Assessment 1: Enhancing Quality and Safety

Assessment 1: Enhancing Quality and Safety

Assessment 1: Enhancing Quality and Safety

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• PRINT
• For this assessment, you will develop a 3-5 page paper that examines a safety quality issue pertaining to medication administration in a health care setting. You will analyze the issue and examine potential evidence-based and best-practice solutions from the literature as well as the role of nurses and other stakeholders in addressing the issue.

Health care organizations and professionals strive to create safe environments for patients; however, due to the complexity of the health care system, maintaining safety can be a challenge. Since nurses comprise the largest group of health care professionals, a great deal of responsibility falls in the hands of practicing nurses. Quality improvement (QI) measures and safety improvement plans are effective interventions to reduce medical errors and sentinel events such as medication errors, falls, infections, and deaths. A 2000 Institute of Medicine (IOM) report indicated that almost one million people are harmed annually in the United States, (Kohn et al., 2000) and 210,000–440,000 die as a result of medical errors (Allen, 2013).

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The role of the baccalaureate nurse includes identifying and explaining specific patient risk factors, incorporating evidence-based solutions to improving patient safety and coordinating care. A solid foundation of knowledge and understanding of safety organizations such as Quality and Safety Education for Nurses (QSEN), the Institute of Medicine (IOM), and The Joint Commission and its National Patient Safety Goals (NPSGs) program is vital to practicing nurses with regard to providing and promoting safe and effective patient care.

You are encouraged to complete the Identifying Safety Risks and Solutions activity. This activity offers an opportunity to review a case study and practice identifying safety risks and possible solutions. We have found that learners who complete course activities and review resources are more successful with first submissions. Completing course activities is also a way to demonstrate course engagement.

Demonstration of Proficiency

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

• • Competency 1: Analyze the elements of a successful quality improvement initiative.

• • • Explain evidence-based and best-practice solutions to improve patient safety focusing on medication administration and reducing costs.

• • Competency 2: Analyze factors that lead to patient safety risks.

• • • Explain factors leading to a specific patient-safety risk focusing on medication administration.

• • Competency 4: Explain the nurse’s role in coordinating care to enhance quality and reduce costs.

• • • Explain how nurses can help coordinate care to increase patient safety with medication administration and reduce costs.

• • • Identify stakeholders with whom nurses would need to coordinate to drive quality and safety enhancements with medication administration.

• • Competency 5: Apply professional, scholarly, evidence-based strategies to communicate in a manner that supports safe and effective patient care.

• • • Organize content so ideas flow logically with smooth transitions; contains few errors in grammar or punctuation, word choice, and spelling.

• • • Apply APA formatting to in-text citations and references exhibiting nearly flawless adherence to APA format.

References

Allen, M. (2013). How many die from medical mistakes in U.S. hospitals? Retrieved from https://www.npr.org/sections/health-shots/2013/09/20/224507654/how-many-die-from-medical-mistakes-in-u-s-hospitals.

Kohn, L. T., Corrigan, J., & Donaldson, M. S. (Eds.). (2000). To err is human: Building a safer health system. Washington, DC: National Academy Press.

Professional Context

As a baccalaureate-prepared nurse, you will be responsible for implementing quality improvement (QI) and patient safety measures in health care settings. Effective quality improvement measures result in systemic and organizational changes, ultimately leading to the development of a patient safety culture.

Scenario

Consider a previous experience or hypothetical situation pertaining to medication errors, and consider how the error could have been prevented or alleviated with the use of evidence-based guidelines.

Choose a specific condition of interest surrounding a medication administration safety risk and incorporate evidence-based strategies to support communication and ensure safe and effective care.

For this assessment:

• • Analyze a current issue or experience in clinical practice surrounding a medication administration safety risk and identify a quality improvement (QI) initiative in the health care setting.

Instructions

The purpose of this assessment is to better understand the role of the baccalaureate-prepared nurse in enhancing quality improvement (QI) measures that address a medication administration safety risk. This will be within the specific context of patient safety risks at a health care setting of your choice. You will do this by exploring the professional guidelines and best practices for improving and maintaining patient safety in health care settings from organizations such as QSEN and the IOM. Looking through the lens of these professional best practices to examine the current policies and procedures currently in place at your chosen organization and the impact on safety measures for patients surrounding medication administration, you will consider the role of the nurse in driving quality and safety improvements. You will identify stakeholders in QI improvement and safety measures as well as consider evidence-based strategies to enhance quality of care and promote medication administration safety in the context of your chosen health care setting.

Be sure that your plan addresses the following, which corresponds to the grading criteria in the scoring guide. Please study the scoring guide carefully so that you know what is needed for a distinguished score.

