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NUR-550 Topic 5 DQ 2 Identify a quality initiative from your workplace
Sample Answer for NUR-550 Topic 5 DQ 2 Identify a quality initiative from your workplace Included After Question
NUR-550 Topic 5 DQ 2 Identify a quality initiative from your workplace
Topic 5 DQ 2
Jan 5-9, 2023
Identify a quality initiative from your workplace. What were some barriers to implementation? What are common barriers for translating research into practice?
REPLY TO DISCUSSION
HK
Heather Kennedy
Jan 8, 2023, 2:53 PM(edited)
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Optional assignment for participation credit. Watch the 3 minute video on a QI initiative at Saratoga Hospital. The video discusses how they implemented technology to better take care of patients.
Do you have an experience working with the Phillips Guardian System they discuss here? Does your facility have something similar or another QI initiative they employ for intervening on patients early?
Philips Healthcare (2017, September 19). Quality improvement in nursing at Saratoga Hospital: A Philips customer story [Video]. https://www.youtube.com/watch?v=7WnYpBMHtQk
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SF
Jan 9, 2023, 11:53 AM
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A Sample Answer For the Assignment: NUR-550 Topic 5 DQ 2 Identify a quality initiative from your workplace
Title: NUR-550 Topic 5 DQ 2 Identify a quality initiative from your workplace
While I do not have experience working with the Philips Guardian system described in the video, I think it is a great use of technology in hospitals. This system detects trends in patients and whether they are trending downwards/abnormally (Philips Healthcare, 2017). By detecting and alerting nurses to abnormal trends earlier, there is more time for interventions before a patient spirals or codes (Philips Healthcare, 2017).
At the inpatient psychiatric facility I worked at we did not use an early detection system like this. Our electronic health system was very basic and also did not connect to the vital machines the facility used. Therefore, BHTs and RNs would have to manually check patient vitals everyday and RNs would have to manually input them into the electronic system. However, sometimes nurses forgot to input the vitals into the system or patients refused to get up for vitals, making it difficult to track trends overtime and determine if there was a need for medical intervention. I think that all hospitals should utilize an early detection system like the one in this video because it helps nurses prioritize the needs of their patients and also improves patient outcomes.
Reference NUR-550 Topic 5 DQ 2 Identify a quality initiative from your workplace
Philips Healthcare (2017, September 19). Quality improvement in nursing at Saratoga Hospital: A Philips customer story [Video]. https://www.youtube.com/watch?v=7WnYpBMHtQk
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LG
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This Guardian monitoring system is wonderful. My post for this DQ was posing the need for something exactly like this, frequent monitoring affords early intervention. Unfortunately, our facility does not have anything like this monitoring system. Our electronic health system is MatrixCare and we are able to see a facility report, progress notes, vital signs, etc. but they are not readily available like the Guardian. Having this technology in our facility would be extremely beneficial, until that time this has encouraged me to do vitals and other monitoring tasks earlier in my shift and keep the information on my clipboard. In the skilled care setting we see a huge number of infections, especially UTIs, and early intervention is key.
Philips Healthcare (2017, September 19). Quality improvement in nursing at Saratoga Hospital: A Philips customer story [Video]. https://www.youtube.com/watch?v=7WnYpBMHtQk
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Tuova Williams
replied toHeather Kennedy
Jan 11, 2023, 2:42 AM
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I am really impressed with the Philips Guardian system. I do not have any experience with using the system or a system like it, but I can immediately think of multiple instances where the system would be useful in my current place of employment. For example, it would be extremely useful to help alert nursing and medical staff of head and neck cancer patients whose weight is trending negatively and allow early intervention.
I do, however, have some concerns about medical staff becoming too dependent on technology and allowing it to take the place of through physical examination (Dempsy Kingsland Osteen, 2018). Overdependence on technology is a real threat as technology becomes more intertwined in the assessment process.
