NURS 4220A – Leadership Competencies in Nursing and Healthcare Course Guide & Examples
NURS 4220A – Leadership Competencies in Nursing and Healthcare Course Guide & Examples
NURS 4220A – Leadership Competencies in Nursing and Healthcare Course (5 credits)
- LC4001A Leadership for Organizational Culture and Growth
- Analyze leadership for organizational culture and growth to promote positive social change through patient quality and safety.
- LC4002A Healthcare Quality
- Analyze healthcare quality for nursing practice.
- LC4003A Quality Improvement Processes
- Analyze quality improvement processes.
- LC4004A Quality Improvement Tools
- Analyze information from quality improvement tools.
- LC4005A Improving Patient Quality and Safety
- Apply quality improvement processes and tools as a scholar-practitioner to improve quality and safety.
NURS 4220A LC4001A Leadership for Organizational Culture and Growth
WU Leadership Strategies to Effect Organizational Change Discussion
Description
Apply leadership strategies to effect organizational change for the promotion of patient quality and safety.
Submission Length: 2- to 3-page paper in response to 2 scenarios
SCENARIO 1
Tower 6 East is a 45-bed medical unit. The nurse leader, Ciera, is a new leader, and one of the measures of her performance is based on the number of medication errors reported on her unit. As a result, she has told everyone very clearly that she will not tolerate errors and that she wants the unit to have zero medication errors each month. When an error does occur, she meets individually with the nurse, writes up the nurse’s error, and puts a report in the nurse’s performance review files. She has put two nurses on performance probation thus far. As a result, the nurses on the unit are afraid to report when an error occurs, and they have begun to cover for each other and not report errors. You are a staff nurse on the unit and you want to serve as a leader and create a blame-free environment.
In your response, address the following:
- Identify and explain whether Ciera’s leadership style toward medication errors on the nursing unit is appropriate and explain why. Then, provide at least one outcome result from Ciera’s leadership approach on the nursing unit. (Yoder-Wise, P. (2019, p.498) Leading and managing in nursing (7th ed.). Mosby Elsevier.
- Explain what leadership style you would use to effect change in this scenario.
- Using the Paradiso & Sweeney article “Just culture: It’s more than policy”, explain a just culture and how a just culture might influence the outcome of medication errors on the unit.
- Scenario
- you are the charge nurse and the nursing assistant comes to you with the following question concerning an assignment she has been asked to carry out by one of the other RN’s on the floor. “Jerry pulled a patient’s dose of Digoxin and asked me to administer it because he is so behind. Am I allowed to do that?”In your response, address the following:
-
- After exploring your state nurse practice act, explain your response to the nursing assistant citing the applicable legal principles for delegation and promotion of drug safety on the nursing unit.
- Explain the education that would need to be provided regarding delegation principles, including the identification of items that can be delegated and items that cannot be delegated by Jerry; and, explain why the delegation educational plan you suggest is appropriate.
- Recommend strategies to develop an effective team that should be implemented on the nursing floor to help develop consistency with delegation. Explain how you would apply these strategies to enhance nursing roles and responsibilities for patient quality and safety as described in the scenario.
- https://journals.rcni.com/nursing-standard/cpd/app…
- https://www.proquest.com/docview/254839484
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- https://cdn2.hubspot.net/hubfs/4632409/Just%20Cult…
- https://www.myamericannurse.com/inspire-transforma…
- https://www.ncsbn.org/Delegation_joint_statement_N…
- https://www.myamericannurse.com/creating-a-nursing…
- https://www.myamericannurse.com/creating-a-nursing…
NWU Health Care Leadership Strategy Nursing Training Discussion
Description
Part 1
Root Cause Analysis
Review the case scenario included in this week’s media resources, and examine the process flow chart, cause/effect diagram, and Pareto chart related to the case scenario.
In the scenario, the nurse manager and the director of pharmacy blame each other for the error. The facilitator (quality assurance person) asks everyone to avoid blaming and focus on applying the tools to analyze the data and get to the root cause of the error. While all of these tools contribute, for this Discussion, select one tool to analyze.
Post each of the following:
- Analyze the composition of the RCA team. Explain what knowledge they can contribute to the RCA.
- Describe the collaboration in the case study that led to effective problem solving. Identify the evidence you observe in the scenario that demonstrates effective collaboration and the avoidance of blaming.
- Explain the team’s process in testing for and eliminating root causes that were not contributing.
- Select one of the performance improvement charts presented in the scenario and critique its effectiveness by explaining how it contributes to identifying the root cause and determining a solution to prevent repeat medication errors.
- Identify the contributing factors, and discuss how to prevent this kind of error from occurring in the future.
Support your response with references from the professional nursing literature. Your posts need to be written at the capstone level (see checklist)
REQUIRED READINGS
Spath, P. (2018). Introduction to healthcare quality management (3rd ed.). Chicago, IL: Health Administration Press.
- Chapter 4, “Evaluating Performance” (pp. 79-118)
- Chapter 5, “Continuous Improvement” (pp. 119-142)
- Chapter 6, “Performance Improvement Tools” (pp. 143-174)
Note: Although these chapters are previously assigned readings, please review them in preparation for this week’s material.
Yoder-Wise, P. S. (2019). Leading and managing in nursing (7th ed.). St. Louis, MO: Mosby.
- Chapter 18, “Leading Change” (pp. 319-335)
Document: Fish Bone: Cause-Effect Diagram (PDF)
Document: Pareto Chart: Medication Error Analysis (PDF)
Document: Process Flow Chart: Medication Administration (PDF)
REQUIRED MEDIA
Laureate Education (Producer). (2016a). Root cause analysis at Downtown Medical [Interactive file]. Baltimore, MD: Author.
