Assignment: NURS FPX 4020 Capella University Improvement Plan in Service Presentation

Assignment: NURS FPX 4020 Capella University Improvement Plan in Service Presentation

Question Description
I’m working on a nursing writing question and need support to help me study.

I am a BSN student needing someone to write my papers for which includes 4 different topic requiring 3-5 pages each and 5-15 slide powerpoint. Assignment: NURS FPX 4020 Capella University Improvement Plan in Service Presentation

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• Assessment 1 Instructions: Enhancing Quality and Safety
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• For this assessment, you will develop a 3-5 page paper that examines a safety quality issue pertaining to medication administration in a health care setting. You will analyze the issue and examine potential evidence-based and best-practice solutions from the literature as well as the role of nurses and other stakeholders in addressing the issue.

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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.
Demonstration of Proficiency
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
• Competency 1: Analyze the elements of a successful quality improvement initiative.
• Explain evidence-based and best-practice solutions to improve patient safety focusing on medication administration and reducing costs.
• Competency 2: Analyze factors that lead to patient safety risks.
• Explain factors leading to a specific patient-safety risk focusing on medication administration.
• Competency 4: Explain the nurse’s role in coordinating care to enhance quality and reduce costs.
• Explain how nurses can help coordinate care to increase patient safety with medication administration and reduce costs.
• Identify stakeholders with whom nurses would need to coordinate to drive quality and safety enhancements with medication administration.
• Competency 5: Apply professional, scholarly, evidence-based strategies to communicate in a manner that supports safe and effective patient care.
• Communicate using writing that is clear, logical, and professional with correct grammar and spelling using current APA style.
• 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.
Professional Context
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.
Scenario
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:
• Analyze a current issue or experience in clinical practice surrounding a medication administration safety risk and identify a quality improvement (QI) initiative in the health care setting.
• Instructions
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.
• Explain factors leading to a specific patient-safety risk focusing on medication administration.
• Explain evidence-based and best-practice solutions to improve patient safety focusing on medication administration and reducing costs.
• Explain how nurses can help coordinate care to increase patient safety with medication administration and reduce costs.
• Identify stakeholders with whom nurses would coordinate to drive safety enhancements with medication administration.
• Communicate using writing that is clear, logical, and professional, with correct grammar and spelling, using current APA style.
• Additional Requirements
• Length of submission: 3–5 pages, plus title and reference pages.
• Number of references: Cite a minimum of 4 sources of scholarly or professional evidence that support your findings and considerations. Resources should be no more than 5 years old.
• APA formatting: References and citations are formatted according to current APA style.

