Leading Organizations for Quality Improvement Initiative

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Quality Improvement Initiative

Description of Quality Initiative

The quality improvement initiative I selected is healthcare staff education on the essence of patient monitoring before the administration of medicine. This initiative is relevant as it is directly related to the QI improvement gap in my organization, which is medication management lacking consideration for physical monitoring such as vital signs, weight, and blood levels for illicit drugs. Education on the need for patient monitoring will remind the nurses and other healthcare providers of the basics of healthcare provision that they may have forgotten or undermined during their practice. The education initiative will differ from a training program in that it will be a one-time thing for the participants, lasting only a few hours.

Handling of Adverse Events in an Organization

My organization appreciates that adverse events are normal in healthcare provision and any other practice in different sectors. This appreciation leads it to watch out for potential adverse events for their prevention. When unwanted events do occur, the healthcare organization encourages the staff to report them so that investigations can be done to find out the cause and prevent their occurrence in the future. In this case, the mental health care facility encourages a just culture and ensures that care providers are not victimized when they make mistakes. According to Barkell and Snyder (2021), a just culture balances system and individual accountability and people perceive that they will be handled fairly if they report mistakes done during care provision. When an organization responds to adverse events fairly and systematically the internal and external stakeholders perceive that the care organization provides quality care as it cares for its staff even when mistakes are made and is not thrown into disarray in the process.

Error Rate from Article

The article I selected is one from Mulac, Taxis, Hagesaether, and Granas (2020), who state that medication errors still occur and cause patient harm despite the global efforts towards their prevention. According to the article, most medication errors occur during administration, accounting for 68% of the errors and the leading types of errors were dosing, omission, and wrong drug errors at 38%, 23%, and 15% respectively (Mulac, Taxis, Hagesaether and Granas, 2020). Furthermore, according to the article, 62% of the errors were harmful, resulting in severe harm or fatal outcomes (Mulac, Taxis, Hagesaether, and Granas, 2020). The error rates from the article relate to my healthcare organization as they reflect the adverse outcomes it may experience if the QI initiative is not undertaken. The mental health patients who visit the facility may suffer severe harm or even die because of the lack of patient monitoring before drug administration by the care provider in the organization.

References

Mulac, A., Taxis, K., Hagesaether, E., & Granas, A. G. (2020). Severe and fatal medication errors in hospitals: findings from the Norwegian Incident Reporting System. European Journal of Hospital Pharmacy.

Barkell, N. P., & Snyder, S. S. (2021, January). Just culture in healthcare: An integrative review. In Nursing Forum (Vol. 56, No. 1, pp. 103-111).

PART 2

CLINICAL ASSIGNMENT 1: DNP PROJECT FACULTY ADVISOR AND SITE IDENTIFICATION—MATCHING REQUEST FORM

For this Assignment, you will:

1. Complete the one-page  PROJECT SUMMARY for this assignment including the following information for the planned DNP Project:

· Planned Project Title: tangible Virtual Treatment

· Organization (site name/type of setting): Virtual Consult MD/Private practice

· Location (city, state, and/or country): Norcross, Georgia, USA

· Practice gap or practice change: The quality improvement practice gap I have identified in my organization is medication management without physical monitoring of vital signs, weight, or blood levels for illicit drugs.

· Proposed Type of Project: Quality improvement initiative

Rubric

NURS_8302_Week6_Assignment2_Rubric

NURS_8302_Week6_Assignment2_Rubric
Criteria	Ratings	Pts
This criterion is linked to a Learning OutcomeThis criterion is linked to a Learning Outcome Complete the DNP Project Committee Request Form.	20 to >0.0 pts Excellent A completed DNP Committee Request Form is submitted and includes site and a possible project information. 0 pts Fair 0 pts Good 0 pts Poor A DNP Request Form is not submitted, or it is missing information.	20 pts
Total Points: 20

NURS 8302 Leading Organizations for Quality Improvement Initiatives

Practicum Assignment: Organization Meeting Summary

Preparation to begin your DNP Project begins with the meeting with an organization to explore a gap in practice or a practice change that you might address as your DNP Project. Preparing for this meeting includes following the instructions in your NURS 8302 course and reviewing the guidelines for your practicum assignment 1. Address the following in a 4–5-page paper using the APA 7 template for writing graduate papers found at https://academicguides.waldenu.edu/writingcenter/templates/general

Introduction

· Identify the organization, location, and participants at the meeting. Indicate the role each person plays in the organization.

· How did you first approach the organization?

· Why did you select this organization?

· Does the organization have a key person for the organization who oversees students doing DNP projects?

· If there is no key person, who represented nursing and/or nursing students at the meeting.

Describe the DNP Project

· Describe exactly what you did to explain the DNP project process at Walden University.

· What questions did the participants have and how did you respond?