Laureate Education (Producer). (2016b). RCA dramatization 1 [Video file]. Baltimore, MD: Author.
Note: The approximate length of this media piece is 4 minutes.
Case scenario involving medication error including pharmacy, physician, and nurse—interdepartmental collaboration.
Interactive media—students select options that generate chart based on choices
(Voiceover reads the document aloud—include a downloadable pdf).Accessible player –Downloads– Download Video w/CC Download Audio Download Transcript
Part 2
Leadership Strategy
As a nurse, you serve an important role in identifying strategies to effectively manage health care resources and in leading health care quality improvement. You must be able to decide what leadership style or strategy to apply in a given situation to achieve an effective resolution of the issue. Read the following two scenarios and select one to focus on in this Discussion. Consider the leadership style or strategy that might be most effective in the scenario you selected.
Scenario 1
You work in a for-profit nursing home, with about 100 beds, on a 20-bed unit that is largely patients with Alzheimer’s disease. Your patient mix is predominantly Medicare and Medicaid patients. Your nursing home is part of a larger system that includes a major medical center, as well as VNA, outpatient dialysis, and a fully integrated network. Your nurse manager is getting feedback from the hospital that your nursing home is sending too many patients to the ED who really don’t need to go. How would you go about figuring out what could be done at the nursing home to prevent avoidable ED visits?
Scenario 2
You’ve been associated with an outpatient cardiology clinic that is part of a large academic medical center. Your patients are mostly charity care and managed Medicaid. Most have a prescription plan, but none have a “family doctor” and use the clinic (and the ED) regularly. Most are unfamiliar with their medications and do not have the resources for care coordination in their family/social network. About 25 CHF patients have been “lovingly,” but inappropriately, called “frequent fliers” because of their inability to manage their own care, their frequent visits to the ED, and their “one night stays” paid at the observation rate. As a staff nurse in this clinic, describe the strategies you could devise for you and your fellow staff nurses targeting these 25 patients. Find at least one article from the professional literature to corroborate your recommendations.
Select one of the scenarios, and post the following:
Describe the most appropriate leadership style and/or strategy to apply in the scenario you chose in order to implement the recommendations successfully. Justify your selection.
REQUIRED READINGS
Spath, P. (2018). Introduction to healthcare quality management (3rd ed.). Chicago, IL: Health Administration Press.
- Chapter 10, “Managing the Use of Healthcare Resources” (pp. 249-280)
Yoder-Wise, P. S. (2019). Leading and managing in nursing (7th ed.). St. Louis, MO: Mosby.
- Chapter 1, “Leading, Managing, and Following” (pp. 1-18)
- Chapter 5, “Gaining Personal Insight: The Beginning of Being a Leader” (pp. 76-87)
- Chapter 20, “Managing Costs and Budgets” (pp. 357-375)
NURS 4220A LC4002A Healthcare Quality
Description
Assume that you are a Quality Officer who is responsible for one of the state’s largest healthcare organizations. You have been told that the quality of patient care has decreased, and you have been assigned a project that is geared toward increasing quality of care for the patients. Your Chief Executive Officer has requested a six to eight-page summary of your recommended initiatives.
Note: You may create and /or make all necessary assumptions needed for the completion of this assignment.
Write a 6-8 page paper in which you:
- Analyze three (3) quality initiatives for your organization.
- Determine the supporting factors that would aid in the reduction of healthcare cost in your organization without reducing quality of care for the patients.
- Differentiate between quality in a free market healthcare system and in single payer government system with three (3) examples for each.
- Specify three (3) common law quality initiatives that are still found in 21st century healthcare organizations.
- Defend your position on the importance of healthcare quality for your organization. Provide support with at least three (3) examples that illustrate your position.
- Assemble a plan to protect patient information that complies with all legal requirements.
- Use at least three (3) quality references. Note: Wikipedia and other Websites do not qualify as academic resources.
Your assignment must follow these formatting requirements:
- Be typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides; citations and references must follow APA or school-specific format. Check with your professor for any additional instructions.
- Include a cover page containing the title of the assignment, the student’s name, the professor’s name, the course title, and the date. The cover page and the reference page are not included in the required assignment page length.
The specific course learning outcomes associated with this assignment are:
- Describe the evolution of hospitals and sources of law.
- Examine tort law and the criminal aspects of health care.
- Analyze the impact of healthcare financing and health insurance on healthcare access, quality, and cost.
- Determine the factors that affect healthcare quality in healthcare organizations.
- Examine information management and health care records and how the legal reporting requirements impact health care.
- Assess the legal implications of ethical decisions that impact consent for treatment, right-to-die, and patient rights and responsibilities.
- Use technology and information resources to research issues in healthcare policy, law, and ethics.
- Write clearly and concisely about healthcare policy and law using proper writing mechanics.
Click here to view the grading rubric.
Points: 200 |
Assignment 3: Healthcare Quality |
Criteria |
Unacceptable
Below 60% F |
Meets Minimum Expectations
60-69% D |
Fair
70-79% C |
Proficient
80-89% B |
Exemplary
90-100% A |
1. Analyze three (3) quality initiatives for your organization.
Weight: 15% |
Did not submit or incompletely analyzed three (3) quality initiatives for your organization. |
Insufficiently analyzed three (3) quality initiatives for your organization. |
Partially analyzed three (3) quality initiatives for your organization. |
Satisfactorily analyzed three (3) quality initiatives for your organization. |
Thoroughly analyzed three (3) quality initiatives for your organization. |
2. Determine the supporting factors that would aid in the reduction of healthcare cost in your organization without reducing quality of care for the patients.
