QI POST , WEEK 1

QI POST DISCUSSION REPLY WEEK 1 ERIN

Quality improvement is important at every healthcare facility because we should always be trying to make our care the best it can be for patients. However, that being said at the transitional care/rehabilitation unit I work at it can be very important because we deal with post acute care patients who can sometimes go from stable to unstable quite quickly. The more we, as nurses, focus on quality improvement the faster we can catch those changes and treat them effectively. When nurses, focus on improving quality of care, they can not only focus on their physical skills, like IVs and med administration, but they can work on their clinical skills such as pathophysiology, signs and symptoms, and family interactions. However, a good quality improvement program requires good leadership and organization. 

 

In an ideal world, I would put together a QI team headed by nurse with a minimum of bachelors but preferably a master’s degree, that person does not need to be employed full time. But should be able to provide or organize skills workshops a few times a year for staff, these should be offered at times that work into all the staff schedules (difficult for 24 hour facilities, but necessary, they may need to offer several different options, flexibility is key). My facility is small so we would also need one person from administration, one floor staff nurse, one CNA, and I would recommend including one resident spokesperson (our facility already has one for this purpose) to bring up any concerns the resident’s may have about safety or chronic issues they may be having. Our resident’s have their own regular meeting’s and then their spokesperson come’s to the QI meetings.  Depending on the size of the facility, more people may be necessary. Our facility only has 38 beds. 

 

According to Sherwood & Barnsteiner, it is the role of the educating nurse to continually update their educational techniques to include ways that help practicing nurses incorporate their clinical knowledge and practical skills, while also developing as professionals. They talk about considering safety, mindsets, and families. These are all things that take practice but also take critical thinking. Often simple role playing scenarios can help healthcare professionals learn de-escalation techniques. Something not taught commonly in school, but something that has a huge quality improvement potential in any facility.  The article from the  Journal of Emergency Nursing 2019, shows just how important the impact of QI programs can be for situations like de-escalation. Now, I know this was for an ER, but the principals translate to any facility, we are seeing more and more verbally aggressive patients and de-escalation techniques are the key to success in these types of situations, but if we don’t teach them through QI programs or find out they are necessary through QI programs, then the situations will just get worse. 

 

There are several ways to encourage participation in QI programs, money is always a good motivator, giving which ever employees are a part of the QI committee a $1-$2/Hr raise, shows that we value their contributions. Also if you pick those employees wisely, you can make them team leads, that way it also shows how much we respect them, and want our other employees to do the same. As far as attendance at QI education fairs or what have you, that just becomes mandatory for employment. As healthcare workers, we all know that comes with the territory. However, the QI team can make them more enjoyable with food and games, which is normally what we see. 

 

  References

  Sherwood, & Barnsteiner, J. H. (2022). Quality and safety in nursing : a competency approach to improving outcomes (Sherwood & J. H. Barnsteiner, Eds.; Third edition.). Wiley-Blackwell.

 

Staff Perception of Interprofessional Simulation for Verbal De-escalation and Restraint Application to Mitigate Violent Patient Behaviors in the Emergency Department: JEN. (2019).  Journal of Emergency Nursing, 45(1), 24. https://doi.org/10.1016/j.jen.2018.07.001