Question

The RN working in cardiac care clinic is tasked with implementing quality improvement measures. To educate the clinic staff,the nurse plans an in-service program to introduce concepts of quality improvement and evidence-based practice. Additionally, the role of the case manager will be included in the presentation.The nurse plans on using care of the patient with cognitive Heart Failure as a template, and prepares Sample clinical pathways, care maps, and multidisciplinary action plans (Learning objective 3).
a. Describe how clinical pathways are used to coordinate care of caseloads of patients.
b. What is the role of the case manager in evaluating a patient's progress?
c. What are examples of evidence-based practice used for planning patient care?

Answer 1

ANSWER A) The clinical pathways are multidisciplinary plans of the best clinical practices for a specific group of patient having a particular diagnosis that will help in providing a coordinated quality care. The clinical pathways are structured in a way that would help in appropriate implementation of the clinical guidelines and protocols. In order to achieve success in the planned clinical pathway, senior management committe and a strong medical and nursing lead are essential. The use of clinical pathways not only improves the multidisciplinary communication but also the communication of patient and clinician. It leads to effective use of resources thus eliminates the prolonged length of stay. It also reduces the mistakes and duplication of effort. It helps to identify the problem at earliest opportunity and correct it promptly.As clinical pathways aim at improving the quality of care through a multidisciplinary approach, this coordinates the care of caseloads of patients.

ANSWER B) A case manager is a person who help people who are in difficult situation with advice, figure out what kind of help is needed, help them to find services, create plan for treatment and recovery, coordinate with other health care providers and akeeps tabs on clients progress with treatment plans. A Case manager play an integral role in ensuring your patients that highest level of care is received. They ensure that the care is timely,adequate and should meet the minimum standard of quality so that patient's progress is positive. In evaluating the patient progress, the case manager measures if the expected goals of a specific treatment or procedure have been met or not. For this he ensure if the patient received the plan treatment on time, the effect of the treatment and communicate the need for any other intervention for patient's health benefits to the care provider.

ANSWER C) Some of the examples of evidence based practices used for planning care for congestive heart failure patients are:

• Infection control: Its the nurse who plays a vital role in infection control. This prevents the risk of infection among patients and health care providers. The use of adequate hand hygiene, PPE , barrier precautions and keeping environment clean are proved practices in infection control based on evidence.
• Use of Oxygen for congestive heart failure patients: This evidenced based practice prevents hypoxia and further organ failure. Giving oxygen to a congestive heart failure patient is a correct treatment based on evidence which enhances the quality of life among them.
• Monitoring intake and output: It has been proven that monitoring intake and output in patients with Congestive cardiac failure will help to prevent fluid overload and thereby reduce the work load on heart. Adequate output is important in such patients in order to reduce the harm due to fluid retention.
• Care rounds and care calls improve the patient satisfaction: It has been proven that the nurses who make frequent care rounds are most accessible to patient and care calls after discharge helps eliminate patient queries about care. Moreover it fosters a good communication which adds to the patient satisfaction about healthcare experience.