HQS-640 Quality Improvement and Patient Safety Practicum Journal 4 Paper

HQS-640 Quality Improvement and Patient Safety Practicum Journal 4 Paper

Practicum Journal 4

HQS-640 Quality Improvement and Patient Safety Practicum Journal 4 Paper

Practicums give advanced nursing students a chance to implement quality improvement interventions aimed at improving better care outcomes for patients in different healthcare settings. Quality and patient safety are at the core of positive outcomes and patient satisfaction, especially in neuroscience units where patients are vulnerable to falls (Linehan & Linehan, 2018). Through the practicum activities covering weeks 7 and 8, this reflective journal outlines the significance of implementing purposeful hourly rounding as an evidence-based practice (EBP) intervention to reduce, prevent, and lower the susceptibility of individuals to fall in the neuroscience unit.

Practicum Activities Reflection

The practicum activities for weeks 7 and 8 demonstrate the need for an advanced nurse student to possess relevant knowledge and competencies to design a host of interventions aimed at improving the health of a selected population. The activities for the period included a staff meeting that was focused on how nurses should implement the fall prevention strategies that they had identified. The meeting was about explaining the present practices and areas that need improvement to enhance patient safety by reducing their susceptibility to falls. The next activity during the period was a patient care meeting. Through the meeting, I reached out to all staff and gave a one-on-one education before the “Go live” event that was to happen two days later on 7th March. Going live occurred on the planned day with unit huddle. I also started observing the process and collecting relevant data on falls in the different areas of concern. These activities were essential in ensuring the effective implementation of purposeful hourly rounding in the neuroscience unit to reduce falls among patients.

The other critical activities during the period included developing tools to implement the proposed strategies. The developed tools audit falls events and includes a fall prevention audit tool for charge nurse and an hourly rounding audit tool for the patient room. These tools allow nurses to collect patient data each hour on falls. The fall prevention audit tool for charge nurses ensures that a provider checks the available interventions like the use of light, bed alarms, and assisted bathroom needs (Montejano-Lozoya et al., 2019). I also developed a purposeful rounds flyer to increase awareness among nurses on the importance of patient safety based on the National Patient Safety Goal. The goal mandates organizations to assess patients’ risk for falls, take action to lower falls and reduce the risk of fall-related injuries and adverse events. The flyer shows the need to reinforce or emphasize purposeful rounding in addressing bathroom needs with the aim of reducing falls.

The information in the flyer demonstrates the increased role that charge nurses play in enhancing patient safety and ensuring quality care outcomes. The interventions identified in the flyer include tackling bathroom needs that a patient may have as earlier data indicated that many of such falls are never reported or witnessed by the in-charge nurse. Setting bed alarm ensures that patients can notify providers of any need and encouragement of call-alight use improves response from nurses. Cable connection allows sharing of information fast for effective response.

Health Care Quality and Patient Safety

Healthcare workers or providers focus on the provision of services from a common perspective, especially in enhancing the quality and patient safety. A core aspect of this common approach to care provision is inter-professional collaboration. Inter-professional collaboration in healthcare denotes multiple health providers from diverse professional specialties working together with patients, families, and communities to deliver the best quality care (Huber, 2022). Effective interprofessional collaboration leads to a team-based approach to care provision while promoting active participation of each specialty and discipline in patient care (Morley & Cashell, 2018). The implication is that all disciplines work together and fully engage patients and the individuals supporting them under team leadership based on patients’ unique needs and situations.

Inter-professional collaboration ensures that all disciplines contribute to improving patient care and outcomes. Patient care outcomes improve because the different perspectives by different healthcare providers lead to a more comprehensive, holistic view of the patient(Manges et al., 2018). Through innovative technologies like Electronic health records (EHRs) and telehealth, these professionals share patient health information to offer the best quality care.  Apart from the care team meeting, many facilities encourage team-based, patient-centered purposeful rounds to enhance patient outcomes and reduce medical and medication administration errors. Inter-professional collaboration makes treatment more prompt and reduces inefficiencies and healthcare costs (Huber, 2022). Inter-professional collaborations also improve staff relationships and interactions as well as job satisfaction levels in organizations.

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Practicum Project Preparation

Effective communication is essential when implementing evidence-based practice (EBP) interventions to reduce and prevent falls in different patient settings. A communication plan allows the project implementer to disseminate information and get feedback from stakeholders to improve the overall delivery and flow of ideas. The communication plan in this case will be to inform stakeholders of different activities concerning the practicum (Linehan & Linehan, 2018). The first part of this plan is to identify the information that stakeholders will be interested in from the project (Gliner et al., 2021). In this case, the information would be mainly about the practicum activities undertaken in the preceding weeks. The timelines will include all activities and their respective dates and covered content. The plan’s duration for information distribution would be weekly based on the logs and journals written daily. The delivery model for the information will be through one-on-one sessions through telecommunication technologies like Zoom, and video conferencing. However, in-person sessions will also occur based on the availability of the audience and hospital schedule.