Refrence:NUR-550 Topic 5 DQ 2 Identify a quality initiative from your workplace
Dempsy Kingsland Osteen. (2018). Doctors: Too dependent on medical technology? https://www.dko-law.com/blog/doctors-too-dependent-on-medical-technology/
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HK
Heather Kennedy
replied toTuova Williams
Jan 11, 2023, 9:49 AM
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Yes, good point. I also think the alarms may become distracting especially in a high-stress environment like the NICU.
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EP
Jan 11, 2023, 4:40 PM
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I don’t have any experience with the Phillips Guardian System however, at my hospital we use a similar system to trend abnormalities. On the unit where I work, we trend Sepsis alert. According to Ferguson et al (2019), sepsis is one of the leading causes of mortality and readmission in the hospital. Therefore, early recognition and treatment produces better outcome for the patient. The sepsis alert protocol is a nurse directed standing order that outlines the different treatment modalities to implement if the patient meets certain criteria. During this research it was noted that sepsis-related mortality rate dropped from 12.5% to 8.4% with a mortality reduction of 4.5 deaths per 100 sepsis- related discharges (Ferguson et al, 2019). This was a great improvement. Improved patient outcome produces improved patient satisfaction and improves the overall health of the community.
Reference NUR-550 Topic 5 DQ 2 Identify a quality initiative from your workplace
Ferguson, A., Coates, D. E., Osborn, S., Blackmore, C. C., & Williams, B. (2019). Early, Nurse-Directed Sepsis Care. The American journal of nursing, 119(1), 52–58. https://doi.org/10.1097/01.NAJ.0000552614.89028.d6
Philips Healthcare (2017, September 19). Quality improvement in nursing at Saratoga Hospital: A Philips customer story [Video]. https://www.youtube.com/watch?v=7WnYpBMHtQk
REPLY
AD
Jan 9, 2023, 11:04 PM
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Just this week, in our huddle notes, there is a quality initiative for the emergency room at my workplace. Management wants us to have shift report at the nurse’s station but wants both the night nurse and the day nurse to go around to each patient, to allow all information to be transferred according. What is said during the report needs to match the patient. It is funny because my whole PICOT statement is regarding shift reports moving bedside. The major barrier to this implementation changes. Nurses are stuck in their ways and habits. After I get the shift report, I usually take the next 15 minutes looking through the patient’s chart to get more of a picture of why they are here. Shift reports at the nurse’s station may be sporadic and it is hard to gauge what happened or what brought them in. Because of this, it may take close to 45 minutes before I set foot in the patient’s room and the status of their condition may have changed. Translation research into practice may have barriers due to a lack of evidence. It is well-known the benefits of doing bedside shift report but there is also a lot of complaints…takes longer and there are many factors that contribute to an effective bedside shift report exchange. The barriers would be to limit outside factors that would affect the quality of the report. For example, there should be a standardized report for each patient, allowing the ease of information to flow from one nurse to another nurse.
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JP
Jan 10, 2023, 8:29 PM
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Amber, that is interesting because I know my work is also working on an initiative for bedside report. My unit is an oncology unit and there is often very sensitive information that revolves around the patients prognosis. Because of this we do a modified bedside report and do report right outside of the room and then go into the room together and check lines, introduce oncoming nurse to patient. This way we avoid reminding the patient every 12 hours about their very sensitive condition and this had improved patient satisfaction. BUT as time has gone on sometimes report is not being done like this. things are being missed, patients aren’t being greeted at shift change, etc. So now they are going back to drawing board to change how we do report. I always wondered how report worked in the emergency department since it can be like a
revolving door down there. Thanks for sharing.
