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Discussion Accountability for Clinical Outcomes

Discussion: Accountability for Clinical Outcomes

Introduction

Throughout your education, patient safety and improving the quality of patient care have been examined. Through numerous readings and media pieces, you have heard about Never Events. These are serious and costly medical errors that are preventable, such as wrong-side surgery, medication errors, and hospital-acquired infections. Each of these types of medical errors is preventable. The consequences of such errors are now financial as well as legal and emotional. The Centers for Medicare & Medicaid Services no longer reimburse for medical errors classified as Never Events.

As a nurse, how can you help to prevent these types of medical errors? What is your accountability for clinical outcomes? There are standards and core measures in place that guide nursing practice. In addition, the National Database of Nursing Quality Indicators (NDNQI) examines those components of clinical care that are specific to nursing. The NDNQI quantifies, or assesses, these nurse-sensitive components and provides specific feedback on how well nursing practice is being executed in those areas related to patient care.

This week, you will consider a series of articles that focus on strategies for ensuring safety and quality care for patients. You will also explore how successful, efficient teamwork between nurses, nursing leaders, physicians, and other medical personnel can help prevent many of the Never Events from occurring and decrease the likelihood of such events in the future.

Learning Objectives

Students will:
  • Analyze the core measures and standards for nursing practice that promote patient safety and quality of care outcomes
  • Analyze the impact of the nurse’s role in clinical outcomes for organizations
  • Analyze nurse-specific challenges for influencing change in quality improvement
  • Analyze the role of the nurse in supporting the organization’s strategic agenda in improving clinical outcomes

Photo Credit: PhotoAlto/Odilon Dimier / PhotoAlto Agency RF Collections / Getty Images


Learning Resources

Prior Knowledge

It is not uncommon for students to be required to complete group projects or to work as part of a team. While obtaining your RN credentials, or at some time in your work career, you have more than likely at some point been part of a unit or a collaborative team. Reflect on that experience of working with others to achieve a common goal. How did the actions of your team members impact your success as a team? Consider how this same philosophy applies within an organization. How might the actions of the individuals influence the success of the organization?

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

Amin, A. N., Hofmann, H., Owen, M. M., Tran, H., Tucker, S., & Kaplan, S. H. (2014). Reduce readmissions with service-based care management. Professional Case Management, 19(6), 255–262. doi: 10.1097/NCM.0000000000000051

Note: You will access this article from the Walden Library databases.

Forster, A. J., Dervin, G., Martin, C., & Papp, S. (2012). Improving patient safety through the systematic evaluation of patient outcomes. Canadian Journal of Surgery, 55(6), 419–425. doi: 10.1503/cjs.007811

Note: You will access this article from the Walden Library databases.

Discussion Accountability for Clinical Outcomes

Discussion Accountability for Clinical Outcomes

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Johansen, M. L. (2014). Conflicting priorities: Emergency nurses perceived disconnect between patient satisfaction and the delivery of quality patient care. Journal of Emergency Nursing, 40(1), 13–19. doi: 10.1016/j.jen.2012.04.013

Note: You will access this article from the Walden Library databases.

McDowell, D. S., & McComb, S. A. (2014). Safety checklist briefings: A systematic review of the literature. AORN, 99(1), 125–137. doi: 10.1016/j.orn.2013.11.015

Note: You will access this article from the Walden Library databases.

Payne, D. (2014). Elderly care: Reflecting on that ultimate ‘never event.’ British Journal of Nursing, 23(13), 702. doi: 10.12968/bjon.2014.23.13.702

Note: You will access this article from the Walden Library databases.

Thornlow, D. K., & Merwin, E. (2009). Managing to improve quality: The relationship between accreditation standards, safety practices, and patient outcomes. Health Care Management Review, 34(3), 262–272. doi: 10.1097/HMR.0b013e3181a16bce

Note: You will access this article from the Walden Library databases.

American Hospital Association. (2016). Retrieved from http://www.aha.org/

 

Explore the American Hospital Association’s website. Focus on the information on improving patient safety and quality of care.

 

American Organization of Nurse Executives. (2016). Retrieved from http://www.aone.org

 

“Since 1967, the American Organization of Nurse Executives (AONE) has provided leadership, professional development, advocacy and research to advance nursing practice and patient care, promote nursing leadership excellence and shape public policy for health care nationwide. AONE is a subsidiary of the American Hospital Association” (AONE, 2016).

 

 

Centers for Medicare & Medicaid Services. (n.d.). Quality of care center. Retrieved August 11, 2016, from http://www.cms.gov/Center/Special-Topic/Quality-of-Care-Center.html?redirect=/center/quality.asp

 

Most health care organizations receive some amount of reimbursement from the Centers for Medicare & Medicaid Services (CMS). Reimbursement continues to be jeopardized and reduced by pay for performance standards. Health care organizations are being held to higher standards by CMS. Explore the standards set to improve patient safety and the quality of care. Consider how they affect acute care providers and nursing practice.

 

 

The National Academies of Sciences, Engineering, and Medicine. (2016). Health and Medicine Division. Retrieved from http://www.nationalacademies.org/hmd/

 

The Health and Medicine Division (HMD) promotes policies and best practices in an effort to improve patient safety and delivery of quality care. Review a few of the publications available at this site.

