1————The goal of this project is to increase patient satisfaction, decrease falls and decrease patient call light use but like many things in healthcare there are factors that could change the results of the anticipated success. “A variable in research simply refers to a person, place, thing, or phenomenon that you are trying to measure in some way” (The first variable that needs to be evaluated is staff participation. Education given at each meeting is vital to keeping staff involved in the project and should make them want to succeed for themselves and the company. If staff are not completing the rounding properly, clustering patient care and attending to their needs while in the room, the results will be inaccurate and may not prove that rounding helps keep patients safe and happy.
Patients also need to be aware of hourly rounding so they can have positive perceptions of their care after discharge. It is encouraged to educate patients at the beginning of each shift telling them that staff will be in to check on them by performing regular intentional. Performing teach back with patients ensures that education delivered was received. Using specific verbiage with patients will help remind them that rounding is taking place, an example would be “I am here to round on you, are you in pain? Let me take you to the bathroom while I’m here, which belongings would you like at your bedside? Let me clear your room of any clutter or throw away any garbage while I’m here.”
Another variable identified is staff turnover. This variable can be appropriate for many healthcare projects. Turnover is a variable that one cannot predict. Ensuring that new hires are properly trained and educated in the expectations of the unit and use of intentional rounding will help to decrease the effects of this variable although they are certainly times during significant turnover that this may also become a factor.
2————–The most significant results come from studies that are statistically and clinically significant (Grove, Gray, & Burns, 2015). “Significant results agree with those predicted by the researcher and support the logical links developed by the researcher among the framework, study questions, hypotheses, variables, and measurement tools” (Grove et al., 2015, p. 353). However, the significance is determined by what is learned by the project, and the significance of a research project may not be seen for years, according to Grove et al. (2015). Sometimes it takes multiple studies to prove the significance of a hypothesis or research question. Sometimes studies may have errors or have too small of a sample size to show statistical significance, and when the study is performed again to account for errors or bias, it can show statistical significance.
“Clinical importance is related to the practical relevance of the findings”, according to Grove et al. (2015, p. 355). Sometimes studies may not have statistical significance, but the researcher can use the information he or she learns from the study, which can be clinically significant. Sometimes studies that are statistically significant for one population may not be clinically significant for a practice, because the patient population is different. According to Ranganathan, Pramesh, & Buyse (2015), “…it is the judgment of the clinician (and the patient) which decides whether a result is clinically significant or not” (p. 170).
When looking at SBIRT (screening, brief intervention, and referral to treatment), not all studies showed statistically significant results for providing referrals to treatment. This provides a learning opportunity for the researcher and does show clinical significance. If results are accurate, these studies can help the researcher learn more about the topic, for example, there are barriers for care. Patients are lost to follow up due to confidentiality of records, so researchers could not always verify the patient completed the referral to treatment. At Indian Health Council, patients decline referrals for treatment, and if the patient is referred outside to a behavioral health counselor, the clinic is not able to verify if the patient kept an appointment due to confidentiality. What the researcher has learned is to have the patient sign a release of information at the behavioral health counselor’s office to obtain the record, and that many patients do not follow through with behavioral health referrals. What research has shown is that brief interventions are one of the most important areas to focus on for SBIRT to be effective. Another important fact is that there are many barriers to providing SBIRT in a practice, and the researcher can share what the best practices are. This can allow a practice to pilot these best practices to see what impact it has on the patients in the facility.