Quality Improvement and Patient Safety Initiatives

The vice president of nursing, Dr. Sasha Mendez, has had a lot of complaints from patients and their families about the difficulties they experience navigating the system at her organization; e.g., going from the E.R. to admissions. Dr. Mendez’s nursing specialty area is psych/mental health. As such, she is very concerned about the stress this is causing the patients.

What are the macro systems that are affecting patient satisfaction at Dr. Mendez’s facility? What micro systems should she also analyze to look at how the patient moves through—from entry, to possible admission, to possible discharge? How do these systems relate? What impacts each system?

The concepts presented in Week 8 serve as a foundation for this week as you continue to look at factors within an organization’s environment that are barriers and facilitators for implementing change. In this Discussion, you examine the macro and micro systems within the organization (of your practicum setting) and identify changes that may need to take place to facilitate quality improvement and achievement of patient safety outcomes.

To prepare:

• Reflect on the issue you have been addressing      through your EBP Project.
• Identify the macro and micro systems that      influence the issue. Review the McClusky and Middleton (2010) article for      an example of this process (See attached file).
• Determine the desired outcomes of resolving the  EBP Project issue and how resolving it will improve quality and patient     safety. (Note: Next week you will evaluate these outcomes. You may      want to view the Week 10 Discussion as you prepare.)
• What procedures/processes would need to be      modified to achieve the desired outcomes?

Post your PowerPoint presentation

By tomorrow Tuesday 10/23/18, in APA format and include 3 scholarly references from the list of required readings below, develop a 5-slide Microsoft PowerPoint presentation for the business unit team and leadership within the organization, sharing your issue, strategies for resolving the issue, and how it will improve quality and patient safety. 

Note: The purpose of the presentation is to persuade the business unit team and leadership to accept your recommendations.

Required Readings

Brooks, P., Spillane, J.J., Dick, K., & Stuart-Shor, E. (2014). Developing a strategy to identify and treat older patients with postoperative delirium. AORN Journal, 99(2), 256-276. (see attached file).

Jarden, R.J. & Sutton, L.J. (2014). A practice change initiative to improve the provision of enteral nutrition to intensive care patients. British Association of Critical Care Nurses, 20(5), 242-254.

McCluskey, A. & Middleton, S. (2010). Delivering an evidence-based outdoor journey intervention to people with stroke: Barriers and enablers experienced by community rehabilitation teams. BMC Health Services Research, 10(18). doi: 10.1186/1472-6962-10-18. Retrieved from https://bmchealthservres.biomedcentral.com/articles/10.1186/1472-6963-10-18. (see attached file).

Murfet, G.O., Allen, P., & Hingston, T.J. (2014). Maternal and neonatal health outcomes following the implementation of an innovative model of nursepractitioner-led care for diabetes in pregnancy. Journal of Advanced Nursing, 70(5), 1150-1163 (see attached file).

PIICOT Question

In patients in extended intensive care within an urban acute care facility in Eastern United States, how does early mobilization as recommended by National Institute of Health and Care Excellence clinical guidelines on rehabilitation of patients after critical illness impact early transfers from intensive care as measured 6 months post-implementation when compared to the current standard of care including minimal mobilization of patients?

P: Adult patients 

I: in extended intensive care within an urban acute care facility

I: increased mobilization of the patients 

C: minimal mobilization of the patients

O: early transfers of the patients from intensive care

T: 6 months

In patients with central lines, what is the effectiveness of daily chlorhexidine bath compared to weekly or as needed dressing changes to reduce infection?

Formulate a research question that you would like answered for your Literature Review Paper.

Conduct a literature search for your research question using the Individual Literature Search Worksheet Preview the documentprovided. Document your systematic search on the form, covering all steps listed below

STEP 1: Think About the Best Way to Search

STEP 2: Plan Your First Search

STEP 3: Begin Your Search

STEP 4: Refine Your Search

STEP 5: Refine Your Search Again

STEP 6: Search another Database

STEP 7: Reflection

Submit your detailed literature review worksheet.

Remember: Read through the articles carefully. Eliminate those not appropriate. It is suggested that you create a summary table. There is an example in the course text to help you organize your thoughts. Synthesize twelve or more full text research articles, beyond your textbooks, that are relevant to your research. Summarize what the studies reveal about your selected topic. Are there consistencies? Are there inconsistencies or “gaps?” Be sure to keep the table of information you developed and the twelve or more articles as you build on the course assignments. The table itself will not be part of the content in your paper; it may be included as Appendix A.