NR 451 Week 4: Evaluating Quality Patient Outcomes

NR 451 Week 4: Evaluating Quality Patient Outcomes

Sample Answer for NR 451 Week 4: Evaluating Quality Patient Outcomes Included After Question

NR 451 Week 4: Evaluating Quality Patient Outcomes

For this weeks’ discussion, we are discussing quality improvement and change. These improvements are not only necessary to decrease occurrence of harm and or wrongful death, but also in improving the quality of life for our patients.  Data can aid in the evaluation of effectiveness, cost, planning delivery of care. It gives insight to the allocation and utilization of resources, and also assesses the accessibility of care for our patients in varied settings. These considerations allow for concerns in economic matters, ethical matters and social diversities.  When discussing an example of data that reflects poor quality of care, I would like to use a personal experience with my own hospital setting. I do this, not because I feel the place I work is a poor place, but we experienced something that I believe is probably widespread and I think many could benefit. We were required to do an error prevention class for the hospital. The wrongful death and harm statistics were from our very own organization. These were people, families in our community effected directly by errors within our health system……. deaths in some cases, by mistake of personnel. It is an eye opener to see charts, graphs and data that reflect errors that you yourself could have easily made. We have had a huge shift in error prevention and culture for error identification. We were shown that a 15% spike in error was seen during our go live with a new software system. This data absolutely identified areas of much needed improvement, more than that …….it identified that change was essential, our patients lives depended on it. We don’t talk about the astonishing numbers that reflect medical error and wrongful death enough. It is not easy to talk about. We are all human, but when you understand that your own life, the lives are your family members receiving care are at stake when healthcare has a “glitch”, it is a whole new perspective. In our assigned article this week it states,” today we may be doing what we can, but tomorrow we can improve”,(Hughes,2008). Quality improvement is definitely a part of daily workflow, because every day we can make strides to perform better, be more efficient, more cost effective. As nurses, we are in actual one on one contact with patients, more than other discipline in healthcare, (ANA,2015). We spend more time, often develop the relationship aspect of healthcare and are looked to for education, intervention, avocation and support by our patients and their families. We bring the “human” to the very technical, often harsh reality of healthcare. I read an article of the influence of quality improvement and how it effects not only our patients by our own work. I feel this sums up the need to change through improvement. “As advances are made, patient’s needs and expectations of healthcare are changing as well. It is part of the dedication to the nursing profession to develop quality and safety measures, identify gaps of knowledge, share innovations of quality and performance improvement initiatives, incorporate technologies to impact workflow efficiency, safety, and cost,” (Weston&Roberts,2013). I read that, jotted in down, and when typing it, I read it out loud about three times…….try it. WOW……. Those are some BIG shoes to fill!!  I have often stated about my own self,” I am just the bedside nurse”. Class and professor, I dare say that according to the above statement, in todays’ healthcare, there is no such thing.  I have taken this statement from this article, as a personal challenge. I have placed it in a sticky note in my locker. For those days, those hard ones, like I just had last night,( you know when you think as you walk to the car at the end of a shift,  checking out groceries at Walmart is looking pretty promising!! LOL) to remind myself, the BIG picture is not mine to “fix”, however, if I commit to these things in the experiences and in the lives of patients I am dealing with a day to day basis, if we all do, the BIG picture will improve without a doubt!

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Weston, M., & Roberts, D. (2013). The influence of quality improvement efforts
on patient outcome and nursing work. The Online Journal of Issues in 
Nursing, 18(3). https://doi.org/10.3912/ojin.vol18no3Links to an external site.

Hughes, R. G. (Ed.). (2008). Patient safety and quality: An evidence-based handbook for nurses(AHRQ Publication No. 08-0043). Agency for Healthcare Research and Quality. Retrieved from https://archive.ahrq.gov/professionals/clinicians-providers/resources/nursing/resources/nurseshdbk/ Links to an external site.

American Nurses Association. (2015). Nursing: Scope and standards of practice (3rd ed.). Silver Spring, MD: Author

A Sample Answer For the Assignment: NR 451 Week 4: Evaluating Quality Patient Outcomes

Title: NR 451 Week 4: Evaluating Quality Patient Outcomes

Wow, that’s’ a pretty big question to answer. Honestly, I do not have any idea where it would begin. So, classmates, I would love to hear some of your ideas. And now , I will attempt to give some insight . First, the question, why are nurses leaving the bedside? I found an article discussing this topic . It states the three top reasons for leaving clinical nursing: “1. unfriendly work environment, 2. emotional distress related to patient care, 3. fatigue and exhaustion”, (AACN,2010). This was described as issues with sexual harassment, verbal and physical abuse from coworkers, managers, physicians in the workplace and consistent lack of support from other RNs. The second issues was having to do with conflict in the decision making aspect of patient care, and perception that patient and family desire was ignored. The third issue was simply a feeling on being overwhelmed with emotional and physical fatigue. I know organizations have approached all of this with education on sexual harassment, what it is, and how to report it. Our organization, and many others,  have programs and encourage involvement in things like “VOICE” to allow for participation at the nurse level in policy and structure of the health system. There is education and “support” for work life balance. However, healthcare has become, for lack of a better word, big business. In nursing we are asked to stay on top of increasing technical demands, increased acuity of patients. Suggestions to retain nursing would be mentoring program to facilitate new nurses into nursing practice, zero tolerance policy for harassment, support networks for nursing staff that are experiencing distress. We have an employee assistance program , that offers a variety of things, including free counseling for up to six sessions. However, our organization is experiencing great turnover in a lot of areas. It becomes difficult for those like myself who have no intention of leaving, despite how negative the climate becomes. We just increased our mandatory call requirements again, many are very upset. We are staffing a NICU in one of the “sister” hospitals that is a 50 minute drive for our facility. We are pulling the call people to that location first. The nurses at that hospital are not required to take call. We feel as if we are taking  mandatory call shifts to be sent to the sister hospital to work as supplemental staff. Why are they a NICU unit with no call mandated? Supposedly we are under the “same umbrella” , or this is the terminology the director has used when we have voiced our feelings, so why not the same requirements of staff from each location?  This sister hospital opened over 18 months ago, we have been staffing it from day 1. So this is not a new issue, just one that we feel has only gotten worse , despite our concern for the past 18 months. Some of our nurses drive over two hours and a half to this location, one way! No travel pay, nothing, just this statement form management, “if you refuse , you will be written up for insubordination “. People have refused and were written up, and eventually have migrated to other work opportunities elsewhere. You no longer work for a “hospital”, but a healthcare “system”. We now have three “locations”. Nursing staff is expected to “cover” for all three locations in certain departments. This is the “big business” part of it , that is distasteful to me, personally. You feel like a chess piece, just waiting to be placed in a different spot as needed.  So, I will have to say , there is no “one stop” solution.

 

American Association of Colleges of Nursing(AACN). (2010). Nursing shortage fact sheet. retrieved form http://www.aacn.nche.edu/Media/pdf.NrsgShortageLinks to an external site.

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Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.

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The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.

Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.

If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.

I do not accept assignments that are two or more weeks late unless we have worked out an extension.

As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

Communication

Communication is so very important. There are multiple ways to communicate with me:

Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.

Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

Important information for writing discussion questions and participation

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.

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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!

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
• Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points.
• Here are some helpful links
• Student paper example
• Citing Sources
• The Writing Center is a great resource