For this written assignment, select one recent (within the last two years) evide

Question

For this written assignment, select one recent (within the last two years) evidence-based article from a peer reviewed nursing journal that describes a "best practice" in an area of nursing you are interested in. For example, if you would like to be a pediatric nurse, select an article that discusses a best practice in pediatric care.

Cite the article and provide a brief overview of how the results or findings were obtained. Then describe the "best practice." Conclude your discussion by explaining whether you thought the research findings supported the conclusions and the best practice.

This assignment must be no more than 3 pages long. It should include all of the required elements. Use APA Editorial format and attach a copy of the article.

Submit your completed assignment by following the directions linked below. Please check the Course Calendar for specific due dates.

Explanation / Answer

THE ROLE OF PEDIATRIC NURSE:

The Accreditation Council for Graduate Medical Education (ACGME) applied rubrics restricting effort hours for residents, lessening the obtainability of residents as providers at education hospitals. These limitations have augmented confidence on Advance Practice Providers (APPs) including nurse practitioners (NPs) and Physician's Assistants (PAs) in provided that inpatient maintenance. The NP hospitalist character comprises inpatient therapeutic administration, organization of care, patient and staff teaching, and excellence development doings. The NP hospitalist role has prolonged out there as additional for condensed occupant work times, totaling value finished resident instruction, expansion of clinical care strategies (CCGs), endurance of maintenance, and understanding with inpatient organization. The NP hospitalist character has been exposed to recover the excellence, competence, and cost efficiency of inpatient maintenance.

Promising superiority and cost amount consequences have been recognized for adult NP hospitalists likened to house staff, counting better-quality patient consequences, augmented patient and staff consummation, reduced length of stay (LOS) and charge of care, and better-quality admission to care. These conclusions are maintained by NP inpatient database assessments at numerous theoretical medical hubs, which also display amplified patient and family gratification and better-quality communiqué between doctors, nurses, and families. One education established that cooperative care organization of mature medical patients by a hospitalist physician and progressive practice nurse led to reduced LOS and enhanced hospital income without altering patient readmission or death. Though there is a rising body of indication secondary the quality and cost efficiency of the NP hospitalist role in adult inpatient care, there is little available data for pediatric agendas.

The PNP hospitalist character at Children's Hospital Colorado (CHCO) was introduced in 2006 to encounter the necessity for supplementary inpatient providers. Inpatient enlistment tests included reduced resident work times as well as tall inpatient capacity throughout the winter breathing period. The PNP hospitalist providers at CHCO self-sufficiently achieve care through hospitalization for patients inside their possibility of practice, and co-manage more complex patients with the presence MD. The PNPs thorough the history and physical examinations, instruct and understand diagnostic examinations, perform events, recommend medications, and contribute with release organization. Patient inhabitants inside the PNP hospitalist possibility of practice comprise straightforward diseases like bronchiolitis, pneumonia, and asthma.

The hospitalist unit at CHCO chief campus comprises two occupant sides and one PNP team. The hospitalist unit also delivers inpatient care at several Network of Care (NOC) sites. These NOC sites are CHCO functioned amenities that are moreover self-supporting or associated to a community infirmary, with an Emergency Department and six to eight inpatient couches. The PNP hospitalist character comprises inpatient organization at the CHCO chief campus as well as in the NOC. The NOC sites are operated with a PNP and MD team who effort collaboratively to achieve inpatient care. The Advanced Practice Hospitalist Program was applied to recover staffing and preserve superiority of patient care in a cost actual way. It is understood as a program assessment with the goalmouth of likening excellence and price of care amid the PNP side, PNP/MD lineup, and resident crews.

Managerial and electronic medical record statistics from July 2009 finished June 30, 2010 remained studied with hindsight. Data were attained from inpatient records at CHCO inpatient medical component and inpatient satellite television locations in the CHCO NOC. The 2008 versions 26 and 27 of 3M All Patient Refined Diagnosis Related Groups (APR-DRG) were secondhand to classify patients by analysis, sternness of illness, and danger of mortality. The upper three APR-DRGs at CHCO originated on bulk of inpatient admittances were chosen for this study, counting Bronchiolitis & RSV Pneumonia, Pneumonia NEC, and Asthma. These three diagnoses accounted for around 60.75% of all inpatient hospitalist meetings, and included 78% of the PNP meetings, 52% of the resident meetings, and 76% of the PNP/MD meetings. APR-DRG sternness of disease groups contain I, II, III, and IV (minor, moderate, major, and extreme, correspondingly). Sternness of disease heights I and II were used for this investigation. Sternness III and IV were omitted due to absence of patients in these groups on the PNP squad and in the NOC. They also comprised surveillance position patients.

Quality events for this program assessment comprised obedience with the Bronchiolitis CCG endorsement to identify bronchiolitis founded on history and test conclusions, while minimalizing the custom of chest x-ray and respiratory viral challenging. Present indication advises that these examinations add charge and experience to radioactivity, and do not automatically foresee sternness of disease or alteration medicinal organization. This package assessment also unhurried obedience with the Asthma commendation to give each asthma enduring individual an Asthma Action Plan (AAP) previous to hospital release. Of reminder, this assessment was accomplished previous to more new indication which enquiries the usefulness of AAP for educating asthma clinical consequences. There stood no associated actions for pneumonia accessible because there was not a CCG in residence at the time of this assessment.

Consequences events for this assessment comprised LOS and price of care for the top three inpatient identifies: bronchiolitis, asthma, and pneumonia. LOS for the inpatient hospitalization was unhurried in times. Straight cost of care was secondhand for this examination, which comprised medical provisions, drugstore, radiology, workroom, and bed duties. Nursing duties were also encompassed in the straight charge due to the closeness of nursing charge to the patient, against more aloof costs such as organization or management. Hospitalist surgeon and NP incomes were not comprised in straight fee examination. Consequences were likened for the PNP team, the occupant teams, and the PN/MD team in the NOC.

Patients were abridged by analysis connected collections and harshness of disease using totals and proportions crossways the PNP team, resident squads, and the PNP/MD side in the NOC. LOS and straight charge is tilted, consequently natural log alterations were recycled to see normal supposition for numerical challenging and displaying. Chi-square and t-tests were achieved to associate consequences among the PNP and resident physician squads, stratified. ANOVA was used to investigate LOS and direct price for the highest three fee cyphers while regulating for insight. The consequences were also likened pairwise amongst the three sides by means of a Linear Mixed Prototypical to regulate for APR-DRG and harshness of disease, considering sternness as a nested outcome inside the APR-DRG. Bonferroni alterations were castoff to regulate for manifold judgements; a p-value < 0.017 was measured statistically important. Boundary marker hoc control examination was finished for the examination of bronchiolitis chest X-ray collation, even however the example size was comparatively big.

PNP devotion to CCGs was analogous to resident sides for the specific events used in this assessment. Grounded on a hospital-wide goalmouth of organization analytic examinations for fewer than 25.4% of inpatients with bronchiolitis, there was no noteworthy alteration among the PNP team and occupant squads. There was no noteworthy alteration in the amount of chest X-ray organization amid the PNP squad and the occupant squads. Correspondingly, there was no important alteration in virus-related testing amongst the PNP and surgeon crews. Post hoc influence investigation designated that a superior example scope would be obligatory to upsurge the control of noticing a statistically important change in chest X-ray collation among these collections. The PNP and occupant crews were also likened using compliance with the Asthma CCGs, exactly connected to the goalmouth of given that an precise AAP to every patient self-confessed for asthma.

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