NUR445 Week 2 Discussion Rebuttal
Respond to discussion
Include citations/Use in text citation where needed
All sources must be 5 years old or newer
Only needs to be about a paragraph long
More like a discussion rather than a paper
Please add to the discussion in your peer responses with informative responses, instead of posts similar to great idea! I really agree with you.
Each response needs to have a citation
In each of your response posts, include one creditable research article and summarize or evaluate its use to support your peer’s project.
POST 1 (Nicole)
My change project proposal has to do with the increase in opioid addiction in this country after prescription opioid use after surgery. 5-6% of people who go in for routine surgery and are prescribed opioids for pain control continue to fill them long after what is considered an average surgical recovery (Mozes, 2017). The outcome leads to chronic opioid addiction after surgery. I propose to utilize different interventions besides single-handed opioids after surgery to prevent addiction.
My preceptor has been an RN for almost 30 years and has her MSN with a background in management. She also served in the United States Air Force for 24 years; many years were in managerial positions. Her last management position was on a surgical unit, where most patients were prescribed opioids for recovery. We worked together in this hospital together. We both feel very strongly about this issue and hope we can bring light to the issue.
Mozes, A. (2017). Many opioid addictions surface after surgery. Webmd.com. Many Opioid Addictions Surface After Surgery (webmd.com)
POST 2 (Katlin)
My quality improvement project will focus on eliminating admission delays to the cardiovascular critical care unit. This project will evaluate the impact of triage parameters at admission and reasons for transfer delays from critical care to acute care beds. This is a chronic problem within our cardiovascular ICU. Studies have found that delayed admission to the ICU is associated with higher mortality rates, increased length of stay, and an additional expenditure of resources. Furthermore, this same study recommended that ICU admission wait times be less than 4 hours from the emergency department (Mathews, Durst, Vargas-Torres, Olson, Mazumdar, & Richardson, 2018).
My preceptor for this project is the Clinical Manager of ICU. He started his medical careers as a medical diver in the US Navy before becoming a critical care registered nurse, charge nurse, house supervisor and now manager. I am really excited to be working on this project with him. He served as my critical care preceptor and mentor when I was new to the critical care team so I feel comfortable approaching him with questions and ideas, as well as confident in the feedback that he will give me during this project.
So far the guidance he has given me has been to remember my scope for this project. The root cause of this concern could be multifaceted and impeded by the demand for ICU beds due to COVID-19. This will be something I remain mindful of as I continue to develop and research my project.
Mathews, K., Durst, M., Vargas-Torres, C., Olson, A., Mazumdar, M. & Richardson, L. (2018). Effects of emergency department and ICU occupancy on admission decisions and outcomes for critically ill patients. Critical Care Medicine Journal, 46(5), 720-727. https://doi.org/10.1097/CCM.0000000000002993
NUR445 Week 2 Discussion Rebuttal
POST 1 (Nicole)
I really think your change project proposal related to opioid addiction is important because opioid addiction has become a significant public health issue in the US. By 2019 the National Institute on Drug Abuse reported at least 50,000 deaths as a result of opioid-related overdoses (Singh et al., 2019). The misuse and addiction to opioids if they offer a last significant national crisis due to its effect on public health but also on the social and economic welfare of the country. The CDC estimates that the total economic burden of prescription opioid misuse totals an average of $78.5 billion a year (Singh et al., 2019). Such costs are associated with lost productivity, healthcare costs, criminal justice involvement, and addiction treatment. The opioid crisis has mainly emerged because of the addictive nature of opioids utilized for pain management. According to Singh et al. (2019), nearly 21 to 29% of patients that receive opioid prescriptions misuse them. Studies have also shown that nearly 12% of individuals who utilize opioids for chronic pain eventually develop an opioid use disorder.
Singh, G. K., Kim, Jr., I. E., Girmay, M., Perry, C., Daus, G. P., Vedamuthu, I. P., de Los Reyes, A. A., Ramey, C. T., Martin, Jr., E. K., & Allender, M. (2019). Opioid Epidemic in the United States: Empirical Trends, and A Literature Review of Social Determinants and Epidemiological, Pain Management, and Treatment Patterns. International Journal of Maternal and Child Health and AIDS (IJMA), 8(2), 89–100. https://doi.org/10.21106/ijma.284
POST 2 (Katlin)
Your quality improvement project that focuses on eliminating admission delays to the cardiovascular critical care unit is well thought of and can contribute significantly to health care delivery. According to Pereverzeva et al. (2021), critically ill patients normally require early intervention that plays a significant role in improving the outcomes. The phenomenon of longer wait times in ICU beds is therefore associated with higher mortality. The positive impact that timely ICU admission will have on patient survival has therefore been shown to be more evident during the first 72 hours after the onset of a critical illness (Pereverzeva et al., 2021). Elimination of admission delays in the cardiovascular critical care unit and other intensive care unit sections has therefore become increasingly important, especially with an aging population that is more morbid and requires timely care to improve the chances of best outcomes.
Pereverzeva, L., Uhel, F., Peters Sengers, H., Cremer, O. L., Schultz, M. J., Bonten, M. M. J., Scicluna, B. P., & van der Poll, T. (2021). Association between delay in intensive care unit admission and the host response in patients with community-acquired pneumonia. Annals of Intensive Care, 11(1). https://doi.org/10.1186/s13613-021-00930-5