Life-Sustaining Hemodialysis Treatments Discussion

Life-Sustaining Hemodialysis Treatments Discussion

Introduction

Life-sustaining hemodialysis treatments improve care and safety for patients with end-stage kidney disease (ESKD). ESKD is a burdensome disease that compromises patient safety by contributing to increased mortality rates, high care costs, and poor quality of life(Benjamin et al., 2022). In the United States, ESKD affects over 500 million people, prompting healthcare professionals to embrace effective treatment mechanisms. Effective cannulation during dialysis is a profound life-sustaining strategy for patients with ESKD. Nurses should be aware of adverse consequences associated with flawed cannulation techniques. Therefore, a nurse education program on cannulation techniques and practices is a crucial quality improvement initiative (Liu et al., 2021)Life-Sustaining Hemodialysis Treatments Discussion.

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Slide 2: Objectives of the Presentation

The proposed project entails a nurse education program on appropriate cannulation techniques during hemodialysis. Therefore, this presentation focuses on various aspects of the proposed program, including:

• Describing one or two measures that are critical to the sustainability of the proposed quality and sustainability program
• Establishing a measurement threshold that will trigger the investigation
• Describing the owner of the improvement process
• Outlining a communication and training plan for improvements and learning
• Identifying a change management theory consistent with the program
• Explaining how the proposed changes will affect staff workload Life-Sustaining Hemodialysis Treatments Discussion

Slide 3: Measures that are Critical to the Proposed Program

Measuring care quality entails assessing the organization’s structures, processes, and outcomes that are consistent with the need to provide quality and convenient care. In this sense, quality measures entail elements of the organizational structure, process, and outcomes that explain the effects of nursing practices and decisions. Also, measures of care quality are essential aspects and tools for ascertaining organizational adherence to quality care guidelines. They reveal the interplay between organizational structures, processes, and outcomes.

In the proposed program, quality measurements include:

• Patient survival rates before and after the implementation of cannulation techniques.
• The tendency of relying on Tunneled Dialysis Catheters (TDCs) even after educating nurses on appropriate cannulation techniques.
• Pre-and post-intervention rates of pain and needlestick injuries.

Slide 4: Data Collection and Monitoring Strategies

Data collection is central to the process of analyzing quality measures and establishing areas of improvement during and after the implementation of quality improvement initiatives. Frequent assessments of the project’s alignment with the desired outcome are a vital phase in the project life cycle. When implementing the nurse education program on cannulation techniques, it is essential to collect data and monitor the effectiveness of the nurse education program on:

• The adoption of cannulation techniques during dialysis
• The reduction of incidences of adverse events associated with flawed cannulation.

An effective data collection and monitoring plan will include surveys and questionnaires to assess levels of knowledge acquisition, reviews of monthly clinical data to ascertain post-intervention improvements, analyzing the project’s alignment with external benchmarks on life-sustaining care for ESKD, and studying the prevalence of pre-and-post intervention errors in dialysis. Life-Sustaining Hemodialysis Treatments Discussion

Slide 5: Determining the Frequency of Quality Measurements

Project evaluation is a vital phase of the project’s life cycle. In this sense, effective evaluation of quality measures entails deciding on the mechanisms of data collection and the time (frequency) of evaluating project variables. When evaluating quality measures critical to the proposed program, it is essential to consider various aspects, including, measure frequency, measure rate, measure duration, and measure latency. For example, I would consider eliminating or reducing the frequency of assessing over-reliance on Tunneled Dialysis Catheters (TDCs) if nursing education on appropriate cannulation techniques improves and reduces the frequency and rate of TDCs use and can conduct cannulation procedures safely without supervision or committing errors.

