The healthcare field is forever changing; therefore, nurses need to be on top of new and improved evidence-based practice. Evidence-based research needs to be done to maintain patient safety and best possible outcomes. One issue that should be investigated is how to manage chronic headaches effectively. Patients with chronic headaches take up resources, time and space in the emergency room.
According to Migraine Research Foundation (2017) migraines are a prevalent neurological disease which affects 38 million people in the United States and one billion worldwide. These patients typically have a hard time with the management of their headaches once they start. Most patients will go through their plan of care, if they have one, and then end up in the emergency department (ED) for pain management when all else fails. Coming up with an educational plan, to educate these patients will help decrease emergency department visits and have better patient outcomes at home.
Background
In a review of emergency room visits within Sentara Quality Care Network, for inappropriate emergency department visits, headaches were noted as the number one reason for visits. Decreasing the emergency department visits for headaches will be a start to providing these patients with appropriate care for better outcomes. The practice setting would take place with case managers in an outpatient setting, over the phone or at the patient’s home. This writers’ clinical setting for this project takes place with Clinical Integrated Network of approximately 3,000 physicians. This network has contracts with several self-ensured entities and an insurer in making sure that they are giving the best care possible. This network has case managers who call and visit with patients to make sure that they are following their treatment plan. These case managers can look in their database to see which patients have been discharged from the emergency and for what. They can identify which patients, once discharged, will benefit from this protocol. They can then begin using this new educational protocol as part of their case management and be able to track them to make sure they are staying out of the emergency room. The trigger for the case managers will be when the patients visit the emergency department for a complaint of a headache. These case managers will be able to poll those who have visited the emergency department within the next six months with a questionnaire. They will work closely with the patients as well as the providers to make sure that the protocol is being followed in which they will include the triple aim; right care, right place and right cost. This education will help the patients to receive the best possible evidence-based care and will have a better quality of life.
Problem Statement