Proposed Project for IDWG Management

Intradialytic weight gain has become a major problem for End Stage Renal Disease (ESRD) patients who are dependent on hemodialysis. This issue has resulted in more complications and hospitalizations of ESRD patients who need effective IDWG management programs that are driven by nurses. This project proposes a project that is geared towards improving IDWG management for these patients by 10% through a 12-week educational program. The paper demonstrates how the project will be implemented in a 19 chair dialysis clinic that functions 6 days every week in order to accommodate 150 hemodialysis patients. The discussion includes a description of the proposed change, rationale for selecting it, implementation methods, and expected results. The author provides evaluation of baseline data collected from patients during implementation and conclusions based on the collected data.

Objectives of CNL Internship Project

The objectives or aim of this CNL Internship Project is to coordinate a plan of care that focuses on enhancing the intradialytic competence and results of hemodialysis patients admitted to the clinic. To this extent, the CNL Internship Project seeks to improve IDWG management in patients dependent on hemodialysis by 10% through implementing an education program that will last for 12 weeks. This project will help improve intradialytic knowledge and outcomes through patient education regarding target weight and better understanding of the impact of lifestyle actions and behaviors on health and overall well-being.

Actual Population and Setting

In order to accomplish the objectives or aim of this CNL Internship Project, an actual population and setting for the project was identified. The actual population for this project is patients suffering from End Stage Renal Disease (ESRD) aged between 22 and 96 years. The patients’ condition can be described the stage when kidneys cannot function effectively and require dialysis or transplant in order to work well enough. Since this type of kidney failure or problem is permanent and cannot be fixed, patients depend on dialysis or transplant for the kidney to function adequately. The setting for the project is a 19 chair dialysis clinic that functions 6 days every week in order to accommodate 150 hemodialysis patients. This clinic is situated around a major metropolitan memorial medical center.

Methods of Implementing the Project

The implementation of the project involved the application of Kotter’s Eight-Step Model, which is a change theory that effectively applies to the proposed educational project (Mento, Jones & Dimdorfer, 2002). The project management team developed the project plan, tested a random sample of patients, developed educational materials, conducted staff training on using educational materials, administered educational questionnaires to patients, and commenced facility wide education of patient census. This was followed by conducting patient evaluations regarding their experience with the project, administering post-education questionnaires, assessing the success of the project, and making necessary adjustments depending on patient needs and survey results. Patient re-education was also carried out to reinforce educational materials and follow-up of patient knowledge on IDWG was conducted with staff and patients.

The baseline data for conducting this educational project a 49.6% overall intradialytic weight gain (based on 150 pts data) at the clinic before patient education. This baseline data showed the need for the project because nearly half of 150 patients on hemodialysis admitted at the hospital experienced increased hospitalizations and complications. Therefore, it was important to develop an effective project to reduce these hospitalizations and complications.

Published Materials and Teaching Aids

The implementation of this educational project also entailed the use of published journal articles, books, pamphlets, brochures, PowerPoint presentations, and technological tools to conduct the education of staff members and patients. The published journal articles were crucial in providing evidence-based findings on the use of such as a project in improving IDWG knowledge. These teaching aids were crucial in making it easy to explain the various concepts and processes involved in the project.

Evaluation and Conclusions

Prior to the implementation of this educational project, the clinic started at 49.6% overall intradialytic weight gain (based on 150 pts data). The education project focused on enhancing IDWG knowledge, fluid management, and target weight, which would result in significant decrease in intradialytic weight gain that is associated with increased complications. Based on the data collected, the overall intradialytic weight gain at the facility decreased significantly by Week 10 i.e. from 49.6% to 36.2%. However, the initial weeks of implementation of this project were characterized by minimal decrease of less than 1%. The minimal decrease is attributed to the fact that Week 2 and 3 involved administering testing, surveying, and education. Through the project, patients demonstrated increased understanding of normal or target weight, storage of fluid in the body, steps to undertake if target weight is not within the normal range, symptoms of poor fluid control, and ways to enhance control of fluid and sodium levels. However, there was little change in patient’s understanding of why fluid management is an issue when suffering from ESRD and the need for additional measures rather than dialysis treatment alone in controlling fluid and sodium levels.

The data exceeded the projections of decreased IDWG at the facility within weeks of implementation. Within the first 10 weeks, the project resulted in a 13.4% decreased of intradialytic weight gain, which was more than the projected 10% by Week 12. Based on this data, an educational project is effective in lessening IDWG for hemodialysis dependent patients (Barnett et al., 2008, p.300, Lingerfelt & Thomton, 2011, p.483). In addition, it is important to focus on educating patients regarding dependence on other measures rather than dialysis treatment alone to understand their role in control of fluid and sodium levels.