• • Explain factors leading to a specific patient-safety risk focusing on medication administration.
  • Explain evidence-based and best-practice solutions to improve patient safety focusing on medication administration and reducing costs.
  • Explain how nurses can help coordinate care to increase patient safety with medication administration and reduce costs.
  • Identify stakeholders with whom nurses would coordinate to drive safety enhancements with medication administration.
  • Communicate using writing that is clear, logical, and professional, with correct grammar and spelling, using current APA style.

Additional Requirements

• • Length of submission: 3–5 pages, plus title and reference pages.
  • Number of references: Cite a minimum of 4 sources of scholarly or professional evidence that support your findings and considerations. Resources should be no more than 5 years old.
  • APA formatting: References and citations are formatted according to current APA style.

Resources: Collaboration and Leadership

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• PRINT
• Collaboration and Leadership
  • Cho, S. M., & Choi, J. (2018). Patient safety culture associated with patient safety competencies among registered nurses. Journal of Nursing Scholarship, 50(5), 549–557. https://doi-org.library.capella.edu/10.1111/jnu.12413

• • • This article discusses the importance of creating a unit-specific patient safety culture that is tailored to the competencies of the unit’s RNs in patient safety practice.

• • SonÄŸur, C., Özer, O., Gün, C., & Top, M. (2018). Patient safety culture, evidence-based practice and performance in nursing. Systemic Practice and Action Research, 31(4), 359–374.

• • • Evidence-based practice is a problem-solving approach in which the best available and useful evidence is used by integrating research evidence, clinical expertise, and patient values and preferences to improve health outcomes, service quality, patient safety and clinical effectiveness, and employee performance.

• • Stalter, A. M., & Mota, A. (2017). Recommendations for promoting quality and safety in health care systems. The Journal of Continuing Education in Nursing, 48(7), 295–297.

• • • This article provides recommendation to promote quality and safety education with a focus on systems thinking awareness among direct care nurses. A key point is error prevention, which requires a shared effort among all nurses.

• • Manno, M. S. (2016). The role transition characteristics of new registered nurses: A study of work environment influences and individual traits. (Publication No. 10037467) [Doctoral dissertation, Capella University]. http://library.capella.edu/login?qurl=https%3A%2F%2Fwww.proquest.com%2Fdissertations-theses%2Frole-transition-characteristics-new-registered%2Fdocview%2F1775393522%2Fse-2%3Faccountid%3D27965

• • • This research study may be helpful in identifying traits and qualities of new registered nurses that are helpful in coordinating and leading quality and safety measures related to this assessment.

• • Boomah, S. A. (2018). Emergence of informal clinical leadership as a catalyst for improving patient care quality and job satisfaction. Journal of Advanced Nursing. 75(5), 1000–1009. https://doi-org.library.capella.edu/10.1111/jan.13895

• • • This research analyzes attributes and best practices of leadership and nursing staff that help aid in patient care quality and job satisfaction.

• • Greenstein, T. (2020). Leading innovation is completely different from leading change. WWD.com.

• • • This article examines competencies that may help nurses collaborate more effectively to improve patient outcomes.

• • Poder, T. G., & Mattais, S. (2018). Systemic analysis of medication administration omission errors in a tertiary-care hospital in Quebec. Health Information Management Journal, 49(2-3), 99–107.

• • • This examination of underlying systemic causes of medication errors may be useful as you consider QI vest practices and ways to coordinate care to increase safety and quality.

• • Antevy, P. (2017). How care collaboration is improving patient outcomes. EMS World, 46(4), 26–33.

• • • This article examines competencies that may help health care professionals collaborate more effectively to improve patient outcomes.

• • Keers, R. N., Plácido, M., Bennet, K., Clayton, K., Brown, P., & Ashcroft, D. M. (2018, October 26). What causes medication administration errors in a mental health hospital? A qualitative study with nursing staff. PLOS One. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0206233

• • • This examination of underlying systemic causes of medication errors may be useful as you consider QI best practices and ways to coordinate care to increase safety and quality.

