Quality Improvement Proposal

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Jane Chima

QualityImprovementProposal (2).docx

Summary

 1363 Words  

Running head: QUALITY IMPROVEMENT PROPOSAL 1

QUALITY IMPROVEMENT PROPOSAL 2

Quality Improvement Proposal

History of the Problem

Shift scheduling tends to be a significant issue within the nursing practice as well as it

Quality Improvement Proposal

Jane Chima

Grand Canyon University HLT- 362 V

6/28/20

is a major contributor to the numerous health care mistakes that occur within the healthcare

delivery system. Often nurses tend to get fatigued when providing the health care services

and these often lead to them not being able to provide quality and satisfactory health services.

This issue has raised significant attention to the need to provide nurse practitioners with a

healthy shift scheduling process which will promote an excellent relationship between the

workforce as well as the relationship between the patients and the nurse practitioners

(Clendon & Gibbons, 2015). Thus, to be able to improve the quality of healthcare delivery, it

is essential to focus on developing a shift schedule that supports the health needs of the nurse

practitioners.

Most private healthcare organizations tend to focus their long-term goals on the

profits that they make at the expense of their workers or the patients that they serve.

Therefore, their management teams are unlikely to have a system where they do not have the

nurses working around the clock as long as they are content with the input that they make.

However, research has pointed out that nurses who do not have a proper shift scheduling are

likely to succumb to fatigue, increase the likelihood of increased patient errors as well as

undesirable health outcomes for the nurses (Clendon & Gibbons, 2015). These issues have

legal, ethical, and professional consequences for the organization as well as the patients and

the nurses, and that is why they need to be addressed before they cause major health

problems. Subsequently, the changes in the nursing practices entail that the organization

where they work are to be accorded the right environment where they can dispense their

duties without negatively affecting their health or that of the patients. Private health care

providers have been under scrutiny from the American Nurses Association and the Institute

QUALITY IMPROVEMENT PROPOSAL 3

of Medicine (IOM) for their mandatory overtime practices so that they can profiteer at the

expense of the healthcare professionals and the patients (Dall'Ora et al., 2015).

Quality Improvement Initiative

Quality improvement initiative is focused on determining the lengths and schedules of

the nurses' shifts and understanding the various negative impacts they cause in the health care

sector. Additionally, the analysis will provide a quality understanding of how fatigued nurses

cause harm or death to the patient population due to carelessness. Irrespective of the section a

nurse works in, if the health organization does not offer a scheduling pattern that fits the

needs of the nursing practitioners, it is quite difficult to acquire quality health care service

provision (Ball et al, 2017). Therefore, in analyzing how nurses shift lengths and scheduling

patterns impact the health care sector, it is worthy to note that the mistakes they make when

they are fatigued and sleep-deprived cause more harm to the industry as patients lose their

lives due to carelessness. Irrespective of whether the nurses work in intensive care units or

general care, when they do not have a scheduling pattern that suits their needs, the patients,

and the organization in which they work, quality care cannot be attained. The ratio of patients

to nurses is supposed to be based on the organization's capability to provide quality

healthcare as per the requirements of the law so that there are gaping differences (Ball et al,

2017). In this regard, it points to the importance of scheduling patterns as a determining

factor of whether the healthcare facility is working within the confinements of the laws.

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Support for Quality Improvement initiative

The essential factors that are supposed to be adhered to when creating schedules are

based on employee preferences, weekend assignments, and unhealthy shift patterns (Ball et

al, 2017). Under each category, the organization is supposed to ensure that they determine

which system works for them, and then they can include it as part of their work schedule

which the nurses analyse and evaluate. Scheduling patterns are not supposed to be done by

QUALITY IMPROVEMENT PROPOSAL 4

the management without consulting the nurses as it affects both parties when mistakes or

progress occurs. Therefore, the system is supposed to be converted to a metric so that it can

be reviewed to suit the healthiness of a given schedule. These metrics are, in turn, analysed

digitally and compared between units and the human resource department to ensure they are

within the financial capabilities.

Work scheduling patterns and shift lengths showcase that the process is used in

promoting structural empowerment and it creates a healthy working environment, which is an

integral part of the healthcare settings. When employees are included in the schedule

creation, it enables the nurses to spend more time in training and advancing their profession

as it ensures that they do not spend all their time in the organization setting. Additionally, in

carrying out the task, it acts as a process of creating nursing managers while they leave the

administrators to undertake other duties and responsibilities (Ball et al, 2017). A sense of

competence, involvement, and responsibility is enhanced amongst the nurses when there is a

work scheduling pattern that is inclusive and tailored according to the needs of the

employees. Therefore, if the healthcare sector requires to improve quality services, the work

scheduling patterns, and shift lengths need to be an inclusive part of this process.

Steps for implementing the Proposed Quality Improvement Initiative

The steps that are necessary to implement work scheduling patterns and shift lengths

in nursing are to ensure that the system that has been adapted accompanies the mathematical

formulas and payment requirements. Computerized scheduling programs that are tailored

according to the nurse's needs are supposed to ensure that they are within the articulated rules

so that when it comes to weekends and holidays, there will be no complaints of prejudice or

preference as it entails overtime or rest (Stimpfel et al., 2015). Therefore, when there is total

compliance to the new quality improvement initiative, there will be a reduction of nurse’s

absenteeism, poor health, patient mistakes, and negligence.

QUALITY IMPROVEMENT PROPOSAL 5

Evaluation of the Quality improvement proposal and identification of variables

To ensure that both shift scheduling patterns as well as the shift lengths are

successful, there needs to be a synchronized working pattern which requires little or no

continuous review as long as all the nurses are available for duty. Consequently, nurses who

feel that they are fatigued, and they face burnout should be encouraged to report such cases

so that they can be evaluated on what is causing their problems. There should be no

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consecutive 12-hour day shifts that exceed four days per week as it would mean that the

nurses are overworking (Harris et al., 2015). Additionally, there should be no nurse who goes

through 12-hour night shifts on three consecutive days, and they should be monitored closely

for signs of fatigue by their supervisors. Commute time for the nurses should also be

monitored or whether they are working in other departments or units, and if they have a

second job. If these factors remain constant, it means that the new quality improvement

initiative is successful.

QUALITY IMPROVEMENT PROPOSAL 6

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References

Ball, J., Day, T., Murrells, T., Dall’Ora, C., Rafferty, A. M., Griffiths, P., & Maben, J. (2017).

Cross-sectional examination of the association between shift length and hospital nurses

job satisfaction and nurse reported quality measures. BMC nursing, 16(1), 26.

Clendon, J., & Gibbons, V. (2015). 12 h shifts and rates of error among nurses: a systematic

review. International journal of nursing studies, 52(7), 1231-1242.

Dall'Ora, C., Griffiths, P., Ball, J., Simon, M., & Aiken, L. H. (2015). Association of 12 h shifts

and nurses’ job satisfaction, burnout and intention to leave: findings from a cross

sectional study of 12 European countries. BMJ open, 5(9), e008331.

Harris, R., Sims, S., Parr, J., & Davies, N. (2015). Impact of 12 h shift patterns in nursing: a

scoping review. International Journal of Nursing Studies, 52(2), 605-634.

Stimpfel, A. W., Brewer, C. S., & Kovner, C. T. (2015). Scheduling and shift work

characteristics associated with risk for occupational injury in newly licensed registered

nurses: An observational study. International journal of nursing studies, 52(11), 1686

1693.