Weight: 12% |
Did not submit or incompletely determined the supporting factors that would aid in the reduction of healthcare cost in your organization without reducing quality of care for the patients. |
Insufficiently determined the supporting factors that would aid in the reduction of healthcare cost in your organization without reducing quality of care for the patients. |
Partially determined the supporting factors that would aid in the reduction of healthcare cost in your organization without reducing quality of care for the patients. |
Satisfactorily determined the supporting factors that would aid in the reduction of healthcare cost in your organization without reducing quality of care for the patients. |
Thoroughly determined the supporting factors that would aid in the reduction of healthcare cost in your organization without reducing quality of care for the patients. |
3. Differentiate between quality in a free market healthcare system and in single payer government system with three (3) examples for each.
Weight: 15% |
Did not submit or incompletely differentiated between quality in a free market healthcare system and in single payer government system with three (3) examples for each. |
Insufficiently differentiated between quality in a free market healthcare system and in single payer government system with three (3) examples for each. |
Partially differentiated between quality in a free market healthcare system and in single payer government system with three (3) examples for each. |
Satisfactorily differentiated between quality in a free market healthcare system and in single payer government system with three (3) examples for each. |
Thoroughly differentiated between quality in a free market healthcare system and in single payer government system with three (3) examples for each. |
4. Specify three (3) common law quality initiatives that are still found in 21st century healthcare organizations.
Weight: 15% |
Did not submit or incompletely specified three (3) common law quality initiatives that are still found in 21st century healthcare organizations. |
Insufficiently specified three (3) common law quality initiatives that are still found in 21st century healthcare organizations. |
Partially specified three (3) common law quality initiatives that are still found in 21st century healthcare organizations. |
Satisfactorily specified three (3) common law quality initiatives that are still found in 21st century healthcare organizations. |
Thoroughly specified three (3) common law quality initiatives that are still found in 21st century healthcare organizations. |
5. Defend your position on the importance of healthcare quality for your organization. Provide support with at least three (3) examples that illustrate your position.
Weight: 15% |
Did not submit or incompletely defended your position on the importance of healthcare quality for your organization. Did not submit or incompletely provided support with at least three (3) examples that illustrate your position. |
Insufficiently defended your position on the importance of healthcare quality for your organization. Insufficiently provided support with at least three (3) examples that illustrate your position. |
Partially defended your position on the importance of healthcare quality for your organization. Partially provided support with at least three (3) examples that illustrate your position. |
Satisfactorily defended your position on the importance of healthcare quality for your organization. Satisfactorily provided support with at least three (3) examples that illustrate your position. |
Thoroughly defended your position on the importance of healthcare quality for your organization. Thoroughly provided support with at least three (3) examples that illustrate your position. |
6. Assemble a plan to protect patient information that complies with all legal requirements.
Weight: 13% |
Did not submit or incompletely assembled a plan to protect patient information that complies with all legal requirements. |
Insufficiently assembled a plan to protect patient information that complies with all legal requirements. |
Partially assembled a plan to protect patient information that complies with all legal requirements. |
Satisfactorily assembled a plan to protect patient information that complies with all legal requirements. |
Thoroughly assembled a plan to protect patient information that complies with all legal requirements. |
7. Three (3) References
Weight: 5% |
No references provided |
Does not meet the required number of references; all references poor quality choices. |
Does not meet the required number of references; some references poor quality choices. |
Meets number of required references; all references high quality choices. |
Exceeds number of required references; all references high quality choices. |
8. Clarity, writing mechanics, and formatting requirements
Weight: 10% |
More than 8 errors present |
7-8 errors present |
5-6 errors present |
3-4 errors present |
0-2 errors present |
NURS 4220A LC4003A Quality Improvement Processes
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.
Process Description and Core Elements
Six Sigma
PDSA
TQM
CQI
Part 2: Verification of Practice Problem
Collect data on the practice problem that you identified (CAUTI) 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 (CAUTI) at your practice experience facility.
Explain whether the data that you found supports the practice problem (CAUTI) that you identified at your practice experience facility.
If the data shows that the selected practice problem (CAUTI) 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, develop a new practice problem that is supported by the data.
Part 3: Quality Improvement Processes
Explain how the information that you found about CAUTI might be addressed by a quality improvement process.
Review the information about the Plan-Do-Study-Act (PDSA) process. Explain how you would apply this process to CAUTI to determine potential solutions to the practice problem.
Describe the measures that should be analyzed after the intervention is applied to determine its success.
NURS 4220A LC4004A Quality Improvement Tools
Have you ever seen one of the quality improvement tools (i.e., Fishbone Diagram, Pareto Chart, or Run Chart) used in practice? How was it used? What data was being depicted? Please describe an additional quality tool that could have been used in the situation?
If you have not had any experience with the quality tools please describe in detail one tool and how the tool could be used in your practice setting. Please support your statements with evidence from the learning resources.
Evidence from scholarly literature
Prompts:
Analyze the fishbone diagram. Explain how the information presented in the fishbone diagram might be used to help inform nursing practice when preventing medication errors. Analyze the Pareto chart Include an explanation of how many medication errors there were and how this information might assist the nursing unit in preventing future medication errors. Analyze the process flow chart. Explain how this information might be used to help inform nursing practice for the prevention of future medication errors
Module 1: Fishbone Diagram
Analyze the fishbone diagram
Analyze the use of fishbone diagrams in preventing medication errors.
