Answer

Formative Assessments

Activity 1: Identification and Reflection of Worker-Researcher Position

            In my profession care provider, I have always had interest in acute emergency care and thus, I have always believed that I will be able to make much contribution to health care through a practitioner enquiry position. My intention is to not only contribute to policy making but also influence good practice in the position. According to Keating and Smith (2011), acute emergency care is among the most necessary segments of hospital care in the UK at the moment. Keating and Smith (2011) estimated that in a year, over 20millionpeople in the UK seek acute emergency care. This number is always increasing on a yearly basis. With the rising population of the elderly in the country, it is also expected that demand for acute emergency care will rise just like in other regions of the world such as the US. In this regard, the UK healthcare system will be seeking ways to ensure better utilization of available resources towards offering adequate care to these people. In this regard, as a worker-researcher, I will conduct practitioner enquiry into ways in which acuter emergency care can be made more effective within hospitals in the UK. Nicols and Cormack (2017) explained practitioner enquiry as an investigative study into the ways in which a practice is done, through engaging an active group of learners and aiming at developing an overall reflection that can improve the practice.

            In this case, by engaging workers in acute emergency care, I will be able to note some of the practice challenges in the UK emergency care section. Furthermore, I will be able to note how these challenges emerge and even work with the health professionals on ways in which the noted challenges could be reduced towards an effective care strategy. Although health workers are guided by health policies and hospital programs, the causes of specific health challenges may have affected the health institution for a while with limited ability to influence positive change. As a worker-researcher, I can use my study to note an issue within emergency care then work with hospital staff providing this care to note the main reasons for the challenges. It is also known that health care practice is highly evidenced at different levels of the practice. My role will be critical towards determining whether existing theories used in providing care in an institution are actually contributing positively to the quality of care. Specifically, are the challenges facing an institution’s acute emergency care a result of outdated research, inefficient working policies or limited data to base the research? By answering these questions in my field, I will be able to effectively ensure practice within the institution I work with is able to influence better care-especially through acute emergency care. Finally, I have always believed that hospital-based challenges are best solved by care staff within an institution. For that reason, in my position as a practitioner inquirer, I will be able to engage an actual practicing team and be able to work towards a solution for existing challenges within their acute emergency care department. This would influence future approaches in solving hospital challenges by encouraging the engagement of actual care providers in solving a care issue.

Activity 2: Comparison of Two Practitioner Reports

Professional Area of Inquiry

Both articles in this study focus on the provision of safe acute emergency care.

Titles, Objectives and Professionalism

            Inquiry 1 is titled Medication Reconciliation During Transitions of Care as a Patient Safety Strategy: A Systematic Review by Kwan, Sampson and Shojania (2013). The main aim for their study was to determine the effectiveness of medication reconciliation interventions as administered in hospitals towards ensuing safety in the provision of acute care. On the other hand, Inquiry 2 is titled Frequency of nurse–physician collaborative behaviors in an acute care hospital by Nair et al (2012). This study was founded on the need for collaborative behavior among nurses and physicians as the main key towards safety in acute care and thus, sought to note the collaborative behaviors that were used frequently and infrequently so as to note how to improve future collaborations. These inquiries guide the initial approaches towards ensuring safety through acute care by presenting possible interventions that would guide further practice. By exploring the existing methods and noting the existing challenges, both inquiries develop possible solutions for safe care in the acute care settings.

Data Collection Methods

In Inquiry 1, Kwan, Sampson and Shojania (2013) use a review approach in which 18 articles discussing the effects of hospital-based medication reconciliation are evaluated towards supporting the main research arguments. In Inquiry 2, Nair et al (2012) use the Nurse-Physician Collaborative tool to determine the collaborative behaviors among 147 hospital staff (114 registered nurses and 33 physicians). Notably, both resources use a qualitative approach to data collection in order to explain how specific behaviors influence patient safety in acute care settings. Both studies however concluded that more research is required on the subject.

Strengths and Weaknesses

            Both researchers acknowledge the needs for safety during the provision of acute emergency car and explore the challenges and offer possible solutions. Using the qualitative approaches also contributes the deeper understanding of how hospital staff behaviors would influence safety within an institution of care. However, both authors may be biased in their selection of challenges to safety as each of them is adopting an intervention based on their personal beliefs on the most eminent avenue for unsafe practices.

Activity 3: Project

Approaches towards Ensuring safety in Acute Emergency Care, During the Transfer of Patients across Service Providers and after Emergency care

Increase in cardiovascular conditions, cancer, obesity and other health stressors continue to increase demand for acute emergency care across the world. According to Keating and Smith (2011), at least 20 million people need emergency department services per year in the UK, and this number increases by about 7% every year. In the US, demand for acute emergency services is also on the rise due to the high population of elderly people that demand this form of care (Lowthian et al, 2011). However, several researchers acknowledge that the current state of acute emergency care across many parts of the world is poor. Some of the main challenges noted include: limited staff to attend to all cases once they are at the hospital, lack of facilities such as emergency rooms to attend to the emergency needs of patients and the inability to guarantee safety during an emergency (Lowthian et al, 2011, Keating & Smith, 2011). Safety remains one of the main determinants of quality health across the globe.

            Nonetheless, hospitals are unable to guarantee the highest levels of safety especially during the transfer of patients across service providers and after an emergency care (Naylor & Keating, 2008). For the elderly with chronic conditions, Naylor and Keating (2008) note that the transfer to another facility or service provider exposes them to numerous risks that would worsen their conditions.  After an operation, poor handling of a patient can increase vulnerability to opportunistic infections and this would either worsen their condition or even lead to death (Puzio et al, 2009). For this reason, there is need to evaluate the safety standards and approaches used when dealing with acute emergency care cases. The intention is not to note the mistakes by healthcare providers but to identify ways in which they can promote safety standards when offering emergency care. Friesen, White and Byers (2008) also added that current hospital operations are becoming complex and bound by pressure to deliver especially in emergency departments. As a worker-researcher, I understand that the need for effective care is clearly based on evidence based research and maximization of working environment. For this reason, this study will focus on safety of patients in acute care during transfers to other service providers and/or clinical staff in order to guarantee safe and quality care.

            In order to achieve this research goal, the study will maximize the opportunities of a practitioner inquiry such as the use of observable knowledge or qualitative data towards initiating behavioral change. In this regard, this research will engage staff in the emergency department towards understanding how various procedures are undertaken, and how safety is guaranteed in these environments.