Improving Care Continuity and Communication Using Adaptive Developmentally Delayed Pediatric Care Planning
AuthorJefferson, Samantha Kirk
AdvisorSatyshur, Rosemarie D.
MetadataShow full item record
AbstractBackground/Problem: Developmentally handicapped patients are representative of an important group who sustain high hospitalization rates with various complications leading to additional hospitalization time. The frequency of advanced care planning conversations between patients and healthcare professionals remains low in clinical practice. This nationwide inconsistency is mirrored within an urban pediatric medical surgical floor in which current practice lacks a dedicated admission protocol process for specializing care planning among the developmentally delayed pediatric patient population. Purpose: The purpose of this QI initiative was to improve care continuity and communication through the use of an Adaptive Care Plan (ACP) that collects the specific information required to create individualized care plans for each developmentally delayed patient. Methods: The project was implemented over an 18-week period. Eligible patients included pediatric patients admitted with a diagnosis of developmental delay. The new standard of practice included documentation of an ACP with the patient’s caregiver upon admission and shift reassessments to ensure the specialized plan of care was being maintained throughout the entire hospital stay. Documentation templates were created to promote ease-of-use, compliance, and consistency among the nursing staff. Weekly chart audits were conducted and run charts were created to reflect the findings. Results: Findings were evaluated in terms of the percentage of compliance with documented ACPs upon admission and shift reassessments. Of the eligible pediatric patients (n=31), results depicted 100% compliance of ACPs documented upon admission and shift reassessments. Conclusions: Findings suggest improvements in specialized care among the developmentally delayed pediatric patients based on compliant documentation, positive staff feedback, and caregiver support. Efforts to promote the practice change and maintain 100% compliance included constant communication, frequent site visits, unit meeting attendance, and the use of change champions. Concluded findings are discussed in terms of staff and caregiver feedback regarding the new standard of practice, its efficacy, barriers, facilitators, and recommendations to promote sustainability. Efforts to promote the practice change post implementation include establishing a change champion team, integration of the ACP within the EHR, development of a best practice alert for nursing reminder, and the addition of the ACP education within the unit’s annual nurse competency training.
Rights/TermsAttribution-NonCommercial-NoDerivatives 4.0 International
KeywordPersons with Mental Disabilities
Advance Care Planning
Continuity of Patient Care
Identifier to cite or link to this itemhttp://hdl.handle.net/10713/20903
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- Creative Commons
Except where otherwise noted, this item's license is described as Attribution-NonCommercial-NoDerivatives 4.0 International