Education on the new strategies will also include creating flyers for the staff and even patients, and holding demonstration acts in the facility. Accessing more information from the website and other online platforms will be effective in disseminating information on the viability of the strategies. The implementation of all these aspects will occur in the neuroscience unit but those reached through technology platforms like Zoom will get shared messaging and notifications. Evaluation of the practicum project will entail getting feedback from different data sources; mainly primary data. These include patients, caregivers, and in-charge nurses. The data on falls will also be tabulated throughpatient charts to assess the effectiveness of implementing the proposed interventions.

Evidence

In their article, Heng et al. (2020) focus on hospital fall prevention strategies as one of the ways to guarantee patient safety and quality outcomes. The scoping review article asserts that including patients in the implementation of falls prevention is critical because it focuses on patient-centered strategies to reduce falls. Therefore, the article is categorical that healthcare providers must work collaboratively to identify these interventions and implement them for better care quality and patient safety. The article identifies direct patient education on fall risks and mitigation, provision of educational tools, and patient-centered materials like brochures and handouts. Further, hospital systems, policies, and procedures are important to enhancing patient safety and reduction in falls.

The article relates to my experience in the last two weeks of practicum as I conducted a session to discuss some of the strategies to prevent and mitigate falls. I designed a flyer that the article considers as educational tools focused on patients and providers to improve the adoption of best practices to reduce and prevent falls. The article demonstrates the critical role that healthcare providers play in the dissemination of information to enhance overall patient outcomes. The article shows that interventions focused on patient involvement are critical in the prevention of falls. As noted, the activities for the period entailed having an audit tool for patients in their rooms to improve response to susceptible falls.

Conclusion

The practicum activities covering weeks 7 and 8 have been critical in implementing the suggested strategies to enhance overall safety and quality outcomes. The activities illustrate the critical role that providers play in fall prevention through the implementation of strategies from an inter-professional perspective. The activities show that fall prevention strategies lead to reduced susceptibility and improve overall health quality for patients.

References

Gliner, M., Dorris, J., Aiyelawo, K., Morris, E., Hurdle-Rabb, D., & Frazier, C. (2021). Patient

falls, nurse communication, and nurse hourly rounding in acute care. Journal of Public Health Management and Practice, Publish Ahead of Print. https://doi.org/10.1097/phh.0000000000001387

Heng, H., Jazayeri, D., Shaw, L., Kiegaldie, D., Hill, A. M., & Morris, M. E. (2020). Hospital

falls prevention with patient education: a scoping review. BMC geriatrics, 20(1), 1-12. https://doi.org/10.1186/s12877-020-01515-w

Huber, C. (2022). Inter-professional Collaboration in Health Care. Praxis, 110(1), 3-4.

https://doi.org/10.1024/1661-8157/a003808.

Linehan, J., & Linehan, J. (2018). Fall prevention in long-term care using purposeful hourly

rounding. Journal of the American Medical Directors Association, 19(3), B17. https://doi.org/10.1016/j.jamda.2017.12.056

Manges, M. E., Zuver, M. C., Mack, K. N. & Abraham, S. P. (2020). Hourly Rounding and

Medical-Surgical Patient Falls: A Review of the Literature. International Journal of

            Science and Research Methodology, 17(2): 85-95.

Montejano-Lozoya, R., Miguel-Montoya, I., Gea-Caballero, V., Mármol-López, M. I., Ruíz-

Hontangas, A., &Ortí-Lucas, R. (2020). Impact of nurses’ intervention in the prevention of falls in hospitalized patients. International Journal of Environmental Research and Public Health, 17(17), 6048. https://doi.org/10.3390/ijerph17176048

Morley, L., & Cashell, A. (2018). Collaboration in health care. Journal of medical imaging and

            radiation sciences, 48(2), 207-216. https://doi.org/10.1016/j.jmir.2017.02.071.

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Asthma and Stepwise Management

Asthma is a respiratory disorder that affects children and adults. Advanced practice nurses often provide treatment to patients with these disorders. Sometimes patients require immediate treatment, making it essential that you recognize and distinguish minor asthma symptoms from serious, life-threatening ones. Since symptoms and attacks are often induced by a trigger, advanced practice nurses must also help patients identify their triggers and recommend appropriate management options. Like many other disorders, there are various approaches to treating and managing care for asthmatic patients depending on individual patient factors.

