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Characterizing the recent evolution in healthcare has been the sustained integration of technological innovations into healthcare practice. These advancements have had the sole aim of improving patient diagnostics, management and follow-up, as well as creating a platform for integrated patient care hence improving the overall quality, efficiency and patient satisfaction in care delivery (Evans, 2016). EHR represents one such fundamental transformation of the healthcare sector that has seen the consolidation of patient information and provided the platform for continued and integrated patient care.
EHR has improved decision-making capabilities of healthcare workers. Arguably, healthcare has morphed into an increasingly convoluted concept affected by multiple patient, social, political and environmental factors (Evans, 2016). For this reason, arriving at appropriate decisions requires extensive considerations of varied issues, a process that has been made easier with the availability of decision support systems (DSS) within most EHRs. DSS are special software that employs specific algorithms to derive best-case scenarios for patients and enhance favorable outcomes (Kuo et al., 2018). Decisions on billing, consultation, insurance payment and referrals often need DSS input.
An overarching impact of EHR involves the enabling prompt and efficient communication among healthcare workers, hence fostering collaboration. Supporting the need for effective intervention are the increasing incidence of chronic illnesses that require long-term follow-up and multidisciplinary care (Evans, 2016; Ramya et al., 2018) alongside the enduring concept of holistic patient management and evidence-based nursing practice. These two factors have meant that an improved collaboration in the healthcare sector could not have been more timely, important or beneficial (Vos et al., 2020). EHR has therefore granted many people the opportunity to receive collaborative healthcare, anywhere, anytime and at an affordable cost.
Crucially, EHR has enhanced the security of patient information. Coupled with cybersecurity laws such as the 1996 HIPAA Act, it is possible to safely store patient data for posterity, hence reducing the need for bulky and risky paper-based systems (Ramya et al., 2018). Since online systems are not immune to unauthorized access, special access protocols, as well as privileges of the users, are used to control entry. Being a central repository of patient information, safe storage translates to adequate synchrony, faster access and hence the enhanced efficiency of service provision (Carlson & Laryea, 2019). The robustness of the EHR system has also made it a fertile ground for research-related ventures, hence the use and examination of patient data for improving service delivery and expanding the knowledge base.
The computerized physician order entry (CPOE) is another remarkable advantage of the EHR. CPOE confers to the physician the ability to enter instructions on specific tests or treatment procedures on a computer directly without needing paper (Wiegel et al., 2019). That has enhanced the promptness of information exchange amongst various departments as well as reduced significant medication and prescription errors. Importantly, the platform has also diminished the time nurses or other professionals seek clarification due to incomplete or illegible instructions, with the overall result being improved patient care.
Despite many hospitals currently using EHR systems, the aspect of setting up and maintaining it remains a daunting prospect for most. First, as with comprehensive online systems, a significant financial outlay is required to drive the purchase and installation of such a project (Ramya et al., 2018). That tends to be difficult for most facilities which operate at narrow profit margins hence the vital role of sponsors and state actors in ensuring such projects come to fruition. Also, maintenance costs are significant in the whole endeavor as software are subject to continual improvement through regular updates and servicing to ensure maximal patient benefit (Alafaireet & Hicks, 2017). Such costs are often prohibitory and may discourage some facilities from establishing a functioning HER system.
EHRs are fairly novel entrants into the basic healthcare service provision arena and are an affirmation of the growing role of technology in improving healthcare delivery. Therefore, to enhance its usage proficiency and acceptability among healthcare workers, requisite training and education is needed before installation and continually throughout its usage to enable the realization of expected outcomes (Longhurst et al., 2019). The training may be costly cumulatively and workers may just turn-down or sabotage the prospect owing to change resistance and poor attitude. These may be addressed through cost-sharing and incentivization as well as improving the human-computer interface through standardization of EHR to enhance its understanding by users (Alafaireet & Hicks, 2017). It is also important to enhance the portability of the EHR.
EHRs are also susceptible to data management malpractices and unauthorized entry practices. Such include data mining, phishing and third-party viewership and represent a constant threat in an ever evolving cybersphere (Osop & Sahama, 2016). Patient data is extremely personal and a massively intimate piece of information that in the wrong hands can be used for endless nefarious intentions. Accordingly, facilities invest in security measures to avert potential attacks and keep their space safe (Osop & Sahama, 2016). That is in addition to employing technicians who constantly monitor the system operability and try to prevent such occurrences by sealing technological loopholes.
In sum, the entry of the EHR into the healthcare corridors has helped, over time, improve the efficiency and quality of healthcare service delivery. Continual research and innovation keep unravelling ways of enhancing the current systems through heightened security, improved connectivity and enhanced usability. Nevertheless, it is the ultimate consideration of all core elements of the system, that is patients, caregivers and the core platform itself, that will spur the next generation of healthcare improvement tools.
Coronavirus Disease 2019 (COVID-19) is a viral disease that has caused a pandemic with significant impacts in all sectors. Most affected are the health and education sectors. The disease has been wide-spreading and has greatly affected the educational and health sectors that heavily relied on face-face learning methods and clinical skills acquisition. Given the need to ensure the safety of both learners and instructors, most learning institutions were forced to suspend operations, with some opting to move learning to online platform.
The closure and change of learning techniques has had extensive impacts on the students, teachers, instructors, and learning institutions. The impacts of COVID-19 on education has been mostly negative, though with some positive aspects. The current discussion focusses on the impacts of COVID-19 on the education sectors with more emphasis on nursing education.
Nursing education requires theoretical and practical or bedside aspects to provide learners with the necessary skills for practice. As reported by the World Health Organization, the disease is lethal to all people, regardless of gender, race, or age. Therefore, schools and other learning institutions have made the tough decision of suspending their operations indefinitely. In some countries, the closure was ordered by their respective government (Fogg et al., 2020). The suspension of leaning means that students cannot acquire the skills and knowledge required to complete their courses on time.
For those who have managed to use non-physical learning methods, there have been obstacles and challenges. The different learning domains, including the knowledge, skills, and attitude, have been significantly affected by the schools attempting non-physical learning. By September 2020, most schools, including universities, had been closed in South America, Africa, and Southeast Asia (Fogg et al., 2020). In the united states and Canada, however, most institutions only closed partially.
In some colleges in the United Kingdom, examinations were canceled or moved to online platforms. Cancellations of examinations have subjected the learners to anxiety and prolongation time or restudying the same concepts while preparing for online exams (O’Flynn-Magee et al., 2020). This disruption has extensively affected students’ learning outcomes, especially in science-based courses that require physical learning and practice. The disruption has interfered with the continuity and momentum already gained by learners, and now they have to readjust to cope with online learning and its associated limitations.
