Peer Review Assignment



Peer Review Assignment

Introduction of the Change Project

Strengths: It is very clear that in our fast paced society, Americans believe in the quick fix. From fast food, to quick auto repairs and disposable goods; we live in a culture that leaves little desire or time to invest in maintenance in what we own and the view point is transposed to the maintenance of our health and welfare of our bodies. Clearly evident in emergency department overcrowding; our society sees health care as a commodity to be purchased and under educated in the use of the health care system, primarily seeks the fastest and quickest remedy to alleviate their health care problems. The goal of this study is to answer if a more streamlined and uniformed triage standardization can assist with decreasing length of stay in the Emergency Department (FierceHealthcare.com, 2007).

Areas for improvement: To address the areas of improvement, the question is that whether can effective triage nursing interventions reduce overall length of stay within the Emergency Department? A number of studies conducted have illustrated with increased management of patients presenting to the Emergency Department, coupled with enhanced nursing interventions as well as treatment in triage significantly reduces the overall length of stay and increases overall patient satisfaction. One study alone illustrated a dramatic decrease in the left without being seen ratio from 43% of patients presenting to 4% through effective triage nursing management in a single year. To move forward and advance our practice as nurses we must be agents of change, to not only accept what works but to know why it works is imperative. Therefore, all the questions matters considerably for addressing the matters related to the areas for improvement.

Rosswurm &Larabee's Six-Step Change Plan

Introduction to Rosswurm and Larabee's Six Step Change Plan: Rosswurm and Larrabee's change model addresses how we as nurses see problems, analyze them and use best and evidenced based practice to create effective change (Rosswurm, M.A., Larrabee, J.H., 1999). Rosswurm and Larrabee's change model is a road map on how to use nursing theory and research and apply it to effecting change at the bedside. According to Rosswurm and Larrabee the first step is assessing the need for change. They include: “including stake holders, collect internal data about current practice, compare internal data with external data, and identify the problem.

Step One: Strengths: Current practice in the Emergency Department has the patient to nurse flow as: pt meets the registration clerk for information entry into the system, the patient is then registered, the patient is then meet by a singular triage nurse without ancillary staff to assist, triage interview is made with triage category assigned (A through E, A being the highest acuity score with E as the lowest), if rooms are available the patient is moved immediately to the room, triage assessment is completed in the room with nursing intervention protocols initiated afterward. If no rooms are available: the triage nurse completes the assessment, nursing intervention protocols are ordered, the orders ...