Problem
You are a staff nurse working in a large community hospital on a medical surgical unit that has primarily elderly cardiac patients. You have worked part time at this hospital for more than 20 years, and now that your children have finished college, you have decided to pursue an advanced degree. You have no interest in pursuing an administrative role, but cardiac patients have always interested you. You note many of your cardiac patients are familiar; there seems to be a bit of a revolving door, and many patients seem to be readmitted.
Your nurse manager knows that you are pursuing an advanced degree and has suggested that reducing readmissions within 30 days for congestive heart failure (CHF) would make a good project. Furthermore, she has mentioned that the quality improvement (QI) department is very interested in this and will be supportive of your efforts as this is an organizational priority.
To further the possibility of framing your project and to better grasp how to evaluate this practice at the population level, answer the following questions.
A. What measurements would be important to framing a DNP practice problem, and how would you go about doing this for the patients in the hospital and on your unit? (hint consider stats on CHF and readmissions etc)
B. How could you determine, more specifically, the nature of the problem?
C. You determine the organizational core business processes that might contribute to the problem and find:
a. Patients have an appointment for follow-up care but lack transportation to get there.
b. Patients at the end of life, and do not have an appreciation for the value of hospice.
c. Frequently admitted patients for CHF have difficulty acquiring medications due to cost and transportation. No pharmacies in the area deliver.
D. Pick one of the areas you identified and write a SMART goal (objective).
E. Describe how you will evaluate the success of your goal.