Maintaining Cost Benefit Analysis in Nursing

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Maintaining Cost Benefit Analysis in Nursing

Based on the recent researches, maintaining CBI has a nurse-knowledge-related problem. Many units are now dealing with an inflow of newly graduated nurses as well as temporary nurses who might not be familiar with the residents of the unit due to the loss of experienced bedside nurses. Inexperienced nurses could overlook warning indicators of insufficient catheter drainage, such as increased bladder spasms, drainage surrounding the catheter, output amounts that are inconsistent with irrigation intake, and rising pain levels (Ling et al., 2022). Furthermore, untrained nurses may not keep an acceptable irrigation rate, failing to completely avoid these issues. In order to solve these problems two nurses namely, Shelsea Pelaez and Samantha Blain-Maiza developed a project aimed at educating nurses in continuous bladder irrigation. The project entails an implementation of rate adjustment education for the facilitation of continuous bladder irrigation in units without specialized urologic nurses. This paper presents a cost/benefit analysis and explains the Cost Benefit Analysis and anticipated return on investment (ROI) on the proposed Doctor of Nursing Practice (DNP) project.

The project involves educating nurses to improve their knowledge, competence, and confidence in handling patients with continuous bladder irrigation as a treatment modality. It aims to maximize treatment using CBI by reducing the frequency of bladder spasm, the incidence of clot-related catheter blockage, the total volume of irrigation solution used, and the total needed irrigation time. The project utilizes three key concepts. These include, engaged leadership, quality improvement strategy, and knowledge with the organized, evidence-based care. The project involves a total of 75 nurses who have been recruited on a voluntary basis. The previous knowledge of the participants was tested using an electronic survey form before being involved in the project. After completing these questionnaires, participants were provided an educational film on CBI management, which they were required to watch before a live demonstration. It was followed by a follow-up demonstration and printed handouts. A 5- to 15-minute post-education survey was given to participants two weeks following the education in-service to measure their understanding of and comfort level with CBI.

The direct cost of the project majorly involves the purchase of instructional and demonstration materials. These materials cost a total of $488.38. These expenses cover both the price of the supplies required to carry out the return demonstration and the supplies for the instructional film. The materials purchased include two 3-way Foley Catheter, 2-CBI irrigation Tubing and 2- 300ml 0.9% Saline Bags costing $29.38, $78.30, and $284.80 respectively. There are two 400ml Urine Drainage Bag required which costs $17.24 and two 2-Foley Anchor costing $10.66. The other materials purchased are Fake Blood, one chux pads and 60ml piston syringe which costs $68.00, $23.89, and $49.09 respectively.

On the other hand, the indirect costs involved include the cost of time spent on the project. Registered Nurses (RNs) are required to spend a maximum of 30 minutes in person. The maximum total time commitment for the nurses is split between in-person and online duties, totaling one hour. The in-person training took place over the course of 30 minutes per session. Participants had access to 30 sessions in all, which took the DNP student 15 hours to complete. The amount of time needed to watch the film and complete the pre- and post-surveys was also kept to a minimum. The pre- and post-surveys took between 5 and 10 minutes to complete, and the film itself isnt very long. Considering, the time for the organizers, creation of the videos alone took a couple of hours used in setting up the scene as well as recording the actual content. Then there is the time for editing and uploading the videos into a form that is accessible to the participants. There are 75 nursing staffs required, therefore, the time cost totaling to $1,125.

One of the main financial benefits of this project is the reduction in expenses by the government on paying specialized neurologic nurses. According to data, an Advanced Urological Practice Provider earns an average of $60 per hour (Brand et al., 2022). When this amount is multiplied by the total number of nurses in the test for thirty minutes, it results to $2250. Therefore, there is a saved cost of $1,125 per hour. In a day of 10.5 working hours the cost benefit will amount to $11,250. The current Urologists to patient ratio are approximately 8 to 100,000. Inexperienced or beginner urologists can take up to seven times more time than a specialized urologist (Lucas & Ward, 2022). Therefore, training 75 non-specialized nurses will take save up to 24.5 hours.

Additionally, this project has a potential cost benefit to the patients and their families by lowering the cost of providing CAUTI treatment. Currently, the estimated cost of treating one case of CAUTI related is approximately $31,000 (Ling et al., 2022). The high cost is contributed by the high cost of employing a urology specialist. When many nurses have the knowledge on how to efficiently handle CBI, there will be fewer cases of CAUTI thus saving many patients from the cost (Anderson, 2022). In addition, the few cases that will arise will not demand the attendance of the expensive urology specialists.

In conclusion, implementation of rate adjustment education for the facilitation of continuous bladder irrigation in units without specialized urologic nurses offers a lot of cost benefit in the healthcare sector. The estimated ROI of the project is approximately $29, 543.22 in a day. Educating the nurses improves their knowledge, confidence and competence in handling patients suffering with continuous bladder irrigation treatment modality. Therefore, the project optimizes treatment, and reduces the total needed irrigation time.

References

Anderson, B. (2022). Urology nursing: Accentuating my experiences of the principles of practice. In B. Anderson (Ed.), A Uro-Oncology Nurse Specialists Reflection on her Practice Journey (pp. 77-113). Springer, Cham.

Brand, T. C., Mitchell, K., Quallich, S., Rubenstein, J., Zwarick Shanley, K., Gutierrez, A., Hooper, G., Motola, J., Zilinskas, B., Robles, J., Erickson, B., Rhee, E., & Spitz, A. (2022). Current state of advanced practice providers in urological practice. Urology Practice, 9(1), 1-7.

Ling, R., Giles, M., & Searles, A. (2022). Budget impact analysis of a multifaceted nurse-led intervention to reduce indwelling urinary catheter use in New South Wales Hospitals. BMC health services research, 22(1), 1-12.

Lucas, A., & Ward, C. W. (2022). Manual and continuous bladder irrigation. Nursing, 52(7), 3136.

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