NSG 601 Quality Healthcare Improvement
NSG 601 Quality Healthcare Improvement
NSG 601 Quality Healthcare Improvement
https://topnursingpapers.com/nsg-601-quality-healthcare-improvement/
Every week, give a response to the questions on the discussion board considering your functions in the future as explained by your program track.
Consider two safety concerns you’ve noticed at work.
Conduct research and outline how you would employ the best evidence to address the issues you have identified.
When developing your discussion and responses, keep human factors, a safety culture, and best practices in mind.
Utilize at least two other sources in addition to the course materials.
Thursday at 11:59 PM EST, the initial post is due, and at least two peer response posts are due Sunday at 11:59 PM EST.
Healthcare safety is a critical aspect of patient care because it involves the promotion of the welfare of patients. It is mainly the responsibility of nurses because they spend the most time with patients. Consequently, it becomes necessary to ensure that there is the advancement of methods to promote patient safety during the care process to improve outcomes. Among some of the most significant healthcare safety issues is the lack of primary nursing care. Another considerable safety issue is misdiagnosis, which can have severe repercussions for patient outcomes.
The lack of primary nursing care can come about because of a variety of circumstances. Among these is a shortage of nurses to such an extent that it becomes tricky to pay constant attention to the patients. For example, it is essential to note that an area that suffers under such circumstances is pressure area care. Some patients are at a high risk of developing pressure sores due to such circumstances as having physical disabilities, which results in a scenario during the inpatient stay and the patient doesn’t have adequate means of communicating with nurses concerning their condition (Li, Li, & Pan, 2021).
It is also pertinent to note that there are instances where nurses lack the equipment needed to turn patients. Therefore, solutions for such issues should include the swift acquisition of turning equipment and special mattresses, allowing for greater efficiency in ensuring the prevention and management of pressure sores (Au et al., 2019). Furthermore, nurses are responsible for keeping a close eye on their patients, especially those with disabilities, to determine what they need during their inpatient stay and make sure there are scheduled follow-ups on patients upon discharge (Li, Li, & Pan, 2021).
Another substantial healthcare safety issue that needs consideration is that of misdiagnosis. Nurses should try to make sure that patients are correctly diagnosed. Misdiagnosis tends to come about because of difficulties in communication with patients, especially those who speak different languages or come from different cultures. Also, there are instances when those with learning disabilities can also be negatively affected through misdiagnosis (Abimanyi-Ochom et al, 2019). Misdiagnosis can lead to scenarios ranging from no harm and misinterpreting to severe harm or death of a patient. It is therefore essential for hospital staff to ensure that they communicate with patients and caregivers as a means of gaining background information on patients while at the same time assessing without presumption. This process is critical in ensuring that there is the promotion of an environment within which patient safety is put at the forefront (Abimanyi-Ochom et al, 2019).
NSG 601 Quality Healthcare Improvement states that the significance of avoiding misdiagnosis is essential to ensure that healthcare safety protocols are observed. It allows for the development of more effective nursing that allows the nurses involved to develop initiatives to establish reasonable monitoring procedures (Abimanyi-Ochom et al, 2019). Trigger algorithms, such as computer-based and alert systems, have been shown to minimize misdiagnosis and promote diagnostic accuracy. For there to be a high level of success, it is vital to encourage healthcare staff to undertake regular checkups and consult with other practitioners concerning the welfare of patients (Abimanyi-Ochom et al, 2019).
References
Abimanyi-Ochom, J., Bohingamu Mudiyanselage, S., Catchpool, M., Firipis, M., Wanni Arachchige Dona, S., & Watts, J. J. (2019). Strategies to reduce diagnostic errors: a systematic review. BMC medical informatics and decision making, 19(1), 174. https://doi.org/10.1186/s12911-019-0901-1
Au, Y., Holbrook, M., Skeens, A., Painter, J., McBurney, J., Cassata, A., & Wang, S. C. (2019). Improving the quality of pressure ulcer management in a skilled nursing facility. International Wound Journal, 16(2), 550–555. https://doi.org/10.1111/iwj.13112
Li, Q. P., Li, J., & Pan, H. Y. (2021). Effects of Online Home Nursing Care Model Application on Patients with Traumatic Spinal Cord Injury. Risk management and healthcare policy, 14, 1703–1709. https://doi.org/10.2147/RMHP.S301874
I agree that nurses are increasingly placed in danger of work-related injuries due to heavy-lifting. As you mentioned, this has grown worse due to short staffing. Low back pain has been identified to be significantly greater within the nursing profession than compared to persons of the same age group in the general population (Gilchrist & Pokorna, 2021). You identified lack of equipment to assist with lifting and turning, Gilchrist and Pokorna (2021) found that state regulations that focus on organizations providing appropriate mechanical equipment with proper education decreases the incident of work related injuries to healthcare workers. I feel like the key word is providing education on the proper use of such equipment.
