Process of Developing a Policy: Nap time for nurses

Order Description
Process of Developing a Policy: Nap time for nurses

1 Objectives
1) Demonstrate the ability to develop a policy as a means of Quality Improvement.
2) Identify the critical components in developing a policy.
Review chapter 5, pages 156 – 158, of your textbook
Final Project Selection Instructions

Look around your place of work. There are usually many procedures and policies regulating the actions of staff for patient safety. Polices attempt to standardize care and help drive positive outcomes for the organization and most importantly for the patients. Policies are stated in the absolute; shall or will. They are directives. Your organization will have several policies. In this course, you are to explore the the process required in developing good policies and getting them implemented. This is similar to the process for developing laws as explained in your text book. Think of the nursing process: Assess, Diagnose, Plan, Implement, and Evaluate. In developing a policy, nurses follow this pattern. In this assignment, you will delineate this process for a particular nursing topic.

1. On a Word document, Submit the title of your selected topic and a brief reason for this selection.
2. The topic must be a nursing issue and within your chain of command, i.e. not hospital policies, staffing policies, or pharmacy policies, or Human Resource policies.
3. This is an optional opportunity to have your selection reviewed. Inappropriate selections and not approved by your TA or faculty will have a negative impact on the grade.
4. Post your final paper topic for review.

5. There is no grade for this assignment. The scoring is Satisfactory or Not Satisfactory. Ignore the percentages associated with the score.
6. You will find the comments and approval or not, in your grade book
7. This assignment is due by Sept 9 at 11:55PM CST

Directions:
Final Project Instructions

Your assignment is to write a paper on how you would develop a policy (new or revised policy and specify which) to address an issue identified in a practice setting. This writing assignment should adhere to APA style and be between 3-5 pages NOT including the title page and reference list.

You are to delineate processes for getting the policy adopted and implemented within that practice setting. Using these “steps” as headings for your paper elaborated on the required items listed here.

The introduction is to cover basic information about the topic supported by research and the need for such a policy. Consider and include, at a minimum, potential issues related to safety, culture, collaboration, finances, information management, and resource utilization, if applicable, when writing this assignment.
a. Who are the people directly addressed in the policy? Includes internal and external people. Internal = within the organization. External = Those coming into the organization such as vendors.
b. What are the needs/wants of the identified people? How will you identify their needs/wants?

c. How will the policy respond to their needs/wants? What does the policy and/or procedure provide for these people?
d. What processes and/or procedures will be needed to produce results to meet the need for the identified people.
e. Who will be responsible for implementing this policy – What is your institution’s process for policy development and revision?
You must follow the steps identified above and support your narrative with evidence from the scholarly nursing literature. Use Headings in your paper to indicate section topics.

Do not use the following example for your assignment:

Perhaps some patients are complaining about wait times in the emergency room. You identify the need for establishing a policy for managing this situation separating minor injuries/ illnesses from more serious issues.

