Promoting Health Care Quality-  Quality Improvement Issue  

To help you move forward with your Course Project, this week you identify a quality issue that you would like to address and submit a description of this issue for Instructor feedback.   Your proposed issue should reflect a genuine need for improvement within your selected health care organization. Through your Course Project, you will analyze this issue and propose strategies to improve outcome(s), including the redesign of a related process.  

To prepare: •Review the six quality improvement aims from the Institute of Medicine (IOM) presented in Chapter 3 of the Sadeghi, Barzi, Mikhail, and Shabot text. 

•Conduct a search of the literature to help you identify a specific issue that warrants attention and action to promote quality improvement. 

•Consider what you have surmised thus far through your analysis of the organization that you selected. What have you noticed that could help you identify a quality-related need for improvement? For instance: 

•What has captured your attention in meetings, reports, and/or daily activities? 

•Have you noticed discrepancies between activities in the organization and recommendations in the research literature, quality standards, and/or the organization’s stated policies and procedures? 

•If so, what do you think could be the reason(s) for variations or gaps between what you have observed and what is recommended?  

•Identify a quality improvement issue that you would like to investigate for this project.

The instructions for this assignment asks for students to identify a quality improvement issue, and provide a description of the issue they wish to pursue. This can be accomplished in 2 paragraphs.

ReferencesHickey, J. V., & Brosnan, C. A. (2017). Evaluation  of health care quality in for DNPs (2nd  ed.). New York, NY: Springer Publishing Company.  

•Chapter 10, “Evaluation of Patient Care Standards, Guidelines, and Protocols” (pp. 207-226)

 •Chapter 12, “Evaluating Populations and Population Health” (pp. 265-280) Chapter 10 reviews methods for using national, local, and organizational standards to evaluate the quality of health care practices. Chapter 12 examines strategies for identifying quality issues through the evaluation of populations.   Sadeghi, S., Barzi, A., Mikhail, O., & Shabot, M. M. (2013). Integrating quality and strategy in health care organizations, Burlington, MA: Jones & Bartlett Publishers. 

 •Chapter 3, “General Concepts in Quality” (pp. 45–82) See the six aims for quality proposed by the Institute of Medicine (IOM).   Bellot, J. (2011). Defining and assessing organizational culture. Nursing Forum, 46(1), 29–37.

https://class.waldenu.edu/bbcswebdav/institution/USW1/201870_27/MS_NURS/NURS_6231/artifacts/USW1_NURS_6231_Week04_Bellot_2011.pdf

 

INSTRUCTIONS

The Case of Marisol

Marisol is a 40-year old single female from a tight knit Puerto Rican family. She is employed full time as a data analyst for a technology company. She has steadily progressed in her career by working for relatively small companies where her role allowed her to work relatively independently. Unfortunately, working for small organizations was less stable financially so she has been working for a larger company for the past four years. Interacting with a larger work group has challenged her comfort zone. She prefers to spend time with a network of close friends she has known most of her life whom she visits with one on one. Her family lives in the area, and she sees them frequently. Her parents and older brother have always provided a support system and practical help. She enjoys quiet evenings alone or at the home of her brother and his family. Her friends and family privately wonder why she’s never dated or wanted to travel.

For each case study, you will complete a descriptive diagnosis using tools you select from the list of assessment tools provided later in the assignment. Each case requires the following information to be addressed:

• Identify presenting concerns from the client’s perspective as described in the video and accompanying narrative. Include relevant cultural and systemic considerations that frame the client’s presentation.
• Describe what information is still needed to make a differential diagnosis and evaluate how at least one assessment tool, which is listed in the List of Assessment Tools resource, will aid in obtaining that information. The Differential Diagnosis Decision Tree may be helpful to guide this process.
• Present DSM-5 and ICD-10 codes, including relevant V and Z codes.
• Provide a descriptive rationale for the DSM diagnosis that best fits the information provided including relevant ICD codes. This should be written in a narrative form using complete sentences. Support your rationale with scholarly sources. Optional readings found in the course syllabus may be particularly relevant.
• Determine if a medication consultation is appropriate and provide a rationale with support from scholarly sources.

