Patient Care Delivery Presentation Speaker Notes Essay

Patient Care Delivery Presentation Speaker Notes Essay

 Slide 1: Objectives of the Presentation

Healthcare professionals have the responsibility to provide quality care and safeguard patient safety amidst threats posed by adverse events. In a hemodialysis facility, patients with end-stage kidney disease (EKDS) are susceptible to various safety issues that contribute to lower survival rate and high mortality rates. Therefore, this presentation focuses on an initiative for improving patient safety and eliminating adverse events, such as interdialytic weight gain (IDWG). The presentation explores the following aspects: Background of issue, SWOT analysis, the proposed solution, how the solution meets the need of the population (stakeholders, cost, and payer to proposed change), proposed change process, expected outcomes, and implications that are realistic and aligned with current and future healthcare financing.

Slide 2: Background oftossue

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End-stage kidney disease is among chronic conditions that pose significant threats on patient safety and well-being. According to Benjamin & Lappin (2022), ESKD is one of the leading causes of death and disability globally. The immediate ramifications of this disease are a massive impairment of the kidneys’ functions. In this sense, people grappling with this disease lose about 90% or more of kidney functions (Rosdiana et al., 2018). Amidst the challenge and concerns associated with deteriorating kidney functions, ESKD patients rely massively upon kidney replacement therapies that vary in effectiveness. For example, hemodialysis remains the widely applied kidney replacement therapy because it plays a significant role in filtering waste and water from the blood, controlling blood pressure, and balancing minerals, such as potassium, sodium, and calcium. Healthcare professionals in the hemodialysis facility should be aware of multifactorial aspects that may compromise the effectiveness of hemodialysis as a kidney replacement therapy.

Slide 3: Background of Issue Continued

Hemodialysis remains the machine-driven process of filtering blood in people experiencing kidney failure. The primary objective of hemodialysis is to replace the kidney with a dialyzer that performs similar functions as the failed kidneys. Although this hemodialysis is a profound kidney replacement therapy, various factors affect its effectiveness. Interdialytic weight gain (IDWG) is one of the issues that affect the survival rate and safety of hemodialysis patients (HP). According to Jalalzadeh et al. (2021), IDWG refers to weight gain between two hemodialysis sessions. Often, ESKD patients may gain weight between hemodialysis sessions due to unmonitored sodium and water intake. IDWG poses significant safety threats to patients because it results in multiple adverse consequences, including Hypotension and hypertension, shortness of breath, nausea, and other complications that threaten patients’ safety and survival. Healthcare professionals should collaborate with patients to prevent IDWG and alleviate its effects. Jalalzadeh et al. (2021) contend that the implementation of evidence-based nutritional guidelines for sodium and water intake can prevent interdialytic weight gain.

Slide 4: SWOT Analysis

Facility-level characteristics and factors can promote or undermine nutritional initiatives for preventing interdialytic weight gain (IDWG). Similarly, the facility’s external environment can determine the trajectories of preventive initiatives. These factors form strengths, weaknesses, opportunities, and threats. Firstly, organizational factors that operate as strengths include the presence of an interdisciplinary team in the hemodialysis facility, leadership commitment to improving care quality and safety for hemodialysis patients, advanced technologies and modalities for assessing interdialytic weight gain, and patients’ self-efficacy and competencies for weight management

Conversely, these factors (weaknesses) undermine organizational-level interventions for preventing IDWG: a lack of standardized facility-level nutritional guidelines for sodium and water intake, the current practices for caring for end-stage kidney disease patients, and fragmented knowledge regarding appropriate nutritional guidelines for sodium and water intake.

Slide 5: SWOT Analysis Continued

Opportunities and threats to the facility-level interventions for preventing interdialytic weight gain (IDWG) are primary elements of the external environment, including nursing staff shortages, discrepancies in the current nutritional guidelines, and research landscapes. For example, the current scholarly knowledge and scientific information regarding dietary guidelines, the interdisciplinary team of experts that can oversee the development and implementation of the Kidney Disease Outcome Quality Initiative Nutrition Guideline, and the presence of resources that support further research provide opportunities for effective implementation of the quality improvement initiative that targets to prevent IDWG.

Conversely, cultural diversities among patients that influence diets and lifestyle choices may affect patients’ perception of dietary control initiatives (Iseki, 2022). Also, staff shortages in the hemodialysis facility and unawareness of nutritional guidelines and practices among patients with end-stage kidney disease (ESKD) compromise the effectiveness of nutritional initiatives for preventing interdialytic weight gain (IDWG).

