As nurses strive to be recognized as professionals, the expansion and application of evidence in nursing is progressively becoming vital within the nursing discipline (Achterberg et al 2006). Patients have the right to expect the best care that will promote their well-being. This essay will critically analyze whether an Integrated care pathway could improve the care of a neutropenic patient, by reducing the time between admission and receipt of antibiotics and secondly, guiding all healthcare professionals within the management of care for neutropenia. The essay will initially discuss the survival rate of for all cancers excluding non-melanoma skin cancer and what overall effect intense treatments have had on the survival rate. Unfortunately these intense treatments have many side effects, the most common being neutropenia; which leads the essay into defining neutropenia and an examination of the current care provision which may reveal opportunities to improve the standard of care.
[...] Careful preparation is needed to assist in the process of a change. Resistance to change is often apparent as they often perceive that no need for the change (Baulcomb 2003). Achieving durable and efficient change entails the collaboration and involvement of the whole team not isolated individuals (Baulcomb 2003; Davis 2005). Many authors suggest the use of Lewins (1951) normative model of change which is based on team participation, including all staff that will be affected by this change. This then increases their approval and implementation of change through a bottom-up method (Murphy 2006). [...]
[...] Journal of Nursing Management 275-280. Begat Ellefson B & Severrinson E (2005) Nurses' satisfaction with their work environment and the outcomes of clinical nursing supervision on nurses' experiences of their well being a Norwegian study. Journal of Nursing Management 13 221-230. Bennett M (2003) The Manager as agent of change. Nursing Management 10 20-23. Braine M E (2006) Clinical governance: applying theory to practice. Nursing Standard 56-65. Bratt-Wyton R (1998) Interpretation of routine blood tests. Nursing Standard 13 42-48. Bryan S (2002) The role of ICPs in improving the patient experience. [...]
[...] ICPs guide patients, nursing staff, doctors, and other healthcare professionals through the expected timeframes through a series of events individual steps involved in recovery (Sweeney et al 2002). They are developed to guide evidence-based practice within health care (Kinsman 2004; Jones 1999) leading to the delivery of high quality care (Ellis & Johnson 1999; Jones 1999). They link clinical practice to standardized, evidence-based practice and should be audited as part of the quality improvement process (Kinsman 2004; Ellis & Johnson 1999; De Luc 2001). [...]
[...] Clinical governance was first described in a White Paper by the Department of Health (1998) as an innovative system within NHS Trusts and primary care to guarantee clinical standards are endured and methods are in place to ensure continuous improvement. Currie, Morrell & Scrivener (2003) describe clinical governance as an umbrella term for all that facilitates improvement of high standards of care. The key principles of clinical governance are: a logical approach to quality improvement, clear lines of accountability and effective processes for discovering and controlling risk and addressing poor performance (NAO 2003). [...]
[...] S734–S740 cited in Ziglam H Gelly K J & Olver W J (2005) A survey of the antibiotic treatment of febrile neutropenia in haematology units in the United Kingdom. Clinical Laboratory of Haematology 27 374-378. Selwood K (2000) ICPs: an audit tool in paediatric oncology. British Journal of Nursing 9 34-8. Simpson E & Courtney (2002) Critical thinking in nursing education: Literature review. International Journal of Nursing Practice 8 89-98. Starey N (2003) What is clinical governance. http://www.evidence-based- medicine.co.uk/ebmfiles/WhatisClinGov.pdf [Accessed 13th May 2006] Stetler C Morsi Rucki Broughton Corrigan Fitzgerald Giuliano Havener P & Sheridan E A (1998) Utilization-focused integrative reviews in a nursing service. [...]
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