NURS 8302 Discussion Quality Improvement Initiative
Sample Answer for NURS 8302 Discussion Quality Improvement Initiative Included After Question
Your organization has recently discovered there have been too frequent errors in medication distribution. After launching an investigation in the matter, and discovering the reasons for the errors, your organization is ready to launch a quality improvement initiative. What might this initiative entail? What is included, and how will it assist in eliminating these errors?
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The purpose of the Quality Improvement (QI) Plan is to provide a formal ongoing process by which the organization and stakeholders utilize objective measures to monitor and evaluate the quality of services—both clinical and operational—provided to the patients. The QI Plan, which often addresses general medical behavioral health and oral healthcare and services, defines and facilitates a systematic approach to identify and pursue opportunities to improve services and resolve identified problems (Health Resources and Services Administration, 2011).
For this Discussion, review the Learning Resources. Then, reflect on how adverse events impact your organization and/or nursing practice. Consider the use of quality improvement initiative in the error rate, using scholarly articles to analyze.
NURS 8302 Discussion Quality Improvement Initiative Reference:
U. S. Department of Health and Human Services Health Resources and Services Administration. (2011). Developing and implementing a QI plan. https://www.hrsa.gov/sites/default/files/quality/toolbox/508pdfs/developingqiplan.pdf
To Prepare:
- Review the Learning Resources for this week, and reflect on the types of quality improvement (QI) initiatives that might be mostrelevant to your healthcare organization or nursing practice.
- Select a QI initiative, you are most familiar with, that has received support from your senior leaders in your healthcare organization or nursing practice.
- Consider how adverse events are handled in your healthcare organization or nursing practice. Reflect on how this may impact the public—as well as the internal—perspective on healthcare quality.
- Find a scholarly article or one from the public press, published within the last 5 years, that recounts a serious error. Reflect on this error, and consider how it may relate to your healthcare organization or nursing practice.
By Day 3 of Week 6
Post a brief explanation of the QI initiative you selected, and why. Be specific. Explain how adverse events are handled in your healthcare organization or nursing practice, including an explanation of how this may impact both public and internal perspectives on healthcare quality. Then, briefly describe the error rate from the article you selected, and explain how this may relate to your healthcare organization or nursing practice. Be specific and provide examples.
By Day 6 of Week 6
Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days by expanding upon your colleague’s post or offering an alternative interpretation of the error rate described by your colleague.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!
Submission and Grading Information
NURS 8302 Discussion Quality Improvement Initiative Grading Criteria
To access your rubric:
Week 6 Discussion Rubric
Post by Day 3 of Week 6 and Respond by Day 6 of Week 6
To Participate in this Discussion:
Week 6 Discussion
A Sample Answer For the Assignment: NURS 8302 Discussion Quality Improvement Initiative
Title: NURS 8302 Discussion Quality Improvement Initiative
Brief Explanation of the Selected Qualitative Improvement (QI) Initiative: QI is a systematic approach using specific techniques to improve quality. QI involves identifying areas for improvement, implementing changes, and measuring the impact of these changes. It necessitates infrastructure-systematic and rigorous approaches to eliminating waste from procedures, improving patient outcomes and experiences, and eliminating errors. These initiatives aim to enhance efficiency, effectiveness, and patient outcomes in healthcare settings (Drew & Pandit, 2020).
Selected QI initiative: Medication errors are common among hospitalized patients and can occur throughout the prescribing, transcribing, prescription auditing, preparation, dispensing, administration, and monitoring processes. Medication errors are considered QI initiatives because these errors can have severe consequences for patients, so it is critical to implement measures to prevent them (Wang et al., 2015).
How Adverse Events are Handled in My Organization: When adverse events occur in an organization or nursing practice, it is crucial to handle them promptly and effectively. In my organization, we have an anonymous reporting system in place to encourage reporting. Once an adverse event is reported, a thorough investigation is conducted to determine the root cause analysis. The findings from the investigation are analyzed to identify areas for improvement. These include adverse events, their causes, and any steps to prevent recurrence, which are communicated to patients and families. This helps to maintain trust and transparency. Changes are implemented based on the findings to prevent another adverse effect. This may include updating policies and procedures, providing additional staff training, and changing the physical environment. Additionally, my organization continuously monitors and evaluates the system and processes to ensure ongoing improvement in patient safety and prevent adverse events.
Public and internal impact: adverse health events can impact the public and internal perspectives of healthcare quality. For example, adverse events can erode public trust in healthcare organizations. Adverse events can affect the internal perspective within healthcare organizations by serving as an opportunity for self-reflection and improvement (Liukka et al., 2020).
