified in primary care and on-the-job training was the most common qualification to be an NP Hospitalist” (Kaplan & Klein, 2020). It seems as though NPs are flourishing in the Hospitalist capacity.
I came by this topic as I initially entered FNP school intending to become a Primary Care Provider looking to work in a clinic. However, I am now looking to become a Hospitalist. This question is important to me as I want to fully grasp what I am undertaking. This will be the next step in my healthcare career. I know this will be a serious challenge but I feel my current role as a Rapid Response RN where I deal exclusively with Code Blues, Traumas, and rapidly declining patients is a great precursor to becoming a Hospitalist. It is with the 3rd patient population where I do my own differential work up to include ordering labs I feel are medically warranted based on clinical presentation as well as PMHx/Comorbidities.
2. The PICOT layout is a process in which clinical questions are formulated in a manner that yields the most pertinent information from a search. A PICOT question is also known as a focus question, is critical to finding evidence to answer that question (Melnyk & Fineout-Overholt, 2019). P-represents the population of interest, I-represents the area of interest or intervention, C-represents the control group, O- is the outcome, and T is the time it takes to achieve the outcome. Taking the PICOT approach will provide clinicians and researchers an initial basis for mutual understanding, communication, and direction to help answer clinical study questions of most relevance (Riva et al., 2012).
Heart Failure is one of the number one reasons for readmission diagnoses to the hospital within thirty days of discharge. One in four heart failure patients are readmitted to the hospital within thirty days of discharge. This not only cost the patients more money it cost the insurance/ healthcare system more money. So, my PICOT question that I would like to propose is: In heart failure patients, how does post discharge follow up with home health compared with no post discharge follow up reduce readmission to the hospital over 30 days? I currently work with the heart and lung floors at a hospital near me. I consistently see patients discharged to their homes and bounce back within thirty days of discharge. There are different ways that I feel home health can assist in this and follow up with patients to help them stay healthy and reduce hospital readmissions.
