My key intervention is having psychology group round with the critical care physicians.

Leadership Strategy in Scenario 1
May 11, 2022
A7 Logic Model Nursing In The Community
May 11, 2022

My key intervention is having psychology group round with the critical care physicians. This would be the main intervention that would potentially cascade into other positive changes in the critical care setting. It has been well documented that patients in the ICU experience prolonged mental health problems, including cognitive deficits and distress (Hosey, et al., 2019). If referrals to psychology happen early then they can start therapies before discharge and be referred to continue therapy after discharge. Hosey, et al. studied referral types over a 10 month period at just one day a week in the critical care unit and found that they attended to a variety of psychological disorders. About one third of all referrals had a pre-existing mental health diagnosis  (Hosey, et al., 2019). If continuing this trend, as the hospital in this study is similar to the hospital I work in, then we could potentially reduce stays of nearly one third of our patients if we referred early and often.

Often we do not think of psychology as a needed piece for health in critical care. We try to fix the acute health episode but forgo the mental health aspect of a critical care stay. Many studies are available on what benefits come from having a practitioner available but not many are done on actual practice in the ICU. Stucky, et al. surveyed a small group that have direct interaction in critical care and emergency settings and found many of those that worked full time in these settings considered themselves rehabilitation psychologists (2016). If we treated this as part of the recovery process then maybe we could lower the percentage of those with continuing mental health issues over a year after their stay. This could potentially contribute to increasing the number of people that are back to baseline and enjoy being part of their community.

Discussion 2:

The leading cause of injury among Americans 65 years old and older is falls (West, 2018).  The injuries can be deadly or may cause injury to patient but not be life threatening. A fatal fall or a fall resulting in injury can be detrimental to patient’s health and financial situations. Multiple different interventions can be put into place to decrease the change of a patient falls. A nurse must do their part to implement these interventions and then the patient must be compliant.

If a nurse implements all necessary fall protocols but never educated the patient, what is the point. In an article in, Nursing 2020, one facility that worked to reduce falls noticed a discrepancy where 75% of patients that fell had fall risk interventions in place but fall risk education with patients was inconsistent (Gordon, 2018). Standardized communication should be used and provided to each patient. If patients are more aware of why they are at risk for falls and what interventions are being made to counteract each one of those risks, then patients will hopefully feel more responsible. Tailor interventions for patient safety or TIPS should be implemented (Dykes, 2017). These interventions should be specifically implemented so the appropriate interventions are put into place and the patient is made aware of those interventions.

 
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