4-Continuous Quality Improvement (CQI) is defined by the American Society for Quality (ASQ) as “a philosophy and attitude for analyzing capabilities and processes and improving them repeatedly to achieve customer satisfaction”. (Huber 292) CQI is something that is relevant to all nurses as we all need to be responsible for continual improvement at work. As professionals we should always have this as a top priority. There are many challenges in the workplace, and by looking for ways to improve, we are constantly learning and growing as a profession, this is a large piece of evidence-based practice, which is something we all hold as a standard in healthcare today.

An example of how I would apply CQI in my current position working as a nurse circulator in the operating room, is to ensure that the time out procedure is followed every single case I circulate. This is important as we often get complacent in rules and regulations, as do surgeons that we are trying to keep happy as they are customers just as much as our patients are.

I had circulated a case with another nurse during orientation in which not all implants for a total knee replacement were in the room. I was not notified of this until after the case started, the patient was anesthetized, and time out had been completed though this requirement was not stated/asked. Later the rep for the implants then stated the implants were in route from another location. This is unacceptable, and I am glad that I was still in orientation at the time this occurred as it was a great learning experience for me. I learned how to write an incident report that day, and why the time out procedure is so important.

Resources

Huber, Diane. Leadership and Nursing Care Management, 5th Edition. Saunders, 10/2013. VitalBook file.

5-Health care delivery requires structure (staff, education, equipment, prospective data collection), and process (policies, procedure, protocols), which when integrated provide a system (programs, organizations, cultures) leading to outcomes (patient safety, quality, satisfaction). An effective health care system has all of these elements – structure, process, system, and patient outcomes in a framework of continuous quality improvement, or CQI (Kronich et al., 2015).

The purpose of QCI is to improve health care by identifying problems, implementing and monitoring corrective action and evaluating its effectiveness. Hospitals use a specific process to find areas in the health care delivery system that need improvement. When an area has been found, staff develop and implement strategies for improvement. General areas that are being studied include access to care, continuity of care, the intake process upon admission, emergency care, and adverse patient events, including all deaths (National Commission on Correctional Care, 2018).

In my previous position, working as a NICU RN, we initially did not use two RN’s to verify the content in the TPN-bags for each patient. Shortly after I started working at this facility, this change was implemented. The purpose was to catch medical errors from pharmacy that sadly was occurring more frequently. This new process of reading labels with another RN while verifying the content with the document from pharmacy, and then hanging the TPN required more time in the nurses’ day. In addition, all this was done toward the end of day-shift around 1730. This process resulted in stress among the RN’s and often overtime, which was not appreciated by management. Thankfully, a solution was found by changing the time of day TPN was delivered to the unit. By working together and brainstorming solutions, everyone was satisfied in the end; quality of care was improved, and the nurses were able to finish their duties in time.

References:

Continuous Quality Improvement. (2018).

Retrieved from https://www.ncchc.org/spotlight-on-the-standards-24-1

Kronich, L., Kurz, M., Lin, S., Edelson, D., Berg, R., Billi, J.,…Cabanas, J. (2015). System of Care and Continuous Quatity Improvement.

Retrieved from https://www.ahajournals.org/doi/abs/10.1161/cir.0000000000000258

6-I agree with your response about having a rapid response team because this helps identify patients at risk for cdoing before the event when you can give care to help prevent a code. I think rapid response teams are a must in facilities. according to patient safety primer .gov 

Rapid response teams represent an intuitively simple concept: When a patient demonstrates signs of imminent clinical deterioration, a team of providers is summoned to the bedside to immediately assess and treat the patient with the goal of preventing intensive care unit transfer, cardiac arrest, or death (psnet.ahrq.gov). I also agree with your staement about the lean technique that is in our text as a useful apporach to imrove efficincy in renedering care. When we are effective communicators and work as a team in our settings, we will definietly be more productive and work loads can be reduced, less stress in the workplace, etc. Team work is amazing when it is used the way it was intended to. Evryone working together to achieve a common goal is also important. If everyone is not on the same page, then this is where conflict can areise. Thank you for sharing, I enjoyed reading your post!

Reference

Retrieved from 

https://psnet.ahrq.gov/primers/primer/4/rapid-response-systems

 Chapter 14 – Violent Behavior in Institutions   Question(s): Be prepared to discuss 2 questions Statistics shows that 48% of no fatal injuries from occupational assaults in the United States occurred in health care and social services particularly mental health workers. Mention and discuss at least 3 precipitating factors for violent behavior in institutions? APA FORMAT SINGLE SPACE, AT LEAST 2 REFERENCE. PLAGIARISM FREE.

