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

Review the story at the link below before posting to the discussion:

Rau, J. (2015). Half of nation’s hospitals fail again to escape Medicare’s readmission penalties. Kaiser Health News. Retrieved from http://khn.org/news/half-of-nations-hospitals-fail-again-to-escape-medicares-readmission-penalties/ (Links to an external site.)

After you have finished, consider how you would respond to the following situation:

Your local hospital has received notice from CMS (Centers for Medicare and Medicaid) regarding their readmission rates.

1. As nurse, you have been asked to serve as a consultant to suggest a new Quality (Performance) Improvement process for ONE of the areas of deficiency. Write some brief steps (suggestions) for improvement as you contemplate accepting the consulting opportunity.
2. Share practice improvements utilized from your own clinical nursing experiences that have led to enhanced patient outcomes.

350 words with 2 references and it text citation.

Make a Change

For this final assignment, imagine that you had the ability to change anything you wanted with regards to the current healthcare system in the United States. In a one to two page paper, outline the changes you would make to increase access, increase quality, and decrease cost. Be sure to utilize references and data to support your position.

Don’t forget to cite your references.

 TO BE COMPLETE FOR 3/18/18 AT 3 PM

FLORIDA

 Review your state’s mandated reporter statute. Provide details about this in your post. If faced with a mandated reporter issue, what are the steps in reporting the issue? Create a mandated reporter scenario and post it. Respond to one of your peer’s scenarios using the guidelines for submission/reporting in your state. Be sure to include a reference to your state’s website related to mandated reporting. 

 

MASS DISASTERS

Brainstorm the types of potential disasters that could occur in your community, resources available, strengths of the community that could be used in the event of a disaster, and available sources of information to report the aftermath of a disaster.  

Respond to ALL of the following questions:

1. To what extent are the individuals and families in the area prepared for a potential disaster?

2. Have families in an disaster-prone region (earthquake, hurricane, etc), gathered supplies that will be needed, in the event of a disaster and placed them in an accessible location?

3. Have emergency esacpes routes from homes, schools, and other buildings been identified?

4. Have families discussed an emergency contact person who can relay messages for and about family members separated in a disaster?

5. Do you conclude that these types of preparation have been ignored.

One page essay 

ALL in APA

Must include At least one peer reviewed nursing journal article