Individual evidence resources
The title for the planned DNP project is ‘Tangible Virtual Treatment’ and the setting will be at the private practice Virtual Consult MD in Norcross, Georgia, USA. The private practice offers telepsychiatry to individuals across the lifespan. Physical monitoring before recommending and prescribing medication for various mental health conditions is not required. This quality improvement practice gap is an issue in my organization. For instance, research indicates that less than 50% of patients on prescription drugs in mental care settings undergo critical monitoring when they seek care in England (Ayre, Lewis, and Keers, 2023). Physical monitoring of vital signs and other areas such as weight and blood level for illicit drugs is critical for mental health patients. Furthermore, it guides the characteristics of the health condition and the patient’s body’s ability to acclimate to the resulting stress on the well-being of their various physiological components (Sapra, Malik, and Bhandari, 2020).
The proposed type of project is a quality improvement initiative. This initiative is in line with the practice gap in my healthcare organization. A quality improvement initiative seeks to improve the identified practice gaps in an organization by implementing the related interventions. For instance, a quality improvement initiative for medication administration without consideration for patient monitoring will also educate staff within the organizational setting. Therefore, reiterating the basics tenants of patient care promotes -evidence-based practice in healthcare organizations while closing practice gaps.
References
Ayre, M. J., Lewis, P. J., & Keers, R. N. (2023). Understanding the medication safety challenges for patients with mental illness in primary care: a scoping review. BMC Psychiatry, 23(1), 1-17. clinical services (No. WHO/CDS/HIV/19.17). World Health Organization.
Sapra, A., Malik, A., & Bhandari, P. (2020). Vital sign assessment.
· The practice gap, in this case, is the administration of medication without prior physical monitoring of vital signs, weights, and blood levels for illicit drugs. The lack of such assessments negatively impacts nurses’ responsiveness to critical solutions. Research carried out on 48,864 patients admitted in general wards between 2015 and 2018 reveals that early warning scores assessments such as vital signs were undermined in one-quarter of measurements (Elliott and Endacott, 2022). Clinical deterioration goes undetected when protocols like physical monitoring before medicine administration have low compliance rates in organization settings including mental health care organizations. This lack of compliance is persistent in health care provision, with the assessment of vital signs being often neglected in clinical practice despite them being a critical part of care provision. According to Eddahchouri, et al. (2021), the factors contributing to negligence in vital signs assessment include the nurse’s experience, the absence of formal guidelines, and the idea that vital signs assessment is neglectable in low-risk patients. The lack of physical patient monitoring is a problem in nursing and healthcare in general as it undermines the lives of patients resulting in avoidable deaths.
References
· Eddahchouri, Y., Koeneman, M., Plokker, M., Brouwer, E., van de Belt, T. H., van Goor, H., & Bredie, S. J. (2021). Low compliance to a vital sign safety protocol on general hospital wards: a retrospective cohort study. International Journal of Nursing Studies, 115, 103849.
· Elliott, M., & Endacott, R. (2022). The Clinical Neglect of vital signs’ assessment: an emerging patient safety issue?. Contemporary Nurse, 58(4), 249-252.
Based on the provided information and references, it’s clear that the lack of physical monitoring before prescribing medication for mental health conditions is a significant practice gap in the private practice setting of Virtual Consult MD. This gap poses risks to patient safety and undermines the quality of care provided to individuals seeking telepsychiatry services. To address this issue effectively, the proposed DNP project, titled ‘Tangible Virtual Treatment,’ will focus on implementing a quality improvement initiative aimed at enhancing physical monitoring practices before medication administration.
Here are some individual evidence-based resources that can inform and support the development and implementation of the quality improvement initiative:
Ayre, M. J., Lewis, P. J., & Keers, R. N. (2023). Understanding the medication safety challenges for patients with mental illness in primary care: a scoping review. BMC Psychiatry, 23(1), 1-17.
– This scoping review provides insights into the medication safety challenges faced by patients with mental illness in primary care settings. It can help in understanding the broader context of medication administration practices and identifying specific areas for improvement related to physical monitoring.
Sapra, A., Malik, A., & Bhandari, P. (2020). Vital sign assessment.
– This resource offers guidance on vital sign assessment, emphasizing the importance of monitoring patients’ physiological parameters before medication administration. It can serve as a reference for developing standardized protocols and procedures for physical monitoring in telepsychiatry settings.
Elliott, M., & Endacott, R. (2022). The Clinical Neglect of vital signs’ assessment: an emerging patient safety issue?. Contemporary Nurse, 58(4), 249-252.
– This article highlights the emerging patient safety issue associated with the neglect of vital signs assessment in clinical practice. It underscores the importance of prioritizing physical monitoring to detect early signs of clinical deterioration and prevent adverse events.
Eddahchouri, Y., Koeneman, M., Plokker, M., Brouwer, E., van de Belt, T. H., van Goor, H., & Bredie, S. J. (2021). Low compliance to a vital sign safety protocol on general hospital wards: a retrospective cohort study. International Journal of Nursing Studies, 115, 103849.
– This retrospective cohort study investigates the factors contributing to low compliance with vital sign safety protocols in general hospital wards. It offers valuable insights into the barriers and challenges faced in implementing physical monitoring practices and suggests strategies for improving compliance.
By integrating these evidence-based resources into the planning and execution of the quality improvement initiative, Virtual Consult MD can enhance patient safety, improve the quality of care provided to individuals with mental health conditions, and bridge the practice gap related to physical monitoring before medication administration.
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