Name
Capella University
NURS-FPX8045
Prof. Name
October, 2024
Interprofessional Communication and Practice Gap
Interprofessional communication is very instrumental in addressing the present practice gaps in health care since this encourages interprofessional collaboration among all stakeholders including health team members, patients, and leadership. In that regard, effective communication ensures everyone involved has a mutual understanding of what gap is being identified such that they will all collaborate to produce coordinated strategies for improvement (Bally et al., 2022). It follows that in addressing a practice gap it will be helpful to engage with all stakeholders where conversations need to be opened to engender open dialogue and to seek feedback actively. Insights can be gathered through clear tailored communication styles set out according to the needs of different groups by practitioners to help refine the identified gap and shape possible interventions. The project’s goals are aligned with clinical and organizational priorities by establishing trust and ensuring active participation from all parties involved. Communication strategies used will be validated, and efforts toward the gap identified in the practice will be collaborative, courtesy of the literature evidence incorporated.
Identification of a Practice Gap for a DNP Project
A considerable practice gap identified at the practicum site relates to inconsistent practice in applying evidence-based guidelines regarding the management of chronic pain across older adults. This is significantly relevant to a DNP project in that it directly concerns patient outcomes and quality of care, hence suitable scope for a quality improvement initiative. The chronic pain management of such patients often depends on the practitioner which leads to uneven care delivery to patients and poor outcomes (Raffaeli et al., 2021). It creates an opportunity for DNP-led intervention which could include standardized protocols, continuing staff education, and continuous monitoring of care practices. This would improve patient comfort and care consistency, according to evidence-based practice, aiming at the improvement of clinical outcomes.
However, outside the scope of this DNP project includes conducting primary research to create new treatments or therapies for pain management, which may seem more like a research-based project rather than an improvement on quality and not, therefore, part of this project. This project further will not attempt to cover more general policy shifts at the national level or all chronic pain conditions in various age groups. The DNP project will continue to center on how to improve the current application of extant evidence-based protocols for managing chronic pain specifically in older adults at the practice site (Moreno-Ligero et al., 2023). Because it is a manageable scope, the project can be done within 8-12 weeks and bring actionable change within the clinical setting.
Evidence for the Identified Practice Gap at the local, state, or national level
In the practicum site, findings indicate that most older adults with chronic pain are not provided with constant and evidence-based care. Such patients, therefore remain at a high risk of developing complicated pain-related complications and prolonged recovery periods (Turner et al., 2021). The site’s most recent internal audit indicates that less than half or 45% of its patients aged 65 and above were treated using standardized pain management procedures, hence variance in quality care and patient outcomes. It is this inconsistency that has led to increased readmissions to hospitals and left patients unsatisfied. It speaks to a need for a structured approach to chronic pain management. Lack of adherence to evidence-based guidelines sets the stage for patients’ compromise on safety and quality and therefore would be one of the matters targeted by a DNP project.
National data similarly reflects problems evident locally, as research indicates much of the elderly population throughout the nation receives suboptimal chronic pain management as a direct result of failure to apply evidence-based interventions to improve processes in a consistent manner. According to the Centers for Disease Control and Prevention (CDC), more than 20% of the elderly suffer from chronic pain (Panicker et al., 2021). However, the national underutilization of established guidelines, which could help alleviate this burden, still exists. At both local and national levels, these findings strongly call for the closure of this practice gap to ensure better patient care. The convergence between site-specific data and broader trends justifies the adoption of a targeted, evidence-based intervention in chronic pain management at the practicum site.
PICOT Question Development
A clearly articulated PICOT question can help bridge the practice gap of inconsistent chronic pain management in older adults at the practicum location. This approach limits the specific focus of the project, targeting a particular population and having an intervention conducted while allowing measurable results over defined periods. The PICOT question for this DNP project is: In older adults with chronic pain (P), how does implementing a standardized pain management protocol (I), compared to current varied practices (C), affect pain levels and patient satisfaction (O) within 8 weeks (T)?
This question looks at improving care by aligning clinical practice with evidence-based guidelines. The result should be an ability to have a structure in place that ensures continuity in the treatment of chronic pain. Each component of the PICOT question is aligned with the gap identified within practice (Sohal, 2020). The population in this case deals with older adults with chronic pain, which is a demographic that usually experiences variability in care. The intervention (I) is the establishment of a standardized protocol for chronic pain management. The comparison (C) is the existing, inconsistent practice of chronic pain management. The outcome (O) will be measured in terms of reported pain levels and patient satisfaction. Lastly, the timeline for the intervention is set at 8 weeks, ensuring that it was enough to be able to assess the outcomes of the standardized process without overshooting the timeline of the DNP project. This PICOT question provides a clear, focused direction for the project, ensuring that it remains feasible and evidence-based.
