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My PICOT is as follows:

P (patient, population, or problem): younger (30-40s) patients in overall good health with new problem

I (Intervention): implement best practices in nursing operations of purposeful rounding and bedside reporting.

C (comparison with other treatment or current practice): Current practice

O (desired outcome): reduction in the left without being seen (LWBS) rate by 2%

T (time frame): 90 days

My PICOT question is:  For younger (30-40s) patients in overall good physical health presenting to the emergency room with a new problem, does implementing bedside reporting and purposeful rounding improve the left without being seen rate?

Within the Chamberlain ER scenario, there seems to be many problem areas. One problem area that is noted is the number of patients that are leaving without being seen (LWBS) which is 4.6% with a national benchmark for 2%.  Developing a PICOT question to direct the change project is crucial to the research process. This approach will allow for better communication and understanding of the problem and research question being asked (Riva, Malik, Burnie, Endicott, & Busse, 2012).  Utilizing a PICOT question when doing research allows for the best evidence available to be used. This will ensure that the impact on nursing practice is done with evidence based research (Echevarria & Walker, 2014).  Within the scenario, patient satisfaction surveys provides evidence of longer wait times from time arriving to time being seen but reflects that nurses and providers displayed the knowledge and competencies to provide the care respectfully. There is an observed lack in effective communication along the process from triage to discharge between nurses and providers. Nursing were observed giving report at the nursing station, not rounding on patients but being on their cell phones, and avoiding discharging patients during busiest times to avoid admissions at end of shift.  Bedside reporting can help to improve patient education and allow for discussion regarding diagnosis and related treatments (Muck, McNeil, McHugh, Bebarta, & Adams, 2015).  Implementing purposeful rounding is a best practice in nursing that ensures patient safety, decreases adverse events like falls, and allows for patient needs to be meet. In this scenario, utilizing purposeful rounding in the Chamberlain ER will help the patient satisfaction score which will help the LWBS rate if patient needs are being met. Rounding will improve the communication and satisfaction with the patients (Daniels, 2016).