Explain how the information presented in the fishbone diagram might be used to help inform nursing practice when preventing medication errors.
Module 2: Pareto Chart
Analyze the Pareto chart
Explain medication error prevention information based on a Pareto chart.
Include an explanation of how many medication errors there were and how this information might assist the nursing unit in preventing future medication errors.
Module 4: Process Flow Chart.
Analyze the process flow chart.
Explain the use of process flow charts in preventing medication errors.
Explain how this information might be used to help inform nursing practice for the prevention of future medication errors
Module 4: Run Chart
Analyze the run chart as it relates to patient satisfaction with pain management.
Explain whether the data in the run chart indicates improved or decreased satisfaction with pain management.
Defend your reasoning for whether the run chart indicates improved or decreased satisfaction with pain management.
Consider the practice problem that you identified in LC4002A and either revised or affirmed in LC4003A.
Choose a fishbone diagram, Pareto chart, process flow chart, or run chart, and apply it to the data relating to the practice problem (that you located in LC4002A).
NURS 4220 Walden University Wk 4 Quality Care & RCA Team Discussions Replies
Description
Diana Johnston
RE: Discussion – Week 4
COLLAPSE
NURS 4220 Week 4 Discussion Initial Post Johnston, D.
The composition of the RCA team consists of a staff nurse, pharmacy technician, and the risk manager to bring together the current focus to assist in medication errors that have taken place for the eighth time within the month. Nursing can bring forth the current challenges that could have contributed to the errors, the pharmacy can bring their expertise to their role in the process of medication administration, and lastly, the risk manager assisting in providing support to both areas to review the facts within the errors and assist in the development of using the Pareto chart for problem-solving (Yoder-Wise, 2019).
Both nursing and pharmacy came to recognize that no one is to blame, instead, a strong commitment to work through the current details that created the errors. Staffing shortages were part of the initial discussion as real challenges for both nursing and pharmacy, but the risk manager wanted to first look at the current events around the medication errors. Nursing started strong with directing blame to the pharmacy, but then took responsibility for not shifting blame as they work to problem-solve together.
All of the possible root causes were pulled from event reports for medication errors that included the reason for the error. There is a list of 12 most common medication errors and of the 12, there were only 7 that resulted from the event reporting. Interestingly enough, staffing was not one of them. The highest of contributing errors 102 was from defective scanning, 60 from look-alike medication labeling, and 60 from pharmacy/tech stress errors. The inability to communicate with the pharmacy resulted in 15 errors. Nursing had a total of 15 errors that were due to unfamiliarity with medication names and five rights.
The nursing staff can provide a review for the 5 rights for safe medication administration and laminate the 5 rights to each of the workstations on wheels to assist with an easy reference tool for medication administration. With the partnership with the pharmacy, providing the brand and generic name for a drug could assist with unfamiliarity with medication names. When it comes to the support needed from Pharmacy, providing a list of those medications that are not scanning and look-alike medications could reveal trends. It provides a starting point to work from for improvements. One of the more concerning root causes was the 60 errors occurring from pharmacy/tech stress errors.
This would require a deeper dive into those errors to determine if it is a trend with employees, certain times of day, or related to staffing, doing more with less resulting in errors. Starting with a philosophy of a “Just Culture” provides direction that education is first and foremost to provide support to the daily practice (Boysen, 2013). A “Just Culture” suggests that one can learn and grow instead of a culture of penalty or punishment.
References
Boysen P. G., 2nd (2013). Just culture: a foundation for balanced accountability and patient safety. The
Ochsner Journal, 13(3), 400–406.
Spath, P. (2018). Introduction to healthcare quality management (3rd ed.). Chicago, IL: Health
Administration Press.
Yoder-Wise, P.S. (2019). Leading and managing in nursing (7th ed.). St. Louis, MO: Mosby
Chapter 18, “Leading Change” (pp. 319-335).
NURS 4220 Week 4 Initial Discussion post Johnston D.docx (16.055 KB)
Paula Miller
RE: Discussion – Week 4
COLLAPSE
A sentinel event occurred at Downtown Medical as a result of a medication error. A root cause analysis (RCA) team has been assembled consisting of a risk manager, a full-time staff nurse who had the medication error, and a full-time pharmacy technician to determine the medication error (Laureate, 2016b). The risk manager’s role is to motivate the staff nurse and pharmacy tech to contribute their experience and expertise to the processes of discovering the RCA (Spath, 2018). The risk manager re-focused the meeting when staff started to blame each other. She stated the importance of fixing the medication error with an open mind for patient safety. Teamwork is vital to identify all parties’ goals and needs to be involved in producing strategies and outcomes beneficial to the problem under discussion (Yoder-Wise, 2015).
The RCA team began its improvement process by creating a flowchart to establish the steps of administering the medication. Flowcharts allow teams to see the workings of the current process and help the members determine where improvements can be made (Spath, 2018). After the flowcharts were completed, the RCA team members formed a cause and effect diagram to identify why medication errors occurred after CPOE and NDMR processes were implemented. Once the fishbone diagram was complete, and the major causes and subfactors were determined, the RCA team members collected data of medication errors over the last year and constructed a Pareto chart based on the issues identified. Pareto charts help the RCA team to focus on inputs that will have the most significant impact, display data so that it is simple and visually appealing in order of importance, and provides an easy way to compare before and after data to confirm that changes in the process created the desired result (Chartier et al., 2018). The three major causes of medication error were scanner glitches, lack of education regarding generic vs. trade names of medications, and pharmacy technician errors related to stress and burnout. A Pareto chart sorts data from the most frequent to less frequent and places focus on the “vital few” causes an issue that affects eight percent of performance (Spath, 2018).