Resources: Quality Improvement Initiatives

• PRINT

·         Quality Improvement Initiatives

• Allison, J. (2016). Ideas and approaches for quality-assessment and performance-improvement projects in ambulatory surgery centers. AORN Journal, 103(5), 483–488.
  • This article focuses on approaches and indicators customary to the services and operations of an ambulatory surgery center, going beyond reviewing data from routine outcome measures and explaining the effect these ideas can have on improving quality of care.
• Coles, E., Wells, M., Maxwell, M., Harris, F. M., Anderson, J., Gray, N. M., Milner, G., & MacGillivray, S. (2017). The influence of contextual factors on healthcare quality improvement initiatives: What works, for whom and in what setting? Protocol for a realist review.Systematic Reviews, 6, 168–178. https://systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-017-0566-8
  • This article examines ways in which the context of a quality improvement initiative plays a role in its success or failure and should help you consider the context of your proposed quality improvement initiative.
• Institute for Healthcare Improvement. (n.d.). Reliability series part 1: What is reliability?[Video]. http://www.ihi.org/education/IHIOpenSchool/resources/Pages/Activities/FrankReliability1.aspx
  • This video discusses the relationship between reliability and quality in health care.
• Robinson, J., & Gelling, L. (2019). Nurses+QI=better hospital performance? A critical review of the literature.Nursing Management (Harrow), 26(4), 22–28.
  • Abstract: NHS regulators, such as NHS Improvement and the Care Quality Commission, promote staff involvement in quality improvement (QI), while national nursing leaders and the Nursing and Midwifery Council advocate nurses’ involvement in improving services. This article critically explores the evidence base for a national nursing strategy to involve nurses in QI using a literature review. A thematic analysis shows that nurse involvement in QI has several positive outcomes, which are also included in the NHS Improvement’s Single Oversight Framework for NHS Providers. The article concludes that nurse involvement in QI helps improve hospital performance (Robinson & Gelling, 2019).
• Chen, H., Feng, H., Liao, L., Wu, X., Zhao, Y., Hu, M., Li, H., Hu, H., & Yang, X. (2020). Evaluation of quality improvement intervention with nurse training in nursing homes: A systematic review.Journal of Clinical Nursing, (29)15–16. https://doi-org.library.capella.edu/10.1111/jocn.15289
  • The need for implementing systemic quality improvement practices to improve safety and quality is discussed in this article.

Resources: Quality and Safety Education

• PRINT

·         Quality and Safety Education

• Lyle-Edrosolo, G., & Waxman, K. (2016). Aligning healthcare safety and quality competencies: Quality and safety education for nurses (QSEN), the Joint Commission, and American Nurses Credentialing Center (ANCC) Magnet® standards crosswalk. Nurse Leader, 14(1), 70–75.
  • This article attempts to align the language used in three quality and safety standards and reduce confusion for health care professionals.
• Altmiller, G., & Hopkins-Pepe, L. (2019). Why quality and safety education for nurses (QSEN) matters in practice.The Journal of Continuing Education in Nursing, 50(5), 199–200.
  • This article discusses the needs for quality and safety education in nursing and how the Journal of Continuing Education in Nursing supportsQSEN competency implementation in practice.
• Johnson, L., McNally, S., Meller, N., & Dempsey, J. (2019). The experience of undergraduate nursing students in patient safety education: A qualitative study.Australian Nursing and Midwifery Journal, 26(8), 55.
  • This article discusses educating nursing students about patient safety early within their learning journey and how it has shown to have a compelling positive impact on each individual’s knowledge, skills, and behavior growth surrounding the concept of patient safety.
• Wieke Noviyanti, L., Handiyani, H., & Gayatri, D. (2018). Improving the implementation of patient safety by nursing students using nursing instructors trained in the use of quality circles.BMC Nursing, 17(2).
  • Abstract: It is recognized worldwide that the skills of nursing students concerning patient safety is still not optimal. The role of clinical instructors is to instill in students the importance of patient safety. Therefore, it is important to have competent clinical instructors. Their experience can be enhanced through the application of quality circles. This study identifies the effect of quality circles on improving the safety of patients of nursing students. Patient safety is inseparable from the quality of nursing education. Existing research shows that patient safety should be emphasized at all levels of the healthcare education system. In hospitals, the ratio between nursing students and clinical instructors is disproportionately low. In Indonesia, incident data relating to patient safety involving students is not well documented, and the incidents often occur in the absence of a clinical instructor (Wieke Noviyanti, Handiyani, & Gayatri, 2018).
• Havaei, F., MacPhee, M., & Dahinten, V. S. (2019). The effect of nursing care delivery models on quality and safety outcomes of care: A cross‐sectional survey study of medical‐surgical nurses.Journal of Advanced Nursing, 75(10), 2144–2155.
  • This study examines components of nursing care delivery and the mode of nursing care delivery. This may be helpful in seeing safety and quality education and best practices.
• Health and medicine – quality of care; new findings from Karolinska Institute in the area of quality of care reported (shared responsibility: school nurses’ experience of collaborating in school-based interprofessional teams).(2017, July 21). Health and Medicine Week.
  • This wire feed examines evidence-based and best-practice strategies for improving the care offered by school nurses, may help you identify useful strategies for your assessment.