NUR-550 Topic 5 DQ 2 Identify a quality initiative from your workplace

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

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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.

https://youtu.be/7WnYpBMHtQk

 

 

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

REPLY

  • 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

REPLY

  • 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

REPLY

  • TW

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/

REPLY

  • 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.

REPLY

  • 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.

REPLY

  • 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

NUR-550 Topic 5 DQ 2 Identify a quality initiative from your workplace
NUR-550 Topic 5 DQ 2 Identify a quality initiative from your workplace

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

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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.
  • Provides relevant evidence of scholarly inquiry clearly stating how the evidence informed or changed professional or academic decisions
  • Evaluates literature resources to develop a comprehensive analysis or synthesis.
  • Uses valid, relevant, and reliable outside sources to contribute to the threaded discussion
  • Provides relevant evidence of scholarly inquiry but does not clearly state how the evidence informed or changed professional or academic decisions.
  • Evaluates information from source(s) to develop a coherent analysis or synthesis.
  • Uses some valid, relevant, reliable outside sources to contribute to the threaded discussion.
  • Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions.
  • Information is taken from source(s) with some interpretation/evaluation, but not enough to develop a coherent analysis or synthesis.
  • Little valid, relevant, or reliable outside sources are used to contribute to the threaded discussion.
  • Demonstrates little or no understanding of the topic.
  • Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions.
  • Information is taken from source(s) without any interpretation/evaluation.
  • The posting uses information that is not valid, relevant, or reliable
  • No evidence of the use of scholarly inquiry to inform or change professional or academic decisions.
  • Information is not valid, relevant, or reliable
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
  • Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources;
  • Applies concepts to personal experience in the professional setting and or relevant application to real life.
  • Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources.
  • Applies concepts to personal experience in their professional setting and or relevant application to real life
  • Interactions with classmates are relevant to the discussion topic but do not make direct reference to lesson content
  • Posts are generally on topic but do not build knowledge by incorporating concepts and principles from the lesson.
  • Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life
  • Does not demonstrate a solid understanding of the principles and concepts presented in the lesson
  • Posts do not adequately address the question posed either by the discussion prompt or the instructor’s launch post.
  • Posts are superficial and do not reflect an understanding of the lesson content
  • Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life
  • Posts are not related to the topics provided by the discussion prompt or by the instructor; attempts by the instructor to redirect the student are ignored
  • No discussion of lesson concepts to personal experience in the professional setting and or relevant application to real life
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)
  • Exceeds minimum post requirements
  • Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts three or more times in each graded thread, over three separate days.
  • Replies to a post posed by faculty and to a peer
  • Summarizes what was learned from the lesson, readings, and other student posts for the week.
  • 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
  • Replies to a question posed by a peer

Summarizes what was learned from the lesson, readings, and other student posts for the week.
  • Meets expectations of 2 posts on 2 different days.
  • The main post is not made by the Wednesday deadline
  • Does not reply to a question posed by a peer or faculty
  • Has only one post for the week
  • Discussion posts contain few, if any, new ideas or applications; often are a rehashing or summary of other students’ comments
  • Does not post to the thread
  • No connections are made to the topic
  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
  • 2-3 errors in APA format.
  • Written responses have 2-3 grammatical, spelling, and punctuation errors.
  • Writing style is generally clear, focused, and facilitates communication.
  • 4-5 errors in APA format.
  • Writing responses have 4-5 grammatical, spelling and punctuation errors.
  • Writing style is somewhat focused.
  • 6-7 errors in APA format.
  • Writing responses have 6-7 grammatical, spelling and punctuation errors.
  • Writing style is slightly focused making discussion difficult to understand.
  • 8-10 errors in APA format.
  • Writing responses have 8-10 grammatical, spelling and punctuation errors.
  • Writing style is not focused, making discussion difficult to understand.
  • Post contains greater than 10 errors in APA format.
  • Written responses have more than 10 grammatical, spelling and punctuation errors.
  • Writing style does not facilitate communication.
  • The student continues to make repeated mistakes in any of the above areas after written correction by the instructor
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.

Also Read:  NUR-550 Topic 5 DQ 1 Identify either a safety or quality improvement initiative related to improving population health