EXAMPLE:
Insulin Pump Policy for the Hospitalized Patient
Insulin pump safety has become an urgent and significant concern for the hospitalized patient and staff. Hospitals have policy and procedures on patient�s storage and self-administration of home medications. However, these policies do not address insulin delivered by an insulin pump (“Insulin Pump Safety,” September 18, 2012). An insulin pump delivers rapid action insulin hourly by a set basal rate and the patient delivers their boluses according to their blood sugar and carbohydrate intake. Boluses are calculated with settings such as insulin to carbohydrate ratio, insulin sensitivity ratio, a blood glucose target, and active insulin time for covering their meals and/or correcting hyperglycemia. These pump settings are determined by their doctor, usually an Endocrinologist.
Target population
Policy development related to insulin pumps is focused on the lack of knowledge by the nursing staff. The lack of adequate policies for patients admitted to the hospital with insulin pumps has resulted in detrimental cases of hypoglycemia and even death. Recently, a local hospital reported a patient whom was admitted through the emergency room needing and emergency surgery. This gentleman was wearing an insulin pump that somehow went unnoticed or was assumed to be turned off. The patient went through three departments: emergency room, surgery, and recovery. He became hypoglycemic with glucose of 20mg/dl because his insulin pump was delivering insulin and the nursing staff was also administering insulin intravenously. It wasn�t until his hypoglycemic attack and family communication to staff about his insulin pump that they realized how this had happened. It would be more comforting to assume that this was a rarity, but research shows what was expected. This local episode was not a rarity and insulin pump patients admitted into the hospital are in real danger.
Population needs
Inadvertent hypoglycemia is can be related to the lack of policy and procedure for the management of the hospitalized patient wearing an insulin pump. Unless facilities establish a plan with policies and procedures to guide the safe management of patients on pumps, errors will occur with some being fatal (Cook, 2009). Investigations with other local nurse educators in the hospital setting, it was alarming to know there are no policies for the patients admitted wearing an insulin pump. There are protocols to follow when the diabetes department is consulted, but nothing for the general nursing staff to initiate and/or follow.
Objectives
The objective of the policy is for the patient and their family to be offered safe quality care, monitoring, and accurate insulin administration. The policy focuses on promoting patient independence in managing their diabetes by wearing their insulin pump. The needs of the patient are safe monitored administration of insulin without hypoglycemic events leading to adverse effects. Diabetic education and use of medical devices for delivery are critical education issues provided by nurses. Polices and protocols are essential tools in the education process. This can be achieved by having the patient review and sign an agreement to follow hospital protocol on insulin pumps. This agreement should include specific actions for all parties involved, nurse, patient, and care-giver. The patient should understand the importance of reporting site changes, boluses, or any pump problems. Both parties agree to communicate daily and at any time, if the patient is unable or unwilling to comply, the insulin pump will be removed (Cook et al. 2005). There should be a concrete algorithm on how the policy gets initiated. For example, admission of a diabetic patient on insulin pump generates consults to the diabetes education department, pharmacy, dietary, and endocrinology. Order sets are populated for insulin pump settings and directions for floor nurses to follow. Nurse assesses contraindications for patient to remain on insulin pump like altered state of consciousness, psychiatry issues, or refusal from family or patient to maintain pump therapy (Cook et al. 2005).
Process and procedures
Research to identify evidence-based practices is critical in providing excellence in patient care. Open discussions with the nursing staff and nurse educators provide the essential background data in establishing current practices and understanding. Soliciting input from interdisciplinary teams promotes a team effort in addressing the issues and providing safe care. Assess patient/family�s willingness, cognitive status, and orientation to self-manage insulin pump. Nursing managers and administrators have the final authority for approval along with the Medical Review Board of the organization. Policies with protocols are needed to protect the safety and quality of care of these unique patients. The first step to achieve this goal is to submit a policy to the hospital�s policy and procedure committee for review and approval. Once approved it should be implemented throughout the hospital where all staff can be guided to give safe quality care and administration of insulin via insulin pump. Not only does this allow these patients independence in self-management, but most importantly will reduce and/or prevent adverse events. Based on the organizational policy, new policies and procedures should be evaluated upon implementation and periodically, usually annually, for possible revisions. Feedback from patients and nursing staff assist administration in policy review and revision.
Conclusion
Organizational response to patient safety needs is the responsibility of all members of the health care team. This responsibility flows from upper administration, through all levels of the organization. Policies and procedures are the guiding tools to provide safety, effective, and efficient patient care. The nursing process provides well-established means to address policy needs within the organization. Assessing the need, identifying the focus, planning the implementation, implementing the plan, and evaluating the results yields greater patient safety. Implementing a policy to meet the needs of Diabetic patients on insulin pumps is an example of patient-centered care and safety.
References
Cook, C. B. (2009). Are two insulin pumps better than one? Retrieved from http//www.webmm.ahrq.gov
Cook, C. B., Boyle, M. E., Cisar, N. S., Miller, V., Bourgeois, P., Roust, L. R., Smith, S.A., Zimmerman, R. S. (2005). Use of subcutaneous insulin infusion (insulin pump) therapy in the hospital setting. The Diabetes EDUCATOR, 31, 849-57. https://dx.doi.org/10.1177/0145721705281563
Insulin Pump Safety. Patient safety tip of the week. The Truax Group Health Care Consulting. Retrieved from https://www.patientsafetysolutions.com/docs/September_18_2012_Insulin_Pump_Safety.htm
Leonhardi, B. J., Boyle, M. E., Beer, K. A., Seifert, K. M., Bailey, M., Miller-Cage, V., Castro, J.C., Bourgeois, P.B., Cook, C. B. (2008). Use of continuous insulin infusion (insulin pump) therapy in the hospital: A review of one�s institution�s experience. Journal of Diabetes Science and Technology, 2, 948-62. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2769830
Mayo Clinic, Scientific Publications. (2008) Patient care policies: Management of the inpatient receiving insulin via a continuous subcutaneous insulin infusion pump. Retrieved from