To acquire clinical skills of nursing and other health-related courses, learners in many parts of the world have been commuting from their residences to the learning facilities. Various governments have formulated new rules and regulations designed to minimize the spread of this disease. Regulations and rules such as partial or full lockdowns either countrywide or in urban areas limited students’ travel to their learning institutions before the closure of schools and universities. This, alongside directives discouraging gatherings such as those in physical classroom settings, meant that students had to halt their learning.
As mentioned earlier, most institutions have adapted virtual learning strategies to provide learners with knowledge and skills. However, the main virtual method that has been leveraged by most institutions is the internet-based learning that involves using computers and websites whose navigation requires training. For students to successfully navigate these platforms, they need to first acquire digital literacy skills. The use of examination applications in learning has also required prior orientation to the students (O’Flynn-Magee et al., 2020). Arguably, the pandemic has forced learning institutions to explore alternative options to learning, most of which are time-consuming. Many institutions that had not integrated e-learning into their systems have had to spend more time orientating their users, including instructors and students, on this new learning methodology.
Various institutions have adopted online learning technologies which can be an expensive method of learning for students. The use of e-learning to cover up for the time lost during the lockdown has brought challenges to the students who cannot afford to acquire the necessary gadgets and know-how required for internet-based learning. With unequal access to internet-based learning, it is likely that online education has resulted in unequal access to learning resources (Baticulon et al., 2020). Internet-based learning involves the sharing of files and learning materials via online platforms. Some of these materials are copyrighted by the intellectual property laws that prohibit their unauthorized sharing. Thus, for students who are unable to acquire the requisite learning materials to avoid infringing on copyright laws, the new model of learning has been anything but smooth.
Adopting internet-based learning, especially for a nurse, has not been as effective as physical face-to-face learning strategies. Specifically, internet-based education does not deliver fully for enhanced psychomotor domain of learning given the limited access to actual patients. Even though simulation, animations, and videos have also enhanced psychomotor skill development among nursing students, its efficacy cannot be compared to physical learning. Further, while assessment of the students’ understanding of the taught concepts has been through online platform, their integrity has not been studied in comparison to physical exams. Moreover, this kind of examination is prone to questionable exam integrity. Even with restricted browsers, verifying that the actual student is doing the exam has been difficult.
With suspension of learning in most institutions following full or partial closures, some institutions have had to refund the students their education. Additionally, the cost of internet-based education can be high, forcing some learners to defer their studies indefinitely. When combined, these factors create an environment in which institutions have low student number, jeopardizing their sustainability goals (Dewart et al., 2020). While some institutions may resort to charging more fees for the existing students, this is a short-term intervention that has been associated with increased student dropout rates in colleges.
COVID-19 has caused various emotional responses from nursing students and their nurse educators. For nurse students, just as is the case with the general population, the pandemic has caused major psychological issues. The associated psychological stress, according to Huang et al. (2020), has affected learners’ ability to grasp the necessary skills and knowledge. According to Bloom’s learning domains, the affective domain is essential in the overall outcome of student learning. The learning environment for nursing students and the work environment for nurse practitioners is the same, which means that they are subjected to almost similar stressing factors.
The disease has impacted the psychological and mental health of nurse educators. More importantly, since people are generally required to self-isolate whenever they contract the virus, nurse educators who fall sick are forced to suspend learning, much to the students’ disadvantage (Huang et al., 2020). In the process, the nursing students in the practicum must survive with reduced numbers of educators and instructors (Chen et al., 2020). This has negatively impacted the quality of education that they get (Al Thobaity & Alshammari, 2020).
The pandemic has forced distant learning on health institutions. Therefore, the mechanisms of communication have switched to email and learning portals as opposed to face-to-face and memos that were initially utilized. Proper communication is key to effective learning. Instructors communicating through learning portals are more likely to miss the attention of the audience, the learners. This has impacted the efficiency of distant online learning (Baticulon et al., 2020). Among other barriers to learning reported by Baticulon et al. (2020) include poor communication.
Learners pursuing distant learning involving e-learning have had a rough time balancing between domestic activities and academic work. There has been limited attention to academic assignments and learning. This has made it difficult to implement student-based interventions in promoting student learning (Dewart et al., 2020) an aspect that further complicates the distant learning process
Despite the extensive negative impacts the pandemic has had on different sectors, is not devoid of positive implications for the field of education and health. There are few subspecialties in the field of education where COVID-19 has promoted a positive situation. The need for digitalization of learning and the provision of remote healthcare services has resulted in expanded technology adoption.
Most learning institutions across the world have adopted online learning. Online learning has digitized requirements that have to put in place before learning starts. Digitized learning has provided numerous advantages in places where the learning institution ensured efficient and successful establishment of the required resources to both students and the educators. Further, online learning makes it easy for students and educators to share resources, a factor that can potentially widen a learner’s scope of knowledge. Further, to support online learning, new tools and software applications have emerged that promote teleconferencing, thereby ensuring effective distant learning. Software applications such as Zoom and Google Meet have promoted online learning by enabling real-time learning sessions.
Additionally, in a bid to control the spread of the disease, most governments across the globe focused on enhancing public awareness by promoting patient education through public health teaching. The media teachings about hygiene and proper disease prevention, particularly regarding how the virus spreads, has added to the existing public knowledge on disease management and prevention. These teachings have enlightened patients about health components that nursing and medical students would have spent educating the patients about.
COVID-19 has provided a fertile ground for research on viral communicable respiratory diseases. Various health and educational resources have been published about this pandemic that can widen the learner’s knowledge of this disease. Arguably, research studies done by learners and corporate organizations concerning this novel virus have promoted a better understanding of the trends and strategies of preventing the disease.
In sum, coronavirus disease 2019 (COVID-19) has negatively affected students, educators, and institutions. In fact, the pandemic has exposed the extent to which most governments across the world have defunded the health and education sectors, setting them up for failure should similar disruptions emerge. For novel diseases for which there are no vaccines and effective treatments, the best management tools tends to entail containment measures such as through physical and social distancing, an aspect that has resulted in extensive change in how schools are managed. Nonetheless, while disruptions to learning has had profound effects on student progress, the pandemic has also highlighted the need for technology adoption and integration in learning.
Create a 500?750-word comprehensive outline that communicates the following about your chosen topic:
Introduction: Identify the risk management topic you have chosen to address and why it is important within your health care sector.
Rationale: Illustrate how this risk management strategy is lacking within your selected organization’s current risk management plan and explain how its implementation will better meet local, state, and federal compliance standards.
Support: Provide data that indicate the need for this proposed risk management initiative and demonstrate how it falls under the organization’s legal responsibility to provide a safe health care facility and work environment.
Implementation: Describe the steps to implement the proposed strategy in your selected health care organization.
Challenges: Predict obstacles the health care organization may face in executing this risk management strategy and propose solutions to navigate or preempt these potentially difficult outcomes.
