– I need a 12 page paper with 10 academic sources about health insurance companies in Maryland, USA.-Paper must be 12 page not including cover page, appendices, in-text citations, and references. At least 10 references required, you are welcome to do more. It must include an executive summary at the beginning. A brief description of the project, its purpose and your role should be included as background information. A SWOT analysis is required too. ( a similar project will be attached only to help you to see the HEADINGS of the paper ).- I will give more details about the paper when this gets assigned- Also a copy of the presentation style is attached, I need 5 or 6 slides only
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Internship Project
NURSING ROUNDS
Executive Summary
While doing my patient rounding, I have made several observations; a few nurses are
not completing their rounds on their patients. Some Nurses are not completing their
board rounds at all, and some of them are recording inconsistently. This could be
associated with either a lack of commitment or negligence. To improve the execution
of these nursing rounds, I have come up with a new rounding process for nurses to
record their round checks. I am implementing an electronic board for the nurse to record
their evaluation of the patient during every round. The electronic board will connect to
the nurses account when they sign in to start their shift.
It will be required for each nurse to record their rounds on their patient every hour on
the electronic board. The system will be set to allow the nurse to evaluate their rounds
at the scheduled time. The icon will only be active for the current hours of evaluation.
After the nurses scheduled time, the evaluation icon will become inactive. The nurse
will only be able to record for the current hour. For example, if the time is 2 am they
will have until 2:50 am to do their rounding. After 2:50 am the time will become
inactive for evaluation. To promote effective use, the system will be equipped with an
alarm reminder. The alarm will notify the nurse 15 minutes before the system
deactivates to record the round within that hour. The nurse manager can sign into the
system to see which nurses are missing their rounds.
There will be a slot in the system that is all marked red to start. When the round is
complete and recorded, the red mark will turn green. For general evaluation, only the
manager will be able to access the final data to know how many rounds each nurse
completed, the exact time it was done, and the number of missed rounds. This new
rounding process will help the manager evaluate how each nurse on their unit has done
on his/her rounds.
1. Introduction
Healthcare institutions are thriving to provide quality and efficient patient care. As
technology advances in healthcare, it is important for hospitals to improve their quality
of care. In order to provide best healthcare services, the institutions should incorporate
specialized methods in their healthcare settings. The improvement of quality healthcare
services means that safety of the patients should be enhanced. Similarly, the
effectiveness of healthcare delivery services should be considered when one wants to
improve the quality of care for patients. However, healthcare features are advancing
and becoming complex daily. In this way, healthcare institutions require enhanced
methods of delivering quality healthcare services.
To enhance healthcare service provision, providing a patient-focused kind of health
care is essential. Patients go through different challenges hence there should be precise
clinical decisions based on the individual patient. Sometimes delay in providing
healthcare assistance to the patients is quite detrimental to his or her health. In order to
improve, there should be advanced technology to solve this healthcare problem.
Equally, efficiency in provision of health services should be considered a priority.
However, with the existing research on how to better patient satisfaction and quality
care, proactive rounding of nurses is the best solution. Thus, the traditional concept that
has no further enhancements like use of manual rounding boards should be replaced
with electronic rounding boards (Meyer, 2018).
2. Background Information
The proactive rounding of nurses over the years is important in improving the quality
of care for patients (Villamin, 2019). However, hospitals like GBMC, which serve at
least 20,000 patients a year; 455 inpatients and 52000 emergency cases yearly. It is
essential GBMC implements a better way of providing efficient, effective, safe, and
equitable healthcare services to its patient population. GBMC should be hiring
proactive nurses who ensure all patients will be evaluated equally and on time. The new
electronic rounding system will help nurses be proactive and check/ record on their
patient’s status. The board will help the hospital to reach its’ mission (Health, Healing,
Hope) and will better the healthcare service delivery to its patients.