 

The Joint Commission. (2016). National Quality Forum (NQF) endorsed nursing-sensitive care performance measures. Retrieved from http://www.jointcommission.org/national_quality_forum_nqf_endorsed_nursing-sensitive_care_performance_measures/

 

The Joint Commission (TJC) also accredits health care organizations. Through funding provided by the Robert Wood Johnson Foundation, the Joint Commission developed the Implementation Guide for the National Quality Forum (NQF) Endorsed Nursing-Sensitive Care Performance Measures. Review this guide as you consider how core measures and national guidelines improve nursing practice.

Accountability for Clinical Outcomes Discussion

Required Media

Laureate Education. (Producer). (2009b). Topics in clinical nursing: Accountability for clinical outcomes and promoting safety and quality [Video file]. Baltimore, MD: Author.

Note: The approximate length of this media piece is 15 minutes.

 


Discussion: Promoting Safety and Quality

In the article “Managing to Improve Quality: The Relationship Between Accreditation Standards, Safety Practices, and Patient Outcomes,” the authors discuss the growing trend by medical insurance companies to eliminate reimbursement for Never Events. As these types of mistakes should be easily preventable, hospitals have developed protocols to lessen or extinguish the occurrence of these events. In addition, The Joint Commission (TJC) and the Centers for Medicare & Medicaid Services (CMS) have developed core measures to guide health care providers’ efforts in improving patient safety and the quality of care delivered.

Health care organizations have developed strategic agendas to help meet these standards and reduce the incidence of Never Events. Nurses significantly influence the overall quality of health care provided and play a pivotal role in improving patient outcomes.

For this Discussion, you will consider the standards that are in place for nurses and how they can be used to improve quality of care.

To prepare for this Discussion:

  • Review the information at the Joint Commission and Centers for Medicare & Medicaid Services websites on the core measures and standards presented in this week’s Learning Resources.
  • Consider the nurse’s role in supporting the organization’s strategic agenda as it relates to improving clinical outcomes.
  • Conduct an Internet search for either a Never Event or a core measure, and select one to address in your post.

Accountability for Clinical Outcomes Discussion

By Day 3

Respond to the following:

  • How has the emphasis on quality of care, patient safety, and clinical care outcomes been impacted by specific standards emanating from TJC and/or CMS? Cite your selected core measure or Never Event in your response.
  • What is the impact of the nurse’s role in clinical outcomes for the organization?
  • Discuss nurse-specific challenges in influencing change in quality improvement.
  • How does this influence the ability of the organization to achieve its strategic agenda?

Support your response with references from the professional nursing literature.

Note Initial Post: A 3-paragraph (at least 250–350 words) response. Be sure to use evidence from the readings and include in-text citations. Utilize essay-level writing practice and skills, including the use of transitional material and organizational frames. Avoid quotes; paraphrase to incorporate evidence into your own writing. A reference list is required. Use the most current evidence (usually ≤ 5 years old).

Read two or more of your colleagues’ postings from the Discussion question (support with evidence if indicated).

Important information for writing discussion questions and participation

Hi Class,

Please read through the following information on writing a Discussion question response and participation posts.

Contact me if you have any questions.

Important information on Writing a Discussion Question

  • Your response needs to be a minimum of 150 words (not including your list of references)
  • There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
  • Include in-text citations in your response
  • Do not include quotes—instead summarize and paraphrase the information
  • Follow APA-7th edition
  • Points will be deducted if the above is not followed

Participation –replies to your classmates or instructor

  • A minimum of 6 responses per week, on at least 3 days of the week.
  • Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article
  • Each response needs to be at least 75 words in length (does not include your list of references)
  • Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count.
  • Follow APA 7th edition
  • Points will be deducted if the above is not followed

Welcome to class

Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to.

I strongly encourage that you do not wait until the very last minute to complete your assignments. Your assignments in weeks 4 and 5 require early planning as you would need to present a teaching plan and interview a community health provider. I advise you look at the requirements for these assignments at the beginning of the course and plan accordingly. I have posted the YouTube link that explains all the class assignments in detail. It is required that you watch this 32-minute video as the assignments from week 3 through 5 require that you follow the instructions to the letter to succeed. Failure to complete these assignments according to instructions might lead to a zero. After watching the video, please schedule a one-on-one with me to discuss your topic for your project by the second week of class. Use this link to schedule a 15-minute session. Please, call me at the time of your appointment on my number. Please note that I will NOT call you.

Please, be advised I do NOT accept any assignments by email. If you are having technical issues with uploading an assignment, contact the technical department and inform me of the issue. If you have any issues that would prevent you from getting your assignments to me by the deadline, please inform me to request a possible extension. Note that working fulltime or overtime is no excuse for late assignments. There is a 5%-point deduction for every day your assignment is late. This only applies to approved extensions. Late assignments will not be accepted.

If you think you would be needing accommodations due to any reasons, please contact the appropriate department to request accommodations.

Plagiarism is highly prohibited. Please ensure you are citing your sources correctly using APA 7th edition. All assignments including discussion posts should be formatted in APA with the appropriate spacing, font, margin, and indents. Any papers not well formatted would be returned back to you, hence, I advise you review APA formatting style. I have attached a sample paper in APA format and will also post sample discussion responses in subsequent announcements.

Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week.

I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!

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