A Brief Description of Selected Article Error Rates: Medication errors (MEs) during prescription, dispensing, and administration are prevalent and avoidable sources of patient harm. It is difficult to establish precise figures for the incidence and prevalence of MEs because the rate changes from study to study. According to studies, the rate of significant patient injuries caused by medication errors ranged from 1 to 2%, 9 to 13%, 29%, and as high as 51.8%, with an estimated 30.5% of deaths per year attributable to MEs in a survey in the United States of America (Jember et al., 2018). For example, a 6% error rate in medication administration means that approximately six errors occur out of every 100 medications administered. This error rate could be a cause for concern and is something to pay attention to. It emphasizes the importance of implementing safety protocols, promoting medication education, and utilizing technology to reduce errors and improve patient safety.
To wrap things up, QI is essential for organizations to improve their processes and outcomes. These initiatives help organizations streamline processes, reduce errors, enhance patient safety, and improve the overall quality of care.
Reference
Drew, J. R., & Pandit, M. (2020, March 31). Why healthcare leadership should embrace quality
improvement. BMJ (Clinical Research ed.).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7190272/
Liukka, M., Steven, A., Moreno, M. F. V., Sara-Aho, A. M., Khakurel, J., Pearson, P., Turune
H., & Tella, S. (2020, June 30). Action after adverse events in Healthcare: An integrative
literature review. International journal of environmental research and public health.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7369881/
Jember, A., Hailu, M., Messele, A., Demeke, T., & Hassen, M. (2018, March 12). The
proportion of medication error reporting and associated factors among nurses: A Cross-
Sectional Study. BMC nursing.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5848571/Links to an external site.
Wang, H.-F., Jin, J.-F., Feng, X.-Q., Huang, X., Zhu, L.-L., Zhao, X.-Y., & Zhou, Q. (2015)
March 5). Quality improvements in decreasing medication administration errors by
nursing staff in an Academic Medical Center Hospital: A trend analysis during the
journey to Joint Commission International Accreditation and in the post-accreditation
ERA: therapeutics and clinical risk management.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4354453/
A Sample Answer 2 For the Assignment: NURS 8302 Discussion Quality Improvement Initiative
Title: NURS 8302 Discussion Quality Improvement Initiative
Quality Improvement (QI) initiatives in healthcare often focus on enhancing patient outcomes, safety, and satisfaction (Nash et al., 2019). The most recent and pertinent quality improvement (QI) endeavor within my present healthcare organization and nursing practice centers around diminishing the rates of cesarean section (CS) among first-time pregnant individuals (primigravids). According to the Centers for Disease Control and Prevention (2023) in the state of Tennessee alone, the CS rate hovers around 32%. Upon scrutinizing and presenting an analysis of the escalating CS rates within our facility, the executive director of our women’s health services and hospital leadership launched a QI initiative. In the context of reducing c-section rates, a QI initiative involves a comprehensive analysis of the factors contributing to high rates, implementation of evidence-based practices, and continuous monitoring to evaluate the impact. Recognizing that a CS during the initial pregnancy often paves the way for subsequent CS, the focus of our prevention strategies is on primiparous women. The reduction in CS rates in hospitals is important for several reasons: encompassing maternal health, neonatal outcomes, and healthcare costs.
Adverse Events in my Healthcare Organization
Adverse events in my healthcare organization are managed through a systematic approach. This typically involves thorough incident reporting, root cause analysis, and implementation of preventive measures. Transparency and communication are crucial to maintaining trust from both the public and internal stakeholders. Additionally, our organization is steadfastly committed to a Just Culture, ensuring fairness and accountability in our approach to healthcare practices particularly when addressing errors and adverse events in healthcare practices (Baarle et al., 2022).
Internal Impact
Managing adverse events is a pivotal component of healthcare quality management, exerting a substantial influence on both public perception and internal dynamics related to healthcare quality. Internally, this is evident in how healthcare quality is affected. For example, a healthcare institution that nurtures a culture of continual learning from adverse events is better positioned to enhance its internal processes. Instead of allocating blame, a culture that prioritizes comprehending the underlying causes of adverse events fosters organizational advancement and resilience (Baarle et al., 2022). Another instance pertains to patient safety, where the proficient management of adverse events plays a pivotal role. Ensuring patient safety involves creating an environment where healthcare professionals can confidently report incidents without the concern of facing repercussions. This fosters a transparent and proactive approach in addressing potential risks. Finally, in the realm of quality improvement, adverse events emerge as invaluable learning opportunities. Organizations that systematically analyze such incidents and proactively implement corrective measures showcase a dedicated commitment to elevating the overall quality of care they deliver (Nash et al., 2019).
