NU480CL Unit 7 Mid-Placement Conference Summary Example

Twenty-Three Screens at Mid-Placement: A Preceptor Conference Summary Recording Two Decisions and the Adjustments That Followed for the Admission Screen on a Composite Rehabilitation Hall, Written From the Student's Side

[Student Name]

Purdue University Global

NU480CL: Four Spheres BSN Capstone Practicum

Unit 7 Preceptor Conference Summary

[Instructor Name]

[Date]

The facility, figures and preceptor are composite; the summary is written from the student's side, and the preceptor's comment field and both signature lines are intentionally blank.

Status in Four Lines

Admissions since the screen began: [27]. Screened within [48] hours: [23] of [27], [85] percent; [3] of the [4] missed were evening admissions. Positive screens: [9]. Positive screens with a recorded goals talk ahead of the first team care meeting: [3] of [9].

What We Reviewed

We looked at the weekly run chart for each measure, the four missed screens and the six positive screens without a conversation. The run chart showed screening improving each week but conversations flat. The missed screens clustered on two busy evenings when evening nurses admitted three patients each.

Decision 1: Evening Admissions Reassigned

For patients arriving after [1700], the screen will be completed by the day nurse the next morning, still within the [48]-hour window. Evening nurses will continue the admission assessment without the screen. My preceptor agreed because the evening admission is already the heaviest workload on the hall, and the window allows it. We will test this as a plan-do-study-act cycle for two weeks and watch the run chart for its effect (Langley et al., 2009).

The screen did not need to be done faster; it needed to be done by the nurse who had time to do it well.

Decision 2: The Social Worker Copied In

From now on, each positive screen also goes to the social worker, not only the attending. Of the six positive screens without a conversation, [four] were waiting for the attending, who had not seen the notification among other messages. Our social worker is able to open that discussion and draw the clinician in afterward, which hospital screening models also recommend to widen who can respond (Weissman & Meier, 2011).

Questions Still Open

1. Will conversations led first by the social worker meet the definition of a documented goals conversation in our measure, or must the attending be present?

2. How should we count patients who decline a conversation: as complete, or separately?

3. Should the screen be repeated if a patient's condition changes during the stay?

These will go to the director of nursing and medical director.

What I Will Do Before the Next Conference

Update the run charts weekly, track the two new changes, draft definitions for the open questions and prepare the progress memo for faculty. I will also record how long social-worker-led conversations take, since the stakeholder analysis estimated [10] to [20] minutes. Good serious illness conversations often begin by asking what the patient understands, so the template will prompt that question (Bernacki & Block, 2014).

How the Decisions Will Be Judged

Both decisions are tests, not permanent changes. If next-morning screening slips below [85] percent for two weeks, we will revisit it. If copying the social worker does not raise conversations within two weeks, we will look for another cause, such as families who cannot attend or notes written in the wrong place.

Student's Note on the Conference

I came expecting to defend the screening rate and found that the real problem was the second target. My preceptor's question, "Who is waiting on whom?", found it faster than my charts did.

Preceptor's Comments

[Left blank for the preceptor.] Preceptor signature and date: ______ Student signature and date: ______

References

Bernacki, R. E., & Block, S. D. (2014). Communication about serious illness care goals: A review and synthesis of best practices. JAMA Internal Medicine, 174(12), 1994-2003. https://doi.org/10.1001/jamainternmed.2014.5271

Langley, G. J., Moen, R. D., Nolan, K. M., Nolan, T. W., Norman, C. L., & Provost, L. P. (2009). The improvement guide: A practical approach to enhancing organizational performance (2nd ed.). Jossey-Bass.

Weissman, D. E., & Meier, D. E. (2011). Identifying patients in need of a palliative care assessment in the hospital setting: A consensus report from the Center to Advance Palliative Care. Journal of Palliative Medicine, 14(1), 17-23. https://doi.org/10.1089/jpm.2010.0347