Part II: Quality Improvement Plan, Resources and Conclusion

In this project, two practice problems have been identified and addressed. One problem is the misinterpretation of the Edmonton Symptom Assessment Scale (ESAS) by some of the hospice team members. The other problem identified is a misinterpretation of the severity of the patient’s symptoms into scale. The interventions used in the plan are evidence-based to ensure that they are effective and applicable in resolving the practice problems with reduced chances of error.

The evidence-based plan will involve five interventions where the first intervention is interviewing the clinical staff regarding their understanding of the ESAS and how they answer the questions each visit. In this intervention, questions concerning the possible solutions to the two practice problems such as interpreting the severity of the patient’s symptoms will be addressed. After the questions are formulated, PICO will be used as the tool for asking the focused clinical questions which will comprise of four main aspects: problem, intervention, comparison and outcome. The second intervention will entail finding information or evidence to answer the questions developed which will entail searching for the best available evidences to ensure the information gathered is empirically tested for its efficiency. The next intervention is to evaluate the information collected by assessing the evidence on basis of trustworthiness and reliability which involves the use of Randomized Controlled Trial (RCT) to determine the impact of each method or solution proposed by the evidence interventions (Vitale, 2018).

After evaluating the collected information, the information will be reviewed with key members of the hospice team in charge of quality, education, and the administrator to formulate a plan to educate the staff best. For instance, if training is settled on the hospice team members concerning the use of the ESAS system, various practitioners will be consulted on the training’s details to ensure it is most efficient. A PowerPoint would be presented at the monthly required staff meeting and the information sent to each nurse’s email. The last intervention evaluates the other previous steps to ensure all are centered towards resolving the practice problems that the plan intends to resolve (Fisher, 2016). The best way to ensure the plan has been effective is to look at the QAPI scores concerning the ESAS scores and nursing visits.

Reference

Fisher, C., Cusack, G., Cox, K., Feigenbaum, K., & Wallen, G. R. (2016). Developing competency to sustain evidence-based practice. The Journal of nursing administration, 46(11), 581.

Vitale, R., Blaine, T., Zofkie, E., Moreland-Russell, S., Combs, T., Brownson, R. C., & Luke, D. A. (2018). Developing an evidence-based program sustainability training curriculum: a group randomized, multi-phase approach. Implementation Science, 13(1), 126.