Ideas and Feedback Received from Stakeholders
Involvement in engaging in open discussions with the different stakeholders, such as members of the nursing staff, physicians, and the representatives of patients, was pretty crucial while implementing a plan that aimed at correcting the practice gap of inconsistency that characterized chronic pain management at the practicum site (Kelly et al., 2021). To facilitate such discussion I made sure that there were meetings that were conducted regularly with the team in attendance where I presented evidence supporting the need for a standardized pain management protocol. These meetings ensured active participation since I adopted a collaborative approach and asked the participants directly involved in patient care for their insights. The use of open-ended questions helped in the expression of experiences and problems by stakeholders, thus starting a productive dialogue. The feedback that they generated was also key in the kind of scope to give the project since it showed where people resisted, as the time-consuming aspect of introducing new protocols and confirmed the patient-centered approach.
Communication methods have been face-to-face team meetings, which proved to be the best method for meaningful discussion. In these in-person conferences, clarification was immediate, and relationships built with stakeholders were trusted because of this immediacy. In contrast, email communications proved useful for all delineations and updates but ineffective when it came to engaging stakeholders with good dialogue, lacking that immediacy and personal connection needed for rich discussion. Furthermore, some of the stakeholders preferred one-on-one presentations compared to group settings, thereby establishing that their feedback would be more personalized (Walsh et al., 2021). Upon combining such face-to-face meetings with additional follow-up emails, all interests could be considered and integrated into the development of the project, though personal and group interactions were crucial to gaining deeper insights.
NURS FPX 8045 Assessment 4 Conclusion
Overall, filling the practice gap of inconstant chronic pain management in older adults at the practicum site is a well-planned scheme that encompasses shared collaboration between different stakeholders involved in the service and evidence-based practices (Engle et al., 2021). A focused PICOT question aided this project in establishing a standardized pain management protocol for better outcomes and patient satisfaction. Communication strategies that have involved the stakeholders have been very important in shaping the project and achieving buy-in among the healthcare team. The appropriate assimilation of these insights will be very crucial for the sustainable implementation and execution of the intervention in the future, thereby improving the quality of care delivered to the patients.
NURS FPX 8045 Assessment 4 References
Bally, J. M. G., Spurr, S., Hyslop, S., Hodgson-Viden, H., & McNair, E. D. (2022). Using an interprofessional competency framework to enhance collaborative pediatric nursing education and practice. BMC Nursing, 21(1). https://bmcnurs.biomedcentral.com/articles/10.1186/s12912-022-00932-z
Engle, R. L., Mohr, D. C., Holmes, S. K., Seibert, M. N., Afable, M., Leyson, J., & Meterko, M. (2021). Evidence-based practice and patient-centered care: doing both well. Health Care Management Review, 46(3), 174–184. https://journals.lww.com/hcmrjournal/fulltext/2021/07000/evidence_based_practice_and_patient_centered_care_.2.aspx
Kelly, M. M., Smith, C. A., Hoonakker, P. L. T., Nacht, C. L., Dean, S. M., Sklansky, D. J., Smith, W., Moreno, M. A., Thurber, A. S., & Coller, R. J. (2021). Stakeholder perspectives in anticipation of sharing physicians’ notes with parents of hospitalized children. Academic Pediatrics, 21(2), 259–264. https://www.academicpedsjnl.net/article/S1876-2859(20)30594-5/abstract
Moreno-Ligero, M., Moral-Munoz, J. A., Salazar, A., & Failde, I. (2023). mHealth intervention for improving pain, quality of life, and functional disability in patients with chronic pain: systematic review. JMIR MHealth and UHealth, 11, e40844. https://mhealth.jmir.org/2023/1/e40844
Panicker, L., Prasun, M. A., Stockmann, C., & Simon, J. (2021). Evaluation of chronic, noncancer pain management initiative in a multidisciplinary pain clinic. Pain Management Nursing. https://www.painmanagementnursing.org/article/S1524-9042(21)00212-5/abstract
Raffaeli, W., Tenti, M., Corraro, A., Malafoglia, V., Ilari, S., Balzani, E., & Bonci, A. (2021). Chronic pain: what does it mean? A review on the use of the term chronic pain in clinical practice. Journal of Pain Research, Volume 14(14), 827–835. https://www.dovepress.com/chronic-pain-what-does-it-mean-a-review-on-the-use-of-the-term-chronic-peer-reviewed-fulltext-article-JPR
Sohal, L. (2020). Implementing a nursing professional model to improve staff nurse engagement and teamwork. The Journal of Continuing Education in Nursing, 51(3), 124–131. https://journals.healio.com/doi/10.3928/00220124-20200216-07
Turner, H. N., Oliver, J., Compton, P., Matteliano, D., Sowicz, T. J., Strobbe, S., St. Marie, B., & Wilson, M. (2021). Pain management and risks associated with substance use: practice recommendations. Pain Management Nursing, 23(2). https://www.painmanagementnursing.org/article/S1524-9042(21)00239-3/fulltext
Walsh, L., Hyett, N., Juniper, N., Li, C., Rodier, S., & Hill, S. (2021). The use of social media as a tool for stakeholder engagement in health service design and quality improvement: A scoping review. DIGITAL HEALTH, 7, 205520762199687. https://journals.sagepub.com/doi/10.1177/2055207621996870
