BCC Nursing The Opioid Pandemic Clinical Issue Discussion Responses

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reply for each student’s discussion:

1st

A clinical quality problem that should be fixed and dealt with is the opioid crisis. It is a vast problem and is not going to be an easy fix by any means but I can pretend. This could be done through an experimental design model. This experiment can start in hospitals that have a pharmacy in them. A program could be started in those hospitals to start a “buy back” program of sorts for opioids and prescription painkillers. A system could be worked out that every pill could be worth a certain dollar amount so that the patient can take pills if necessary but is less likely to take all the pills. First, there would have to be teaching to practitioners who are prescribing the medications. In most hospitals “… the progressive advancement of medical education surrounding such fields as cardiology and oncology, advances in pain management education are entirely absent or minimally developed—often limited to a few hours of didactic lectures over multiple years of training” (Bonnie et al., 2017). Mandatory training would more than likely stop the handing out of one or two pain scripts which would be nice. But then along with regular opioid training practitioners would the trained on the new program. Most patients are unlikely ever to take their medicine, so returning those medicines would help show practitioners that there is no need to be prescribing as much as they are. However, there are some drawbacks to this experiment. Some people may realize that they could get more money from these prescription pills on the street and make a bad choice and sell them on the street. However, I do not know if all the elderly people being prescribed these meds are likely to become drug dealers but that is a risk I am willing to take. There is also a drawback that people may not take the pills and suffer from pain that they should be taking the meds for. There is also the risk that people could take the pills and try to return other medications instead possibly skewing the data.

2nd

The quality problem I chose is CLABSI, or central line associated blood-stream infection. I would want to use an experimental design for this quality problem study, more specifically a classic randomized clinical trial. I feel like for this issue, I would want a process with a clear cause and effect. Quasi-experimental allows for more adaptability, but I feel that an experimental design would be best for this problem. Not only would the experimental design go more I depth with the actual cause and effect of a particular issue, it can allow for more randomization of the data. So that we can be less generalized in our evaluation of the data. We would also just have more control over our data, and can really pinpoint if the change or intervention we performed actually made a difference in the incidence rate of a certain problem. Like, for example, the CLABSI rates could be tested using a control group that uses the same method that has been done previous and an experimental group who is having a newer intervention performed on them. This allows for a more concise and structured way to collect data. Experimental designs also have a random element to them, so that we can rule out flukes and other coincidences more easily. There are also problems with experimental design, like how much time they take to set up and actually get people who will participate in them. Not to mention the cost of running an operation like this, especially in a hospital setting. There is even the problem of messing up the workflow of a hospital unit in order to carry out this study on the floor. Also will hospitalization involves many different factors, and the thing that you’re trying to test on could happen for a completely different reason than you’re testing for. While these types of designs are great for getting very specific, there is always the problem of randomness as a benefit and a problem. Especially in a hospital setting, where so many different things could happen