3. Definition of the Problem
Patient rounding is one of the many elements that is important in ensuring there is
consistent as well as superior care. Patient satisfaction and experience are better served
through patient rounding. Through hourly rounding and the 5Ps of rounding, the
patients’ needs and those of healthcare professionals can be improved to a considerable
extent. However, this can be achieved by bettering access to timely, quality, and safe
provision of care. Rounding in nursing is an important factor that should be prioritized
to improve the quality of care. Hourly checking every patient in the hospital everyday
by the nurse is the best way to provide excellent care and a positive experience for
patients (Villamin, 2019). The frequency of checking patients at night should be less
compared to during the day to ensure that patients get proper rest.
However, this is not the case when it comes to nursing rounds at GBMC. During my
internship program in the Intensive Care Unit (ICU) at GBMC. I recognized an issue
related to nurse rounding’s. For best care services to the patients, nurses should always
ensure that they complete their daily rounding.
During my stay in the ICU, I found that nurses are:
1. Not completing their rounds on time
2. Not completing their rounds entirely
3.Not completing all rounds during their shift.
This is very detrimental to patients’ care since patients might be going through serious
problems, and there is no one to check on them. Nurses need to go around to every
room and assess the 5P’s. The 5Ps of rounding include pain, position, potty, periphery,
and pump. In this way, they should ask the patient the extent of their pain,
comfortability, and whether he or she needs to use the bathroom. The nurses doing the
rounding should also ask the patient if they need any assistance beyond their reaches,
for an example; moving a trash can or phone. Similarly, the nurse should check on an
hourly basis for the IV pump. However, when some nurses don’t adhere to their
rounding schedules like the GBMC ICU, patients will miss some of these services.
Incomplete rounds will cause patients to be unhappy with the care services as well as
suffer if it is a medical emergency.
By nurses completing their rounds, they will feel safer and more secure about the care
they are receiving. Nursing rounds ensures the patient that the nurse will come back
and check on him or her. Thus, the failure of nurses to complete their rounding on
scheduled time or completely failing will mean that there will lack the best patient
experience as well as better care. However, to avoid these, GBMC ICU should come
up with ways of developing and maintaining proactive rounding of nurses.
4. Problem Analysis
I wanted to implement a process to make it impossible for nurses to fail to complete
their rounding on time as scheduled, fail to complete all the assigned rounds, or
completely fail to do patient rounding. Similarly, successful hourly rounding at the
GBMC ICU has never been that easy even though the hospital has made significant
efforts in ensuring that the nurses are properly trained and reducing staff time. In doing
so, the hospital has experienced some frustration due to the failure to solve the problem
and produce excellent results.
First, some nurses might feel that the hourly rounding process was forced upon them
which is why they are not serious in completing their rounds. Similarly, other nurses
might claim that they don’t feel that sense of ownership of hourly rounding approach.
Nurses could be interested in knowing the origin and how effective the hourly rounding
process could be in benefiting the patients. Also, some nurses have perceived hourly
rounding as an optional task. They consider it a luxury activity that is done when there
is time; in one sense, they don’t own the hourly rounding.
Secondly, nurses have not been motivated to complete patient rounding; hence they
become reluctant in their activities. Motivation is very critical in a situation like this of
ensuring that the nurses complete their rounds. However, leaders of the ICU at GBMC
should have been motivating the nurses to complete their hourly rounding. On the other
leaders, should ensure they lead as examples by performing all the rounding of patients
to validate the patient rounding process. The leaders also in the ICU might not have
been reviewing rounding logs, making it easy for nurses to underrate the whole nurses’
rounding process.
Proactive rounding of nurses from recent studies has shown that there are a lot of
benefits to the patients (Huang, 2017). Notably, fall reduction has significantly reduced
since, through the rounding of nurses, the patients have had easy access to their items.
Bathroom needs by the patients is another cause of falls in hospitals, and this has been
solved by hourly rounding. Studies also show that there has been almost 40% call light
reduction in hospitals. Because of this change, patient satisfaction has been improved.
Nurses face a lot of challenges from being disturbed to increased walking time as a
result of more call lights. Similarly, the reduction of pressure ulcers has been greatly
associated with proactive rounding. Thus, by bettering the hourly rounding ICU at
GBMC will experience positive results.