· How did you and the organization identify possible gaps in practice or practice changes that might be addressed by the DNP project.

· Describe the gap or problem and cite two sources that justify the gap or problem in nursing.

· What approach (clinical practice guideline, staff education, quality improvement initiative) did you discuss to address a practice gap or practice change?

· What questions did the organization representatives have, and what were your responses?

· How does the proposed practice change support positive social change, diversity, equity, and inclusion?

Project Team

· Who would be the key stakeholders and potential team members (e.g. organization leader, project mentor) for a project to address gap in practice or practice change?

Next Steps

· Describe the information that you provided to the organization regarding the next steps in the process.

· What questions were asked?

· What responses did you have?

· What decisions were made?

Evidence

Explore three sources of current evidence (no older than five (5) years) that could support the project initiative. You may include the two citations you cited under the Describe the DNP Project section.

Citation	Evidence Type	Sample, Sample size, Setting	Findings that help address the gap in practice or practice change

Summary

· Summarize the strengths and weaknesses of the meeting.

· What would you have done differently?

· What additional information do you need before you meet with your faculty advisor in NURS 8702, project mentoring course.

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Applying Project Management Approaches for a Quality Improvement Practice Gap

Quality Improvement Gap

The quality improvement practice gap I have identified in my nursing organization is medication management without physical monitoring of vital signs, weight, or blood levels for illicit drugs. This practice gap is noticeable in my organization and evident in many organizations providing mental health assistance and medical care in general. In research carried out in England, it was found that only 40% of patients on lithium prescriptions in mental hospitals received the necessary checks in primary care (Ayre, Lewis, and Keers, 2023). Many health care providers undermine medication management resulting in medical errors in healthcare settings because of undermining the need for monitoring vital signs and physical patient monitoring.

Sapra, Malik, and Bhandari (2020) state that vital signs are important for present and future care and their monitoring at any medical appointment can provide an outlook of the intensity of the medical issue and the body’s ability to cope with the resulting stress on the physiological wellbeing of the patient. Physical patient monitoring is also critical for medication management, especially in my organization, where patients may have indulged in one or more illicit drugs and this may interfere with the medicine, they are to receive for their mental health care.

SMART Objectives for Quality Improvement Project

One objective for quality improvement for closing the gap in medicine management in mental health practice and my organization specifically is to ensure that the vital signs are checked. Another objective is to ensure the monitoring of the physical factors of patients before the administration of medicine for effective medicine management. The following is the SMART breakdown of the objectives;

· Specific- The objectives will target care providers, where nurses like myself and other members of healthcare teams will be expected to carry out vital signs checks before the administration of any medication. Those who fail to monitor patients will be at risk of disciplinary followings to review their conduct in providing mental health services in the organization.

· Measurable- To measure whether these objectives are being attained, feedback will be gained from administrative records on checking vital signs and physical patient monitoring. According to the World Health Organization (2019), administrative records are one of the sources of data for identifying quality improvement gaps and quantifying the outcomes of related programs for closing the gaps.

· Attainable- The objectives are attainable as they only require the nurses and other care providers in my organization to comply and act accordingly.

· Relevant- These objectives will close the practice gap in the care setting thus reducing medical errors and promoting positive care outcomes for patients dealing with mental health issues.

· Time Bound- Timing such a change in quality improvement and closing the gap in medication management in my organization will require about 3 months as such time is enough to track the critical changes in the practice gap and any more time will undermine the safety of patients and the quality of care provided in the organization.

Activities for Quality Improvement Project

Closing the practice gap in medicine management in my organization will require consideration of the objectives and the resources at hand. In this case, since the organization is still hiring nurses and other healthcare providers, a relevant activity for the mental health facility will be to hire nurses and other healthcare professionals with consideration and competency for medicine management for the patients. This process will involve finding nurses from reputable institutions who demonstrate appreciation for evidence-based practice through the integrity and reliability of the research projects they undertook while studying the course.

The human resource management of the facility will be responsible for this project by thoroughly going through the transcripts and the CVs of the nurse applicants to check for their experience with medicine management. Another activity for closing the gap in medicine management in the organization will be to train the present staff on the need for vital signs and physical patient monitoring before medicine administration. Training the present staff will remind them of the importance of patient monitoring while hiring staff knowledgeable in the same will ensure the culture is retained for closing the gap in the long run.

References

Ayre, M. J., Lewis, P. J., & Keers, R. N. (2023). Understanding the medication safety challenges for patients with mental illness in primary care: a scoping review.  BMC Psychiatry,  23(1), 1-17.

clinical services (No. WHO/CDS/HIV/19.17). World Health Organization.

Sapra, A., Malik, A., & Bhandari, P. (2020). Vital sign assessment.

World Health Organization. (2019). Maintaining and improving quality of care within HIV