NR505-61331 Week 2 PICOT Worksheet Assignment. LT

NR505-61331 Week 2 PICOT Worksheet Assignment. LT

NR505-61331 Week 2 PICOT Worksheet Assignment. LT

1. Identify your MSN Specialty Track: Nursing InformaticsDescribe practice concern/problem?  The practice concern/problem is readmission rates have been problem not only to the patients but also the hospital. Hospitals are under financial stress for having too many readmission rates.  Why is this concern/problem important to nursing and healthcare? I think telemedicine is importance to my future role as a nurse informaticist not only nurses informaticist plays an imperative role in the infrastructure of telemedicine but telemedicine is the new era of medicine. Since the birth of COVID-19, we don’t have to choose between medical care and social distancing. The uses of telemedicine have shown an increase in use of service by both HCP and patients. Physicians turned to telemedicine as a way to remain engaged with their patients. This form of real-time, audio-video communication allows physicians and patients to connect from different locations existed prior to the pandemic, but certain restrictions limited widespread usage (Downes, Mervin, Byrnes & Scuffham, 2016).What is the scope of the concern? First, readmission rates have been transparent with the Centers for Medicare and Medicaid Services (CMS) and JCAHO. Hospitals are being penalized with reimbursement for having high readmission rates. Second, hospital readmission increase hospital expenditure and resources. Other researchers suggested readmissions increased lengths of stay, mortality, and affects the quality of life of the patients (Upadhyay, Stephenson & Smith, 2019).  What evidence is there for the need for change?  According to the National Hospital Discharge Survey (NHDS) data is in 2000 and in 2010, there were an estimated 1 million hospitalizations for CHF, and CHF is one of the most common reasons those aged 65 and over are hospitalized. In The Hospital Readmission Reduction Program (HRRP) was designed as a Medicare value-based purchasing program that decreases payments to hospitals. the penalties have increased from 1% to 3% (or a factor of .97) for hospitals with excessive readmissions. Include a minimum of 2 scholarly sources per APA format:1. Downes, M. J., Mervin, M. C., Byrnes, J. M., & Scuffham, P. A. (2016). Telemedicine for general practice: a systematic review protocol. Systematic reviews. (4) 134. https://doi.org/10.1186/s13643-016-0115-22. Upadhyay, S., Stephenson, A. L., & Smith, D. G. (2019). Readmission Rates and Their Impact on Hospital Financial Performance: A Study of Washington Hospitals. Inquiry: a journal of medical care organization, provision and financing56, 46958019860386. https://doi.org/10.1177/0046958019860386
2. Define each element of your PICOT question, in one or two sentences. P- Population and problem – What is the nursing practice issue or problem and whom does it affect?The problem is too many patients diagnosed with CHF have been shown on data to be readmitted too soon. I- Intervention – What evidence-based solution for the problem would you like to apply? The evidence-based solution for the problem I would like to use to fix the readmission problem is to utilize telemedicine for chronic disease such as CHF to manage and reduce readmission to hospital. Studies at home monitoring programs/ telemonitor (TM) have shown improvement in management of HTN, CHF and diabetes (Board on Health Care Services; Institute of Medicine, 201). C- Comparison – What is another solution for the problem? Note that this is typically the current practice, no intervention at all, or an alternative solution.The effect of telemonitor to manage chronic disease when compare to on-site visitations from home health nurses that typically 2-3x a week. O- Outcome – Very specifically, how will you know that the intervention worked? Think about how you will measure the outcome. Specifically, this intervention will measure through the readmission rates with the assistance of telemonitor. T- Time frame – For the purpose of this EBP project, you will want to keep the timeframe within 6-8 weeks.The timeframe for this EBP project will be measure over 6 months period. 
3. Write your PICOT question in the standard PICOT question format (narrative and separately):Narrative: In-patient diagnosed with CHF (Population) what is the effect of implementing of telehealth monitor (TM) in the home  (Intervention) in comparison to on site visitations from the home healthcare nurses (Comparison) on in the prevention of re-hospitalizations (Outcome) to be completed over a 6-month period (Time). Separately:P: Patient diagnosed with CHFI: how effective is the implementation of telehealth monitor (TM) in the homeC: on-site visitations from home healthcare nurses O: in the prevention of re-hospitalizationsT: Over a 6-month time period
4. Identify the key search terms and phrases for your literature search:Keywords- Telemedicine, telemonitor, CHF, and readmission
5. Identify a theoretical framework/nursing theory that can guide the EBP project:When design and conducting the study. I’ll considering the mixed methods approach of both quantitative and qualitative. 

NR505-61331 Week 2 PICOT Worksheet Assignment. LT

References

Downes, M. J., Mervin, M. C., Byrnes, J. M., & Scuffham, P. A. (2016). Telemedicine for general practice: a systematic review protocol. Systematic reviews. (4) 134. https://doi.org/10.1186/s13643-016-0115-2

Board on Health Care Services; Institute of Medicine. (November 3rd, 201) The Role of Telehealth in an Evolving Health Care Environment: Workshop Summary. The Evolution of Telehealth: Where Have We Been and Where Are We Going?. https://www.ncbi.nlm.nih.gov/books/NBK207141/

Upadhyay, S., Stephenson, A. L., & Smith, D. G. (2019). Readmission Rates and Their Impact on Hospital Financial Performance: A Study of Washington Hospitals. Inquiry: a journal of medical care organization, provision and financing56, 46958019860386. https://doi.org/10.1177/0046958019860386

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