Photo Credit: Photo Library / Getty Images
One method that supports the clinical decision making of drug therapy plans for asthmatic patients is the stepwise approach, which you explore in this Assignment.
To Prepare
• Reflect on drugs used to treat asthmatic patients, including long-term control and quick relief treatment options for patients. Think about the impact these drugs might have on patients, including adults and children.
• Consider how you might apply the stepwise approach to address the health needs of a patient in your practice.
• Reflect on how stepwise management assists health care providers and patients in gaining and maintaining control of the disease.
By Day 7 of Week 3
Create a 5- to 6-slide PowerPoint presentation that can be used in a staff development meeting on presenting different approaches for implementing the stepwise approach for asthma treatment. Be sure to address the following:
• Describe long-term control and quick relief treatment options for the asthma patient from your practice as well as the impact these drugs might have on your patient.
• Explain the stepwise approach to asthma treatment and management for your patient.
• Explain how stepwise management assists health care providers and patients in gaining and maintaining control of the disease. Be specific.

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RUBRIC:

Excellent Good Fair Poor
Describe the long-term control and quick relief treatment options for the asthma patient from your practice, as well as the impact these drugs might have on your patient. 27 (27%) – 30 (30%)
The presentation clearly and accurately describes in detail the long-term control and quick relief treatment options for the asthma patient from their practice.

The presentation clearly and accurately describes in detail the impact these drugs might have on their patient. 24 (24%) – 26 (26%)
The presentation accurately describes the long-term control and quick relief options for the asthma patient from their practice.

The presentation accurately describes the impact these drugs might have on their patient. 21 (21%) – 23 (23%)
The presentation inaccurately or vaguely describes the long-term control and quick relief options for the asthma patient from their practice.

The presentation inaccurately or vaguely describes the impact these drugs might have on their patient. 0 (0%) – 20 (20%)
The presentation inaccurately and vaguely describes the long-term and quick relief options for the asthma patient from their practice, or is missing.

The presentation inaccurately and vaguely describes the impact these drugs might have on their patient, or is missing.
Explain the stepwise approach to asthma treatment and management for your patient. 27 (27%) – 30 (30%)
The presentation clearly and accurately explains in detail the stepwise approach to asthma treatment and management for their patient. 24 (24%) – 26 (26%)
The presentation accurately explains the stepwise approach to asthma treatment and management for their patient. 21 (21%) – 23 (23%)
The presentation inaccurately or vaguely explains the stepwise approach to asthma treatment and management for their patient. 0 (0%) – 20 (20%)
The presentation inaccurately and vaguely explains the stepwise approach to asthma treatment and management for their patient.
Explain how stepwise management assists health care providers and patients in gaining and maintaining control of the disease. Be specific. 27 (27%) – 30 (30%)
The presentation clearly and accurately explains in detail how stepwise management assists health care providers and patients in gaining and maintaining control of the disease.

The presentation provides accurate and detailed examples to support the explanation provided. 24 (24%) – 26 (26%)
The presentation accurately explains how stepwise management assists health care providers and patients in gaining and maintaining control of the disease.

The presentation provides accurate examples to support the explanation provided. 21 (21%) – 23 (23%)
The presentation inaccurately or vaguely explains how stepwise management assists health care providers and patients in gaining and maintaining control of the disease.

The presentation provides inaccurate or vague examples to support the explanation provided. 0 (0%) – 20 (20%)
The presentation inaccurately and vaguely explains how stepwise management assists health care providers and patients in gaining and maintaining control of the disease, or is missing.

The presentation provides inaccurate and vague examples to support the explanation provided, or is missing.
Written Expression and Formatting – Paragraph Development and Organization:
Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance. 5 (5%) – 5 (5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity. 4 (4%) – 4 (4%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. 3.5 (3.5%) – 3.5 (3.5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. 0 (0%) – 3 (3%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time.
Written Expression and Formatting – English writing standards:
Correct grammar, mechanics, and proper punctuation 5 (5%) – 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors 4 (4%) – 4 (4%)
Contains a few (1–2) grammar, spelling, and punctuation errors 3.5 (3.5%) – 3.5 (3.5%)
Contains several (3–4) grammar, spelling, and punctuation errors 0 (0%) – 3 (3%)
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding
Total Points: 100

Learning Resources

Required Readings (click to expand/reduce)

Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.
• Chapter 62, “Drugs for Asthma and Chronic Obstructive Pulmonary Disease” (pp. 557–579)
• Chapter 63, “Drugs for Allergic Rhinitis, Cough, and Colds” (pp. 580–588)

Document: APA Presentation Template

Required Media (click to expand/reduce)

Speed Pharmacology. (2020). Drugs for asthma and COPD (Made Easy) [Video]. https://www.youtube.com/watch?v=-DVZ9pl0rGY
Note: This media program is approximately 14 minutes.

Speed Pharmacology. (2017). Antihistamines (Made Easy) [Video]. https://www.youtube.com/watch?v=D5PHANcdA_E&t=25s
Note: This media program is approximately 10 minutes.

Optional Resources (click to expand/reduce)

National Heart Lung and Blood Institute. (2007). Expert panel report 3 (EPR3): Guidelines for the diagnosis and management of asthma. Retrieved from http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm

This web resource presents guidelines for diagnosing and managing asthma and outlines treatment recommendations for specific age groups.