Evaluation: Outline your plan to evaluate the success of the proposed risk management program and how well it meets the organization’s short-term, long-term, and end goals.
Opportunities: Recommend additional risk management improvements in adjacent areas of influence that the organization could or should address moving forward.
You are required to incorporate all instructor feedback from this assignment into Educational Program on Risk Management Part Two ? Slide Presentation assignment in Topic 5.
To save time later in the course, consider addressing any feedback soon after this assignment has been graded and returned to you. It may be helpful to preview the requirements for the Topic 5 assignment to ensure that your outline addresses all required elements for submission of the final presentation.
You are required to support your statements with a minimum of six citations from appropriate credible sources.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
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Domestic violence and its effects are one of the major problems facing health care delivery today. By being among the frontline workers, nurses constantly face domestic violence victims requiring both physical and psychological care. A nurse’s previous experience with abuse has both positive and negative effects on his/her clinical decisions when dealing with domestic violence victims. One of the positive impacts is that the experience acts as an important reference in understanding the current situation (Alaseeri, Rajab, & Banakhar, 2019). In this case, a nurse relates his/her experience with that of the victim and thus can have a clear understanding of what transpired. Secondly, having gone through the same ordeal and successfully came out of it, a nurse can prescribe the best treatment model based on firsthand experience. Also, a nurse’s past experience can help develop a relationship with the patient after sharing his/her experience which earns trust from the patient (Alaseeri et al., 2019). Notably, establishing a trusting relationship between a patient and a healthcare provider has been shown to significantly improve health outcomes.
Apart from the positive impacts, past experience with abuse can have negative effects on nurses especially those who are still in the healing process. Çelik and Aydin (2019) note that after a traumatic experience, most victims suffer from flashbacks which are quite detrimental to the healing process. Dealing with a domestic violence victim for such a nurse might thus be a source of flashbacks. This may make a nurse unable to focus fully on such patients as dealing with them brings back dreaded memories. Secondly, having had a similar experience in the past might impair a nurse’s decision as they may want to force their circumstances to fit that of the patient. For this reason, nurses need to understand that there are many facets of domestic abuse which need to be dealt with differently (Çelik & Aydin, 2019). Forcing a patient to undertake certain treatment methods just because it worked on a different case is a wrong clinical decision based on assumptions.
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Winter Elementary school has a total of 600 students in the K-5 grade, 40% of who are English language learners (ELL). The school relies on three-tier model of reading, mathematics, behavior, attendance and writing. In 2019-2020, 75% of the third-grade learners met or exceeded the state-defined standard of reading part of the text, while 73% passed the state-defined standard on math. Other important demographics of Winder Elementary school is that 38% of the students receive free or reduced-price lunch, while 10% of the students serve in special education. Lastly, 3.8% of the students identify as those with learning disabilities.
The proposed strategic plan seeks to eliminate infidelity among the teachers and help them become more faithful to the Response to Intervention (RTI) framework. the strategic plan should yield into a road map for training the teachers and helping them understand the documentation process together with its importance in the implementation of RTI framework.
With a basic understanding of why the RTI needs to be effectively implemented, the Winter Elementary school executive director and the entire leadership have shown support and commitment to see the project through to the end. The planning process will take a top-down process whereby those in the highest level of the organization are perceived to be the thinkers of what is best for the school (Alahmari, 2019).
However, a major disadvantage of this approach that the planning team will experience is getting the lower level staff to understand and embrace the plan. As such, the planning committee will take all the necessary steps to involve the staffs in the planning process. Considering the experiences from the previous planning process, involving the staffs makes them feel part of the proposed changes, and are therefore more likely to accepts the changes that the plan proposes to bring.
The other pitfall that must be avoided is too much rigidity and formality of the planning process. Considering that Winter Elementary school is a highly bureaucratic institution, being too rigid with the planning process may curtail creativity and slow down the planning process (Bartholomew & De Jong, 2017).
The main participants in the planning process will be the executive director, board of directors, staffs and an outside consultant. The executive director will be the chief planner, who will lead the strategic planning process from beginning to end. The school board of directors will ensure that the strategic plan aligns with the school mission, vision and values. A few staffs will be part of the planning committee, including the special education teacher and reading specialists.
Their main role will be to shape the relevance and workability of the plan to ensure buy-in to the school’s strategies and goals with regards to RTI. Lastly, consultant’s main role will be to bring and independent perspective to the strategic planning process (Kressler & Cavendish, 2020).
Historically, Winter Elementary school has used RTI for a different purpose. Earlier on, the school implemented RTI as a formality and a means of assessing student’s eligibility for special education. As such, the school implemented RTI in line with its formal and legal definition; as means of determining students with learning disabilities in case they do not make enough progress in the context of scientifically based intervention and instruction.
However, the proposed strategic plan should help the school to use RTI as an instructional framework that is informed by individual student need based on their performance through an easily implemented progress-monitoring criteria. As such, students who fail to adequately respond learning will receive an increasingly intense instruction within a tiered model of learning resource allocation. Therefore, the teachers needed professional training on the new use of RTI to understand how to implement it and measure outcomes.
Some of the key information needed for the planning process are the key trends in the RTI program environment, attitudes and plans of teachers, demographic changes within the student fraternity and the regulatory changes that have occurred since the RTI framework was first implemented (Alahmari, 2019).
Furthermore, the planning committee will need student information about the students’ performance to evaluate the RTI program, data trends for the past three years, changes in the student mix based on teacher observation, quality indicators and changes in the RTI program base in the past three years. Lastly, the planning committee will need the financial implications of the RTI framework over the past three years for conducting a cost-benefit analysis.
Winter Elementary school generally serves elementary grade students. All the teaching services are delivered within the school compound that has all the teaching resources and infrastructure. The RTI framework implementation would fit within the school’s daily activities that are supported by various revenue streams as highlighted in the table below.
The RTI presents as the program with the most mission impact because it monitors and improves student’s general academic performance. It is also the most attractive financially because parents and other donors pay for the student’s academic excellence. As such, implementing the RTI would be profitable in that sense that it attracts enough financial support to fully cover its costs. Nonetheless, it is worth noting that the 80% of the budget goes to staffing costs. Appendix 1 contains Winter Elementary school’s revenue and expenses involved in running the RTI program.
The adoption of value-based care calls for continuous quality improvement. An improvement plan toolkit aims to eliminate inefficient or ineffective systems in health care with the view of patient outcomes, health experiences and the quality of care. Some of the unique qualities of an improvement plan include; guarantee of quality, improving patient outcomes, and improving safety by eliminating errors, injuries, and harm to patients. Below are the sources used to explain the concept of improvement plan toolkit.
