2.50
Hdl Handle:
http://hdl.handle.net/10755/164276
Category:
Abstract
Type:
Presentation
Title:
An Innovative Approach to Enhance Diagnostic Reasoning at the Bedside
Author(s):
Dunscomb, Jennifer
Author Details:
Jennifer Dunscomb, RN, MSN, CCRN, Columbus Regional Hospital, Columbus, Indiana, USA, email: nacnsorg@nacns.org
Abstract:
Purpose: The purpose of the inquiry was to design an early warning trigger system that would identify patients for rapid evaluation, diagnostic reasoning, and prompt planning/interventions to prevent failure to rescue events. Significance: It is estimated that 70% of respiratory and cardiac arrest can be prevented through early recognition and planning. With the complexity and high demands of nurses, recognition of subtle physiologic changes becomes difficult on a medical-surgical unit. Design: There are numerous scoring systems that help the nurse predict deterioration in the patients condition, however these systems are implemented manually at the bedside. Other systems require retrospective review to obtain physiologic predictions or expensive computerized technology for implementation. Thompson Healthcare-Mdata Care Focus is a customizable profiling engine, which utilizes hospital defined clinical data to identity, specified patient populations within a hand-held device. Methods: The Clinical Nurse Specialist collaborated with Information Services to design a care focus program that utilized vital sign parameters from the Early Warning Scoring System; specific triggers from the Institute of Health Care Improvement Global Trigger Tool, Systemic Inflammatory Response Syndrome criteria, and physiology from Acute Physiologic And Chronic Health Evaluation. The care focus, Early Warning Trigger System, is used to highlight abnormal patient information and the combination of variables that together may contribute to adverse harm. The CNS reviews patients daily for potential complication with further evaluation and diagnostic reasoning. Plans are then quickly developed to initiate rapid treatment to mitigate potential complications. The application was tested, then disseminated to other nurses who partner with the CNS to assure progression to the plan of care. The CNS provided knowledge transfers by collaboratively partnering with nurses to identify triggers and engage in clinical reasoning of real time patient experiences. Findings: Post rapid testing of the clinical innovation, medical-surgical codes have reduced by 50% with an indirect decrease in hospital mortality. Conclusions: Potential adverse complications were mitigated in multiple scenarios when the CNS designed and applied the early warning trigger system. Implications for Practice: The implication for nursing and advanced practice nursing is immense when enhancement of clinical reasoning, knowledge transfer, and improvement of patient outcomes can occur with the use of innovative technology.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2008
Conference Name:
Clinical Nurse Specialists: Leaders in Clinical Excellence
Conference Host:
NACNS - National Association of Clinical Nurse Specialists
Conference Location:
Atlanta, Georgia, USA
Description:
Conference theme: Clinical Nurse Specialists: Leaders in Clinical Excellence, held March 5 - 8 at the Westin Peachtree Plaza in Atlanta, Georgia
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleAn Innovative Approach to Enhance Diagnostic Reasoning at the Bedsideen_GB
dc.contributor.authorDunscomb, Jenniferen_US
dc.author.detailsJennifer Dunscomb, RN, MSN, CCRN, Columbus Regional Hospital, Columbus, Indiana, USA, email: nacnsorg@nacns.orgen_US
dc.identifier.urihttp://hdl.handle.net/10755/164276-
dc.description.abstractPurpose: The purpose of the inquiry was to design an early warning trigger system that would identify patients for rapid evaluation, diagnostic reasoning, and prompt planning/interventions to prevent failure to rescue events. Significance: It is estimated that 70% of respiratory and cardiac arrest can be prevented through early recognition and planning. With the complexity and high demands of nurses, recognition of subtle physiologic changes becomes difficult on a medical-surgical unit. Design: There are numerous scoring systems that help the nurse predict deterioration in the patients condition, however these systems are implemented manually at the bedside. Other systems require retrospective review to obtain physiologic predictions or expensive computerized technology for implementation. Thompson Healthcare-Mdata Care Focus is a customizable profiling engine, which utilizes hospital defined clinical data to identity, specified patient populations within a hand-held device. Methods: The Clinical Nurse Specialist collaborated with Information Services to design a care focus program that utilized vital sign parameters from the Early Warning Scoring System; specific triggers from the Institute of Health Care Improvement Global Trigger Tool, Systemic Inflammatory Response Syndrome criteria, and physiology from Acute Physiologic And Chronic Health Evaluation. The care focus, Early Warning Trigger System, is used to highlight abnormal patient information and the combination of variables that together may contribute to adverse harm. The CNS reviews patients daily for potential complication with further evaluation and diagnostic reasoning. Plans are then quickly developed to initiate rapid treatment to mitigate potential complications. The application was tested, then disseminated to other nurses who partner with the CNS to assure progression to the plan of care. The CNS provided knowledge transfers by collaboratively partnering with nurses to identify triggers and engage in clinical reasoning of real time patient experiences. Findings: Post rapid testing of the clinical innovation, medical-surgical codes have reduced by 50% with an indirect decrease in hospital mortality. Conclusions: Potential adverse complications were mitigated in multiple scenarios when the CNS designed and applied the early warning trigger system. Implications for Practice: The implication for nursing and advanced practice nursing is immense when enhancement of clinical reasoning, knowledge transfer, and improvement of patient outcomes can occur with the use of innovative technology.en_GB
dc.date.available2011-10-27T11:45:20Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:45:20Z-
dc.conference.date2008en_US
dc.conference.nameClinical Nurse Specialists: Leaders in Clinical Excellenceen_US
dc.conference.hostNACNS - National Association of Clinical Nurse Specialistsen_US
dc.conference.locationAtlanta, Georgia, USAen_US
dc.descriptionConference theme: Clinical Nurse Specialists: Leaders in Clinical Excellence, held March 5 - 8 at the Westin Peachtree Plaza in Atlanta, Georgiaen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.en_US
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