Identifying these three contributing factors are essential and necessary steps to develop a resolution o eliminate medication errors. Scanners should be repaired or replaced immediately. While nursing staff should always follow the five rights of medication administration. To prevent errors from occurring in the future, the team members need to develop a process improvement plan using a method such as Plan-Do-Study-Act (PDSA) or another model that suits their needs. The team needs to work towards a goal. A team with positive group dynamics tend to trust each other, focus on the issues for improvement, and hold each other accountable to provide quality care and prevent future errors.
References
Chartier, L. B., Cheng, A. H., Stang, A. S., & Vaillancourt, S. (2018). Quality improvement primer part 1: preparing for a quality improvement project in the emergency department. Canadian Journal of Emergency Medicine, 20(1), 104-111.
Laureate Education (Producer). (2016b) RCA dramatization 1 [Video File]. Baltimore, MD: Author.
Spath, P. (2018). Introduction of healthcare quality management (3rd ed.). Chicago, IL: Health Administration Press.
Yoder-Wise, P.S. (2015). Leading and managing in nursing (6th ed.) St. Louis, MO: Mosby
Practice Experience
Sohilla Ahmadi
RE: Pointers for Week 4
COLLAPSE
Quality care is at the heart of every healthcare worker in any capacity. As patients visits the healthcare facility, they are entitled to receive a proper service which is safe and less life threatening.as well timely. With expectations, nurses and other health workers need to ensure patients safety hospital related infections such CLASBI. Central line- associated bloodstream infection is a major safety concern to every healthcare as it accounts for more death of patients across the globe. Central line-associated bloodstream infection occurs when germs enters the patients’ bloodstream through the central line which later results in a bloodstream infection (Lozano, R. 2020).
In order to improve patient’s safety and improved practice towards minimizing the rate of the infection, there are key measures that needs to implemented in order to achieve the desired outcome towards the infection. The proposed action steps and techniques include; education of the staff about CLASBI rates. In a resource poor environment, the education is of key importance in reducing the rate of CLABSI in hospitals. Basic education concerning the entire phenomena of the infection needs to be made clear to understand the measures needed to reduce the rate of the infection as well as understand the role they play as health care workers in prevention and reduction of the infection.
Another action step in achieving improved practice towards reduction of the rate of infection, involves the enhancement of proper hygiene. Hand hygiene is considered to be the major contributor to the high rates of the infection among the patients majorly in intensive care unit. Maintaining a proper hand hygiene before and after catheter insertion. Also hand hygiene needs to be observed during the dressing of the area used as insertion site of the catheter. Lastly the palpation of the insertion site should be done after the application of the antiseptic or unless otherwise the antiseptic measures and techniques are maintained in order to prevent the occurrence of the infection. Another technique is the application of the antiseptic in the dressing and cleaning of the catheter.
The measures discuss above are faced with many challenges resulting from the cost of the implementation of the measure and also the unwillingness of the health workers to cooperate. For instance, the education of the heath care workers is expensive as well as the purchase of hygienic substances such as antiseptics. Also the implementation of the measures calls for extra personnel in the hospital which is costly.
Reference:
Lozano, R. J. (2020). Psychological Impact of Restraint Practices on Mental Health Technicians in Inpatient Psychiatric Facilities (Doctoral dissertation, Alliant International University).
REPLY QUOTE EMAIL AUTHOR
Paula Miller
RE: Group B Practice Experience Discussion – Week 4
COLLAPSE
A fall prevention project is currently underway at a mental health facility. The project’s mission is to strive for excellence in confronting frequent fall incidents among admitted patients and prevent negative physical and psychological consequences such as fractures, pain, infection, and depression. The quality improvement plan consists of a complicated process, including conducting a root cause analysis in post-fall huddles. The proposed action steps for implementing an improved practice by preventing falls on the mental health units may be a challenge, and there may be impediments in implementing a quality improvement plan.
The nursing staff assumes a vital role in fall prevention. Although continuing education is vital for all professionals, it is equally important that nurses provide patients with detailed information about preventative measures related to falls. A primary concern in the mental health unit is inadequate staff engagement in fall prevention. According to one article, it is crucial to educate everyone involved in the patient’s care, even if it is outside the unit, including teaching families about fall prevention strategies. A team effort and communication appear to be needed to impact fall rates (Howard, 2018). Ongoing, continued education of healthcare workers, patients, and family members has been one measure shown by evidence -based practice that decreases falls within a mental health facility. Staff can learn fall prevention strategies through monthly required e-learning education.
Patient rounding is one of the most critical actions health care workers can take to improve patient safety and reduce falls up to 50% (Hicks, 2015). It would be feasible for nursing management to redesign the nursing workload to increase direct patient care contact opportunities. Intentional rounding on every patient, including assessing for falls, identifying environment safety concerns, and attending to patient needs, will increase patient satisfaction and decrease falls (Sun et al., 2020). It has been observed that unlicensed team members do not always perform rounding duties every fifteen minutes as directed—the checklist states where the patient is located and if they are involved in activity or sleeping. Nurses would need a decrease in workloads to monitor patients and direct patient care. Redundant charting is time-consuming. An intervention of modifying and condensing electronic patient records would allow nurses more time on the floors.
