Nursing is currently in a paradoxical situation since there is an emphasis on interdisciplinary cooperation, but the core aspects of nursing practice are being scrutinized for utility by the economics of the health care market. Therefore, the reality of the devaluation of nursing creates a culture where physicians are less likely to consider a nurse’s expertise or professional opinion. Nurse-practitioner cooperation cannot be competently achieved until some aspect of equality in the workplace is established (Foth, Block, Stamer, & Schmacke, 2015).
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The United States holds the highest rate of nurses in the population, at 40.5 nurses per 100,000 people and continuously growing. It is considered that between 63% and 93% of primary care visits can be provided by NPs (Maier, Barnes, Aiken, & Busse, 2016). Therefore, as the number of nurses increases and there is potential for physician substation, it is critical to improve cooperation and hand-off communication.
The primary purpose of this investigation is to determine whether increased nurse-practitioner communication has an effect on patient outcomes. The PICOT investigation statement is as follows:
- Population – nurses and patients in traditional hospital setting;
- Intervention – workplace initiatives and guidelines to enable and improve nurse-practitioner communication and feedback;
- Control – data and feedback will be collected before the intervention is implemented for comparison for post-intervention results;
- Outcome – increased cooperation and communication between nurses and practitioners with the goal to increase patient outcomes and satisfaction. A comprehensive overview will be conducted to determine changes.
- Timeline – three months
Clostridium Difficile Paper
The purpose of this paper is to determine the clinical significance and practicality of developing evidence-based guidelines for the prevention of Clostridium difficile.
The Clostridium difficile infection is one of the most prevalent hospital-acquired infections in developed countries. Rates of CDI infections have risen consistently over the last decade. From 2000 to 2005, the number of CDI infections upon discharge increased from 139,000 to 301,000 and the amount grew to 350,000 by 2008 (Dubberke, 2012). While other hospital-acquired infections have declined, C. diff prevalence has risen. Furthermore, the bacterium has emerged with hypervirulent strains with increased severity leading to elevations in mortality rates throughout the country. There has been incremental progress recently for the prevention and treatment of the infection. Antimicrobial drugs such as fidaxomicin are able to limit recurrence of the infection in patients. Meanwhile, risk factors regarding the transmission of the disease have led to preventive measures such as isolating carriers, use of sporicidal cleaning techniques and improving stewardship of antibiotic and proton pump inhibitors (Caroff, Yokoe, & Klompas, 2017).
The C. diff infection is a significant public and clinical concern as out of 15,461 cases in the United States, 65.8% were healthcare-associated, and 24.2% were acquired during hospitalization (Lessa et al., 2015). These cases have been identified to increase the length of stay by 7.19 days and cost an additional $12,500 per patient (Zappas et al., 2016). The infection is associated with increased morbidity and mortality, which leads to societal and financial burdens. Infection and transition are preventable through targeted hygiene initiatives and guidelines which are implemented at a clinical level (Tschudin-Sutter et al., 2018). The CDC and hospital administrations recognize the importance of reducing hospital-acquired cases of C. diff, and there is a significant push for the development of best practices and prevention capabilities.
Caroff, D. A., Yokoe, D. S., & Klompas, M. (2017). Evolving insights into the epidemiology and control of Clostridium difficile in hospitals. Clinical Infectious Diseases, 65(7), 1232-1238. Web.
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Dubberke, E. (2012). Clostridium difficile infection: The scope of the problem. Journal of Hospital Medicine, 7(S4), 1-4. Web.
Foth, T., Block, K., Stamer, M., & Schmacke, N. (2015). The long way toward cooperation: Nurses and family physicians in northern Germany. Global Qualitative Nursing Research, 2, 1-14. Web.
Lessa, F. C., Mu, Y., Bamberg, W. M., Beldavs, Z. G., Dumyati, G. K., Dunn, J. R.,… Mcdonald, L. C. (2015). Burden of Clostridium difficile infection in the United States. New England Journal of Medicine, 372(9), 825-834. Web.
Maier, C. B., Barnes, H., Aiken, L. H., & Busse, R. (2016). Descriptive, cross-country analysis of the nurse practitioner workforce in six countries: Size, growth, physician substitution potential. BMJ Open, 6(9), e011901. Web.
Tschudin-Sutter, S., Kuijper, E., Durovic, A., Vehreschild, M., Barbut, F., Eckert, C.,… Broeck, J. V. (2018). Guidance document for prevention of Clostridium difficile infection in acute healthcare settings. Clinical Microbiology and Infection, 1-18. Web.
Zappas, K., Mcclelland, J., Schwartz, K., Price, J., Stankiewicz, C., Cruz-Betancourt, A.,… Jones, B. (2016). Initiation of a performance review committee (PRC) with multidisciplinary healthcare team members and the impact on hospital-acquired Clostridium difficile infection (CDI). Open Forum Infectious Diseases, 3(Suppl_1), 515. Web.