Summary
Health workers integrate clinical experience with external evidence from systematic research. They also consider patients’ values and circumstances when deciding on the best wellness approaches. EBD takes into account the characteristics of the practice in which caregivers work. For instance, working in acute care nursing requires expertise because it involves the consideration of complex factors (Nibbelink & Brewer, 2018).
Importance: EBD is relevant because it aims to provide the most effective treatment using the available evidence to improve patient outcomes. For instance, acute care units should utilize experienced nurses in decision-making (Roshangalb et a., 2018).
Recommendation and Rationale
The patient has an intensivist MD monitoring the chart and receiving alerts of shifts in the patient’s condition as well as a video and audio feed into the room. The MD can see and talk to the patient, zoom in and read the vent settings on the device, and alert the floor nurse that the patient needs hands-on care.
Beyond these general cost savings, telehealth can help boost revenue by turning on-call hours into billable time, attracting new patients, reducing no-shows, and even reducing overheads for physicians who decide to switch to a flexible work-from-home model for some days of the week (Alotaibi & Federico, 2017).
The quality of an ICU is determined by the presence of a critical care physician. This is because the unit requires intensive consultation and urgent responses to reduce mortality and improve patient care (Nibbelink & Brewer, 2018).
Remote ICU monitoring has been successful due to technological improvements such as telemedicine, which facilitate remote intensivist monitoring of ICUs.
Despite its significance, remote monitoring of ICU is the least effective patient engagement initiative. These statistics can be explained by the fact that the use of wearables is still not available to everybody. The system is not effective in chronic disease management. In addition, healthcare professionals based on their experience express doubt that the technology alone is likely to change the behavior of higher-risk patients. Doctors are also concerned about the difficulties they can face in handling received data. Patients can also be afraid of their data being accessed by third parties.
This approach combines bedside management with telemedicine. Nurses provide bedside care y conducting assessments, administering medications, taking vital roles, bathing patients, providing face-to-face information, and changing linens. Moreover, they provide emotional support to assist patients in their recovery process. Combining remote and bedside monitoring is efficient because a physician can be assigned more than one patient at different locations. The doctor, through the bedside nurse, is able to access all information about the patient’s progress (Williams et al., 2019). However, it is costly because bedside caregivers must understand how the system works. Bedside caring teaches nurses and other health workers to value patients. Therefore, expanding the ICU and including beds managed by bedside teams provides timely care, addressing patients’ basic needs.
Expanding with Regular and ICU Beds will promote autonomy. Without a remote system, caregivers can consult with local physicians about care and, sometimes, have in-depth discussions about the advice for care. Thus, there is improved patient supervision with better health outcomes (Nibbelink & Brewer, 2018). Nurses would not look forward to adding another source of contradictory advice. That advice would be coming from a source with which they are unfamiliar.
The third option will ensure proper patient monitoring because caregivers will be concerned with the patient’s progress and update physicians to provide the necessary treatment courses. Additionally, the option will enable caregivers to identify critical conditions on time and seek remedies. For example, when the floor nurse is down the hall caring for another patient and his blood pressure rises, the nurse alerts are sent to the remote ICU that attract the attention of the assigned staff members. Due to the introduction of ICU monitoring rooms for patients with critical illnesses, the hospital will experience low mortality rates. Patient outcomes will improve in the long run (Gallagaher-Ford & Conner, 2020).
Recommended Alternative
The hospital should expand the ICU with a combination of ICU beds and regular beds managed by a combination of bedside and remote ICU monitoring (Alotaibi & Federico, 2017). The reasons to choose this option are disparate. For instance, not all patients in the ICU require sophisticated resources. Moreover, it saves on cost because caregivers will be managing both regular and ICU beds. The hospital will receive better-operating costs and margins in return. The system is beneficial due to the ease of maintenance. The additional remote ICU monitoring will provide employment opportunities for new staff. The system will provide a spacious working environment, making it more conducive.
The organization can benefit from expanding the ICU with a combination of ICU beds and regular beds managed by a combination of bedside and remote ICU monitoring because they will experience high productivity as a result of better collaboration among health workers (Mahtani, 2020). The hospital will receive more patients due to improved patient care. Remote ICU monitoring will minimize medical errors, improving patient outcomes.
The company will remain competitive due to the all-time availability of intensive care units. From the case study, option 2 utilizes computerized clinical intelligence algorithms with direct electronic links to physiologic, laboratory, and pharmacy data, as well as patient diagnoses, to focus attention on potential adverse outcomes or trends in individual patients and to notify caregivers before trends manifest as adverse outcomes.
Evidence Evaluation
Evidence-based decision-making is crucial in intensive care unit management and hospital planning at large. Raul, the investigator in the case study found enough evidence to decide on the appropriate expansion method to adopt (Gallagaher-Ford & Conner, 2020). The importance of evidence is also demonstrated when experienced nurses guide new employees in a remote monitored ICU. Combining ICU beds and regular beds is necessary to improve patient outcomes. High productivity will be experienced due to enhanced care coordination. The company will have improved monitoring for critically ill patients as stated in the case study.
Each piece of evidence used to decide on patient care is vital because it improves patient confidence. They will be certain that they are receiving the best care believing that treatment is based on current and informed medical procedures (Mahtani, 2020). Improved care means a cost reduction because concerns such as unnecessary readmissions will be avoided. Thus, the evidence obtained in this case study will help the hospital to avert avoidable problems in daily healthcare operations. Improved care will also benefit the hospital and the community by reducing mortality rates. High reimbursements will be experienced due to trusted patient care. Evidence-based care improves transparency, accountability and value to the clinicians, patients and the community at large.
The investigator was fascinated by Becky’s feedback and experience with the intended expansion option. She noted that remote monitoring increased the number of patients under the care and improved collaboration among caregivers. The investigator also considered the fact that expanding ICU units with remote monitoring would improve outcomes due to better consultations among nurses and physicians. The system is also available throughout, ensuring continuous monitoring of patients. The number of errors induced in the operations is few, meaning the healthcare workers would deliver reliable information (Williams et al., 2019). Reduced periods of staying in the ICU and also motivated the decision because it offsets operating costs when patients are taken to regular beds over time.
References
Alotaibi, Y. K., & Federico, F. (2017). The impact of health information technology on patient safety. Saudi Medical Journal, 38(12), 1173.
Gallagaher-Ford, L., & Conner L. (2020). Transforming healthcare to evidence-based healthcare: A failure of leadership. Journal of Nursing Administration, 50(5), 248. Web.
Mahtani, K. (2020). What does it take to be a leader in evidence-based healthcare? Center for Evidence-based Medicine.
Nibbelink, C. W., & Brewer, B. B. (2018). Decision‐making in nursing practice: An integrative literature review. Journal of Clinical Nursing, 27(5-6), 917-928.
Roshanghalb, A., Lettieri, E., & Aloini, D., et al. (2018). What evidence on evidence-based management in healthcare? Management Decision, 56(10), 2069–2084.
Williams, V., Boylan, A., Nunan, D. (2019). Qualitative research as evidence: Expanding the paradigm for evidence-based healthcare. BMJ Evidence-Based Medicine, 24(5), 168.