Slide 6: Quality Measurement Threshold that will trigger an Investigation

Discrepancies between the project’s progress and the desired outcomes may prompt an investigation to identify challenges that impend effective project implementation, as well as areas of improvement. For instance, the purpose of educating nurses on the recommended cannulation strategies is to improve patient safety and care quality. In this sense, a nurse education program will improve nurses’ awareness and knowledge of appropriate cannulation strategies, enable nurses to ensure patient safety by preventing errors associated with flawed dialysis, improve the patient survival rate, and reduce the prevalence of adverse ramifications, including pain, hemorrhage, and needle stick injuries. Consequently, a high prevalence rate of injuries, pain and hemorrhage even after educating nurses on cannulation strategies should trigger an investigation to identify areas of improvement. Persistent post-intervention adverse events may signify ineffective education programs and flawed adoption of the change initiative. Life-Sustaining Hemodialysis Treatments Discussion

Slide 7: The Owner of the Improvement Process

Project ownership is a profound strategy for ensuring effectiveness. In turn, effective leadership is a prerequisite for project initiation, implementation, and sustenance since leaders provide directions, communicate the vision, and create a sense of ownership of healthcare projects. In the proposed project, nurse leaders will authorize changes and facilitate change adoption. They will play other significant roles, including controlling all other unit activities and overseeing communication, conducting performance appraisal, and aligning the project with organizational culture and vision (Scott & Scott, 2020). Finally, nurse leaders will advocate for quality care by ensuring consistency between the project’s processes and desired outcomes.

Slide 8: A Communication and Training Plan for Improvements and Learning

A comprehensive communication and training plan is necessary to guide practices, improve interactions, and enhance the project’s outcomes. According to Sibiya (2018), effective and timely communication improves sound relationships, collaboration, and cooperation among team members. Stakeholders require a consistent flow of information and regular updates on the project’s progress. Since the proposed program will rely upon interdisciplinary teams comprising nurse leaders, nurses, unit nephrologists, and advanced nurse practitioners, a communicant and training plan will include various aspects and tenets; Face-to-face interactions during training unit social media platforms, email texts, and frequent reports and updates by nurse leaders

On the other hand, training programs will encompass simulations, demonstrations by unit nephrologists, and the provision of reference materials, including scholarly articles and clinical guidelines. According to van Eck van der Sluijs et al. (2021)Life-Sustaining Hemodialysis Treatments Discussion, process simulation will be the major training strategy because it results in faster knowledge acquisition and retention.

Slide 9: Change Management Theory

Organizations are susceptible to multiple challenges when navigating the change process. According to Errida & Lotfi (2021), the change process is complex and risky, prompting healthcare organizations to prepare adequately to tackle challenges associated with change. As a result, change management is central to the organizational determination to initiate, implement, and sustain change because it entails dealing with transition, supporting change implementation, and enabling employees to adapt to new interventions, processes, or behaviors. When facing challenges to initiate, implement, and sustain change, a change management theory can provide a roadmap or a framework that would inspire change initiation, implementation, and adoption (Errida & Lotfi, 2021). For example,  Kurt Lewin’s three-step change theory can enable change advocates to reduce change resistance and enhance project success in the proposed project.

Slide 10: Change Management Theory Continued

Kurt Lewin’s three-step theory is popular in healthcare due to its emphasis on appropriate interventions for initiating, implementing, and sustaining change. According to Saleem et al. (2019), this theory has three profound steps of change management: unfreezing, moving, and refreezing. The unfreezing stage entails addressing resistance to change, establishing a rapport, building coalitions, preparing employees for change, and establishing communication strategies. On the other hand, the moving phase represents the implementation stage where stakeholders and team members actualize the project’s deliverables. Finally, the refreezing phase involves anchoring new approaches in the organizational culture through the adoption process to ensure change sustenance. This stage entails changing the organizational culture and aligning it to new practices.

Slide 11: How the proposed changes will affect staff workload

Heavy workload poses a significant challenge for healthcare professionals and organizations, considering its association with various elements of unfavorable workplace environments. Banda et al. (2022) contend that heavy workloads lead to stress, burnout, and increased likelihood of medication and procedural errors, especially during dialysis. Nurses grapple with heavy workloads that compromise their ability to provide quality and convenient care. Therefore, healthcare organizations should implement quality improvement initiatives that target to reduce workload and the associated consequences. Life-Sustaining Hemodialysis Treatments Discussion

The proposed program will not increase workloads. Instead, it will streamline workflows by ensuring accuracy when implementing cannulation techniques, improving adherence to the recommended dialysis practices, reducing errors, and alleviating the burden associated with pain management and other adverse events emanating from flawed dialysis practices.

