NURS 8302 WEEK 6 Discussion Quality Improvement Initiative INSTRUCTIONS PLUS RUBRIC

NURS 8302 WEEK 6 Discussion Quality Improvement Initiative INSTRUCTIONS PLUS RUBRIC

Sample Answer for NURS 8302 WEEK 6 Discussion Quality Improvement Initiative INSTRUCTIONS PLUS RUBRIC 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.

_{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 most relevant 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

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 WEEK 6 Discussion Quality Improvement Initiative INSTRUCTIONS PLUS RUBRIC

Title:  NURS 8302 WEEK 6 Discussion Quality Improvement Initiative INSTRUCTIONS PLUS RUBRIC

Multimorbidity, defined as two or more chronic medical conditions, resulting in polypharmacy, which is often described as the long-term use of five or more prescribed drugs daily (Sivasamy et al., 2023).  Pharmacokinetics: Drugs commonly prescribed to older people, such as antihistamines, can reduce oral secretions, and PPI, which reduce gastric acid secretion, both of which affect drug absorption.  Pharmacodynamics: Haloperidol and amitriptyline together can cause major anti-cholinergic side effects.

Having a centralized national repository of medical records allows medical practitioners to be informed of the medications the patient is taking, so to avoid polypharmacy or even a prescribing cascade.  A prescribing cascade occurs when additional adverse events are mistaken as a new medical condition, which leads to the addition of new drugs to treat it.  This, in turn, places patients at risk of experiencing additional adverse drug events from the unnecessary treatment (Chen et al., 2019).

The US was one of the first countries to establish the National Medication Errors Reporting Program (MERP) to monitor medication error (Chen et al., 2019).  Human error is inevitable.  The best we can do is educate and train healthcare staff and patients about the use of medications.  We currently utilize Omnicell at my organization.  To be certain that I am giving the correct medication to the right patient, when I pull the medication, I make sure that it is exactly the medication I need.  I scan the patient, and I go through the 5 rights: right name, right medication, right time, right dose, right route.

As healthcare staff, we must be vigilant and advocate for our patients by being careful what we give them is exactly what they need.  For example, a new nurse pulled Narcan instead of Norco by pressing the wrong button.  She was asking for a waste for the Norco from another nurse who thought that maybe there was a liquid Norco, so she looked and realized the new nurse pulled Narcan out instead.

References:

Chen, Y., Wu, X., Huang, Z., Lin, W., Li, Y., Yang, J., & Li, J. (2019). Evaluation of a medication error monitoring system to reduce the incidence of medication errors in a clinical setting. Research in Social and Administrative Pharmacy, 15(7), 883–888. https://doi.org/10.1016/j.sapharm.2019.02.006

Vignesh Sivasamy, King Fan Yip, Kaysar Mamun, & Kiat Wee Lim. (2023). A review of the effectiveness of interventions to reduce medication errors among older adults in Singapore. Proceedings of Singapore Healthcare, 32. https://doi.org/10.1177/20101058231172232

A Sample Answer 2 For the Assignment: NURS 8302 WEEK 6 Discussion Quality Improvement Initiative INSTRUCTIONS PLUS RUBRIC

Title:  NURS 8302 WEEK 6 Discussion Quality Improvement Initiative INSTRUCTIONS PLUS RUBRIC

Great job Quennie! Your post provides valuable insights into the challenges associated with multimorbidity, polypharmacy, and the importance of having a centralized national repository of medical records. It emphasizes the need for awareness among healthcare practitioners to prevent prescribing cascades and reduce the risk of adverse drug events. To expand on your post, it’s worth highlighting the role of technology in medication management and error prevention (Chen et al., 2019). The use of electronic health records (EHRs) and integrated systems can significantly contribute to the reduction of medication errors. These systems not only store comprehensive medical records but also facilitate communication among different healthcare providers, ensuring that all involved parties are aware of the patient’s current medications.

Additionally, incorporating decision support tools within EHRs can assist healthcare professionals in making informed and safe prescribing decisions. These tools can alert providers to potential drug interactions, duplicate therapies, or allergy concerns, further mitigating the risks associated with polypharmacy. Furthermore, continuous education and training for healthcare staff on the latest advancements in medication management, as well as fostering a culture of open communication about errors, can contribute to improving patient safety (Rodziewicz, Houseman & Hipskind, 2018). Learning from mistakes and implementing corrective measures is crucial for enhancing the overall quality of healthcare delivery.

While your colleague mentions the use of Omnicell for medication administration, it’s essential to acknowledge that technology solutions, such as automated dispensing cabinets like Omnicell, play a pivotal role in reducing medication errors (Chen et al., 2019). These cabinets help in maintaining accurate and secure medication dispensing processes, promoting the concept of the “5 rights” that your colleague follows – ensuring the right medication is given to the right patient, at the right time, in the right dose, and through the right route.

 References

Chen, Y., Wu, X., Huang, Z., Lin, W., Li, Y., Yang, J., & Li, J. (2019). Evaluation of a medication error monitoring system to reduce the incidence of medication errors in a clinical setting. Research in Social and Administrative Pharmacy, 15(7), 883–888. https://doi.org/10.1016/j.sapharm.2019.02.006

Rodziewicz, T. L., Houseman, B., & Hipskind, J. E. (2018). Medical error reduction and prevention.

A Sample Answer 3 For the Assignment: NURS 8302 WEEK 6 Discussion Quality Improvement Initiative INSTRUCTIONS PLUS RUBRIC

Title:  NURS 8302 WEEK 6 Discussion Quality Improvement Initiative INSTRUCTIONS PLUS RUBRIC

Multi-morbidity relates to the presence of two more long-term health issues. These involve defined physical and mental health issues including schizophrenia or diabetes or ongoing health problems such as learning disability. The problem of multi-morbidity has increased in the recent past leading to an increased impact on individuals and their families, health systems, and society (Skou et al., 2022). It is a problem that needs addressing due to its increased prevalence. For instance, in the United States, it is estimated that 42% of the population aged 18 and older have multi-morbidity (Schiltz, 2022). These individuals have increased mortality rates, reduced health-related quality of life, potential poor health outcomes, and increased healthcare use. It is possible for healthcare professionals to help these individuals with a centralized medical records repository that aids in data analysis and visualization. Research conducted by Heins et al. (2020) shows that EHR can help in identifying patients with multi-morbidity and as a result help with their needs.

References

Heins, M., Korevaar, J., Schellevis, F., & Rijken, M. (2020). Identifying multimorbid patients with high care needs – A study based on Electronic Medical Record Data. European Journal of General Practice, 26(1), 189–195. https://doi.org/10.1080/13814788.2020.1854719Links to an external site.

Schiltz, N. K. (2022). Prevalence of Multimorbidity Combinations and Their Association with Medical Costs and Poor Health: A Population-Based Study of U.S. Adults. https://doi.org/10.1101/2022.01.18.22269483Links to an external site.

Skou, S. T., Mair, F. S., Fortin, M., Guthrie, B., Nunes, B. P., Miranda, J. J., Boyd, C. M., Pati, S., Mtenga, S., & Smith, S. M. (2022). Multimorbidity. Nature Reviews Disease Primers, 8(1). https://doi.org/10.1038/s41572-022-00376-4Links to an external site.

 

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Content

Name: NURS_8302_Week6_Discussion_Rubric

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		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

Name: NURS_8302_Week6_Discussion_Rubric

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NURS 8302 WEEK 6 Discussion Quality Improvement Initiative INSTRUCTIONS PLUS RUBRIC 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.

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