In this article, authors Mojtaba Vaismoradi, Susanna Tella, Patricia A. Logan, Jayden Khakurel, and Flores Vizcaya-Moreno assert that prevention of practice-errors and the improvement of patient safety depend on nurses’ ability to adhere to patient safety principles. The authors point out that patient harm is one of the leading concerns for the healthcare sector because it is ranked among the top ten leading causes of disability and death to patients (Vaismoradi et al., 2020). Besides, the authors continue to assert that losses associated with practice errors amount to several trillion dollars every year-something adversely affects the provision of quality care to patients.
Snezana Kusljic and Angela Wu in this article look at the importance of reducing medication errors by using different interventions such to curb prescription, dispensing, and administration medication errors. The authors assert that a combination of effective intervention methods such as prescriber education, computerized medication, patient education, using trained medication experts, and using automated drug distributors are some of the most effective methods to control medication errors.
In this article, Albert Wu and Isolde Busch assert that the lack of patient safety in many healthcare facilities is caused by lack the right training and attitude on patient safety for healthcare professionals. The authors assert that bulk of the practice-errors committed by nurses and other caregivers can be traced to the lack of schools in the health profession to offer any or adequate training on patient safety. Wu and Busch maintain that training on patient safety must be introduced early at the college/university level for nurses and the training must continue beyond postgraduate level.
Carayon, Wooldridge, Hose, Salwei, & Benneyan assert that human factors and system engineering-HF/SE are some of the emerging solutions to understanding and improving safer care for patients. According to the authors, HF/SE can help healthcare facilities to curb most of the safety issues leading to improved patient safety. The authors assert that HS/SE contains numerous principles, methods, and approaches that improve and optimize patient safety. They give the example of effective systems as a contributor to patient safety.
In this article, the authors assert that nurses with training on patient safety early in their education approach the issue with the seriousness it deserves and avoid making mistakes/errors leading to patient safety. Slawomirski, Auraaen, and Klazinga refer to a study by the World Health Organization-WHO that cites preventable harm as the world’s twentieth-most cause of morbidity and mortality (Slawomirski, 2017). To prevent the increasing cases of preventable harm, the authors assert that there is evidence that education and training through safety curricula helps to improve the quality of care while boosting patient safety.
Amr Hossein Khoshakhlagh, Elham Khatooni, Isa Akbarzadeh, Saeid Yazdanirad and Ali Sheidaei conducted a cross-sectional study to analyze the impact of patient safety culture as one of the critical components to achieving quality health and patient safety. The objective of this study was to analyze the factors that affect patient safety in private and public healthcare facilities. A sample of 1203 caregivers in three private and three public facilities participated in the study using a stratified random sampling.
In this article, Sloane, Smith, McHugh, & Aiken assert that the behaviour of healthcare workers is directed by a positive patient safety culture. The authors assert that shared cultural perceptions, teamwork, continuous training and learning, communication, problem-solving skills, and personal responsibility are some of the factors that contribute to a positive culture in healthcare sector. The authors assert that a positive patient safety culture is the first step to eliminating errors, reducing patient harm, and improving patient outcomes (Sloane et al., 2018). To this end, the authors assert that before implementing structural interventions, it is critical for healthcare facilities to first instill a patient-safety culture.
In this article, the singles out burnout as one of the leading causes of patient harm leading to compromised patient safety. The authors base their argument on Roteinstein’s study that found out that up to 80% of nurses in America suffer from burnout (Garcia et al., 2019). The authors assert that at least one-in- three nurses have either professional achievement, depersonalization, or emotional exhaustion at any given time. The authors show that there is a link between nurse burnout and patient safety.
In this article, Satorre examines the prevalence of medical errors as one of the leading causes of patient harm. He asserts that medication errors is one of the factors that contribute to high level of patient comorbidity and mortality. Satorre discusses some of the effective ways of managing medication errors. To curb medication errors, Satorre asserts that only qualified personnel must be used in dispensing medication to avoid errors.
Jamileh Farokhzadian, Nahid Dehghan Nayeri and Fariba Borhani provide that safety culture is a recent discovery that has the potential to contain patient harm while improving patient safety and outcomes. The authors assert that the experiences, skills, and knowledge of nurses can facilitate the creation of better strategies to improve patient safety. They assert that healthcare facilities can avert preventable harm by “designing and planning safety processes and techniques” (Farokhzadian et al., 2018). The authors conclude that preventing harm in healthcare facilities require the implementation of safety improvement programs that lead to improved patient safety.
Levine, Carmody, and Silk (2020) argue that the culture of remaining silent when medical errors occur is a huge contributor to lack of patient safety. The authors assert that it is critical for nurses and other healthcare workers to report incidences of errors so that appropriate action can be taken. Besides, the authors assert that reporting medical errors help healthcare facilities to avoid similar errors in future by putting in place measures to prevent them. In their conclusion, the authors assert that organizations with a culture of reporting events and incidences record fewer errors if any.
In this article, the authors assert that there as link between the physical and mental health, self-reported errors, and work environment with patient safety. Regarding physical and mental health, the authors assert that nurses in poor physical and mental health committed more medical errors. Melnyk, et al. (2021) assert that nurses with better mental and physical health committed little or no errors. To improve patient safety in hospitals, the authors assert that it is critical for such facilities to ensure a conducive work place devoid of too much stress and pressure. This will ensure that employees are of good mental and physical health.
This improvement plan tool kit aims to enable nurses to implement and sustain safety improvement measures in health care settings in a geropsychiatric unit. The tool kit has been organized into four categories with three annotated sources each. The categories are as follows: general organizational safety and quality best practices, environmental safety and quality risks, staff-led preventive strategies, and best practices for reporting and improving environmental safety issues.
Sherwood, G., & Horton-Deutsch, S. (2015). Reflective organizations: On the front lines of QSEN and reflective practice implementation. Retrieved from https://ebookcentral- proquest-com.library.capella.edu/lib/capella/detail.action?docID=3440207#
This e-book presents the paradigm shift required for organizations to provide QSEN (quality and safety education to nurses). It provides readers with the innovative pedagogical approaches required to change traditional content-based health care education methods to interactive methods that engage learners.
These approaches include facilitative teaching, visual thinking strategies, creating a presence that is authentic, and meaningful learning through debriefing. Concrete examples in the resource demonstrate the application of reflective learning. Additionally, the reflective questions in the resource guide readers to evaluate their own practice, either independently or in groups, to implement formal education programs with a focus on self-improvement. The resource prepares nursing students for advanced competency, which will help them adopt reflective thinking, develop a safety culture, and therefore qualitatively improve practices in critical health units such as geropsychiatry units.