Slide 12: Conclusion

End-stage kidney disease (ESKD) is a burdensome disease that results in a high mortality rate and other adverse ramifications like increased care costs, prolonged hospitalization, and compromised quality of life. Nurses rely massively upon dialysis as the primary life-sustaining option for patients with ESKD. However, flawed dialysis practices can result in multiple adverse effects, including injuries, pain, and hemorrhage. As a result, nurses should familiarize themselves with evidence-based guidelines for cannulation techniques during dialysis. Awareness of effective dialysis techniques averts adverse events, such as pain, hemorrhage, and needle stick injuries. Therefore, a training program for nurses is essential in enhancing their knowledge and improving care outcomes. Life-Sustaining Hemodialysis Treatments Discussion

References

Banda, Z., Simbota, M., & Mula, C. (2022). Nurses’ perceptions on the effects of high nursing workload on patient care in an intensive care unit of a referral hospital in Malawi: A qualitative study. BMC Nursing, 21(1). https://doi.org/10.1186/s12912-022-00918-x

Benjamin, O., Lappin, S. L., & Hashmi, M. F. (2022). End-Stage renal disease. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK499861/

Errida, A., & Lotfi, B. (2021). The determinants of organizational change management success: Literature review and case study. International Journal of Engineering Business Management, 13(1). Sagepub. https://doi.org/10.1177/18479790211016273

Liu, Z., Bible, J., Petersen, L., Roy-Chaudhury, P., Geissler, J., Brouwer-Maier, D., & Singapogu, R. (2021). Measuring cannulation skills for hemodialysis: Objective versus subjective assessment. Frontiers in Medicine, 8. https://doi.org/10.3389/fmed.2021.777186

Saleem, S., Sehar, S., Afzal, M., Jamil, A., & Gilani, Dr. S. A. (2019). Accreditation: Application of Kurt Lewin’s theory on private health care organizational change. Saudi Journal of Nursing and Health Care, 02(12), 412–415. https://doi.org/10.36348/sjnhc.2019.v02i12.003

Scott, S. M., & Scott, P. A. (2020). Nursing, advocacy, and public policy. Nursing Ethics, 28(5), 096973302096182. https://doi.org/10.1177/0969733020961823

Sibiya, M. N. (2018). Effective communication in nursing. Effective Communication in Nursing, 1(1). https://doi.org/10.5772/intechopen.74995

van Eck van der Sluijs, A., Vonk, S., van Jaarsveld, B. C., Bonenkamp, A. A., & Abrahams, A. C. (2021). Good practices for dialysis education, treatment, and eHealth: A scoping review. PLOS ONE, 16(8), e0255734. https://doi.org/10.1371/journal.pone.0255734

For this assignment, you will create a sustainability plan and present your plan using PowerPoint and Loom.

General Requirements:

• A minimum of three scholarly or peer-reviewed research articles are required. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.
• While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide.

Directions:

Based on the feedback you have received from your instructor on the “Sustainability Plan Worksheet,” compile the elements (measurement, ownership, communication, change management, and workload) into a presentation that you would present to the stakeholders of your proposed quality and/or safety sustainability program.

Develop a PowerPoint presentation (10-15 slides) to present your final sustainability plan. Create speaker notes of 100-250 words for EACH slide. For the presentation of your PowerPoint, use Loom to create a voice-over or a video. Include an additional slide for the title and Loom link at the beginning and an additional slide for References at the end.

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Include the following: Life-Sustaining Hemodialysis Treatments Discussion

1. Describe one or two measures that are critical to the sustainability of your proposed quality and/or safety sustainability program and decide on the data collection and monitoring process. Additionally, discuss whether you will reduce or eliminate the frequency of certain measurements.
2. Describe a measurement threshold that will trigger investigation.
3. Describe the owner of the improvement process who authorizes changes and will be responsible for sustaining improvement.
4. Outline a communication and training plan for improvements and learning. Consider who needs to know what, when and how often they need to know it, what communication method would work best, and who the best person is for initiating communication or sharing information.
5. Identify a change management theory that you will use to standardize the process so that it supports the improved process.
6. Explain how the proposed changes will affect staff workload. Ideally, the improvement has removed work and made people’s jobs easier and more efficient. Changes that decrease workload have a higher chance of success over time. Life-Sustaining Hemodialysis Treatments Discussion