Sustainability Plan

The sustainability plan for maintaining the change upon completion of the practicum entails incorporating it as part of the clinics policy and procedures. Secondly, this process will involve conducting periodic review of its effectiveness through obtaining feedback from staff members and patients. Third, the feedback will be utilized to make necessary changes from time to time depending on emerging issues and desired goals and objectives.

References

Barnett, T., Li, Y.T., Pinikahana, J. & Si-Yen, T. (2008, February). Fluid Compliance among Patients having Haemodialysis: Can an Educational Programme Make a Difference? Journal of Advanced Nursing, 61(3), 300-306.

Lingerfelt, K. & Thornton, K. (2011). An Educational Project for Patients on Hemodialysis to Promote Self-Management Behaviors of End Stage Renal Disease. Nephrology Nursing Journal, 38(6), 483-489.

Mento, A., Jones, R. & Dirndorfer, W. (2002). A change management process: Grounded in both theory and practice. Journal of Change Management, 3(1), 45-70. Retrieved from EBSCO Host, AN 7329277.

Appendix

Prior to education, Facility started at a 49.6% overall Intradialytic Weight Gain (based on 150 pts data)

Week 2 and 3 administered testing, surveying, and education

By week 3: 48.2%

By week 4: 47.6%

By week 5: 45.2%

By week 6: 39.8%

By week 7: 36.5%

By week 8: 40.2%

By week 9: 36.6%

By week 10: 36.2%

Starting Patient Survey with ending results

Facility: Rosemead Springs and SFS

Date Range:

Number of Shifts And Chairs:

4 shifts and 20 chairs

Number of Patients: 150

Correct

Incorrect

Missing/

Invalid

1

What is your normal or target weight?

Pre

127 (85.2%)

22

1

Post

143 (96.0)

6

1

2

How does your body obtain fluids and sodium?

Pre

142 (95.9%)

6

2

Post

142 (95.9%)

6

2

3

Where is most of fluid stored on the body?

Pre

79 (56.0%)

62

9

Post

101 (71.6%)

40

9

4

If your target weight is not in the normal range, what is the first thing you should do?

Pre

66 (52.0%)

61

23

Post

72 (56.7%)

55

23

5

What are the symptoms of poor fluid control?

Pre

12 (8.2%)

4

Post

17 (11.4%)

1

6

Why is fluid management a problem when your kidneys are not working well?

Pre

115 (85.8%)

19

16

Post

117 (87.3%)

17

16

7

Dialysis treatments along can control your fluid and sodium levels.

Pre

131 (89.1%)

16

3

Post

132 (89.8%)

15

5

8

What are ways that can help your control your fluid and sodium levels?

Pre

44 (30.1%)

4

Post

59 (39.9%)

Get Professional Assignment Help Cheaply

Are you busy and do not have time to handle your assignment? Are you scared that your paper will not make the grade? Do you have responsibilities that may hinder you from turning in your assignment on time? Are you tired and can barely handle your assignment? Are your grades inconsistent?

Whichever your reason is, it is valid! You can get professional academic help from our service at affordable rates. We have a team of professional academic writers who can handle all your assignments.

Why Choose Our Academic Writing Service?

• Plagiarism free papers
• Timely delivery
• Any deadline
• Skilled, Experienced Native English Writers
• Subject-relevant academic writer
• Adherence to paper instructions
• Ability to tackle bulk assignments
• Reasonable prices
• 24/7 Customer Support
• Get superb grades consistently

Online Academic Help With Different Subjects

Literature

Students barely have time to read. We got you! Have your literature essay or book review written without having the hassle of reading the book. You can get your literature paper custom-written for you by our literature specialists.

Finance

Do you struggle with finance? No need to torture yourself if finance is not your cup of tea. You can order your finance paper from our academic writing service and get 100% original work from competent finance experts.

Computer science

Computer science is a tough subject. Fortunately, our computer science experts are up to the match. No need to stress and have sleepless nights. Our academic writers will tackle all your computer science assignments and deliver them on time. Let us handle all your python, java, ruby, JavaScript, php , C+ assignments!

Psychology

While psychology may be an interesting subject, you may lack sufficient time to handle your assignments. Don’t despair; by using our academic writing service, you can be assured of perfect grades. Moreover, your grades will be consistent.

Engineering

Engineering is quite a demanding subject. Students face a lot of pressure and barely have enough time to do what they love to do. Our academic writing service got you covered! Our engineering specialists follow the paper instructions and ensure timely delivery of the paper.

Nursing

In the nursing course, you may have difficulties with literature reviews, annotated bibliographies, critical essays, and other assignments. Our nursing assignment writers will offer you professional nursing paper help at low prices.

Sociology

Truth be told, sociology papers can be quite exhausting. Our academic writing service relieves you of fatigue, pressure, and stress. You can relax and have peace of mind as our academic writers handle your sociology assignment.

