NUR 674 GCU: Designing and Implementing a Project Paper

NUR 674 GCU: Designing and Implementing a Project Paper

NUR 674 GCU: Designing and Implementing a Project Paper

Perioperative staff is always tasked with the complex task of ensuring the safety of the patient during the surgery. The role of these healthcare professionals requires the utmost attention to all the factors that can affect their work. Most duties in the operating rooms entail a delicate process that requires no any additional harm to the patients undergoing this process (Limchantra et al., 2019). The surgical smoke comes from various power tools and destructive devices that affect the health of both the surgical team and the patient. The smoke may have bacteria, chemicals, blood, and tissues that may present a substantial risk to the patient and the staff. The purpose of this assignment is to discuss the leadership project, how the outcomes will be measured, potential barriers, the success of the project, and the goals that were met by this project.

Leadership Focus

Eliminating the risk of surgical smoke in the operating room does not only increase the safety of patients operated on but also reduce health risk for the surgical team. The project focus on the application of an EBP approach in the elimination of surgical smoke risk. The aim of the project is to ensure the safety of the patient and the team in the surgical room (Georgesen & Lipner, 2018). The need to enhance safety in the surgical room contributed to the main idea behind this project. The site for implementation will be in the surgical room. Perioperative staff will be tasked with the role of implementing the project because they are the main healthcare workers skilled in the surgical department. Besides, the staff experience and application of the EBP would be evaluated through their feelings and experience they have on the project.

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Measurement of the Outcome

Outcome measures are important in the clinical and financial outcomes of health care organizations. The aim of the project is to unveil the problem and provide a better solution to it. Later, it can identify different measures that would show the success or failure of the project. The outcome measures show the impact that a particular clinical intervention has on the health care status of patients and the surgical team (Lyon et al., 2018). The assessment of the measurement outcome would as well be effective in making effective decisions on the application of the proposed EBP approach to the problem. The implementation of change in the surgical suite patients and the preoperative team having exposure to surgical smoke by providing education and utilizing smoke evacuation systems in all surgical cases, compared to not using a smoke evacuation system in surgical cases leading to lower exposure to surgical smoke contaminants

The first measure chosen for the project is the number of patients suffering from surgical site infections. This measure would be important in determining the impact of the EBP approach in reducing surgical site infections. Surgical smoke is one of the major causes of SSI that affect most patients after undergoing surgery. Therefore, the increase in the number of patients suffering from SSI would imply that the EBP approach is ineffective in reducing the risk of SSI among the patients (Li et al., 2019). However, the reduction in the number of patients suffering from SSI would imply that the EBP approach taken towards reducing the risks of surgical smoke has an impact on the overall safety of the patients who have undergone surgery within healthcare institutions.

The number of perioperative staff complaining about health complications would be another outcome measure in this project. The staff is directly exposed to the surgical smoke, and thus, any success or failure of the project would be measured by these staff (Limchantra et al., 2019). A nurse survey that shows that the EBP approach aimed at reducing the risk of surgical smoke is effective would come from the perioperative staff. The reduction in the number of staff registering complaints such as breathing problems would be important in proving the positive impact of the EBP approach designed towards reducing the effect of surgical smoke plumes on the staff.

Readmission rates were selected as an outcome measure because they are expensive and preventable. The rates are important in overseeing the overall quality of care starting from the surgical room. The readmission rates always reflect the care quality offered by the health care provider. Therefore, high readmission rates would imply that the provider is providing poor quality care, while law rates would show the increased quality of care (Limchantra et al., 2019). The cost of treating infections caused by surgical smoke is comparatively high. This implies that the efforts to reduce readmission rates through educational programs on the issue can save patients. For instance, ensuring the implementation of change in the surgical suite patients and the preoperative team having exposure to surgical smoke by providing education and utilizing smoke evacuation systems in all surgical cases.

Potential Barriers

Undeniably, any project often faces potential barriers to its success. However, the effective management of the barriers increases the chances of success in a project. The first potential barrier to the utilization of performance measures is the hospital leadership structure that would ensure the success of the implementation process. For instance, if the leaders mistake measurement for management, it would affect the entire project hindering its success. Leaders viewing performance measures as a measurement exercise would fail to realize that measurement of the project outcome relies on the feedback from nurses and patients (Duncombe, 2018). Secondly, poor measures taken to receive the feedback from the patients would limit the hospital from capturing the feeling and perceptions of the patients concerning the approach. A system that provides quantitative and qualitative data on the perception of perioperative staff would be effective in determining gaps within the performance of a program.

Despite the mention of potential barriers, the management can devise effective mitigation of the barriers. The management needs to structure a system that allows perioperative staff to speak out their feeling about a program. This would imply that powers are given to the perioperative staff to capture the opinions of the clients and present them for an effective change process within the system (Li et al., 2019). Besides, management needs to conduct benchmark activities in other institutions to learn effective means of utilizing performance measures from healthcare professionals.

