NUR 590 Based on the PICOT you developed for NUR-550, summarize the intervention you are proposing

NUR 590 Based on the PICOT you developed for NUR-550, summarize the intervention you are proposing

NUR 590 Based on the PICOT you developed for NUR-550, summarize the intervention you are proposing

Transitioning from child to adult medical services can be overwhelming even for healthy individuals. Those who have chronic illnesses can find this transition more overwhelming and challenging. Working in adolescent behavioral health, I see firsthand the fears these young people experience as they approach 18 years of age and the fragmented care available. In general child and adolescent care is child-friendly, with family/support involvement, and a team approach. In adult care, the patient is expected to make decisions, has fewer supports available, and the care can be less compassionate.   In transitional-age patients with mental health diagnoses, how does the transition go with early intervention and support compared to transitions without, affect patient outcomes within 1 year of transition?

Coming from an adult med/surg background, I have not come across this issue in healthcare. I could only imagine the uncertainty and overwhelming transition these young adults have to deal with in transitioning from child to adult healthcare. I remember your posts from previous classes where you have educated us on this issue in healthcare. I am looking forward to seeing your future posts about this issue. As a mother of three healthy children, I remember taking them to their first adult appointment. I can certainly remember having to answer questions for them about their health status, and my children are healthy. Lately I have had an increase of SCD, sickle cell disease, sufferers as patients. Many of them are very young adults. Because of your post, I have found that the government had a special tool kit that helps to transition them from pediatric to adult care in my state of South Carolina. I have posted the link below.

SCDHEC. (2023). Health Care Transition & Sickle Cell Disease. Retrieved from SCDHEC: https://scdhec.gov/sites/default/files/media/document/Health-Care-Transition-Sickle-Cell-Disease.pdf

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I am curious to see what your research produces. I would argue with the use of technology and information readily

NUR 590 Based on the PICOT you developed for NUR-550, summarize the intervention you are proposing
NUR 590 Based on the PICOT you developed for NUR-550, summarize the intervention you are proposing

available that medical care is easier to understand and receive. In my experience kids who have chronic illness such as type 1 diabetes that require insulin shots or even cancer, take control of their own care, are very knowledgeable, and independent. When they reach “adulthood” their condition is a norm for them and so the hand holding care, or overwhelming support isn’t needed as much. But I’m just speaking from what I’ve seen I’m sure there are a variety of factors that I am overlooking, can’t wait to read more about your research and findings.

Findings from Johns Hopkins University Has Provided New Data on Pediatrics (Health Care Transition In Adolescents and Young Adults With Chronic Kidney Disease: Focus On the Individual and Family Support Systems). Pediatrics Week. February 11, 2023. Accessed June 21, 2023. https://search-ebscohost-com.lopes.idm.oclc.org/login.aspx?direct=true&db=edsgao&AN=edsgcl.735948602&site=eds-live&scope=site

PICOT:

Among healthcare staff in the clinical and acute care setting who are victims of workplace violence (WPV), will implementing violence prevention tactics and policies, reduce healthcare staff abuse? By using this intervention, the hope is to reduce the outcome of staff bullying and violence by patient’s, family members and among each other in a timeframe of approximately a year.

My hope is to reduce WPV in healthcare and have nurse want to show to work and not feel overwhelmed by the sheer lack of support from management and the system alike. By implementing higher security, violence prevention as well as place policies in to protect staff instead of condemning them. Verbal and physical abuse at the workplace have been sweeps under the rug too many times and it keeps being an issue that has gone long enough. The way to aid nurses is not by assuming they “signed up for this” and ” understand it comes with the territory” the way to support nurses is by standing with them and prevent the abuse that has become commonplace among the healthcare setting. Limit the amount of visitors that can come to the patients side, have a zero tolerance for verbal and/or physical abuse from visitors or patients, as well as prepare nurses to de-escalate violent behavior. The workplace is a setting where nurses spend most of their waking moment in, and becoming victims in this environment is grounds for having tired, overworked and staff that will quit without interventions in place to prevent WPV. The toll that this exerts in nurses’s physical, mental, and professional lives negatively impacts not just their work but also has a significant impact at home (Hassankhani et al., 2018). Thus, exerting a substantial burden in nurses affecting direct patient care.

Hassankhani, H., Parizad, N., Gacki-Smith, J., Rahmani, A., & Mohammadi, E. (2018). The consequences of violence against nurses working in the Emergency Department: A qualitative study. International Emergency Nursing39, 20–25. https://doi.org/10.1016/j.ienj.2017.07.007

Valeria, in light of the increase in societal violence and its impact on healthcare workers this is a very relevant EBP practice project topic. You may find the peer-reviewed article on the evaluation of nurses’ perception and confidence of an implemented workplace aggression and violence prevention training program by Story et al. (2020) useful as well as the related articles on OVID.

Unfortunately, workplace violence is a hazard we must all be cautious of in our profession – when people are hurt or sick they feel vulnerable, and one of the ways that they may ‘cope’ with those feelings of vulnerability may be lashing out in violence, though of course there are also aggressive individuals and those with altered mentation affecting their judgements to contend with as well. I am very curious to know if there are better ways of integrating staff education about violence prevention techniques as well as better strategies for mitigating aggression when it appears in the workplace. This topic especially interests me because I have seen countless incidences of workplace violence inflicted on coworkers of mine during my career, and while I have been very fortunate to have never suffered a workplace injury, I have had several incidences of patients threatening me with physical violence in the workplace – sometimes only avoiding harm by simply being faster than the patient who was threatening me. Currently, my organization teaches staff violence mitigation techniques with the AVADE workplace violence prevention training modules, but I am very intrigued by your mention of better security support for nursing staff, as having more people physically able to support bedside staff in events of physical aggression could help nurses feel more secure while at their places of work (Wolf & Burchill, 2023). Overall fantastic topic, I am eager to see how your research will develop!

Reference

Wolf, L. A., & Burchill, C. N. (2023). Researching Workplace Violence: Challenges for Emergency Nursing Researchers. Journal of Emergency Nursing49(3), 330–332. https://doi-org.lopes.idm.oclc.org/10.1016/j.jen.2023.01.004

Thank you so much for bringing this to light. After having worked in the ED, I have been subjected to many incidents, including verbal and physical assault. Despite the high number of incidents, the hospital I worked for removed our police officer in the front lobby. After much pushback and concern from staff, they replaced our police officer, and increased security – including K9 units. This really helped in situations of potential violence, as the dogs were extremely intimidating. We almost never had to actually utilize them. No staff should ever have to be worried about their physical well-being, especially while trying to provide care for patients.