Fleiszer, A. R., Semenic, S. E., Ritchie, J. A., Richer, M.-C., & Denis, J.-L. (2016). A unit-level perspective on the long-term sustainability of a nursing best practice guidelines program: An embedded multiple case study. International Journal of Nursing Studies, 53, 204–218. https://doi.org/10.1016/j.ijnurstu.2015.09.004
This article helps analyze the sustainability of a best practice guidelines program implemented in acute health care settings. The sustainability of the program was characterized by the following: benefits for patients as the rate of incidence of falls reduced; routinization of best practices as the team’s adherence to guidelines improved; and, in the long term, the development of the team’s adaptability to changes in circumstances that threatened the program.
Seven key factors that accounted for the sustainability of the program were also identified. The source explains how relationships between the characteristics of sustainability (benefits, routinization, and development) and the seven key factors contributed toward the sustainability of the improvement program. This source is valuable for nursing students as it helps them understand how safety programs can be sustained to ensure the long-term reduction of the incidence of sentinel events in geropsychiatric units.
Kossaify, A., Hleihel, W., & Lahoud, J.-C. (2017). Team-based efforts to improve quality of care, the fundamental role of ethics, and the responsibility of health managers: Monitoring and management strategies to enhance teamwork. Public Health, 153, 91–98. https://doi.org/10.1016/j.puhe.2017.08.007
This paper discusses the benefits of teamwork in improving the quality of health care. It presents a review of 33 papers identified after performing a search on PubMed. The paper discusses the important ingredients of efficient teamwork such as self-awareness and the individual behavior of team members, the ethical climate within the team, the work environment and institutional infrastructure, positive moderation from leadership, and communication and coordination among team members.
Effective teamwork can help reduce the incidence of sentinel events that result from preventable medical errors, which are often caused by dysfunctional communication among team members. Teamwork is more reliable and efficient than individual work in high-risk environments such as a geropsychiatry unit. Although the specific contexts of readers’ practices may be different, this resource is valuable for nursing administrators and professionals as it discusses the implementation of values needed for positive teamwork as well as the monitoring and management of teamwork.
Powell-Cope, G., Quigley, P., Besterman-Dahan, K., Smith, M., Stewart, J., Melillo, C., Friedman, Y. (2014). A qualitative understanding of patient falls in inpatient mental health units. Journal of the American Psychiatric Nurses Association, 20(5), 328–339. https://doi.org/10.1177/1078390314553269
This source mentions a study conducted to analyze falls in geropsychiatric patients. The study also focused on selling falls prevention in psychiatric units. The risk factors that lead to the falls were identified by a focus group. The focus group formulated an improvement plan to reduce the number of falls, and it was found that implementing infrastructural changes such as the use of geriatric-friendly sanitary ware such as raised toilet seats helped reduce the rate of incidence of falls. Although all the changes may not be feasible in a given setup, many of the strategies mentioned in this study could serve as a starting point for the prevention of falls. The article helps nursing students understand the challenges that occur in an adult mental health unit and the quality improvement measures taken to resolve these challenges.
Wong Shee, A., Phillips, B., Hill, K., & Dodd, K. (2014). Feasibility, acceptability, and effectiveness of an electronic sensor bed/chair alarm in reducing falls in patients with cognitive impairment in a subacute ward. Journal of Nursing Care Quality, 29(3), 253– 262. https://doi.org/10.1097/NCQ.0000000000000054
This source is a preliminary study conducted to determine the effectiveness of electronic sensor bed/chair alarms to reduce the occurrence of falls in patients with cognitive impairment. These alarms can be attached to the patient’s body or to the bed/chair the patient uses to alert the nursing staff every time the patients move or leave their seat. Nurses were educated about the alarms and asked to document their observations and provide feedback.
Although effective at preventing falls in patients with cognitive impairment, the electronic sensors needed improvements such as the elimination of cords that may be hazardous to patients and the additional provision of alerting nurses through pagers. This source helps nursing students understand both the effectiveness and the limitations of electronic sensor alarms in reducing the occurrence of falls.
Chari, S. R., Smith, S., Mudge, A., Black, A. A., Figueiro, M., Ahmed, M., . . . Haines, T. P. (2016). Feasibility of a stepped wedge cluster RCT and concurrent observational sub-study to evaluate the effects of modified ward night lighting on inpatient fall rates and sleep quality: A protocol for a pilot trial. Pilot and Feasibility Studies, 2(1). https://doi.org/10.1186/s40814-015-0043-x
Inadequate lighting at night in geropsychiatric wards is one of the important causes of falls in geropsychiatric units. Psychotropic medications can cause cognitive impairments and blurring of vision, which can be aggravated by dim lighting in the units. The article presents a trial pilot study conducted to evaluate the effects of the use of modified night lighting in inpatient wards to prevent falls. LED lights were installed in the vicinity of the beds and the toilets, where falls were likely to occur.
The study provides valuable insights that could inform design and refurbishment efforts at geropsychiatric units. An important limitation of the study is that a stepped wedge, cluster randomized controlled trial has not yet been applied to test environmental modifications in any setting. However, the modifications discussed could still be implemented as an important intervention strategy for preventing falls in older adults with cognitive impairment.
Morgan, L., Flynn, L., Robertson, E., New, S., Forde?Johnston, C., & McCulloch, P. (2016). Intentional rounding: A staff?led quality improvement intervention in the prevention of patient falls. Journal of Clinical Nursing, 26(1–2), 115–124. https://doi.org/10.1111/jocn.13401
This article highlights an intervention strategy called intentional rounding to reduce the occurrence of inpatient falls. Intentional rounding is a specific strategy in which nurses conduct a routine check on patients at certain time intervals based on the needs of the patient. The rounding was implemented through effective communication and teamwork among the nursing staff and iterations of plan-do-check-act measures. This proactive staff-led strategy helped reduce the rate of falls by 50%.
This study achieved success through the combined efforts of the research team that conducted the analysis of the system to design the rounding format and the frontline nursing staff who conducted the intentional rounds. Although its sample size was small and not entirely representative, the study does establish intentional rounding as an effective falls-prevention strategy, which when implemented with adequate staff engagement and support from leadership definitively reduces the occurrence of falls.
Moncada, L. V. V., & Mire, G. L. (2017). Preventing falls in older persons. Am Fam Physician, 96(4), 240–247. Retrieved from https://www.aafp.org/afp/2017/0815/p240.pdf
The article posits that a history of falls in older persons is associated with an increased risk of a future fall. The American Geriatrics Society recommends that older adults aged 65 and above should undergo annual screening for balance impairment and a history of falls as a preliminary intervention for the prevention of falls. The article also highlights an algorithm developed by the Centers for Disease Control and Prevention.
The algorithm suggests assessment and multifactorial interventions to prevent falls in patients who have had more than two falls and more than one fall-related injury. The multifactorial interventions include exercise routines that include balance and gait training, the use of vitamin D supplements with or without calcium based on the community in which the patients dwell, and the management of psychotropic medication.
