Implementing iCARE in a Skilled Nursing Facility
Getting Started: Interprofessional teams are part of practice trends we see developing in all aspects of care delivery. Consider you own work environment (or recent clinical setting).
For this assignment, consider the concept of interprofessional teamwork and patient outcomes.
Look to your current workplace as an example. (If you are not currently employed, look to a past workplace or clinical practice area.)
Apply the components of the iCARE concept to interprofessional teams in a short paper. (Body of the paper to be 3 pages, excluding the title page and references page)
iCARE components are:
E vidence-Based Practice (EBP)
How could you contribute to an interprofessional team and patient outcomes through nursing actions of: compassion, advocacy, resilience, and evidence-based practice?
Select one scholarly nursing article from CINAHL as a resource for your paper.
Additional scholarly sources can be used but are optional.
When searching in the CINAHL database, please limit your search word to one component of the paper you wish to emphasize, such as ‘Resilience’. Searching for the term iCARE will not produce the results you need.
Elements of iCARE paper
Below are the headings to be used for this assignment.
Introduction: (No heading needed here in APA) Explain the type of work setting you are discussing and whether interprofessional teams are currently present. If interprofessional teams are present, indicate a team function that could be improved. If interprofessional teams are NOT present, indicate what type of team you think might be possible in the setting.
Describe a nursing action item for each component below that could contribute to: interprofessional team support; how this might impact the culture of your unit or organization; and possible impact on patient outcomes.
Summary: Include a summary statement of how iCARE components can support interprofessional teams and patient outcomes. Address how you may be able to influence this process of support for interprofessional teams overall in your unit or organization.
References: List any references used in APA format.
Implementing iCARE in a Skilled Nursing Facility
A skilled nursing facility is a unique health setting where caregivers provide different forms of direct care to their patients. Often, the facility tends to older adults with chronic illnesses and functional impairment. The diversity of clinical and non-clinical needs requires the involvement of nurses (advanced practice, registered, licensed vocational and practical nurses), nursing assistants, physical therapists, dieticians, facility administrators (finance and procurement officers), and resident physicians. These caregivers constitute an interprofessional team whose collaboration enhances care outcomes. While the team enjoys relative success, there is room to improve care coordination. The team should implement better information organization, transmission, and utilization strategies to enhance patient safety, experience, and specific health outcomes. They can accomplish this improvement by implementing the iCARE elements (compassion, advocacy, resilience, and evidence-based practice). Therefore, the current paper examines how registered nurses working at the facility can implement the iCARE entities to improve care coordination.
Nurses should be compassionate to their patients and their colleagues. However, repeated exposure to the suffering of others results in the decline of their empathetic capacity. The fatigue hinders the nurse’s competency, resulting in, among other things, failed care coordination. Therefore, nurses can organize a support group for colleagues where they discuss the challenges they encounter and help each other deal with their emotional burdens (Peters, 2018). Each support group would consist of a few caregivers to enhance confidentiality and encourage the members to be more expressive. The nurses should also schedule regular meetings to promote the support group’s efficacy. Hence, the support groups will ensure that the nurses’ compassion levels are optimal. Consequently, the team members will be empathetic enough to promptly identify patient suffering and alleviate it as well as possible.
Nursing advocacy entails understanding patient and family needs and taking decisive actions to address any concerns they might have. Thus, nurses can enhance advocacy by organizing wide-latitude meetings with patients and relatives. Most encounters between caregivers and patients are structured since they focus on specific issues that either party wants to address. Therefore, some matters remain unaddressed, resulting in the clients not receiving the type of care they may wish. Thus, organizing open sessions will facilitate discussions on multiple topics, including cultural preferences in the case of a code, long-term health goals, and palliative care preferences (Carpenter et al., 2018). The nurses will then relay the information to the other team members, facilitating an optimal care experience for the patients.
Resilience is the ability to recover from physical and emotional challenges and continue attending to patients, such as the loss of a patient, unprecedented exhaustion due to emergency-related overtime, and the repercussions of medication errors and near misses. Thus, a skilled nursing facility nurse requires an effective strategy to overcome these adversities. One such approach entails engaging in a creative recreational activity, such as painting. The creative process enables nurses to relieve the stress they may have accumulated during their working hours. Consequently, they recharge emotionally, making them mentally resilient to deal with the next set of challenges (Kim & Chang, 2022). The creative process also allows them to relax, enhancing their physical resilience. Therefore, resilience facilitates nurses to perform their duties, making the interprofessional team more effective.
Nurses at the skilled nursing facility can contribute to evidence-based practice by conducting local surveys. They can investigate various aspects of care delivery, including the patient’s experience, perception of the quality of care they receive, etc. After collecting the data, the nurses should analyze it, enabling them to develop statistical and thematic results. If these outcomes are challenges, they should explore external evidence and engage their colleagues in developing effective solutions. If the results are positive indicators of care quality, the nurses will ensure that all the team members are aware of it and encourage them to maintain those standards.
Therefore, conducting surveys improves the facility’s culture by sensitizing the team members on the importance of using evidence in decision-making and change implementation. Additionally, since the surveys provide insights into the care process, the outcomes will allow the team to enhance its care delivery performance, creating a culture of excellence (Sharplin et al., 2019). Consequently, patients will enjoy better care experiences through culturally competent care, fewer safety concerns, and more engagement in the care process.
The clinical diversity in the skilled nursing facility requires an elaborate interprofessional team. Nurses are pivotal to the team’s success since they can enhance individual and collective compassion, advocacy, resilience, and evidence-based practice competency. Compassion allows the caregivers to be more receptive to the patient’s needs, while advocacy enables the needs assessment. Meanwhile, resilience ensures that the interprofessional team members are physically and emotionally capable of performing despite the challenges they encounter. Lastly, evidence-based practice ensures that decisions and interventions reflect the population’s needs. Nurses can influence the application of these iCARE competencies through the various actions identified in the paper. Hence, the components promote individual competency, which translates to better cooperation with interprofessional teammates, resulting in enhanced care coordination.
Carpenter, J. G., Berry, P. H., & Ersek, M. (2018). Care in Nursing Facilities after Palliative Consult. Journal of Hospice and Palliative Nursing, 20(2), 153–159. https://doi.org/10.1097/NJH.0000000000000420
Kim, E. Y., & Chang, S. O. (2022). Exploring nurse perceptions and experiences of resilience: a meta-synthesis study. BMC Nursing, 21(26). https://doi.org/10.1186/s12912-021-00803-z
Peters, E. (2018). Compassion Fatigue in Nursing: A Concept Analysis. Nursing Forum, 53(4), 466-480. https://doi.org/10.1111/nuf.12274
Sharplin, G., Adelson, P., Kennedy, K., Williams, N., Hewlett, R., Wood, J., Bonner, R., Dabars, E., & Eckert, M. (2019). Establishing and Sustaining a Culture of Evidence-Based Practice: An Evaluation of Barriers and Facilitators to Implementing the Best Practice Spotlight Organization Program in the Australian Healthcare Context. Healthcare, 7(4), 142. https://doi.org/10.3390/healthcare7040142