Date of Award

Spring 3-17-2024

Document Type

Scholarly Project

Degree Name

Doctor of Nursing Practice (DNP)

First Advisor

Sheri Jacobson, PhD, RN

Second Advisor

Spencer Cho, DNP, RN

Abstract

Practice Problem: At a major metropolitan VA hospital, there was a lack of adherence by the nursing staff to the TeleCritical Care program for adult patients in the critical care setting.

PICOT: The PICOT question guiding this project was: In adult patients admitted to critical care (P), does the implementation of TeleCritical Care (I) compared to standard critical care without telemedicine (C) decrease length of stay (O) within 8 weeks (T)?

Evidence: The literature review identified improved quality of care delivery, decreased length of stay, and reduced mortality rates as key benefits of implementing TeleCritical Care in critical care settings.

Intervention: The intervention involved providing knowledge and training to support nurses in utilizing TeleCritical Care, a system linking bedside nurses to a remote team for consultation, monitoring, and intervention recommendations. Nurses were trained on initiating TeleCritical Care for all new ICU/PCU admissions and using it for procedures like verifying skin breakdown on admission. The ADKAR change model guided awareness building, fostering desire, providing knowledge/training, and ensuring ability through tools like checklists, and reinforcement.

Outcome: The anticipated outcome of decreased length of stay was not statistically significant, although there was a 23% increase in nursing utilization of TeleCritical Care during the 8-week implementation period.

Conclusion: While the project did not demonstrate a decrease in length of stay, the increased utilization of TeleCritical Care by nurses indicates progress toward integrating this evidence-based practice into the critical care setting to improve the quality of patient care.

Comments

Scholarly project submitted to the University of St. Augustine for Health Sciences in partial fulfillment of the requirements for the degree of Doctor of Nursing Practice

Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.

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