Public Impact
Examining the public perspective in the context of healthcare quality unveils critical facets such as transparency and trust, accountability, and communication with patients. The public’s perception of healthcare quality is intricately tied to transparency, with organizations openly acknowledging and addressing adverse events showcasing transparency, thereby bolstering public trust (Baarle et al., 2022). Conversely, a lack of transparency can erode trust and confidence. Accountability further shapes public perception, as organizations holding themselves responsible for adverse events positively influence trust, while any perception of evasion can have detrimental effects (Baarle et al., 2022). Additionally, the crucial role of communication in mitigating the impact of adverse events on patients is highlighted, emphasizing the need for honest and empathetic dialogue to foster satisfaction and trust, contrasting with the potential consequences of a lack of communication or misinformation.
Selected Article in Relation to my Nursing Practice
The scholarly article I selected delves into adverse events and error rates that play a role in maternal morbidity and mortality. This brief addresses the impact of diagnostic errors on maternal morbidity and mortality. It explores existing knowledge on this issue, elucidates the reasons for enhancing diagnostic methods, and outlines a research agenda to advance diagnostic safety in this evolving field (Agency for Healthcare Research and Quality, 2021). The emphasis is on maternal events within the childbirth period and up to a week postpartum, with a particular focus on maternal hemorrhage. This condition is highlighted as a primary example due to its widespread occurrence, high preventability rate, and the collaborative effort required among healthcare professionals for accurate diagnosis and effective treatment (Agency for Healthcare Research and Quality, 2021).
In the context of my nursing practice and within the framework of my healthcare organization, consider the case of maternal deaths associated with hemorrhage. Enhancing awareness of risk factors, conducting precise assessments of blood loss, and promptly identifying signs of hypovolemia could markedly improve our ability to recognize and address hemorrhage effectively. Preventable errors often stem from delays in assessing clinical warning signs, providing accurate diagnoses, administering optimal treatment, and coordinating care with multidisciplinary teams (Agency for Healthcare Research and Quality, 2021). In conclusion, timely recognition of risk factors and the swift escalation of care are essential in preventing maternal morbidity and mortality.
References
Agency for Healthcare Research and Quality. (2021). The contribution of diagnostic errors to maternal morbidity and mortality during and immediately after childbirth: state of the science. https://www.ahrq.gov/sites/default/files/wysiwyg/patient-safety/reports/issue-briefs/dxsafety-issuebrief-maternal-morbidity.pdf
Baarle, E., Hartman, L., Rooijakkers, S., Wallenburg, I., Weenink, J., Widdershoven. G., (2022). Fostering a just culture in healthcare organizations: experiences in practice. BMC Health Services Research, 22(1), 1–7. https://doi.org/10.1186/s12913-022-08418-z
Centers for Disease Control and Prevention. (2023). Stats of the States-Cesarean Delivery Rates. https://www.cdc.gov/nchs/pressroom/sosmap/cesarean_births/cesareans.htm
Nash, D. B., Joshi, M. S., Ransom, E. R., & Ransom, S. B. (Eds.). (2019). The healthcare quality book: Vision, strategy, and tools (4th ed.). Health Administration Press.