Business

We take pride in having some of the best business writers in the industry. Our business writers have a lot of experience in the field. They are reliable, and you can be assured of a high-grade paper. They are able to handle business papers of any subject, length, deadline, and difficulty!

Statistics

We boast of having some of the most experienced statistics experts in the industry. Our statistics experts have diverse skills, expertise, and knowledge to handle any kind of assignment. They have access to all kinds of software to get your assignment done.

Law

Writing a law essay may prove to be an insurmountable obstacle, especially when you need to know the peculiarities of the legislative framework. Take advantage of our top-notch law specialists and get superb grades and 100% satisfaction.

What discipline/subjects do you deal in?

We have highlighted some of the most popular subjects we handle above. Those are just a tip of the iceberg. We deal in all academic disciplines since our writers are as diverse. They have been drawn from across all disciplines, and orders are assigned to those writers believed to be the best in the field. In a nutshell, there is no task we cannot handle; all you need to do is place your order with us. As long as your instructions are clear, just trust we shall deliver irrespective of the discipline.

Are your writers competent enough to handle my paper?

Our essay writers are graduates with bachelor's, masters, Ph.D., and doctorate degrees in various subjects. The minimum requirement to be an essay writer with our essay writing service is to have a college degree. All our academic writers have a minimum of two years of academic writing. We have a stringent recruitment process to ensure that we get only the most competent essay writers in the industry. We also ensure that the writers are handsomely compensated for their value. The majority of our writers are native English speakers. As such, the fluency of language and grammar is impeccable.

What if I don’t like the paper?

There is a very low likelihood that you won’t like the paper.

Reasons being:

• When assigning your order, we match the paper’s discipline with the writer’s field/specialization. Since all our writers are graduates, we match the paper’s subject with the field the writer studied. For instance, if it’s a nursing paper, only a nursing graduate and writer will handle it. Furthermore, all our writers have academic writing experience and top-notch research skills.
• We have a quality assurance that reviews the paper before it gets to you. As such, we ensure that you get a paper that meets the required standard and will most definitely make the grade.

In the event that you don’t like your paper:

• The writer will revise the paper up to your pleasing. You have unlimited revisions. You simply need to highlight what specifically you don’t like about the paper, and the writer will make the amendments. The paper will be revised until you are satisfied. Revisions are free of charge
• We will have a different writer write the paper from scratch.
• Last resort, if the above does not work, we will refund your money.

Will the professor find out I didn’t write the paper myself?

Not at all. All papers are written from scratch. There is no way your tutor or instructor will realize that you did not write the paper yourself. In fact, we recommend using our assignment help services for consistent results.

What if the paper is plagiarized?

We check all papers for plagiarism before we submit them. We use powerful plagiarism checking software such as SafeAssign, LopesWrite, and Turnitin. We also upload the plagiarism report so that you can review it. We understand that plagiarism is academic suicide. We would not take the risk of submitting plagiarized work and jeopardize your academic journey. Furthermore, we do not sell or use prewritten papers, and each paper is written from scratch.

When will I get my paper?

You determine when you get the paper by setting the deadline when placing the order. All papers are delivered within the deadline. We are well aware that we operate in a time-sensitive industry. As such, we have laid out strategies to ensure that the client receives the paper on time and they never miss the deadline. We understand that papers that are submitted late have some points deducted. We do not want you to miss any points due to late submission. We work on beating deadlines by huge margins in order to ensure that you have ample time to review the paper before you submit it.

Will anyone find out that I used your services?

We have a privacy and confidentiality policy that guides our work. We NEVER share any customer information with third parties. Noone will ever know that you used our assignment help services. It’s only between you and us. We are bound by our policies to protect the customer’s identity and information. All your information, such as your names, phone number, email, order information, and so on, are protected. We have robust security systems that ensure that your data is protected. Hacking our systems is close to impossible, and it has never happened.

How our Assignment  Help Service Works

1.      Place an order

You fill all the paper instructions in the order form. Make sure you include all the helpful materials so that our academic writers can deliver the perfect paper. It will also help to eliminate unnecessary revisions.

2.      Pay for the order

Proceed to pay for the paper so that it can be assigned to one of our expert academic writers. The paper subject is matched with the writer’s area of specialization.

3.      Track the progress

You communicate with the writer and know about the progress of the paper. The client can ask the writer for drafts of the paper. The client can upload extra material and include additional instructions from the lecturer. Receive a paper.

4.      Download the paper

The paper is sent to your email and uploaded to your personal account. You also get a plagiarism report attached to your paper.

PLACE THIS ORDER OR A SIMILAR ORDER WITH US TODAY AND GET A PERFECT SCORE!!!