Improving Patient Outcomes by Implementing the Interact Care Path (ICP) Symptoms of Lower Respiratory Infection Pathway in the Long-Term Care Setting

Lam, Jennifer

Improving Patient Outcomes by Implementing the Interact Care Path (ICP) Symptoms of Lower Respiratory Infection Pathway in the Long-Term Care Setting

Files

Lam_hawii_0085A_10596.pdf (2.3 MB)

Date

2020

Authors

Lam, Jennifer

Advisor

Kathman, Julie

Department

Nursing

Abstract

Pneumonia is the second most common infection to occur in elderly who reside in long-term care settings. There is significant morbidity and mortality as a consequence of untreated pneumonia. Consistent and frequent respiratory assessment is needed in order to identify the early symptoms of pneumonia. In the long-term care setting, licensed nurses are responsible for 15-20 patients and many of these nurses are new graduates, which can lead to inadequate assessment. This project focuses on implementing an easy to use care pathway that facilitates the recognition of signs and symptoms of pneumonia in patients on two short term rehabilitation floors. Pre- and post-tests were administered to compare the staff’s baseline knowledge about respiratory assessments and knowledge after attending in-service sessions and again six weeks after each in-service session. Out of 38 nursing staff, 32 attended the in-service sessions and completed the pre- and post-tests. The Confidence and Recommendation Survey (CRS) was administered to determine the staff’s confidence level in performing respiratory assessments, utilizing the care path, recommending attendance to in-service sessions and recommending utilization of the care path in future respiratory assessments. Only 10 nursing staff completed the CRS which showed an increase in confidence level in what was previously mentioned. The average registered nurses (RNs) and licensed practical nurses (LPNs) pre-test score was 1.57 out of 5 (31%) and average certified nursing assistants (CNAs) pre-test score was 2.33 out of 5 (47%). The average RNs and LPNs post-test scores was 3.9 out of 5 (78%) and the average CNAs post-test scores was 3.8 out of 5 (76%). All scores showed an increase in knowledge. Out of 32 patients monitoring for pneumonia, a total of 26 patients (81%) respiratory assessment was guided by the care path, indicating respiratory function was assessed utilizing the care path, health care providers were notified in a timely manner, orders were carried out accordingly, and zero patients were sent out to acute care due to complications of a lower respiratory infection. Overall, the implementation of the care path and providing in-service sessions to the nursing staff improved respiratory assessment skills which has potential to reduce inappropriate antibiotic use, reduce transferring patient to a higher level of care and improve patient care in long term care settings.

Keywords

Nursing, Algorithm, Incorrect, Long term care, Pneumonia, Prescription, Skilled nursing facilities

URI

http://hdl.handle.net/10125/69045

Extent

55 pages

Rights

All UHM dissertations and theses are protected by copyright. They may be viewed from this source for any purpose, but reproduction or distribution in any format is prohibited without written permission from the copyright owner.

Collections

D.N.P. - Nursing Practice

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