Asm1 Task 1: Innovation Proposal Advancing Evidence-Based Innovation In Nursing Practice — D031

Asm1 Task 1: Innovation Proposal Advancing Evidence-Based Innovation In Nursing Practice — D031

Asm1 Task 1: Innovation Proposal Advancing Evidence-Based Innovation In Nursing Practice — D031

Innovation is a key driver to better service delivery and improved patient outcomes in the healthcare sector. Nurses have a critical role in promoting innovation by collecting relevant data and using them to define possible health issues and the solutions to them. Nurse innovators engage in various activities that facilitate better healthcare delivery and patients outcomes. Data collection is important in the innovation process. It is impossible to identify key health issues without engaging in data analysis and management. Therefore, the first role of a nurse innovator is to gather data from the patients which are used in the development of innovation framework. The innovation in this case involves developing a telehealth system that will promote healthcare delivery to people with chronic illnesses. Therefore, the innovative nurse leaders must work with their teams to gather information on the possible factors influencing the patients’ wellbeing and their health determinants. The experiences of patients with chronic illnesses are unique depending on their surroundings and environment. On the other hand, it may be difficult to develop a framework that is unique to all patients. However, by collecting relevant data from the patients, the nurses can help in the development of an integrated system that will facilitate quality healthcare delivery to the patients and produce the desired outcomes. Socio-cultural and emotional factors are also important in the management of patients with chronic illnesses and this can only be addressed when the nurses practice patient-centered care delivery approaches and gather relevant data from their patients.

Secondly, innovative nurse leaders are also responsible for creating an environment that supports change development. Them being part of the organization’s leadership, they must develop a friendly environment with appropriate cultural values and systems. Some of the desired values include team-work, cooperation, unity, and adaptability among all the stakeholders in the organization. Teamwork will create a sense of belonging among the healthcare providers and so reduces the barriers linked to resistance from the employees in the implementation of the innovation. Furthermore, the innovative nurse leader will guide the utilization of the practices developed in the implementation plan. They will develop effective clinical practices that will result in better outcomes.

Community of Practice

The study focuses on improving the quality of healthcare delivery to people with chronic illnesses. The burden of chronic illnesses in the community is high and so developing the telehealth system in managing such conditions will help improve the treatment outcomes.

Organization Characteristics

The organization is a tertiary level that received patients from various secondary and primary healthcare institutions. The facility serves as a referral facility that offers specialized care to the patients. Besides, the organization offers specialized care delivery to patients with chronic illnesses including cancer, diabetes, and other cardiovascular diseases.

Demographic characteristics

The proportion of males in the community is 46% with 54% being females. In terms of ethnic composition, the majority of the population are whites followed by African Americans, Hispanics, and other races. The proportion of the whites in the community is 40% with the African Americans occupying 25% of the population and the rest shared among other ethnic groups. Furthermore, the community has a considerably high population of elderly people. The percentage of people aged 65 years and above is approximately 13%. The majority of the population are aged between 18 years and 64 years. The incidence of chronic illnesses among the population is significantly high. For instance, about 40% of the mortalities in the region result from cardiovascular diseases and related conditions. Furthermore, the burden of diabetes among the population is significantly high (18%).

Team member roles

The execution of the nursing innovation will involve an inter-professional collaboration which will involve contributions from different healthcare providers and IT departments. The inter-professional team will be made of IT experts, health assistants, nurses, physicians, and health record officers. The nursing informatics knowledge will be critical in the implementation of the innovation.

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Shared team values

The inter-professional team must have a common goal of promoting health outcomes among the patients. The effectiveness of the innovation depends on the willingness of the inter-professional team to work together and achieve a common goal. They must own the change process and work to improve the patients’ outcomes. As a result, intercultural competencies and embrace of diversity as some of the required values for the team members.

Internal and External Factors

Various internal and external factors influencing the implementation of the innovation and its success include low utilization of health technologies, high ratio of patient to providers, and a demotivated workforce. Furthermore, the lack of knowledge among the healthcare providers to use the technology also affect the implementation of the innovation. Proper training must be provided to the healthcare staff and ensure that they are conversant with the usage and application of the telehealth system. The external factors that contributed to the issues included competition, changes in the demographics of the populations being served by the organization, and technological changes in the healthcare system.

Professional Alignment

The telehealth system will ensure a seamless transition of the patients’ management from the healthcare setting to home-based care. Health promotion measures aim at improving the ability of the healthcare providers to self-care; however, there are cases where patients may require health from the healthcare providers. Besides, in emergency cases, the patients have to be rushed to the hospitals. On the other hand, the implementation of the telehealth system will ensure that patients receive healthcare services and consultations at their homes. The patients will not require to visit the hospital facilities and this will reduce the medication costs as well as reduce their risk of acquiring nosocomial infections.