NURS 8302 Discussion Quality Improvement Initiative Rubric Detail
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Content
Name: NURS_8302_Week6_Discussion_Rubric
| Excellent
90–100 |
Good
80–89 |
Fair
70–79 |
Poor
: 0–69 |
||
| Main Posting:
Response to the Discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources. |
Points Range: 40 (40%) – 44 (44%)
Thoroughly responds to the Discussion question(s). Is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources. No less than 75% of post has exceptional depth and breadth. Supported by at least three current credible sources. |
Points Range: 35 (35%) – 39 (39%)
Responds to most of the Discussion question(s). Is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module. 50% of the post has exceptional depth and breadth. Supported by at least three credible references. |
Points Range: 31 (31%) – 34 (34%)
Responds to some of the Discussion question(s). One to two criteria are not addressed or are superficially addressed. Is somewhat lacking reflection and critical analysis and synthesis. Somewhat represents knowledge gained from the course readings for the module. Cited with fewer than two credible references. |
Points Range: 0 (0%) – 30 (30%)
Does not respond to the Discussion question(s). Lacks depth or superficially addresses criteria. Lacks reflection and critical analysis and synthesis. Does not represent knowledge gained from the course readings for the module. Contains only one or no credible references. |
|
| Main Posting:
Writing |
Points Range: 6 (6%) – 6 (6%)
Written clearly and concisely. Contains no grammatical or spelling errors. Adheres to current APA manual writing rules and style. |
Points Range: 5 (5%) – 5 (5%)
Written concisely. May contain one to two grammatical or spelling errors. Adheres to current APA manual writing rules and style. |
Points Range: 4 (4%) – 4 (4%)
Written somewhat concisely. May contain more than two spelling or grammatical errors. Contains some APA formatting errors. |
Points Range: 0 (0%) – 3 (3%)
Not written clearly or concisely. Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style. |
|
| Main Posting:
Timely and full participation |
Points Range: 9 (9%) – 10 (10%)
Meets requirements for timely, full, and active participation. Posts main Discussion by due date. |
Points Range: 8 (8%) – 8 (8%)
Meets requirements for full participation. Posts main Discussion by due date. |
Points Range: 7 (7%) – 7 (7%)
Posts main Discussion by due date. |
Points Range: 0 (0%) – 6 (6%)
Does not meet requirements for full participation. Does not post main Discussion by due date. |
|
| First Response:
Post to colleague’s main post that is reflective and justified with credible sources. |
Points Range: 9 (9%) – 9 (9%)
Response exhibits critical thinking and application to practice settings. Responds to questions posed by faculty. The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives. |
Points Range: 8 (8%) – 8 (8%)
Response has some depth and may exhibit critical thinking or application to practice setting. |
Points Range: 7 (7%) – 7 (7%)
Response is on topic and may have some depth. |
Points Range: 0 (0%) – 6 (6%)
Response may not be on topic and lacks depth. |
|
| First Response: Writing |
Points Range: 6 (6%) – 6 (6%)
Communication is professional and respectful to colleagues. Response to faculty questions are fully answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English. |
Points Range: 5 (5%) – 5 (5%)
Communication is mostly professional and respectful to colleagues. Response to faculty questions are mostly answered, if posed. Provides opinions and ideas that are supported by few credible sources. Response is written in standard, edited English. |
Points Range: 4 (4%) – 4 (4%)
Response posed in the Discussion may lack effective professional communication. Response to faculty questions are somewhat answered, if posed. Few or no credible sources are cited. |
Points Range: 0 (0%) – 3 (3%)
Responses posted in the Discussion lack effective communication. Response to faculty questions are missing. No credible sources are cited. |
|
| First Response: Timely and full participation |
Points Range: 5 (5%) – 5 (5%)
Meets requirements for timely, full, and active participation. Posts by due date. |
Points Range: 4 (4%) – 4 (4%)
Meets requirements for full participation. Posts by due date. |
Points Range: 3 (3%) – 3 (3%)
Posts by due date. |
Points Range: 0 (0%) – 2 (2%)
Does not meet requirements for full participation. Does not post by due date. |
|
| Second Response: Post to colleague’s main post that is reflective and justified with credible sources. |
Points Range: 9 (9%) – 9 (9%)
Response exhibits critical thinking and application to practice settings. Responds to questions posed by faculty. The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives. |
Points Range: 8 (8%) – 8 (8%)
Response has some depth and may exhibit critical thinking or application to practice setting. |
Points Range: 7 (7%) – 7 (7%)
Response is on topic and may have some depth. |
Points Range: 0 (0%) – 6 (6%)
Response may not be on topic and lacks depth. |
|
| Second Response: Writing |
Points Range: 6 (6%) – 6 (6%)
Communication is professional and respectful to colleagues. Response to faculty questions are fully answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English. |
Points Range: 5 (5%) – 5 (5%)
Communication is mostly professional and respectful to colleagues. Response to faculty questions are mostly answered, if posed. Provides opinions and ideas that are supported by few credible sources. Response is written in standard, edited English. |
Points Range: 4 (4%) – 4 (4%)
Response posed in the Discussion may lack effective professional communication. Response to faculty questions are somewhat answered, if posed. Few or no credible sources are cited. |
Points Range: 0 (0%) – 3 (3%)
Responses posted in the Discussion lack effective communication. Response to faculty questions are missing. No credible sources are cited. |
|
| Second Response: Timely and full participation |
Points Range: 5 (5%) – 5 (5%)
Meets requirements for timely, full, and active participation. Posts by due date. |
Points Range: 4 (4%) – 4 (4%)
Meets requirements for full participation. Posts by due date. |
Points Range: 3 (3%) – 3 (3%)
Posts by due date. |
Points Range: 0 (0%) – 2 (2%)
Does not meet requirements for full participation. Does not post by due date. |
|
| Total Points: 100 | |||||
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The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
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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.
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!
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