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Slide 6: The Proposed Solution

The notable causes of interdialytic weight gain include unmonitored sodium and water intake, limited awareness of healthy diet plans for ESKD patients, and a lack of comprehensive and regular weight assessment practices. Therefore, the proposed solution entails the implementation of the Kidney Disease Outcome Quality Initiative Nutrition Guidelines for sodium and water intake. According to IKizler et al. (2020), the quality initiative nutrition guidelines include various recommended steps: Salt and protein restrictions, proper assessment of patients’ nutritional assessments, the use of bioelectrical Impedance for Patients on Maintenance Hemodialysis (MHD), and oral, Enteral, and Intradialytic Parenteral Nutrition Supplementation. Further, it is essential to understand patients’ cultural predispositions like values, practices, and norms that influence dietary and nutritional choices (Iseki, 2022). Finally, educating patients on ideal nutrition recommendations for preventing interdialytic weight gain because it enhances health literacy and improves patients’ self-efficacy.

Slide 7: How does the solution meet the need of the population?

The target population for the proposed quality improvement initiative is interdisciplinary stakeholders, including patients, healthcare professionals, and payers. In this dimension, the solution entails team-based collaboration between nephrologists, dialysis technicians, dietitians, dialysis doctors, and medical social workers. These stakeholders will benefit from the initiative by gaining insights into evidence-based nutritional practices for preventing interdialytic weight gain and engaging in nutritional interventions that reduce mortality and morbidity rates. On the other hand, patients will benefit from the initiative through improved survival rates and the alleviation of complications associated with IDWG, such as hypertension and hypotension. They will access comprehensive pre-and post-dialysis weight assessment and access information regarding recommended dietary restrictions. Consequently, the return on investment of the proposed initiative would manifest through decreased mortality rates, improved survival rates, and reduced incidences of rehospitalization. Finally, the facility will benefit from Medicare reimbursement for hemodialysis services,  meeting the payers’ needs in the proposed initiative.

Slide 8: Proposed Change Process

Change is inevitable in healthcare, especially when healthcare organizations target to implement new quality improvement initiatives. Although the change process is inevitable, the underlying restraining factors require change advocates to utilize theoretical frameworks and concepts. For example, the proposed change process is consistent with Kotter’s 8-step change management theory. This theory has three primary tenets that accommodate all eight change management steps:

Creating the climate and environment for change through cultivating a sense of urgency, developing partnerships and coalitions, and developing a vision and strategy; enabling the whole facility by communicating the change vision, empowering employees for broad-based action, and generating short-term successes; and implementing and sustaining change by producing more change, and anchoring new guidelines into the facility’s culture (Carman et al., 2019).

Slide 9: Proposed Change Process Continued

Kotter’s change theory provides a rubric for initiating, implementing, and sustaining change. However, the theory can be ambiguous when appropriate institutional-level strategies are lacking. For example, strategies for implementing and sustaining the Kidney Disease Outcome Quality Initiative Nutrition Guideline include developing an interdisciplinary team of experts to review the current patient care practices, communicating the objectives of the initiative to staff members in the hemodialysis facility, and utilizing the current scholarly evidence to develop guidelines (Ikizler et al., 2020). Also, it is vital to conceptualize organizational-level nutritional guidelines and disseminate them to all units and constantly review the guidelines for regular updates and improvements.

Slide 10: Expected outcomes

The primary objective of implementing the Kidney Disease Outcome Quality Initiative Nutrition Guideline project is to safeguard patient safety by preventing interdialytic weight gain (IDWG) among hemodialysis patients (HD). Therefore the anticipated outcomes of the proposed quality improvement initiative include the reduction of mortality rates associated with interdialytic weight gain, the alleviation of complications associated with IDWG, including hypotension and hypertension, reduction of the rate of readmissions emanating from interdialytic weight gain, and improvements in facility-level nutritional status assessment practices. Further, successful implementation of the initiative will enhance patients’ self-efficacy through education and reduce care costs associated with readmissions of end-stage kidney disease (ESKD) patients.

Slide 11: Implications

Successful implementation of the Kidney Disease Outcome Quality Initiative Nutrition Guideline would significantly impact patients, healthcare professionals, and overall care costs. The implications of this project on patients include improved survival rates and reduced mortalities and the alleviation of complications associated with interdialytic weight gain. Similarly, healthcare professionals will gain from the initiative by implementing evidence-based recommendations for preventing interdialytic weight gain, promoting patient safety and well-being, and the plausibility of gaining knowledge and insights into evidence-based nutritional recommendations. Finally, the project will impact care costs by reducing costs associated with readmissions due to IDWG-related complications and increasing the likelihood of improved Medicare reimbursements for end-stage kidney disease services.