Grading Criteria:  The answer should be based on the knowledge obtained from reading the book, no just your opinion. If there are 2 questions in the discussion, you must answer both of them. Your grade will be an average of both questions. Student mentions 3 precipitating factors for violent behavior in institutions (45 points – 15 points each clue). Student discusses / explains each precipitating factor (55 points – 18.3 points each clue).

Read the article “Sentence Variety,”      https://www.englishclub.com/writing/sentence-variety.htm 

and then write a response that discusses the importance of using sentence variety when writing.As part of your response, address the following:Find and post an example of a simple sentence: Explain why a simple sentence was most effective in this case, or explain why it might need to be changed to a different sentence type.Look at the sentences before and after. Are they both simple sentences as well? If so, does sentence variety need to be addressed here? Why or why not?Find and post an example of a complex sentence in your rough draft: Explain why a complex sentence was most effective in this case, or explain why it might need to be changed to a different sentence type.Look at the sentences before and after. Are they both complex sentences as well? If so, does sentence variety need to be addressed here? Why or why not?Find and post an example of a compound sentence in your rough draft: Explain why a compound sentence was most effective in this case, or explain why it might need to be changed to a different sentence type.Look at the sentences before and after. Are they both compound sentences as well? If so, does sentence variety need to be addressed here? Why or why not?Check all three sentences to see if they are correctly punctuated, and if not, address what changes need to be made and why.

Hello to all of my classmates and professor.  My name is Brent Braswell.  After serving in the US Air Force for almost a decade, I decided to become a nurse.  I started as a LVN (LPN) and a year later I went back for my RN.  I tried hospital nursing and while the acute experience is very valuable, I simply was not happy.  I soon found myself trying other things such as hospice and even the county jail, yet I could still not find that happy place I was searching for.  Then I discovered geriatrics and there was the icing on my cake! I absolutely found my calling in long term care and rehabilitation.  After a short time working as a floor nurse I was asked to fill in for the director of nursing while they were out on a family emergency.  After that I was addicted and have been a director of nursing for skilled facilities ever since and I have no regrets.  It has been amazing and while many times my frustration with the system can grow, I always know in my heart that geriatrics is my passion.

Leadership Style

                My leadership style is hard for me as I vary from one to another depending on the situation.  Predominantly I would have to choose democratic leadership as my primary choice.  A democratic leader encourages participation and exchange of ideas from her/his team regarding the directions the team should take and what actions they should prioritize. When faced with a complex problem, she/he will elicit ideas from others, listen attentively and build consensus, but may put off making difficult decisions (Chapman, Johnson, & Kilner, 2016).

Evidence

It is very important to me that I always include my staff in decision making. I am the boss, but that does not mean that I know everything or that I think of all possibilities.  Encouraging my staff to speak up and pass along their ideas brings about camaraderie and trust with each other. I also believe in autonomy. I have three assistants that are called unit managers. Until they were to give me a reason to micromanage their jobs, I simply will not. This allows me to show that I trust their judgment and knowledge.  The nurses who work the floor are full of ideas concerning the specific needs of their patients. I do not take care of these patients all day, so why on earth would I not ask their opinion when an issue arises? When there is a change in regulations it is my job to know and understand the details of that change and how it may impact daily routines. It is also my job to explain it to the staff so that they understand. At that point I will have already formed ideas of how to make it work, but I still call a meeting with my staff to teach the change and to share ideas of the best way to implement the change.

Chapman, A. L., Johnson, D., & Kilner, K. (2016). Leadership styles used by senior medical leaders: Patterns, influences and implications for leadership development. Leadership in Health Services; Bradford Vol. 27, Iss. 4, (2014): 283-298. , 8.

 What is a thyroid gland? How much do people understand about it? The organ is located at the base of the neck, surrounding the trachea. This seemingly insignificant body part plays a vital role in maintaining optimal development and ensuring the balance of an organism’s central nervous system. In cases where it malfunctions, endocrine diseases may arise. This is reflected    in Erica* who is a sufferer of Grave’s disease. This essay will first examine the effects of Erica’s medical condition on her physical and psychological health, and on her lifestyle. Secondly, Erica’s personal perception of the disease and reaction to the diagnosis will be discussed. Next, environmental    triggers and any other predictors that may have an impact on aspects of the disease will be addressed. Finally, emphasis will be given to Erica’s expectations for the future. The author’s own predictions will also be included strategically throughout the essay.