Introduction
Research, evidence-based practice (EBP), and quality improvement (QI) are pivotal for ensuring high-quality care in an ICU (Intensive Care Unit) setting. This paper evaluates the culture, leadership, communication channels, and other aspects of the author’s ICU and recommends a model aimed at improving the quality of patient care. Based on the specific needs of the selected unit, the Plan, Do, Study, Act (PDSA) model is recommended to achieve better patient outcomes, increase quality, and reduce the cost of care.
Research, Evidence-Based Practice (EBP), and Quality Improvement (QI)
Quality improvement, evidence-based practice, and research are all related to improving patient care in nursing. They are similar in their use of data and evidence to guide decision-making. However, QI, EBP, and research have different specific focuses and goals.
According to Grys (2022), research is a systematic investigation of a phenomenon to create new knowledge about patient care or understand it better. Evidence-based practice refers to the best available evidence in making decisions about healthcare (Melnyk & Fineout-Overholt, 2022). Finally, quality improvement can be described as using data and other information to identify opportunities for improving the quality of care and then taking action to make those improvements (Grys, 2022).
In this regard, research plays a pivotal role in both models. In EBP, research is used to inform clinical decision-making, while in QI, it helps identify areas for improvement and measure the impact of changes made. In practice, nurses use research to inform their practice, apply evidence-based guidelines to make clinical decisions and utilize QI methods to improve patient care continually.
The Intensive Care Unit Assessment
The culture of the Intensive Care Unit can be assessed by observing the staff interactions and patient care. For instance, valuable information can be obtained by watching and analyzing team meetings and rounds (Melnyk & Fineout-Overholt, 2022). In particular, the culture in my ICU can be described as progressive and diverse due to the unit’s commitment to inclusion and technology. However, it lacks staff collaboration and engagement, which should be enhanced through the selected project.
The leadership in my ICU includes the medical director, the nurse manager, and the charge nurse, while the stakeholders are patients, their families, nurses, physicians, and hospital administration. The change champions involve nurse leaders implementing improved practices and research findings into daily processes. Typically, decisions in the ICU are made by a multidisciplinary team of healthcare professionals directly involved in care provision, such as physicians and nurses (Gopalan & Pershad, 2019). Issues regarding patient care are discussed within the team, and the solutions are offered and evaluated.
Furthermore, the leadership has the authority to resolve controversial issues and finalize decisions. The role of others, namely, hospital administration, is to manage and oversee the operations in the unit. The organizational chart of the ICU reflects the hierarchy of roles and responsibilities in the hospital.
The communication channels in the ICU involve staff meetings, newsletters, email, and intranet, enabling the exchange of ideas and the announcement of policy changes. Overall, the communication is open; however, it occasionally lacks the cultural competence of the team. Physicians, nurses, respiratory therapists, physical therapists, case managers, and nursing assistants make up the staff.
The human and financial resources in the unit are insufficient due to understaffing and a lack of funding. As a result, there is not always enough money to buy the newest technology. However, the ICU uses electronic records and assistive communication tools to improve patient care.
Finally, feedback in the ICU is obtained through performance metrics, auditing, and patient satisfaction surveys. They allow for evaluating whether changes are successful and whether the newly implemented measures are effective by comparing the outcomes with healthcare standards and initial goals (Gopalan & Pershad, 2019). The outcomes are assessed by the auditors and made public within the organization. In this regard, quality improvement initiatives could be enhanced by focusing on staff education and training based on the evaluation results. In this regard, feedback can be delivered effectively and applied in practice.
Model Selection
To improve the quality of patient care, one of the following approaches can be implemented in the unit: the Johns Hopkins Evidence-Based Practice Model or the Plan, Do, Study, Act (PDSA) model. The EBP process emphasizes the importance of using evidence to guide decision-making and alter practice in healthcare (Grys, 2022). The QI framework uses data to test and implement changes in a controlled and systematic way and to monitor and improve the process. Both approaches focus on continuous improvement, data collection, and stakeholder involvement (Melnyk & Fineout-Overholt, 2022).
Based on the evaluation of various aspects of the unit at hand, it can be concluded that the Plan, Do, Study, Act model can best meet the team’s needs and drive positive change. My topic, patients, facility, and team would fit into the model when viewing the steps by determining problems such as lack of staff collaboration and education, as well as insufficient human and financial resources, and identifying solutions. Furthermore, the PDSA framework would provide the unit with an effective process to implement, evaluate, and improve change, resulting in enhanced performance.
Conclusion
To conclude, research is vital in the healthcare and ICU setting as it helps improve the care and outcomes for critically ill patients. In particular, it can be used to identify best practices and evidence-based guidelines to meet patients’ medical needs. The Plan, Do, Study, Act model is one of the quality improvement forms based on data collection and analysis. By identifying problems, ICU teams can implement changes to processes and protocols that can reduce errors and increase overall efficiency in the unit.
References
Gopalan, P. D., & Pershad, S. (2019). Decision-making in ICU: A systematic review of factors considered important by ICU clinician decision makers with regard to ICU triage decisions. Journal of Critical Care, 50, 99-110. Web.
Grys, C. A. (2022). Evidence-based practice, quality improvement, and research: A visual model. Nursing, 52(11), 47-49. Web.
Melnyk, B. M., & Fineout-Overholt, E. (2022). Evidence-based practice in nursing & healthcare: A guide to best practice (5th ed.). Lippincott Williams & Wilkins.