5. Problem Solution
Technological change in every setting is inevitable in the technology-dominated world.
Over the years, we have seen the value of technology in need to automate and improve
patient care as well as enhancing their experiences. Nurses have recently been ranked
as the top-most trusted professionals in the United States by Gallup Poll (Gallup, 2018).
Nurses do not have to struggle so much to embrace modern technology in their practice
because technology has found its place in nursing profession. Nurses should always
maintain and incorporate technology that will better patient care. Proactive rounding of
nurses is the key motivating factor.
The ICU at GBMC is facing difficulties when it comes to nurse rounding’s. The
traditional use of boards to monitor how nurses do their rounding is not effective at all.
Nurses still fail to effectively and timely complete their rounding since the boards are
not effective in holding them accountable for failing to take their rounding seriously.
However, to provide the solution to the problem at hand at GBMC in the ICU, electronic
rounding board will be able to solve the problem completely. The effectiveness of the
electronic rounding board is quite high when compared to traditional manual rounding
boards. The key significant result of employing electronic rounding boards in nursing
is the realization of patient safety and quality of care.
Manual Rounding Board
Electronic Rounding Board
6.1 Importance of Electronic Rounding Boards
Rounding is one of the most valuable functions that the hospital should be more
concerned with. Thus, there is a need to understand how it is being carried out on an
hourly basis (Patel, 2018). However, with the use of electronic boards, patient and nurse
satisfaction will be achieved easily. The workflow in the ICU at GBMC will also be
streamlined. Thus, below are some of the key benefits of changing from use of pen and
paper to use of electronic rounding board.
6.1.1 Consistency
The primary purpose of rounding is to consistently check on patients and ask them
various questions to determine their current health state. The 5Ps of rounding on
rounding scripts are proven healthcare practice questions that seek to ensure that the
patient is satisfied with the care being given to them. By using electronic rounding
boards, consistency and efficiency is greatly achieved. E-rounding provides suitable
scripts with only a few clicks to do the rounding, thereby solving the problem of
shuffling through papers and searching for the right files. This opportunity is provided
by the electronic board application when spotting nursing rounding trends especially
when each nurse asks the same questions.
6.1.2 Accountability
Through the use of manual rounding boards, it is not easy to know if the rounding is
being done at the agreed time. Also, one cannot know whether the rounds are being
carried out as per the agreed schedule. Manual rounding boards do not provide the
opportunity to monitor whether the questions on the scripts are those being asked.
Similarly, when using manual boards, you cannot know whether the patient health
issues have been resolved quickly. Nurses have to prioritize timely resolution of patient
health problems. Therefore, use of electronic rounding boards provides accountability
during the patient health problem resolution and ensures that patient interaction is
extended at a granular level, not only in the ICU but also across the entire hospital.
6.1.3 Data collection
Data collection is a significant aspect of nursing rounding which the GBMC needs to
prioritize. With that in place, the GBMC hospital will get information concerning all
hospital operations, thereby developing initiatives to improve them. Through nurses
rounding, the data collected will help the hospital in understanding the experience and
satisfaction of patients throughout their stay at the hospital. Trends and insights in the
hospital will be identified easily through use of digital rounding tool. E-rounding
ensures effective and meaningful achievement of daily occurrences. Therefore,
transparency, nurse accountability and best patient experience can be highly enhanced
through electronic rounding board.
6.2 MTR® Automated Hourly Rounding
MTR® Automated Hourly Rounding is a system that seeks to improve patient safety
and satisfaction and advancing patient care by communicating rounding status to
caregivers from various locations without interrupting patient care or workflow
(Jessica, 2017).
6.3 How the MTR® Automated Hourly Rounding Works
Every nurse has to conduct their rounding every hour on the application or electronic
system or board. The system will be set to only allow the nurse to evaluate the rounding
at the scheduled time. Thereafter, the evaluation icon will become inactive and be active
for the subsequent hours of evaluation. That is meant to prevent the nurses form doing
their rounding at once and they can only see the current hour. Nurses have only 50
minutes after the start of every hour do their rounding. To promote effective use the erounding application, the system will be equipped with an alarm reminder which will
notify nurses 15 minutes prior to the next rounding shift. On the system, the nurse on
duty will sign into the account and check their scheduled rounding hours (Jessica,
2017).
