Competency

Explain the basic models of quality improvement in healthcare.

Course Scenario

Chaparral Regional Hospital is a small, urban hospital of approximately 60 beds, and offers the following:

• Emergency room      services
• Intensive care
• Surgical care
• Obstetrics
• Diagnostic      services
• Some      rehabilitation therapies
• Inpatient      pharmacy services
• Geriatric      services
• Consumer      physician referral services

Recently, the CEO has been hearing complaints from both patients and staff, varying from long wait times to rude physicians. You have been hired to design and implement a Quality Improvement Plan to help uncover quality problems and to satisfactorily resolve them.

Scenario Continued

The CEO has met with you to let you know that some members of the Board of Directors are questioning the value of developing a quality improvement plan. She has asked you to create an executive summary and an information sheet to be included in the next Board packet.

Instructions

Topics for the executive summary should include:

1. What is a Quality Improvement plan?

2. Why do healthcare facilities create improvement plans?

3. Why would you recommend the facility create and implement a QI plan?

4.Identify purpose of QI plan and supporting details

NOTE – APA formatting for the reference list, and proper grammar, punctuation, and form required.

  After completing the Executive Summary, you will create a one-page information sheet for the Board that they can use to answer questions about QI plans.

a. The information sheet should give your CEO and the Board of Directors enough information to have an educated conversation with patients and other stakeholders on the value of QI plans.

b. Make sure to use audience-specific language and tone on your information sheet. Remember, you are writing this information sheet for your CEO and the Board of Directors.

c. Be creative, and make your information sheet fun and organized.

Stakeholder support is necessary for a successful change proposal project implementation. Consider your internal stakeholders, such as the facility, unit or health care setting where the change process is situated, and your external stakeholders, like an individual or group outside the health care setting. Why is their support necessary to the success of your project, and how you will go about securing that support?

Comment 1

Qualitative and quantitative methods differ in many ways, one being that quantitative data collection is much more structured than qualitative data collection method (DeFranzo, 2011). Qualitive research focuses on generating meaning and understanding to data that are related to opinions, concepts, values and behaviors of people in a social context. Quantitative research focuses on gathering numerical data to explain a particular phenomenon.  The use of either qualitative and quantitative methods depend on the research question of the study. However, researchers are now using mixed methodology research, which involves the use of both qualitative and quantitative methods with the assumption that it will address the research question more comprehensively then qualitative and quantitative method alone (Tarig & Woodman, 2013). Mixed methodology can be extremely beneficial to studies addressing complex multifaceted issues such as health service interventions.

A potential challenge in conducting mixed method research would be that qualitative and quantitative research methods belong to separate and incompatible paradigms. Both have different and conflicting ways of how they view the world and gather research data (Tariq & Woodman, 2013). Another challenge would be that it can be extremely time consuming to the researcher that it would benefit if it was conducted by a large team instead of just one researcher in order to conduct the study in a timely manner. Studies involving both quantitative and qualitative research can be challenging at times, however it also provides the researcher with a wider range of tools to answer their study question more efficiently.

Comment 2

With modern medicine advancing and new treatments invented each year, healthcare professionals including nurses need a reliable source of information to improve their practice and stay updated. Evidenced-based practice was implemented as a great tool that helps nurses to better provide their nursing care and improve patient’s outcomes. According to the article, “ Evidence-based practice (EBP) results from the integration of available research, clinical expertise, and patient preferences to individualize care and promote effective care decision-making”. ( Wyant, 2017) 

There are few EBP models that are used nowadays in nursing. They all have five basic phases that make the process more effective: 

1. Identification of a clinical problem.
2. Review of the relevant literature.
3. Critical appraisal of the evidence.
4. Evaluation for practice change and potential implementation.
5. Evaluation of he outcomes.

( Wyant, 2017)

Certain organizations use specific EBP models. However, their only goal is to identify the problem and find the solution in order to improve nursing practice and patient’s outcomes. 

Students are required to maintain weekly reflective narratives throughout the course to combine into one course-long reflective journal that integrates leadership and inquiry into current practice as it applies to the Professional Capstone and Practicum course.

In your journal, you will reflect on the personal knowledge and skills gained throughout this course. The journal should address a variable combination of the following, depending on your specific practice immersion clinical experiences:

1. New practice approaches
2. Intraprofessional collaboration
3. Health care delivery and clinical systems
4. Ethical considerations in health care
5. Population health concerns
6. The role of technology in improving health care outcomes
7. Health policy
8. Leadership and economic models
9. Health disparities

Students will outline what they have discovered about their professional practice, personal strengths and weaknesses that surfaced, additional resources and abilities that could be introduced to a given situation to influence optimal outcomes, and finally, how the student met the competencies aligned to this course.

While APA style is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.

As an NP student, you need to determine the medications for onychomycosis.

1.  According to the AAFP/CDC Guidelines, what antifungal medication(s) should this patient be prescribed, and for how long? Write her complete prescriptions using the prescription writing format in your textbook.

This is patient should be prescribed with Terbinafine; this is an antifungal systemic medication. This medication is indicated for different types of fungal infection and must be used for 12 weeks by oral 

Prescription:

Yamile Carrazana. FNP

Name: D.E  DOB: 00/00/0000  Date: 02/04/2020

Terbinafine 250 mg 

Disp: 30 Tablets

Sig: 1 Tablet PO Daily for 12 weeks. For Onychomycosis

Refill: 2.

Yamile Carrazana. FNP.  DEA# on file in Pharmacy.

2.  What labs for baseline and follow up of therapy would you order for this patient? Give rationale.

For this patient I would like to order before to start the treatment a Liver Function Test, this test is in blood and measures specifics proteins and liver enzymes to get an overall sense of how the liver is working because this medication can be toxic for the liver and one of its contraindications is in chronic or active liver disease. One of the functions of the Liver is regulating the amount of sugar in the blood stream, this is a diabetic patient.

This test checks for ALT/SGPT: Alanine Aminotransferase, enzyme founding in the hepatic cells, if the liver is damaging this enzyme will be found in blood. Albumin is a protein made in the liver very helpful to diagnoses liver disease. Alkaline Phosphatase, Aspartate Aminotransferase, Bilirubin, Globulin, total protein.

Other test will be request is a Comprehensive Metabolic Panel to check electrolytes, renal function and glucose.

During the complete treatment and with regularity I would like to keep checking LFT’s (Liver Function test)

References:

Wood, M. & Robinson. M, V. Pharmacotherapeutics for Advanced Practice Nurse Prescriber. (4th Edition).

Arias, E. (2010). United States Life tables, 2006. National Vital Statistics Reports.

Medscape:  Clinically Relevant Drug-Drug Interactions in Primary Care Mary Carpenter, PharmD; Holly Berry, PharmD; Allen L. Pelletier, MD. Am Fam Physician. 2019;99(9):558-564.