REPLY
JP
Jan 9, 2023, 9:33 PM
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A new quality initiative in my workplace in about scanning barcodes on medications, and lab specimens. Although scanning is not a new thing, I guess that the percentage of lab specimen collections and medications that are being scanned is very low. This brings safety concerns. Management noticed this trended and has now identified quality initiatives to improve this to reduce errors and improve patient safety. Scanning patients, medications, and specimens also protects the nurses license to practice. There is a bonus for the nurse with highest scanning percentage on the unit each month, also there is now a informatics nurse that comes around once every shift asking if we need scanning or EMR help. On top of this we are now required to call pharmacy if a barcode is not scanning. We have to then tube the medication down to the pharmacy and fill out paperwork. We are not allowed to give medication that cannot be scanned. Also, when it comes to lab specimens if the patient’s band or sample is not scanned it will be rejected by the laboratory and the specimen will need recollected.
Some barriers I believe to the implementation of medication barcode scanning is if the technology is not working or the barcode is not perfect and not scanning, I do not think it’s okay to delay patient care to fix it. If it is a reasonable timeframe like a quick fix such as pulling a new med from the pyxis or trying a different scanner but having to call to pharmacy and tube down the medication and wait for a response is an unnecessary wait to help a patient control their pain, give insulin, or any other very important time sensitive medication. Also, when it comes to having to recollect a lab specimen this is invasive to the patient, puts them more at risk for being exposed to an infection and should be avoided. Something such as scanning should not cause a patient to go through this again. Especially if the patient is a hard draw. There is obviously evidence that scanning these things helps prevent errors and improves patient safety but there is a line to where a nurse needs to be accountable and have the competence to safely pass a medication without the use of technology. Medication safety is the responsibility of all members of the healthcare team from the nurses to the prescribers, to the pharmacist and medication errors are one of the leading causes of death in hospitalized patients (Naidu & Alicia, 2019). Use of
barcode systems effectively reduce the number of errors with efficient technology and with the appropriate training and support, the healthcare team would be able to adhere to a high standard through the use of technological advancement in healthcare and reduce the number of reported errors (Naidu & Alicia, 2019).
References NUR-550 Topic 5 DQ 2 Identify a quality initiative from your workplace
Naidu, M., & Alicia, Y. L. Y. (2019). Impact of Bar-Code Medication Administration and Electronic Medication Administration Record System in Clinical Practice for an Effective Medication Administration Process. Health, 11(05), 511–526. https://doi.org/10.4236/health.2019.115044
NUR-550 Topic 5 DQ 2 Identify a quality initiative from your workplace Grading Rubric Guidelines
Performance Category | 10 | 9 | 8 | 4 | 0 |
Scholarliness
Demonstrates achievement of scholarly inquiry for professional and academic decisions. |
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Performance Category | 10 | 9 | 8 | 4 | 0 |
Application of Course Knowledge –
Demonstrate the ability to analyze, synthesize, and/or apply principles and concepts learned in the course lesson and outside readings and relate them to real-life professional situations |
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Performance Category | 5 | 4 | 3 | 2 | 0 |
Interactive Dialogue
Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days. (5 points possible per graded thread) |
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Summarizes what was learned from the lesson, readings, and other student posts for the week. |
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Minus 1 Point | Minus 2 Point | Minus 3 Point | Minus 4 Point | Minus 5 Point | |
Grammar, Syntax, APA
Note: if there are only a few errors in these criteria, please note this for the student in as an area for improvement. If the student does not make the needed corrections in upcoming weeks, then points should be deducted. Points deducted for improper grammar, syntax and APA style of writing. The source of information is the APA Manual 6th Edition |
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0 points lost | -5 points lost | ||||
Total Participation Requirements
per discussion thread |
The student answers the threaded discussion question or topic on one day and posts a second response on another day. | The student does not meet the minimum requirement of two postings on two different days | |||
Early Participation Requirement
per discussion thread |
The student must provide a substantive answer to the graded discussion question(s) or topic(s), posted by the course instructor (not a response to a peer), by Wednesday, 11:59 p.m. MT of each week. | The student does not meet the requirement of a substantive response to the stated question or topic by Wednesday at 11:59 pm MT. |