These interventions have been known to cause a significant decrease in the rate of falls and can be implemented across all geropsychiatric wards to prevent sentinel events. The source is authentic and hence can be referred to by nursing students to understand multifactorial interventions in the prevention of falls.
Isaac, L. M., Buggy, E., Sharma, A., Karberis, A., Maddock, K. M., & Weston, K. M. (2018). Enhancing hospital care of patients with cognitive impairment. International Journal of Health Care Quality Assurance, 31(2), 173–186. https://doi.org/10.1108/IJHCQA-11- 2016-0173
This paper evaluates the TOP5 intervention strategy of improving patient care. The strategy involves engaging with carers of geriatric patients (individuals who are family members or friends of the patients) to collect characteristic non-clinical information about patients to personalize care and reduce falls. The carers of patients narrated to the nursing staff five important and distinct characteristic details such as the patients’ needs and past emotional experiences. The nursing staff then prepared a customized plan of care for each patient based on this information. This study reported a significant reduction in falls and qualitatively improved care. The study enables nursing students to meaningfully involve the carers of cognitively impaired patients and reduce the incidence of falls.
Tan, A. K. (2015). Emphasizing caring components in nurse-patient-nurse bedside reporting. International Journal of Caring Sciences, 8(1), 188–193. Retrieved from https://library.capella.edu/login?qurl=https%3A%2F%2Fsearch.proquest.com%2Fdocview%2F1648623547%3Faccountid=27965
This source provides a review of strategies that improve bedside reporting and transfer of duties after a change of shift among nursing staff. The source also emphasizes team engagement that can help reduce the incidence of sentinel events, especially in health care units such as geropsychiatry units. Bedside reporting is a vital concern in geropsychiatric units as patients are prone to behavioral changes and unpredictable behavior may affect other patients in the unit. During a shift change, the nursing staff can alert the incoming staff about the condition of such patients to proactively prepare the staff to address any forthcoming issue.
Barriers to bedside reporting were also analyzed, and barriers perceived by patients and those perceived by nurses were identified. These barriers can be eliminated through open communication and by educating the nursing staff. The article provides a valuable discussion of factors that influence bedside reporting such as patient-centered care philosophy, guidelines of the Joint Commission Institute, demand for patient participation in making health care decisions, and the shortcomings of traditional handover practices.
Stergiopoulos, S., Brown, C. A., Felix, T., Grampp, G., & Getz, K. A. (2016). A survey of adverse event reporting practices among US healthcare professionals. Drug Safety, 39(11), 1117–1127. https://doi.org/10.1007/s40264-016-0455-4
This article highlights the severity of underreporting of adverse drug events. An adverse drug event is defined by the World Health Organization as “a response to a medicine which is noxious and unintended, and which occurs at doses normally used in man.” Adverse drug events are estimated to cause 7,000 deaths across health care settings in the United States each year. It is also said that half of these adverse drug events result from preventable medication errors. The article also identifies factors that lead to the underreporting of the adverse drug events such as lack of training among health care professionals and standardized reporting processes.
Underreporting of adverse drug events can be a critical problem, especially in health care units such as geropsychiatry units. Individual patients may react differently to psychotropic drugs; reactions may include overdoses or allergic reactions. These reactions need to be monitored closely and reported efficiently to avoid complications including falls. Nursing students can understand the importance of reporting adverse drug events through this source.
Lozito, M., Whiteman, K., Swanson-Biearman, B., Barkhymer, M., & Stephens, K. (2018). Good catch campaign: Improving the perioperative culture of safety. AORN Journal, 107(6), 705–714. https://doi.org/10.1002/aorn.12148
This article provides evidence-based results to show that the culture of safety in a perioperative unit was improved after implementing the good catch campaign. Good catch is the ability of nursing staff to point out mistakes and report them to avoid sentinel events. The campaign described in the article involves implementing a standardized electronic reporting system and debriefing process.
The nursing staff discusses the plan of care for each patient at the end of the day during debriefing. This helps the nursing staff note characteristic risks involved with each patient and provide better care. Training nursing staff to implement the good catch campaign in health care units such as geropsychiatry units should enable the effective reporting of factors that could cause falls with a view to avoid them. This source enables nursing students to implement electronic reporting systems to report good catches and thereby reduce falls.
Chari, S. R., Smith, S., Mudge, A., Black, A. A., Figueiro, M., Ahmed, M., . . . Haines, T. P. (2016). Feasibility of a stepped wedge cluster RCT and concurrent observational sub- study to evaluate the effects of modified ward night lighting on inpatient fall rates and sleep quality: A protocol for a pilot trial. Pilot and Feasibility Studies, 2(1). https://doi.org/10.1186/s40814-015-0043-x
Fleiszer, A. R., Semenic, S. E., Ritchie, J. A., Richer, M.-C., & Denis, J.-L. (2016). A unit-level perspective on the long-term sustainability of a nursing best practice guidelines program: An embedded multiple case study. International Journal of Nursing Studies, 53, 204– 218. https://doi.org/10.1016/j.ijnurstu.2015.09.004
Isaac, L. M., Buggy, E., Sharma, A., Karberis, A., Maddock, K. M., & Weston, K. M. (2018). Enhancing hospital care of patients with cognitive impairment. International Journal of Health Care Quality Assurance, 31(2), 173–186. https://doi.org/10.1108/IJHCQA-11- 2016-0173
Kossaify, A., Hleihel, W., & Lahoud, J.-C. (2017). Team-based efforts to improve quality of care, the fundamental role of ethics, and the responsibility of health managers: Monitoring and management strategies to enhance teamwork. Public Health, 153, 91–98. https://doi.org/10.1016/j.puhe.2017.08.007
Lozito, M., Whiteman, K., Swanson-Biearman, B., Barkhymer, M., & Stephens, K. (2018). Good catch campaign: Improving the perioperative culture of safety. AORN Journal, 107(6), 705–714. https://doi.org/10.1002/aorn.12148
Moncada, L. V. V., & Mire, G. L. (2017). Preventing falls in older persons. Am Fam Physician, 96(4), 240–247. Retrieved from https://www.aafp.org/afp/2017/0815/p240.pdf
Morgan, L., Flynn, L., Robertson, E., New, S., Forde?Johnston, C., & McCulloch, P. (2016). Intentional rounding: A staff?led quality improvement intervention in the prevention of patient falls. Journal of Clinical Nursing, 26(1–2), 115–124. https://doi.org/10.1111/jocn.13401
Powell-Cope, G., Quigley, P., Besterman-Dahan, K., Smith, M., Stewart, J., Melillo, C., Friedman, Y. (2014). A qualitative understanding of patient falls in inpatient mental health units. Journal of the American Psychiatric Nurses Association, 20(5), 328–339. https://doi.org/10.1177/1078390314553269
Sherwood, G., & Horton-Deutsch, S. (2015). Reflective organizations: On the front lines of QSEN and reflective practice implementation. Retrieved from https://ebookcentral- proquest-com.library.capella.edu/lib/capella/detail.action?docID=3440207#
Stergiopoulos, S., Brown, C. A., Felix, T., Grampp, G., & Getz, K. A. (2016). A survey of adverse event reporting practices among US healthcare professionals. Drug Safety, 39(11), 1117–1127. https://doi.org/10.1007/s40264-016-0455-4
Tan, A. K. (2015). Emphasizing caring components in nurse-patient-nurse bedside reporting. International Journal of Caring Sciences, 8(1), 188–193. Retrieved from https://library.capella.edu/login?qurl=https%3A%2F%2Fsearch.proquest.com%2Fdocvie w%2F1648623547%3Faccountid=27965
Wong Shee, A., Phillips, B., Hill, K., & Dodd, K. (2014). Feasibility, acceptability, and effectiveness of an electronic sensor bed/chair alarm in reducing falls in patients with cognitive impairment in a subacute ward. Journal of Nursing Care Quality, 29(3), 253– 262. https://doi.org/10.1097/NCQ.0000000000000054
Medication administration errors (MEAs) are among the leading causes of disabilities, mortalities, lengthy hospitalization, and increased costs of compensating care services. According to Tsegaye et al. (2020), the World Health Organization (WHO) estimates the annual global cost associated with medication errors to be approximately $42 billion, accounting for about 0.7% of healthcare expenditures. Despite such ramifications, health organizations face challenges in eliminating medication mistakes because they can occur at any stage of the medication management process.