However, the set hours will be marked red, and when the nurse does the rounding, the
red will change to green. For general evaluation, only the manager will access the final
data to know how many rounds each nurse did, the exact time it was done, and the
number of missed rounds. By doing so, the manager will evaluate the effectiveness of
nurses during their rounding.
The application system ensures that all the patients are assessed based on their
individual needs. The application through the use of an alarm system reminds the nurses
to carry out their rounding. In so doing, the patient will be evaluated on time. However,
the consistency of hourly rounding is kept steady through the use of the MTR system.
Whiteboard Showing Hourly Rounding
Similarly, nurses can be evaluated directly through the application. MTR system
evaluates nurses automatically based on their completed rounding hours. The MTR
system also provides rounding-only boards displaying nurses’ assignments and
appointments.The end of bed reports is eliminated through the use of the MTR system
which will be achieved because every patient visit by the nurse is documented and
displayed electronically (Jessica, 2017). Additionaly, the MTR system records
information such as the check sheets and paper logs.
Digital Patient Room Board Rounding
The system displays the rounding success of each nurse which is verifiable during
nursing rounding reports. In this way, transparency and accountabilty of nurses is
ehanced. The systemcompiles statistics of the whole hospital operationsvital in making
decisions and improvements within the GBMC hospital.
Rounding Statistics
Rounding Report on Room
6 Implementation
The implementation process starts with identifying the vendor. The procurement team
should contact the vendor of the MTR system and provide honest, detailed, and realistic
solutions they want the system to solve. The hospital goals of the new rounding program
should set in advance to ensure that the vendor is aware of what is actually required in
the hospital. The procurement team will comprise of technical teams who will assist the
hospital in communicating the organization’s technical requirements. After the vendor
and the hospital reach an agreement, they can go ahead to discuss important details,
such as the timeline required for the implementation and the scope of the program.
When all is set, there will be a massive awareness of the introduction of new technology
(MTR) for nurses, which is meant to ensure the effective and efficient rounding of
nurses at GBMC.
Also, training of nursing staff at GBMC hospital will ensure effective and thorough
comprehension of how the MTR rounding system operates. This will be facilitated by
the MTR rounding system experts assisted by the technical team from the hospital.
Brochures consisting of MTR system information, guidelines, and user manual will be
distributed to all nursing staff at the hospital(Al Danaf, et al., 2018).After that, the
technical department will carry out a plenary session whereby there will be an exchange
of questions and answers between the nursing and technical staff concerning the
launching of MTR® Automated Hourly Rounding System. Here, the nurses will be
encouraged to freely point out theoretical issues that they did not understand from the
user manual.
Notably, a practical session or a pilot test for the new nursing rounding system will be
carried out where the nursing staff will understand how the system shall be working.
The nursing staff will be able to know how the system will monitor their nursing rounds.
For instance, they will be shown what the system displays when maybe a nurse misses
their nursing rounds completely, or when they do the rounds past the scheduled time,
and when the nurse fails to complete all the assigned rounds. Similarly, the nursing staff
will get the skills required to operate the MTR® Automated Hourly Rounding System.
However, after the nursing staff has been equipped with skills on how to operate the
new rounding system, technical implementation takes effect. The vendor and hospital
IT department will then choose the preferred interface the system will use when
transferring files. The hospital will then automate the system so that there will be
consistent sending of nurse rounding data. Similarly, the vendor will be given access to
the hospital’s wireless network. The setting up of the MTR system software will then
follow the process. During setting up of the MTR software, the hospital should have
purchased new devices like monitors and iPads as required by the vendor. Also, analytic
platforms required by the vendor should be already in place (Sang, et al., 2019). GBMC
hospital’s management should carry out constant consultation with the vendor and work
together as well through the entire process of setting up the system.
Equally, the rounding process will begin after the vendor gets all the information about
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