Description of the Ace Star Change Model
- the key device for developing skills;
- the model incorporates five crucial stages;
- stages 1- 2: discovery research, evidence summary;
- stages 3-4: translation to guidelines, practice integration;
- stage 5: evaluation of outcomes (Schaffer, Sandau, & Diedrick, 2013).
The ACE Star Model is the major way of developing nurses’ skills. The nurses need to deploy the model since it is the basis for the gradual development of the guidelines. The model will enable the promotion of oral and written communication with patients. The opportunities for shaping the model to meet the needs of the target population will be created.
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- chronic obstructive pulmonary disease patients;
- excessively high hospital readmission rates;
- COPD – a major cause of morbidity;
- patients have various clinical phenotypes (Simmering, Polgreen, Comellas, Cavanaugh, & Polgreen, 2016).
- 10%-20% are readmitted within a month (Simmering et al., 2016).
COPD is one of the most dangerous health conditions, leading to high morbidity rates. The statistical data show that readmissions rates are excessively high (Simmering et al., 2016). Therefore, it is necessary to manage the problem of high readmission rates (Ko et al., 2016). COPD care programs have been proved to eliminate the problem (Ko et al., 2016).
Scope of the Problem
- patients who receive written and verbal education.
- current healthcare opportunities are rather good.
- still, readmission rates are too high.
- threats for patients are serious (Guerrero et al., 2016).
- the need to manage the situation.
COPD patients receiving written and verbal education about the disease during discharge from hospital settings fall under the scope of the issue. The reasons for such high readmission rates are not clear. The risk of mortality is very high. Therefore, it is necessary to include more effective strategies in the plan of education.
- an interdisciplinary team is needed.
- key members: advanced practice nurse.
- key members: nurse educator, therapist.
- outcomes: view the problem from different perspectives.
- outcomes: will design the ultimate approach.
To make sure that patient needs are met, an interdisciplinary team is necessary. By helping to view the issue from different angles, the experts will solve the problem. The nurse educator will be responsible for promoting active knowledge among patients. The advanced practice nurse will make sure that the required services are administered to the patients.
Evidence to Support the Need for Change
- focus on gathering the relevant evidence;
- evidence will show the possible changes;
- key support of the study: data acquisition;
- patient awareness impacts the quality of outcomes;
- patient education: an effective tool.
Consistent acquisition of the data related to the changes in patients’ health is the major support of the study. Clinical practice guidelines are also significant. The use of patient education as a framework for reducing COPD readmission levels is an effective way of improving patient outcomes (Guerrero et al., 2016). Information about causes of COPD, its symptoms, and ways of treatment has a positive effect on the quality of care.
- the identification of the necessary information;
- patient learning will improve the population outcomes;
- a series of lectures with visual support;
- detailed instruction for education nurses;
- patients will learn self-management strategies.
The first step toward the improvement of COPD population outcomes is the identification of the necessary data. Then, a series of lectures supported by visuals need to be designed. Detailed instructions will be given to educating nurses. These measures will teach patients about self-management strategies.
Timeline for the Plan
- the process will take four weeks;
- week 1: designing the learning sessions;
- weeks 2 and 3: training sessions;
- week 4: data collection and assessment;
- week 4: discussion of the strategy.
The plan is expected to cover a period of four weeks. During the first week, learning sessions will be designed. During the second and third weeks, the sessions will be implemented. The last week will be dedicated to data collection and evaluation of the strategy.
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The Nurse’s Role and Responsibility in the Pilot Program
- nurse’s role: to provide education;
- nurse’s role: to provide care;
- nurse’s responsibility: to check the comprehension level;
- nurse’s responsibility: to promote active knowledge;
- advanced nurse’s responsibility: to control the process.
The roles and duties of nurses in the pilot program are diverse. Nurses have to provide the necessary care and opportunities for education for the patients. Also, they have to promote knowledge. Finally, nurses need to control the whole process of the program.
- step 1: identifying the level of knowledge;
- step 2: establishing the necessary change;
- step 3: giving patients the necessary materials;
- step 4: making sure that they understand;
- step 5: evaluating the achievements.
The initial stage of the change process is evaluating the patients’ level of knowledge. Then, it is necessary to give patients lacking information. Nurses have to provide a regular assessment of the patients’ level of understanding. Finally, they will evaluate the overall change.
Forms that Will Be Used
- personal communication to create contact;
- written materials to provide information;
- oral presentations to allow questions;
- using EBP for the most effective solutions;
- discussions to promote a better understanding.
Nurses should use a variety of forms to guarantee the best outcomes. Written materials should be given to the patients, providing knowledge about the issue. Additionally, oral presentations will be performed. It is also necessary to discuss the issues that the patients do not understand.
Resources Available to the Staff
- EBP materials describing the most typical cases;
- EBP materials describing the least typical cases;
- prepared lectures including visual support;
- journal records, medical history records;
- electronic databases, search engines, libraries.
The staff needs to have a number of resources available in order to implement the program. The most important data concerning the most and least typical cases are reflected in EBP materials. Also, nurses will use the lectures designed for the study. Apart from that, they can employ a variety of electronic materials and hospital records.
Barriers to the Staff Education
- resistance to dedicate extra efforts;
- not enough time to study;
- not enough time to educate the patients;
- the insufficient motivation for the participation;
- insufficient access to the materials.
There may occur some serious obstacles in the process of implementing the program. Nurses may feel a lack of time or access to the materials. Also, they may be unwilling to spend extra effort on the project. Finally, the lack of motivation can be a great barrier for staff education.
Strategies to Eliminate the Barriers
- increasing the level of motivation;
- allowing some extra time to accommodate to the program;
- providing bonuses for the most successful participants;
- helping to cope with difficult moments;
- creating the atmosphere of mutual support.
To eliminate the barriers to staff education, it is necessary to increase the motivation level among the nurses. Also, it is important to let the staff know that in case of any difficulty, they can address someone for help and support. It is a good idea to come up with some promotion for those nurses whose patients show the best results at the end of the program. It is necessary to organize the most favorable conditions for the nurses participating in the program.
- COPD is a dangerous health condition;
- eliminating the readmission rates is crucial;
- patient education is a good approach;
- staff education is a necessary tool;
- barriers should be predicted and eliminated.
Chronic obstructive pulmonary disease is one of the most dangerous health conditions. It has serious adverse effects and may cause complications. Therefore, it is necessary to eliminate the risks, including one of the high readmission rates. Educating staff that will take care of helping the patients to cope with their health condition is a necessary measure for managing the problems related to COPD.
Guerrero, M., Crisafulli, E., Liapikou, A., Huerta, A., Gabarrús, A., Chetta, A., Torres, A. (2016). Readmission for acute exacerbation within 30 days of discharge is associated with a subsequent progressive increase in mortality risk in COPD patients: A long-term observational study. PLOS ONE, 11(3), e0150737.
Ko, F. W., Ngai, J. C., Ng, S. S.,Chan, K. P., Cheung, R., Leung, M. Y., … Hui, D. S. (2016). COPD care programme can reduce readmissions and in-patient bed days. Respiratory Medicine, 108(12), 1771-1778.
Schaffer, M. L., Sandau, K. E., & Diedrick, L. (2013).Evidence-based practice models for organizational change: Overview and practical applications. Journal of Advanced Nursing 69(5), 1197-1209.
Simmering, J. E., Polgreen, L. A., Comellas, A. P., Cavanaugh, J. E., & Polgreen, P. M. (2016). Identifying patients with COPD at high risk of readmission. Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation, 3(4), 729-738.