Possible difficulties that can compromise these proposed improvements are the compliance of the healthcare providers. Some team members do not like change, getting them to abide by new implementations can be challenging. Some nurses may take shortcuts to save time by not providing detailed information on preventing falls. Staff members may skip a rounding responsibility and initial that the rounding was completed. The project outcome’s success will depend on the team’s ability to address patient falls systematically and largely depend on the cooperation of team members and the department’s organization in implementing change. The project cannot be solved individually and would need a project improvement team that is coordinated by the efforts of different professionals with varying knowledge, skills, and perspectives (Spath, 2018).The resources needed to implement change are managerial support, educational material, incentives, and new computer programming. These interventions are cost-effective and less expensive than the cost involved with patient falls. Less charting for nurses will provide more patient care and fewer falls. Incentives such as pizza parties monthly or quarterly celebrates reduced falls within the facility. It is believed these interventions are the first steps and will positively impact the facility in decreasing patient falls.
References
Hicks, D. (2015). Can rounding reduce patient falls in acute care? An integrative literature review. Medsurg Nursing, 24(1), 51.
Howard, K. (2018). Improving Fall Rates Using Bedside Debriefings and Reflective Emails: One Unit’s Success Story. MEDSURG Nursing, 27(6), 388–391.Retrieved from: https://eds-a-ebscohost-com.ezp.waldenulibrary.org/eds/pdfviewer/pdfviewer?vid=9&sid=13ae39e9-09aa-483d-a6ba-415c281e70ae%40sessionmgr4007
Spath, P. (2018). Introduction of healthcare quality management (3rd ed.). Chicago, IL: Health Administration Press.
Sun, C., Fu, C. J., OʼBrien, J., Cato, K. D., Stoerger, L., & Levin, A. (2020). Exploring practices of bedside shift report and hourly rounding. Is there an impact on patient falls? The Journal of Nursing Administration, 50(6), 355–362. https://doi-org.ezp.waldenulibrary.org/10.1097/NNA…
NURS 4220 Week 4 Discussion Instructions
Review the case scenario included in this week’s media resources, and examine the process flow chart, cause/effect diagram, and Pareto chart related to the case scenario.
In the scenario, the nurse manager and the director of pharmacy blame each other for the error. The facilitator (quality assurance person) asks everyone to avoid blaming and focus on applying the tools to analyze the data and get to the root cause of the error. While all of these tools contribute, for this Discussion, select one tool to analyze.
Post each of the following:
- Analyze the composition of the RCA team. Explain what knowledge they can contribute to the RCA.
- Describe the collaboration in the case study that led to effective problem solving. Identify the evidence you observe in the scenario that demonstrates effective collaboration and the avoidance of blaming.
- Explain the team’s process in testing for and eliminating root causes that were not contributing.
- Select one of the performance improvement charts presented in the scenario and critique its effectiveness by explaining how it contributes to identifying the root cause and determining a solution to prevent repeat medication errors.
- Identify the contributing factors and discuss how to prevent this kind of error from occurring in the future.
NURS 4220A LC4005A Improving Patient Quality and Safety Assessment
LC4005A Assessment Instructions
Review the details of your assessment including the rubric. You will have the ability to submit the assessment once you submit your required self-assessments and engage with your Faculty Subject Matter Expert (SME) in a substantive way about the competency.
Overview
In this Assessment, you will complete a comprehensive paper and develop a quality improvement storyboard for your Quality Improvement Project. You will also submit a completed practice experience documentation form signed by the health professionals who collaborated with you in developing the Quality Improvement Project. LC4005A Improving Patient Quality and Safety Assessment
Submission Length: 4- to 5-page comprehensive paper and a quality improvement storyboard, and a completed practice experience documentation form.
Instructions
To complete this Assessment, do the following:
- Be sure to adhere to the indicated assignment length.
- Access the following:
- Review the following website regarding the use of a quality improvement storyboard and provide examples of the information and interventions that need to be included in a storyboard: Multi-State Learning Collaborative. (n.d.). Guidelines for the development of quality improvement storyboards.
- Your deliverables for this Assessment include:
- Part 1. Comprehensive Paper
- Part 2. Storyboard
- Part 3. Practice Experience Documentation Form
Before submitting your Assessment, carefully review the rubric. This is the same rubric the SME will use to evaluate your submission and it provides detailed criteria describing how to achieve or master the Competency. Many students find that understanding the requirements of the Assessment and the rubric criteria help them direct their focus and use their time most productively.
Rubric
All submissions must follow the conventions of scholarly writing. Properly formatted APA citations and references must be provided where appropriate. Submissions that do not meet these expectations will be returned without scoring.
This Assessment requires submission of three files. Save your first file as LC4005A_firstinitial_lastname_part1 (for example, LC4005A_J_Smith_part1); save your second file as LC4005A_firstinitial_lastname_part2 (for example, LC4005A_J_Smith_part2); save your third file as LC4005A_firstinitlal_lastname_part3 (for example, LC4005A_J_Smith_part3)..
You may submit a draft of your assignment to the area to check for authenticity. When you are ready to upload your completed Assessment, use the Assessment tab on the top navigation menu.
Important Note: As a student taking this Competency, you agree that you may be required to submit your Assessment for textual similarity review to Turnitin.com for the detection of plagiarism. All submitted Assessment materials will be included as source documents in the Turnitin.com reference database solely for the purpose of detecting plagiarism of such materials. Use of the Turnitin.com service is subject to the Usage Policy posted on the Turnitin.com site.