The goal of the Innovation

The goals for the innovation will be as follows:

• To reduce the hospital visits by the patients with chronic illness by about 75% in the next six months.
• To reduce the burden of emergency cases among the patients with chronic illnesses by 40% by the end of six months after implementing the telehealth system.
• To improve the patients’ satisfaction rates from the current 75% to 95% within the next six months.
• Improve the healthcare providers’ experience and reduce the incidences of burnout by 50% within the next three months.

Part B: Literature Synthesis

Table 1.
Relevant Sources Summary Table
Reference Citation	Relevant Findings	Evidence Strength	Evidence Hierarchy
APA formatted reference citation with a DOI or retrievable link.	Present a summary of the information you found from this source that supports your innovation plan or that offers advice regarding the best approach for implementing the innovation.  This information could be from research studies that have already tested the innovation or recommendations from credible sources and sites.	Numbers I-VII.	From the WGU Levels of Evidence document under the Assessments tab located with supporting documents.
Orozco-Beltran, D., Sánchez-Molla, Sanchez & Mira, (2017).	The study aimed at evaluating the impact of telemonitoring on patients with chronic illnesses who are at high risk of re-hospitalization. The study involved a quasi-experiment where patients with chronic illnesses such as diabetes, cancer, COPD, and cardiovascular diseases were enrolled on the telehealth program (ValCronic) after one year of primary care monitoring. A total of 521 participants were recruited. The study indicated that the use of emergency services among the participant reduced from 13.1% to 6.3%. Furthermore, the incidences of hospital admissions also dropped. Therefore, the author concluded that the telehealth program improves the outcomes of targeted disease controls and reduces the resources used in their management.	Level III	Quasi-experiment
Bohingamu Mudiyanselage et al., (2019)	This study was conducted to determine the impact of home-based telehealth monitoring on the quality of life, cost, and health outcomes of patients with chronic obstructive pulmonary disease and diabetes over 12 months period. The study was a pilot randomized controlled trial where 85 participants were assigned to the intervention group while 85 participants were placed in the control group. The results of the study showed that there was a significant improvement in depression, anxiety, and health literacy in the intervention group than the control group. The results also showed that the length of hospital stay, visit, and cost of care was significantly reduced in the intervention than in the control group. The authors, therefore, concluded that the use of telehealth technologies is effective in improving the quality of life and health outcomes of patients with chronic health problems at no extra cost.	II	Randomized control trial
Sayani et al., (2019)	This study investigated the economic benefits of utilizing telemedicine for patients. The study focused on outcomes that included time and cost savings alongside the potentials of telehealth in improving the outcomes of chronic disease management. The study was a retrospective cross-sectional study that compared telemedicine services with in-person consultations. The data for this study was obtained from a database of teleconsultation visits. The results obtained from 25182 teleconsultation visits showed that the cumulative savings from telemedicine were USD 9,175,132, 1,876,146 hours, and 213.1 years. The results also showed a significant difference in the meantime savings and mean cost savings with the use of telehealth. The authors, therefore, concluded that the use of telehealth is associated with considerable economic benefits to patients and health organizations. The benefits could be enormous for patients from low-resource settings. The authors also asserted that the use of telehealth could improve the outcomes of chronic disease management by reducing the socioeconomic barriers in health due to access and cost and enhancing the uptake of healthcare services.	IV	Non-experimental: retrospective cross-sectional design
Lee et al., (2018)	This study investigated the perceptions of the patients on the use of telehealth for diabetes mellitus type 2. The study utilized a phenomenological study design to explore the in-depth perceptions of the participants. The data for the study was obtained from ten participants who participated in the interviews. The results of the study revealed positive themes associated with telehealth that included service perceptions, empowerment, and technology consideration. The results from the study showed that the patients perceived telehealth services to be beneficial to them, as they enhanced their quality of life, enhanced their independence and control over their health status. Therefore, the empowerment of the patients to take control over their lives makes telehealth a desirable technology for use in the nursing practice.	VI	Single qualitative study: phenomenology
Srivastava et al., (2019)	This study investigated the impact of telehealth in reducing readmissions and healthcare-associated costs in patients suffering from heart failure. The study was a retrospective analysis that analyzed the impact of telehealth on 197 patients with heart failure. The outcome measures that were of focus in the research included admissions for any cause, admissions due to heart failure, total hospital stays, the average length of stay per admission, emergency room visits, and primary care visits. The analysis of data showed that the use of telehealth was associated with a significant reduction of total hospital stay, admission rate, length of stay, and emergency room visits. Therefore, the researchers concluded that personalized telehealth monitoring among patients with heart failure improved outcomes of treatment without increasing the need for urgent and outpatient care visits.	IV	It was a retrospective, non-experimental study.