Success Evaluation

After the implementation process, there would be the need to evaluate the success of the project. The main focus of the evaluation is to give information regarding the effectiveness or impact of the project concerning the outcomes alongside assessing the effectiveness of the methods employed in achieving the desired outcomes (Duncombe, 2018). However, in this case, evaluation of the project would not be possible because of the high budget that affected its implementation process. However, despite the budget constraints, the project would take the next phases that would be important in applying the information in healthcare.

The project stakeholders would revisit the project planning phase, where it will communicate the budget constraints to the vendors and contractors. This process would be important in gaining flexibility that would as well change the entire budget of the project (Duncombe, 2018). Re-evaluation of the workflow would as well reduce the cost of implementation. Ensuring that lines of communication are open would aid in putting as a system of checks and balances in place, which would aid in tracking the progress. Resourcing more labor and application of modern technology in patient and staff education would also be important in cutting the cost of implementing the project.

Goals to be Achieved

The project was to reduce the problem of surgical smoke among patients and healthcare professionals. This goal was to be achieved by implementing an EBP approach that aims to educate the perioperative staff and patients on the danger of surgical smoke (Georgesen & Lipner, 2018). The proposed change targets SSI patients and preoperative team who are likely to be exposed to surgical smoke by providing education and utilizing smoke evacuation systems in all surgical cases, compared to not using a smoke evacuation system in surgical cases leading to lower exposure to surgical smoke contaminants.

Besides, through this project meeting, the AONE competencies were imperative because the success of the project highly depended on these competencies. Communication and relationship management is one of the key competencies that this project aims to achieve (Liu et al., 2019). The EBP approach of training the staff and nurses on the surgical smoke effects would develop from the effective communication process within the interdisciplinary team. Again, knowledge of the healthcare setting, leadership, and professionalism also would play an imperative role in the success of the proposed project.

Conclusion

Surgical smoke in operating rooms is a common issue that the healthcare system has fought since time immemorial. The smoke comprises potentially harmful substances such as chemicals, blood, bacteria, and viruses that can threaten the health of the patients and healthcare providers. Breathing in the smoke through the respiratory system affects both nurses and patients. The inhalation of a high concentration of surgical smoke increases the risk of irritation of the upper respiratory tract, infections, and occlusion. Therefore, utilization of performance measures in an organization often faces barriers such as inadequate institutional support and a poor feedback data system. The solution to these barriers starts by changing the leadership system and ensuring that the target team gains enough training on the utilization of performance measures on the proposed project.

References

Duncombe, D. C. (2018). A multi‐institutional study of the perceived barriers and facilitators to implementing evidence‐based practice. Journal of Clinical Nursing, 27(5-6), 1216-1226. https://doi.org/10.1111/jocn.14168

Georgesen, C., & Lipner, S. R. (2018). Surgical smoke: risk assessment and mitigation strategies. Journal of the American Academy of Dermatology, 79(4), 746-755. https://doi.org/10.1016/j.jaad.2018.06.003

Li, S., Cao, M., & Zhu, X. (2019). Evidence-based practice: Knowledge, attitudes, implementation, facilitators, and barriers among community nurses—systematic review. Medicine, 98(39). https://dx.doi.org/10.1097%2FMD.0000000000017209

Limchantra, I. V., Fong, Y., & Melstrom, K. A. (2019). Surgical smoke exposure in operating room personnel: a review. JAMA Surgery, 154(10), 960-967. doi:10.1001/jamasurg.2019.2515

Liu, Y., Song, Y., Hu, X., Yan, L., & Zhu, X. (2019). Awareness of surgical smoke hazards and enhancement of surgical smoke prevention among the gynecologists. Journal of Cancer, 10(12), 2788. https://dx.doi.org/10.7150%2Fjca.31464

Lyon, A. R., Cook, C. R., Brown, E. C., Locke, J., Davis, C., Ehrhart, M., & Aarons, G. A. (2018). Assessing organizational implementation context in the education sector: confirmatory factor analysis of measures of implementation leadership, climate, and citizenship. Implementation Science, 13(1), 1-14. https://doi.org/10.1186/s13012-017-0705-6

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Project: Use of a smoke evacuation system in the operating room.
NOT ABLE to implement due to budget constraints and lack of surgeon support. I included a previous paper that describes the project for reference.

Throughout your practicum experience, you have been designing and implementing a project. You will now assess that experience. Prior to beginning this paper, discuss the topics below with your preceptor. Include their feedback as well as your own. In a 1,500-1,750-word document, discuss the following topics:

Describe your leadership project, its focus, and the site where it was implemented. How did you discover the need for this project?
Discuss how the outcomes of your project will be measured? Is your project one that is sustainable or is it designed to be a single occurrence?
Did you encounter any real or potential barriers during your practicum experience related to your project?
Evaluate the success of your project. If you were not able to implement your project, discuss why. What are the next steps for the project?
What were the goals you set for yourself and the AONE competencies you hoped to achieve?
Summarize your project experience related to those goals and AONE competencies.
Use a minimum of two peer-reviewed resources (published within the last 5 years) as evidence to support your views.