Misdiagnosis is prevalent in diverse populations. is an important key to closing the health inequities that exist in diverse populations. As stated in NSG 601 Quality Healthcare Improvement,providing written information in the appropriate language and using hospital verified interpreters are ways to close this gap. The United States healthcare system remains the lowest developed country to provide healthcare that includes recognition and the effect of statuses such as socioeconomic, education, psychosocial, and racial background (Murdaugh et al., 2019).
References:
Gilchrist, A, & Pokorna, A. (20121). Prevalence of musculoskeletal low back pain among registered nurses: Results of an online survey. Journal of Clinical Nursing, 30, 1675-1683. https://doi.org.rivier.idm.oclc.org/10.1111/jocn.15722 (Links to an external site.)
Murdaugh, C. L., Parsons, M. A., & Pender, N. J. (2019). Health promotion in nursing practice (8th ed.). Pearson
Upon reflection of the current state of my unit, a 30 bed cardiac stepdown at Lowell General Hospital, two major safety issues I have identified here are increased falls amongst patients and decreased scanning rate of barcoded medications. Both are the result of a unit culture that is under stress from the current pandemic and short staffing.
According to NSG 601 Quality Healthcare Improvement, patient falls are a very common adverse hospital event. While interventions such as bed alarms, identifying high risk patients through john hopkins, and non-skid socks are implemented in nearly all healthcare facilities, oftentimes falls seem inevitable. My unit is very large and the patients can be pretty acute, combine that with the short staffing we are currently experiencing and you have a recipe for not getting to bed alarms in time. In order to decrease our inpatient falls, we have been attempting to do post fall huddles. During these huddles the nursing staff discusses what may have caused the fall and how we can prevent another one from happening. However, oftentimes not all the staff can make it to the huddle. After researching, it appears that other hospitals have similar issues. Rohm et al. (2021), found that when attempting interdisciplinary huddles after a fall, only ~68% of staff members were able to be present due to patient volume and acuity, both of which are issues we have been combating on our unit. While we should still perform the post fall safety huddles to promote a culture of safety, the conversation should not stop there – where only a few of the on shift staff are present. After each fall we should send out a unit wide email discussing the event. Human error is inevitable and therefore we should focus more on getting to the root cause of why each fall is occurring. We need to make nurses/ PCTs comfortable being honest with one another regarding things such as forgetting to alarm the patient, leaving the patient in the bathroom to answer another call light etc. If we begin being honest and sending out this information to all staff we can target these issues and prevent future falls.
Medication barcode scanning ensures that there is an extra step between the nurse pulling medication from the med room and administering it to the patient. While technology cannot always be completely reliable, this extra check ensures that the patient is getting the proper medication. Without these checks it is much easier for a medication error to occur. The medication barcode scanning rate on our unit has been declining since the beginning of the COVID-19 pandemic. according to NSG 601 Quality Healthcare Improvement, during this time, nurses began running medications to their peers who were hanging out of the door frames of covid rooms. It started with tylenol, zofran etc. but eventually we became almost completely desensitized to removing this added medication check during medication administration. A recent report from our unit manager indicated that our scanning rates are hanging out around the high 80s%. Her method of beginning to show us the data for medication scanning rates is actually in line with what current research suggests as a solution to this safety issue. In a recent study utilizing PDSA cycles and focusing on creating a culture of safety, researchers held meetings with a team of unit pharmacists, nurse managers and staff RNs to come up with ways to combat their low scanning rates (Ho & Burger, 2020). Through interventions including pharmacy staff fixing barcodes, IT assisting with technicality issues and nurse managers sending out this data in an easy to view visual (graphs/charts) they were able to improve their scanning rate by 14%! In turn, their rate of adverse drug events decreased by 17%. These numbers are astounding and demonstrate the importance of keeping in mind the root cause of a safety issue and targeting that to improve on a quality initiative.
Ho, J. & Burger, D. (2020). Improving medication safety practice at a community hospital: a focus on bar code medication administration scanning and pain reassessment. BMJ Open Quality, 9(3). https://doi-org.rivier.idm.oclc.org/10.1136/bmjoq-2020-000987
Rohm, C. D., Swanson-Biearman, B., Whiteman, K., & Stephens, K. (2020). Interprofessional collaboration to reduce falls in the acute care setting. Medsurg Nursing, 29(5), 303–307. https://search-ebscohost-com.rivier.idm.oclc.org/login.aspx?direct=true&db=c8h&AN=146412755&site=eds-live&scope=site