Part 1: Quality Improvement Processes
For each of the quality improvement processes and approaches listed, describe the process and the core elements associated with it.
|Description and Core Elements
|Various quality improvement processes can be related to nursing practice. They include six sigma, PDSA, TQM, and CQI (Ratner & Pignone, 2019). Six Sigma processes eliminate defects and wastes, thereby improving quality and efficiency. This is done by improving and streamlining all the organizational processes(Ratner & Pignone, 2019). It has six core principles or elements. The elements include focussing on the customer, understanding how work happens, making processes flow smoothly, concentrating on value and reducing waste, removing variation and stopping defects, getting buy-in through team collaboration, and making the efforts scientific and systematic (Ratner & Pignone, 2019).
|Plan-Do-Study-Act quality improvement process has four phases in problem-solving. It is commonly used in implementing change and improving a process (Ratner & Pignone, 2019). The four core elements include planning, doing, studying, and acting. The key aspect encompasses communicating the accomplishments and taking long-term steps to preserve and sustain them.
|The focus of total quality management (TQM) focus is to detect and eliminate or reduce errors in organizational activities. The other goals of TQM are streamlining processes, improving customer experience, and ensuring employees are onboard with training (Ratner & Pignone, 2019). The eight-core principles of TQM include communications, fact-based decision making, continual improvement, strategic and systematic approach, process approach, total employee commitment, and customer focus. Successful implementation of the key principles brings about a large cultural shif t(Ratner & Pignone, 2019).
|Finally, continuous quality improvement (CQI) is a deliberate and defined process that focuses on continuous and ongoing efforts to improve measurable achievements. This includes improving effectiveness, efficiency, accountability, performance, and other quality indicators of a program. It is considered the best practice in public health(Ratner & Pignone, 2019). CQI has various guiding elements. They include focussing on improving services from the consumers perspective, engaging all levels required for success, recognizing all processes that can be improved, continual learning, and improved decision making using team knowledge and data,
Part 2: Verification of Practice Problem
Review the practice problem that you identified in LC4001 (ORDER #115467), and review the feedback provided by your faculty SME. You will use this practice problem in this Assessment as well.
Collect data on the practice problem that you identified in LC4001(ORDER #115467), that deals with an issue at your practicum facility. There are several places that you can gather data on the practice problem. They include, but are not limited to:
- Interview infection control and quality nurses at your practice experience facility
- Review HCAHPS data
- Access and review dashboards at the facility (QI dashboards)
- Use the Hospital Compare website (https://www.medicare.gov/hospitalcompare/search.html)
You should aim to collect enough data to ensure that you understand how many times or how often a problem is occurring and over what time frame. Note that the data that you need is not global, national, or even state data. You want to focus on data that is specific to the facility and area.
|Summarize the data that you found surrounding this practice problem at your practice experience facility.
The medication errors data was retrieved from the facilities intranet from January to March. Statistics indicate how medication errors are prevalent in the psychiatric unit. One of the major problems experienced in the Legacy unit was short staffing and inadequate training of its staff members. Statistics from the unit’s records indicate 20 instances documented involved delayed medication or provision of medical orders and treatments. 150 medication errors occurred over the past three months. The total number of doses administered was 1500. The medication error rate was 0.1.
|Explain whether the data that you found supports the practice problem that you identified at your practice experience facility.
|The data collected above confirms that medication errors are indeed one of the major concerns in the psychiatric facility. The number of errors (60) occurring within the last three months is very high. The rate indicates that medication error is one of the major problems in the facility. The rate of 0.1 medication error is an issue.
The data supports the need for a medication error project with the gaoal of reducing medication error rate from 150 to 75.
|If the data shows that the selected practice problem is actually an issue, either state that it is unchanged, or make minor edits. If the data does not support that the practice problem is an issue at the facility, create a new practice problem that is supported by the data.
|Medication error is an issue in the unit. Therefore, the problem is unchanged.
Part 3: Quality Improvement Processes
|Explain how the information that you found about the practice problem might be addressed by a quality improvement process.
|The six sigma quality improvement process can address medication errors. The process revolves around eliminating defects and waste to improve quality and efficiency. In medication errors, defects can be related to those factors that contribute to medication errors. They may include lack of policies and protocols, lack of and ineffective technology application, staffing shortages, and nursing burnout (Manias, 2018). Eliminating these factors may reduce the causes of medication errors in the psychiatric facility.
|Review the information about the Plan-Do-Study-Act (PDSA) process. Explain how you would apply this process to your selected practice problem to determine potential solutions to the practice problem.
|The four phases of the quality improvement process can determine potential solutions to medication errors.
The main objective of the quality improvement project is to reduce the rate of medication errors in the facility. The plan will involve reducing medication errors by fifty percent. I will recruit a team that will eliminate and prevent medication errors. Then a draft statement can be made focussing on what the organization is trying to accomplish. This includes a statement of changes that will eliminate or reduce medication errors in the facility. Finally, more information can be gathered regarding the best solution in planning. In planning the aim is to minimise medication errors. The goal is to reduce medication errors by 50% of the total errors (150) within two months of implementation. This will translate to 75 medication errors in three months. The plan will be implemented in the nursing unit in the psychiatric facility. The intervention will involve educating the staff on the five rights of medication administration. The measures will include the number of medication errors two months after implementing it. Hanson et al.(2018) Conducted a systemic review on the five rights of medication administration and how this can reduce medication errors. The researcher found out that educating the staff members on the five rights of medication errors. The rights of medication administration are not only the role of nurses but the responsibility of the entire health care organization (Hanson et al., 2018). The five rights are considered as solutions to addressing inadequacies among nurses and other healthcare practitioners. I will inform the nurses of the medication errors statistics in the unit. The target population for the intervention will be nurses and pharmacists. Data will be collected from the incidence reports in the facility. The reports will indicate the number of medication errors in the facility.
In the second phase, the action plan is implemented. The plan will be implemented on April 1, 2022. The implementation will involve educating the staff members on the five rights of medication errors. The measure will be the level of knowledge and the statistics of medication errors 2 months after implementation. Intervention success will depend on the number of medication errors.
In the third phase, a study is conducted to identify the plan’s success. Various data will collected in the Do phase will be summarized and analyzed statistically to identify the success of the intervention. In the nursing unit the knowledge level of the nurses will be analysed. The data indicating the incidence of medication errors will also be analyzed. Statistics indicated that educating the staff reduced the rate of medication errors.
Finally, if the intervention is feasible, it can be incorporated into the policies and procedures in the organization. If the goal will be met, been met, the organization will set a rule involving periodic educating of staff members on the rights of medication administration
|Describe the measures that should be analyzed after the intervention is applied to determine its success.
|Various measures can be analyzed to determine the success of the interventions. The first measure is the incidence and the prevalence of medication errors. Upon implementation, there will be a decrease in medication errors. the measure of success is an outcome measure. The outcome is to reduce the rate of medication errors in the department
Hanson, A., & Haddad, L. M. (2021). Nursing Rights of Medication Administration. StatPearls [Internet].Oregon Nurses Association(ONA) (2021). The consequences of short staffing at Legacy Unity Centre for Behavioural Health. https://cdn.ymaws.com/www.oregonrn.org/resource/resmgr/unity/srdf_report_unity_2021-03-10.pdf
Ratner, S., & Pignone, M. (2019). Quality Improvement Principles and Practice. Primary Care: Clinics in Office Practice, 46(4), 505-514.
Manias, E. (2018). Effects of interdisciplinary collaboration in hospitals on medication errors: an integrative review. Expert opinion on drug safety, 17(3), 259-275.
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