Click each of the items below for more information on this Assessment.
Your Comprehensive Paper provides the theoretical background to support your quality improvement practice problem and Quality Improvement Project. Many of the elements of this paper are parts of your Competency Assessments from previous competencies in this area of expertise. In a 4- to 5-page paper, address the following:
- Describe the data-driven quality improvement practice problem you identified. (Use your submission and the SME feedback from LC4001A and LC4002A to help complete this section.)
- Explain the importance of the quality improvement practice problem you identified for nursing practice. Support your explanation by synthesizing evidence-based literature found through a literature search, using a minimum of five (5) scholarly sources. (Use your submission and the SME feedback from LC4002A to complete this section)
- Describe the quality improvement tools that will aid in the interpretation of the data that will support addressing the quality improvement practice problem you identified. (Use your submission and the SME feedback from LC4003A and LC4004A to help complete this section.)
- Explain why these quality improvement tools are most useful in addressing your quality improvement practice problem. (Use your submission and the SME feedback from LC4004A to help complete this section.) LC4005A Improving Patient Quality and Safety Assessment
- Explain how you would apply the PDSA quality improvement process to your quality improvement practice problem. Support your plan by synthesizing a minimum of five (5) pieces of scholarly evidence found through a literature search. (Use your submission and the SME feedback from LC4003A to help complete this section.)
Be sure to integrate capstone-level writing guidelines in the completion of your Comprehensive Paper. This is an expectation of the completion of this program and is a requirement for future study in graduate school.
A quality improvement storyboard is required for this Competency. The Practice Experience Project Storyboard is a brief, visual summary of a completed Quality Improvement initiative. The storyboard highlights key aspects of a quality improvement effort by documenting the Practice Experience Project from beginning to end. Note that you do not have to develop different information. You are presenting the same information that you wrote about in your paper. The Competency template uses a PowerPoint format to complete this assignment. The first slide is the summary of the Quality Improvement Project; the second slide is the reference page. Choose the most pertinent information from your Comprehensive Paper to complete the Storyboard. A template is provided to guide you as you develop your storyboard.
Your Practice Experience Documentation Form should be completed and signed by your mentor. In order to successfully complete this element, your mentor must indicate that you participated sufficiently in the practice experience.
Resources – LC4005A Improving Patient Quality and Safety Assessment
Chapter 20, “Managing Costs and Budgets” (pp. 358–376) Chapter 23, “Managing Quality and Risk” (pp. 407–427) Yoder-Wise, P. (2019). Leading and managing in nursing (7th ed.). Mosby Elsevier.
Chapter 10, “Managing Use of Health Care Resources” (pp. 249–280) Spath, P. (2018). Introduction to healthcare quality management (3rd ed.). Health Administration Press.
Melnyk, B. M. (2016). Improving healthcare quality, patient outcomes, and costs with evidence-based practice. https://nursingcentered.sigmanursing.org/features/more-features/Vol42_3_improving-healthcare-quality-patient-outcomes-and-costs-with-evidence-based-practice
Tschannen, D., Aebersold, M., Kocan, M. J., Lundy, F., & Potempa, K. (2015). Improving patient care through student leadership in team quality improvement projects. Journal of Nursing Care Quality, 30(2), 181–186. doi:10.1097/NCQ.0000000000000080
Minnesota Department of Health. (n.d.). Quality improvement storyboard. https://www.health.state.mn.us/communities/practice/resources/phqitoolbox/qistoryboard.html
Chapter 6, “Performance Improvement Tools: Quality Storyboards” (pp. 169–170) Spath, P. (2018). Introduction to healthcare quality management (3rd ed.). Health Administration Press.
LC4005: Improving Patient Quality and Safety: Apply quality improvement processes and tools as a scholar- practitioner to improve patient outcomes. Assessment Rubric
Rubric Criteria |
Does Not Meet Expectations |
Meets Expectations |
Exceeds Expectations |
Module 1: Applying Quality Improvement Processes to Practice |
Describe the data- driven quality improvement practice problem you identified. |
Response does not adequately describe the data-driven quality improvement practice problem that you identified. LC4005A Improving Patient Quality and Safety Assessment |
Response adequately describes the data-driven quality improvement practice problem that you identified. |
Response clearly and completely describes the data-driven quality improvement practice problem that you identified. |
Learning Objective 1.1: Describe data-driven quality improvement practice problems |
|
|
|
Explain the importance of the quality improvement practice problem you identified for nursing practice. |
Response does not adequately explain the importance of the quality improvement practice problem you identified for nursing practice. |
Response adequately explains the importance of the quality improvement practice problem you identified for nursing practice. |
Response clearly and completely explains the importance of the quality improvement practice problem you identified for nursing practice. |
Learning Objective 1.2: Explain the importance of quality improvement practice problems in nursing practice |
|
|
|
Support your |
Response does not |
Response adequately |
Response clearly and |
explanation by |
adequately support your |
supports your explanation |
completely supports your |
synthesizing evidence- |
explanation by |
by synthesizing evidence- |
explanation by |
based literature found |
synthesizing evidence- |
based literature found |
synthesizing evidence- |
Rubric Criteria |
Does Not Meet Expectations |
Meets Expectations |
Exceeds Expectations |
through a literature search, using a minimum of five (5) scholarly sources.
Learning Objective 1.3: Synthesize scholarly evidence |
based literature found through a literature search or does not use a minimum of 5 scholarly sources. |
through a literature search, using a minimum of 5 scholarly sources. LC4005A Improving Patient Quality and Safety Assessment |
based literature found through a literature search, using a minimum of 5 scholarly sources. |
Describe the quality improvement tools that will aid in the interpretation of the data that will support addressing the quality improvement practice problem you identified.