Slide 12: Conclusion

End-stage kidney disease (ESKD) poses significant safety threats to patients due to its association with adverse consequences and events. The disease is among the leading causes of death, comorbidities, increased care costs, high rates of readmissions, and disability. The primary consequence of ESKD is deteriorating kidney functions. For example, patients with ESKD lose about 90% of kidney functions. Therefore, they entirely depend on hemodialysis as the most effective kidney replacement therapy. The effectiveness of hemodialysis is susceptible to various factors. Interdialytic weight gain (IDWG) is a predictor of sodium and water intake that results in various adverse ramifications, including hypertension, hypotension, and reduced survival rates among ESKD patients. Implementing the Kidney Disease Outcome Quality Initiative Nutrition Guideline can prevent IDWG and its associated complications.

References

Benjamin, O., & Lappin, S. L. (2022). End-Stage renal disease. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK499861/

Carman, A. L., Vanderpool, R. C., Stradtman, L. R., & Edmiston, E. A. (2019). A change-management approach to closing care gaps in a federally qualified health center: A rural Kentucky case study. Preventing Chronic Disease, 16(E105). https://doi.org/10.5888/pcd16.180589

Ikizler, T. A., Burrowes, J. D., Byham-Gray, L. D., Campbell, K. L., Carrero, J.-J., Chan, W., Fouque, D., Friedman, A. N., Ghaddar, S., Goldstein-Fuchs, D. J., Kaysen, G. A., Kopple, J. D., Teta, D., Yee-Moon Wang, A., & Cuppari, L. (2020). KDOQI Clinical Practice Guideline for Nutrition in CKD: 2020 update. American Journal of Kidney Diseases, 76(3), S1–S107. https://doi.org/10.1053/j.ajkd.2020.05.006

Iseki, K. (2022). Nutrition and quality of life in chronic kidney disease patients: A practical approach for salt restriction. Kidney Research and Clinical Practice. https://doi.org/10.23876/j.krcp.21.203

Jalalzadeh, M., Mousavinasab, S., Villavicencio, C., Aameish, M., Chaudhari, S., & Baumstein, D. (2021). Consequences of interdialytic weight gain among hemodialysis patients. Cureus. https://doi.org/10.7759/cureus.15013

Murdeshwar, H. N., & Anjum, F. (2022). Hemodialysis. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK563296/

Rosdiana, I., Cahyati, Y., & Hartono, D. (2018). The effect of education on interdialytic weight gain in patients undergoing hemodialysis. Malaysian Journal of Medical Research, 02(04), 16–21. https://doi.org/10.31674/mjmr.2018.v02i04.002

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Patient Care Delivery

Assessment Description

There will be times when the doctorally prepared advanced practice nurse will need to suggest a change in patient care delivery. It will be important for the doctorally prepared advanced practice nurse to understand how to deliver information and what information should be shared with an audience.

This assignment will give you practice with presentation software along with preparing you to provide specific information for your proposed changes. This is a two-part assignment that will also give you practice in presenting to administrators.

General Requirements:

This assignment requires that at least two additional scholarly research sources related to this topic and at least one in-text citation from each source.

Directions:

Part 1:

Create a 12-15 slide presentation (PowerPoint or voice-over; Prezi, include voice-over) that presents a proposed change in patient care delivery related to your DPI Project. The presentation must demonstrate considerations for finance, quality, patient safety, and patient experience.

The speaker notes must contain a detailed script of your presentation, as if you were verbally presenting. The speaker notes must include embedded citations supporting your presentation. (About 100 Words per slide)Please send copy of speaker notes in seperate document as well as included in presentation.

Include the following:

Background of issue

SWOT analysis

The proposed solution

How the solution meets the need of the population (stakeholders, cost, and payer to proposed change)

Proposed change process

Expected outcomes

Implications that are realistic and aligned with current and future health care financing

Part 2:

Present your presentation to at least one administrator. Inform the administrator on the purpose of the assignment and that you will be seeking feedback on content and delivery. This is an opportunity to practice presenting to the executive team.

Write a brief summary (250 words) of the feedback given to you by the administrator(s).

(12 (Slides not including cover and reference) with approx 100 words speaker slides = 1200 words plus 200 words summary = 1400 words)

 

 

 

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