LIST OF ASSESSMENT TOOLS AND SUPPORTING RESOURCES

• Beck, A. T., Epstein, N., Brown, G., & Steer, R. (1988). Beck Anxiety Inventory. Psyctests, doi:10.1037/t02025-000
  • Bardhoshi, G., Duncan, K., & Erford, B. T. (2016). Psychometric meta‐analysis of the English version of the Beck Anxiety Inventory. Journal of Counseling & Development, 94(3), 356–373.
    • Review this source to review how to interpret the Beck Anxiety Inventory.
• Derogatis, L. R. (1977). Symptom checklist-90–revised. Psyctests, doi:10.1037/t01210-000
  • Grande, T. L., Newmeyer, M. D., Underwood, L. A., & Williams, C. R. (2014). Path analysis of the SCL-90-R: Exploring use in outpatient assessment. Measurement and Evaluation in Counseling and Development, 47(4), 271–290.
    • Review this source to review how to interpret the SCL-90-R.
• Prevatt, F., Dehili, V., Taylor, N., & Marshall, D. (2015). Anxiety Symptom Checklist. Psyctests, doi:10.1037/t39906-000
• Beck Depression Inventory–II
  • Erford, B. T., Johnson, E., & Bardoshi, G. (2016). Meta-analysis of the English version of the Beck Depression Inventory–Second edition. Measurement and Evaluation in Counseling and Development, 49(1), 3–33.
    • This resource will help you use the Beck Depression Inventory-II if you access that assessment tool.

SUBMISSION REQUIREMENTS

• Written communication: Written communication must be grammatically correct and free of errors that detract from the overall message. Writing should be consistent with graduate level scholarship.
• APA formatting: Title page, main body, and references should be formatted according to the current APA style and formatting.
• Number of resources: Minimum of six scholarly resources. Distinguished submissions typically exceed this minimum.
• Length of paper: 5–7 typed double-spaced pages. Abstract and Table of Content pages are not necessary.
• Font: Times New Roman, 12 point.

 

An RN working in the Intensive Care Unit (ICU) is caring for a patient with an acute gastrointestinal hemorrhage related to Hepatitis C liver damage that resulted from cocaine abuse. At the end of the shift, the outgoing RN states to the incoming RN, “I have been in that patient’s room all day, transfusing blood products. It’s such a waste of resources. Why should we even bother to treat him, since he will just be using cocaine again after discharge?”

Initial Discussion Post:

Address the following:
What is the most appropriate way for the incoming RN to approach this situation after hearing the outgoing nurse’s comments? Include ethical and legal considerations.
What is the role of an RN in addressing the value system of other health care workers that may have a negative impact on patient care? Include ethical and legal considerations.
Should an RN be able to refuse an assignment if a patient’s value system is in direct conflict with his/her own? Why or why not? Include ethical and legal considerations.

350 words

 APA format  no more than 5 years

and in text citation

 

Read the article: “Coker-Bolt, P., Jarrard, C.,Woodard, F., & Merrill, P. (2013). The effects of oral motor stimulation on feeding behaviors of infants born with univentricle anatomy. Journal of Pediatric Nursing, 28(1), 64-71.” After reviewing the article, please answer the following questions (see below).

Coker-Bolt, P., Jarrard, C.,Woodard, F., & Merrill, P. (2013). The effects of oral motor stimulation on feeding behaviors of infants born with univentricle anatomy. Journal of Pediatric Nursing, 28(1), 64-71.

1. The Problem/Question:

• Was there a clear statement of the question, objectives and aims of the research?
• Is the problem practically important?
• What is the hypothesis?

2. Background

• Are the cited sources pertinent to the study?
• Is the review too broad or too narrow?
• Are the references recent?
• Was a theoretical perspective identified?

3. Design and procedures

• What research methodology was used?
• What are the variables? What is the dependent variable and independent variable?
• How was sampling performed?

4. Conclusions and Implications

• Were the implications discussed?
• What recommendations were made at the conclusion?
• Is it possible to implement these recommendations in practice?