Learning Objective 1.4: Describe quality improvement tools used to interpret data related to quality improvement practice problems |
Response does not adequately describe the quality improvement tools that will aid in the interpretation of the data that will sill support addressing the quality improvement practice problem you identified. |
Response adequately describes the quality improvement tools that will aid in the interpretation of the data that will sill support addressing the quality improvement practice problem you identified. |
Response clearly and completely describes the quality improvement tools that will aid in the interpretation of the data that will sill support addressing the quality improvement practice problem you identified. |
Explain why these quality improvement tools are most useful in addressing your quality improvement practice problem. |
Response does not adequately explain why these quality improvement tools are most useful in addressing your quality improvement practice problem. |
Response adequately explains why these quality improvement tools are most useful in addressing your quality improvement practice problem. |
Response clearly and completely explains why these quality improvement tools are most useful in addressing your quality improvement practice problem. |
Rubric Criteria |
Does Not Meet Expectations |
Meets Expectations |
Exceeds Expectations |
Learning Objective 1.5: Justify the use of quality improvement tools to address quality improvement practice problems |
|
|
|
Explain how you would apply the PDSA quality improvement process to your quality improvement practice problem.
Learning Objective 1.6: Apply quality improvement processes to quality improvement practice problems |
Response does not adequately explain how you would apply a quality improvement process to your quality improvement practice problem. |
Response adequately explains how you would apply a quality improvement process to your quality improvement practice problem. |
Response clearly and completely explains how you would apply a quality improvement process to your quality improvement practice problem. |
Support your plan by synthesizing a minimum of five (5) pieces of scholarly evidence found through a literature search.
Learning Objective 1.7: Synthesize scholarly evidence relating to quality improvement plans |
Response does not adequately support your plan by synthesizing a minimum of 5 pieces of scholarly evidence found through a literature search. |
Response adequately supports your plan by synthesizing a minimum of 5 pieces of scholarly evidence found through a literature search. |
Response clearly and completely supports your plan by synthesizing a minimum of 5 pieces of scholarly evidence found through a literature search. |
Rubric Criteria |
Does Not Meet Expectations |
Meets Expectations |
Exceeds Expectations |
Module 2: Developing a Storyboard |
Create a storyboard for your quality improvement practice problem.
Learning Objective 2.1: Create storyboards to display plans for quality improvement practice problems |
Response does not adequately create a storyboard for your quality improvement practice problem. LC4005A Improving Patient Quality and Safety Assessment |
Response adequately creates a storyboard for your quality improvement practice problem. |
Response creatively, thoughtfully, and completely creates a storyboard for your quality improvement practice problem. |
Complete Practice Experience Documentation Form.
Learning Objective 2.2: Justify successful practice experience through
documentation form |
Practice Experience Documentation Form is not signed and complete, or affirmative participation is not indicated. |
Practice Experience Documentation Form is signed and complete, and affirmative participation is adequately indicated. |
Practice Experience Documentation Form is signed and completed, and affirmative participation is exceeded as indicated by the mentor. |
Professional Skills Assessment
Professional Writing |
Professional Writing: |
Content contains significant |
Content contains few |
Content is free from |
Clarity, Flow, and |
spelling, punctuation, and/or |
spelling, punctuation, |
spelling, punctuation, and |
Organization |
grammar/syntax errors. |
and/or grammar/syntax |
grammar/syntax errors. |
|
Writing does not |
errors. Writing |
Writing demonstrates |
|
demonstrate adequate |
demonstrates adequate |
appropriate sentence and |
|
sentence and paragraph |
sentence and paragraph |
paragraph structure. |
|
structure and requires |
structure and may require |
Content presented is clear, |
|
additional |
some editing. Content |
logical, and well-organized. |
|
editing/proofreading. Key |
presented is satisfactorily |
|
|
sections of presented |
clear, logical, and/or |
|
|
content lack clarity, logical flow, and/or organization. |
organized, but could benefit from additional editing/revision. |
|
Professional Writing: Context, Audience, Purpose, and Tone |
Content minimally or does not demonstrate awareness of context, audience, and/or purpose. Writing is not reflective of professional/scholarly tone and/or is not free of bias.
Style is inconsistent with the professional setting/workplace context and reflects the need for additional editing. |
Content demonstrates satisfactory awareness of context, audience, and purpose. Tone is adequately professional, scholarly, and/or free from bias, and style is mostly consistent with the professional setting/workplace context. LC4005A Improving Patient Quality and Safety Assessment |
Content clearly demonstrates awareness of context, audience, and purpose. Tone is highly professional, scholarly, and free from bias, and style is appropriate for the professional setting/workplace context. |
Professional Writing: Originality, Source Credibility, and Attribution of Ideas |
Content does not adequately reflect original writing and/or paraphrasing. Writing demonstrates inconsistent adherence to reference requirements, including the use of credible evidence to support a claim, with appropriate source attribution (when applicable) and reference. There are numerous and/or significant errors. |
Content adequately reflects original writing and paraphrasing. Writing demonstrates adequate adherence to reference requirements, including the use of credible evidence to support a claim, with appropriate source attribution (when applicable) and references. There are one or two minor errors. |
Content reflects original thought and writing and proper paraphrasing.
Writing demonstrates full adherence to reference requirements, including the use of credible evidence to support a claim, with appropriate source attribution (when applicable) and references. |
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