Healthcare professionals, especially nurses, must adhere to safety guidelines by observing various “rights,” including the right patient, doses, time, routes, and documentation during medication administration practices. Medical administrators must incorporate evidence-based practice and best strategies to safeguard patient safety and avert errors. Therefore, this paper describes a scenario of medication administration mistakes while elaborating root causes, evidence-based strategies, and organizational resources for preventing MEAs.
Medication administration errors are preventable acts that result in improper medication use in the treatment process, leading to multiple safety concerns such as adverse reactions, disability, and death (Tsegaye et al., 2020). In this sense, healthcare professionals responsible for administering regimens to patients fail to uphold the “medication rights” such as correct dosage, administration routes, documentation, and frequency due to the prevailing organizational, human, and technical factors. As a registered nurse operating in a skilled nursing facility (SNFs) in the cardiovascular care department, I have witnessed numerous scenarios where caregivers commit near misses or actual errors that lead to adverse medical outcomes.
In one instance, a registered nurse (RNs) tasked to administer digoxin doses to a 50-year-old male patient with arrhythmia episodes decided to delegate medication administration practices to unlicensed assistant personnel (UAP). Often, our organization allows registered nurses to delegate responsibilities to UAPs after conducting competency assessments and knowledge enhancement programs such as training and educational interventions. Although the nurse had fulfilled such guidelines, the delegate committed an error by administering incorrect dosage at the right time.
After observing the patient’s reactions, the nurse assistant detected the mistake that suggested potential digoxin toxicity, including nausea, vomiting, and irregular heart rhythms. After identifying the error, the nurse assistant did not communicate early or alert the delegator about the incident. Fortunately, one on-floor nurse saved the patient from the impending safety threats by administering an antidote. From such a scenario, l learned about the root causes of medication administration errors and possible ways to prevent mistakes.
Many scholarly studies provide evidence about the root causes of medication administration errors consistent with the case study. For instance, Vaismoradi et al. (2020) contend that various institutional factors facilitate medication mistakes. These factors include organizational patient-safety culture and environment, nurses’ workloads, the effectiveness of interprofessional collaboration and communication, the presence of education and training programs for nurses, and the availability of institutional guidelines for medication administration.
In this sense, health organizations should provide opportunities that enable healthcare professionals to adhere to and comply with patient-safety principles. In our case study, timely incident reporting and effective communication between the nurse assistant and the delegator nurse would have prevented an error that almost claimed the patient’s life.
Other primary causes of medication administration mistakes are technical and human factors. In organizations where clinicians use computerized physician order entries (CPOEs) and automated medication administration technologies, incidences of technical glitches may compromise medication administration practices leading to errors of commission and omission. Although technical factors are often accidental and unanticipated, human factors are significant causes of medication errors.
Tsegaye et al. (2020) argue that medication administration mistakes occur due to various human-related issues, including the level of knowledge and training on medication administration practices, work experience, familiarity with organizational guidelines, ability to communicate and report near misses or actual sentinel events, and competencies to adhere to safety guidelines. Since a human is to error, it is essential for healthcare organizations to invest massively in implementing evidence-based and best practices for enhancing employee competencies and knowledge of safe practices for medication administration.
Health organizations must incorporate the best evidence and implement proven interventions for preventing medication administration errors. In our case study, communication breakdown and human factors facilitated an administrative error that adversely affected the patient. Manias et al. (2020) support the possibility of preventing causal factors for medication errors by implementing scientifically proven interventions, including interprofessional collaboration, prescriber education, technological advancements to incorporate computerized physician order entry (CPOE), and pharmacist-led medication reconciliation.
On the other hand, Reeves et al. (2017) suggest effective communication and reporting systems as ideal approaches for reducing medication mistakes. Implementing these recommendations requires institutions to embrace contingency plans and consolidate resources for enacting quality improvement initiatives.
Undoubtedly, health organizations must implement quality improvement initiatives and evidence-based strategies to prevent medication administration errors. In this sense, these steps include educating and training prescribers about safe medication administration practices, enhancing reporting and communication systems, installing advanced technologies to replace the traditional documentation steps, and encouraging interprofessional collaboration by transforming workplace cultures.
According to Yousef & Yousef (2017), an ideal plan for preventing medication errors must contain educational workshops for physicians, process automation and technological advancement, setting standardized general guidelines, creating suitable workplace environments to eliminate blame, and punishment for error perpetrators, and empowerment programs. Institutions should consistently implement these recommendations because eliminating medication errors requires continuous quality improvement initiatives.
Health organizations and quality improvement implementation teams should leverage the existing institutional resources to guarantee plan sustainability and realize strategic goals. In this sense, it is possible to utilize employees’ competencies, experience, and skills when implementing training and educational programs for newly registered nurses and prescribers. Reputable physicians, IT experts, and informaticists can input these initiatives by sharing information, educating novice nurses about safety guidelines, and ensuring smooth operations of technological infrastructures.
