DQ: What changes will you need to make in order to have a feasible topic for your PICOT-D?
I must be the odd one out here. I did not have a topic in mind when I started this program. I had no idea that I had to have an idea of what I wanted to work on or accomplish when I started this program and it was one of the things that delayed my starting the program in January among other things. Even when I applied, I still had no definite idea of what I wanted to do. So, based on my last stationed unit as a full-time case manager/discharge planner, I chose a topic that was dear to my heart to find a way to fix some of the issues that contributes to people having strokes especially recurrent strokes. Also, not having a practice site as well as a mentor was also another barrier to deciding on a topic and also not being in direct patient care anymore, I am not familiar with all the products and knowledge of all the things that are used in other areas of nursing except for the one in my unit and with discharge planning. Now that I have a mentor, I have to mention this topic to her and she will have to be comfortable with the topic as well or she may not be able to help guide me.
Based on Professor Etheridge’s feedback so far, it appears that my topic may or may not be feasible depending on the angle it takes. It will not be feasible as a nurse to teach preventive or monitoring strategies to other disciplinary professionals such as Physical or Occupational therapists or Nutritionists or even physicians unless I work in collaboration with them but for a nursing DPI project, I should be managing and directing the nurses involved. Also, since this is a quality improvement project, I have to be able to find enough articles that have dealt with this topic that will enable or effect a quality improvement (QI) change. Quality improvement is the framework used by healthcare professionals to improve the quality of health care provided to patients. Therefore, nurses are tasked with being part of the team to improve the quality of care given to patients since they are the primary care providers and very much concerned with the safety of patients (Adolfo, Albougami, Roque, & Almazan, 2021).
I will search more databases and review more articles to look for quality improvement interventions. I will also discuss some more with my mentor and professor to see what other ideas and feedback they will give me. Of which I will implement. If it is still not feasible, then I will have to pick another topic. Something in sepsis or hospital acquired infection.
Reference:
Adolfo, C., Albougami, A., Roque, M., & Almazan, J. (2021). Nurses’ attitudes toward quality improvement in hospitals: Implications for nursing management systems. Nursing Practice Today. https://doi.org/10.18502/npt.v8i3.5935
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Having practiced in a COVID unit for the major part of the COVID-19pandemic, we witnessed several challenges in healthcare delivery ranging from an inadequate supply of PPEs (personal protective equipment) to congestion among others. However, the greatest challenge was that of a shortage of skilled nurses in home health to facilitate the continuity of care of COVID-19 patients discharged
DQ What changes will you need to make in order to have a feasible topic for your PICOT-D
early for home based care (HBC). The organization noted that most patients who were discharged early for HBC got readmitted within 30 days, an indicator of poor quality of care and potential gaps in discharge and follow up. To address this issue, the author proposed telenursing/telehealth as the intervention of choice (Tabacof et al., 2021). Researchers recommend telenursing/telehealth as an intervention to follow up chronically ill patients, particularly those with heart failure to reduce 30-day readmissions (Xu et al., 2022). Since my population of interest (COVID-19 patients) is different from that of patients with Heart failure, it would not be appropriate to conclude that telehealth/telenursing is an intervention that homecare nurses can implement to follow up COVID-19 patients enrolled for home based care and prevent 30-day readmission. Therefore, I formulated the following PICOT-D question to determine the appropriateness of my clinical issue, intervention, and outcome: Among COVID-19 patients enrolled for Home Based Care (HBC), does remote care through telenursing compared to direct patient home visits reduce the rates of readmission within 30 days.
Based on the instructor feedback, I have a feasible topic for my PICOT-D. Feasibility simply refers to whether a study can be conducted with consideration of the study, time, stakeholder cooperation, participant availability, and availability of resources, researcher’s interest, and expertise (Fandino, 2019). The author purposes to demonstrate to the organization in which he will conduct the study the value of the study in regards to the resource expenditure versus outcome value, for potential funding. This also includes the need for special telenursing equipment, having in mind that the organization has already integrated technology in the delivery of healthcare services. In regards to participants’ availability, researcher interest, and expertise, I work in a COVID-19 unit and have undergone several COVID-19 trainings for inpatients and those on HBC, I am certain that I have the needed experience and expertise in this area of study. Besides, it will be easier to get an adequate number of voluntary participants for the study. Considering the time factor, six to twelve months maximum provides an adequate duration to complete this study.