Also, organizations should utilize the existing health record systems and information frameworks to promote interprofessional collaboration and effective communication. In this sense, the presence of electronic health records (EHRs), automated alert systems, and other technologies provide ideal opportunities for healthcare organizations to prevent medication errors. When leveraging the existing organizational resources, it is essential to conduct need assessments to identify resource strengths, opportunities, weaknesses, and threats.
Medication administration errors (MAEs) are among sentinel events that result in multiple patient safety concerns, including adverse reactions to medications, disabilities, mortalities, lengthy hospitalization, and increased economic burden of compensating care. From the case study, it is valid to contend that human, technical, and organizational factors combine to determine the likelihood of error occurrence.
In this sense, issues like ineffective communication and timely reporting systems, time pressure, prescriber experience, familiarity with guidelines, and technological advances significantly determine organizational susceptibility to medication administration errors. While many scholarly studies propose training and educational programs for prescribers, among other strategies, it is essential to embrace the evidence-based practice and implement the best interventions that are consistent with the need to prevent medication errors. Also, it is vital to align and leverage the existing resources when implementing these prevention approaches.
Manias, E., Kusljic, S., & Wu, A. (2020). Interventions to reduce medication errors in adult medical and surgical settings: A systematic review. Therapeutic Advances in Drug Safety, 11, 204209862096830. https://doi.org/10.1177/2042098620968309
Reeves, S., Clark, E., Lawton, S., Ream, M., & Ross, F. (2017). Examining the nature of interprofessional interventions designed to promote patient safety: A narrative review. International Journal for Quality in Health Care, 29(2), 144–150. https://doi.org/10.1093/intqhc/mzx008
Tsegaye, D., Alem, G., Tessema, Z., & Alebachew, W. (2020). Medication administration errors and associated factors among nurses. International Journal of General Medicine, Volume 13, 1621–1632. https://doi.org/10.2147/ijgm.s289452
Vaismoradi, M., Tella, S., A. Logan, P., Khakurel, J., & Vizcaya-Moreno, F. (2020). Nurses’ adherence to patient safety principles: A systematic review. International Journal of Environmental Research and Public Health, 17(6), 2028. https://doi.org/10.3390/ijerph17062028
Yousef, N., & Yousef, F. (2017). Using a total quality management approach to improve patient safety by preventing medication error incidences. BMC Health Services Research, 17(1), 1-16. https://doi.org/10.1186/s12913-017-2531-6
Health care organizations and professionals strive to create safe environments for patients; however, due to the complexity of the health care system, maintaining safety can be a challenge. Since nurses comprise the largest group of health care professionals, a great deal of responsibility falls in the hands of practicing nurses.
Quality improvement (QI) measures and safety improvement plans are effective interventions to reduce medical errors and sentinel events such as medication errors, falls, infections, and deaths. A 2000 Institute of Medicine (IOM) report indicated that almost one million people are harmed annually in the United States, (Kohn et al., 2000) and 210,000–440,000 die as a result of medical errors (Allen, 2013).
The role of the baccalaureate nurse includes identifying and explaining specific patient risk factors, incorporating evidence-based solutions to improving patient safety and coordinating care. A solid foundation of knowledge and understanding of safety organizations such as Quality and Safety Education for Nurses (QSEN), the Institute of Medicine (IOM), and The Joint Commission and its National Patient Safety Goals (NPSGs) program is vital to practicing nurses with regard to providing and promoting safe and effective patient care.
You are encouraged to complete the Identifying Safety Risks and Solutions activity. This activity offers an opportunity to review a case study and practice identifying safety risks and possible solutions. We have found that learners who complete course activities and review resources are more successful with first submissions. Completing course activities is also a way to demonstrate course engagement.
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
References
Allen, M. (2013). How many die from medical mistakes in U.S. hospitals? Retrieved from https://www.npr.org/sections/health-shots/2013/09/20/224507654/how-many-die-from-medical-mistakes-in-u-s-hospitals.
Kohn, L. T., Corrigan, J., & Donaldson, M. S. (Eds.). (2000). To err is human: Building a safer health system. Washington, DC: National Academy Press.
As a baccalaureate-prepared nurse, you will be responsible for implementing quality improvement (QI) and patient safety measures in health care settings. Effective quality improvement measures result in systemic and organizational changes, ultimately leading to the development of a patient safety culture.
Consider a previous experience or hypothetical situation pertaining to medication errors, and consider how the error could have been prevented or alleviated with the use of evidence-based guidelines.
Choose a specific condition of interest surrounding a medication administration safety risk and incorporate evidence-based strategies to support communication and ensure safe and effective care.
For this assessment:
The purpose of this assessment is to better understand the role of the baccalaureate-prepared nurse in enhancing quality improvement (QI) measures that address a medication administration safety risk. This will be within the specific context of patient safety risks at a health care setting of your choice. You will do this by exploring the professional guidelines and best practices for improving and maintaining patient safety in health care settings from organizations such as QSEN and the IOM.
Looking through the lens of these professional best practices to examine the current policies and procedures currently in place at your chosen organization and the impact on safety measures for patients surrounding medication administration, you will consider the role of the nurse in driving quality and safety improvements. You will identify stakeholders in QI improvement and safety measures as well as consider evidence-based strategies to enhance quality of care and promote medication administration safety in the context of your chosen health care setting.
Be sure that your plan addresses the following, which corresponds to the grading criteria in the scoring guide. Please study the scoring guide carefully so that you know what is needed for a distinguished score.
Consider reviewing the following case studies as you complete your assessment:
For this assessment, you can use a supplied template to conduct a root-cause analysis. The completed assessment will be a scholarly paper focusing on a quality or safety issue pertaining to medication administration in a health care setting of your choice as well as a safety improvement plan.
As patient safety concerns continue to be addressed in the health care settings, nurses can play an active role in implementing safety improvement measures and plans. Often root-cause analyses are conducted and safety improvement plans are created to address sentinel or adverse events such as medication errors, patient falls, wrong-site surgery events, and hospital-acquired infections.
Performing a root-cause analysis offers a systematic approach for identifying causes of problems, including process and system-check failures. Once the causes of failures have been determined, a safety improvement plan can be developed to prevent recurrences. The baccalaureate nurse’s role as a leader is to create safety improvement plans as well as disseminate vital information to staff nurses and other health care professionals to protect patients and improve outcomes.
As you prepare for this assessment, it would be an excellent choice to complete the Quality and Safety Improvement Plan Knowledge Base activity and to review the various assessment resources, all of which will help you build your knowledge of key concepts and terms related to quality and safety improvement. The terms and concepts will be helpful as you prepare your Root-Cause Analysis and Safety Improvement Plan. Activities are not graded and demonstrate course engagement.
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
Nursing practice is governed by health care policies and procedures as well as state and national regulations developed to prevent problems. It is critical for nurses to participate in gathering and analyzing data to determine causes of patient safety issues, in solving problems, and in implementing