• PRINT

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• Resources
• Collaboration and Leadership
• Cho, S. M., & Choi, J. (2018). Patient safety culture associated with patient safety competencies among registered nurses. Journal of Nursing Scholarship, 50(5), 549–557. https://doi-org.library.capella.edu/10.1111/jnu.12413
• This article discusses the importance of creating a unit-specific patient safety culture that is tailored to the competencies of the unit’s RNs in patient safety practice.
• SonÄŸur, C., Özer, O., Gün, C., & Top, M. (2018). Patient safety culture, evidence-based practice and performance in nursing. Systemic Practice and Action Research, 31(4), 359–374.
• Evidence-based practice is a problem-solving approach in which the best available and useful evidence is used by integrating research evidence, clinical expertise, and patient values and preferences to improve health outcomes, service quality, patient safety and clinical effectiveness, and employee performance.
• Stalter, A. M., & Mota, A. (2017). Recommendations for promoting quality and safety in health care systems. The Journal of Continuing Education in Nursing, 48(7), 295–297.
• This article provides recommendation to promote quality and safety education with a focus on systems thinking awareness among direct care nurses. A key point is error prevention, which requires a shared effort among all nurses.
• Manno, M. S. (2016). The role transition characteristics of new registered nurses: A study of work environment influences and individual traits. (Publication No. 10037467) [Doctoral dissertation, Capella University]. http://library.capella.edu/login?qurl=https%3A%2F%2Fwww.proquest.com%2Fdissertations-theses%2Frole-transition-characteristics-new-registered%2Fdocview%2F1775393522%2Fse-2%3Faccountid%3D27965
• This research study may be helpful in identifying traits and qualities of new registered nurses that are helpful in coordinating and leading quality and safety measures related to this assessment.
• Boomah, S. A. (2018). Emergence of informal clinical leadership as a catalyst for improving patient care quality and job satisfaction. Journal of Advanced Nursing. 75(5), 1000–1009. https://doi-org.library.capella.edu/10.1111/jan.13895
• This research analyzes attributes and best practices of leadership and nursing staff that help aid in patient care quality and job satisfaction.
• Greenstein, T. (2020). Leading innovation is completely different from leading change. WWD.com.
• This article examines competencies that may help nurses collaborate more effectively to improve patient outcomes.
• Poder, T. G., & Mattais, S. (2018). Systemic analysis of medication administration omission errors in a tertiary-care hospital in Quebec. Health Information Management Journal, 49(2-3), 99–107.
• This examination of underlying systemic causes of medication errors may be useful as you consider QI vest practices and ways to coordinate care to increase safety and quality.
• Antevy, P. (2017). How care collaboration is improving patient outcomes. EMS World, 46(4), 26–33.
• This article examines competencies that may help health care professionals collaborate more effectively to improve patient outcomes.
• Keers, R. N., Plácido, M., Bennet, K., Clayton, K., Brown, P., & Ashcroft, D. M. (2018, October 26). What causes medication administration errors in a mental health hospital? A qualitative study with nursing staff. PLOS One. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0206233
• This examination of underlying systemic causes of medication errors may be useful as you consider QI best practices and ways to coordinate care to increase safety and quality.
• Allison, J. (2016). Ideas and approaches for quality-assessment and performance-improvement projects in ambulatory surgery centers. AORN Journal, 103(5), 483–488.
• This article focuses on approaches and indicators customary to the services and operations of an ambulatory surgery center, going beyond reviewing data from routine outcome measures and explaining the effect these ideas can have on improving quality of care.
• Coles, E., Wells, M., Maxwell, M., Harris, F. M., Anderson, J., Gray, N. M., . . . MacGillivray, S. (2017). The influence of contextual factors on healthcare quality improvement initiatives: What works, for whom and in what setting? Protocol for a realist review. Systematic Reviews, 6, 168–178. Retrieved from https://systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-017-0566-8
• This article examines ways in which the context of a quality improvement initiative plays a role in its success or failure and should help you consider the context of your proposed quality improvement initiative.
• Institute for Healthcare Improvement. (n.d.). Reliability series part 1: What is reliability? [Video]. Retrieved from http://www.ihi.org/education/IHIOpenSchool/resources/Pages/Activities/FrankReliability1.aspx
• This video discusses the relationship between reliability and quality in health care.
• Robinson, J., & Gelling, L. (2019). Nurses+QI=better hospital performance? A critical review of the literature. Nursing Management (Harrow), 26(4), 22–28.
• Abstract: NHS regulators, such as NHS Improvement and the Care Quality Commission, promote staff involvement in quality improvement (QI), while national nursing leaders and the Nursing and Midwifery Council advocate nurses’ involvement in improving services. This article critically explores the evidence base for a national nursing strategy to involve nurses in QI using a literature review. A thematic analysis shows that nurse involvement in QI has several positive outcomes, which are also included in the NHS Improvement’s Single Oversight Framework for NHS Providers. The article concludes that nurse involvement in QI helps improve hospital performance (Robinson & Gelling, 2019).
• Chen, H., Feng, H., Liao, L., Wu, X., Zhao, Y., Hu, M., Li, H., Hu, H., & Yang, X. (2020). Evaluation of quality improvement intervention with nurse training in nursing homes: A systematic review. Journal of Clinical Nursing, (29)15–16. https://doi-org.library.capella.edu/10.1111/jocn.15289
• The need for implementing systemic quality improvement practices to improve safety and quality is discussed in this article.
Quality and Safety Education
• Lyle-Edrosolo, G., & Waxman, K. (2016). Aligning healthcare safety and quality competencies: Quality and safety education for nurses (QSEN), the Joint Commission, and American Nurses Credentialing Center (ANCC) Magnet® standards crosswalk. Nurse Leader, 14(1), 70–75.
• This article attempts to align the language used in three quality and safety standards and reduce confusion for health care professionals.
• Altmiller, G., & Hopkins-Pepe, L. (2019). Why quality and safety education for nurses (QSEN) matters in practice. The Journal of Continuing Education in Nursing, 50(5), 199–200.
• This article discusses the needs for quality and safety education in nursing and how the Journal of Continuing Education in Nursing supports QSEN competency implementation in practice.
• Johnson, L., McNally, S., Meller, N., & Dempsey, J. (2019). The experience of undergraduate nursing students in patient safety education: A qualitative study. Australian Nursing and Midwifery Journal, 26(8), 55.
• This article discusses educating nursing students about patient safety early within their learning journey and how it has shown to have a compelling positive impact on each individual’s knowledge, skills, and behavior growth surrounding the concept of patient safety.
• Wieke Noviyanti, L., Handiyani, H., & Gayatri, D. (2018). Improving the implementation of patient safety by nursing students using nursing instructors trained in the use of quality circles. BMC Nursing, 17(2).
• Abstract: It is recognized worldwide that the skills of nursing students concerning patient safety is still not optimal. The role of clinical instructors is to instill in students the importance of patient safety. Therefore, it is important to have competent clinical instructors. Their experience can be enhanced through the application of quality circles. This study identifies the effect of quality circles on improving the safety of patients of nursing students. Patient safety is inseparable from the quality of nursing education. Existing research shows that patient safety should be emphasized at all levels of the healthcare education system. In hospitals, the ratio between nursing students and clinical instructors is disproportionately low. In Indonesia, incident data relating to patient safety involving students is not well documented, and the incidents often occur in the absence of a clinical instructor (Wieke Noviyanti, Handiyani, & Gayatri, 2018).
• Havaei, F., MacPhee, M., & Dahinten, V. S. (2019). The effect of nursing care delivery models on quality and safety outcomes of care: A cross‐sectional survey study of medical‐surgical nurses. Journal of Advanced Nursing, 75(10), 2144–2155.
• This study examines components of nursing care delivery and the mode of nursing care delivery. This may be helpful in seeing safety and quality education and best practices.
• Health and medicine – quality of care; new findings from Karolinska Institute in the area of quality of care reported (shared responsibility: school nurses’ experience of collaborating in school-based interprofessional teams). (2017, July 21). Health and Medicine Week.
• This wire feed examines evidence-based and best-practice strategies for improving the care offered by school nurses, may help you identify useful strategies for your assessment.

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Assessment 2 Instructions: Root-Cause Analysis and Safety Improvement Plan
For this assessment, you will use a supplied template to conduct a root-cause analysis of a quality or safety issue in a health care setting of your choice and outline a plan to address the issue.
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.
Demonstration of Proficiency
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
• Competency 1: Analyze the elements of a successful quality improvement initiative.
• Apply evidence-based and best-practice strategies to address a safety issue or sentinel event pertaining to medication administration. ;
• Create a viable, evidence-based safety improvement plan for safe medication administration.
• Competency 2: Analyze factors that lead to patient safety risks.
• Analyze the root cause of a patient safety issue or a specific sentinel event pertaining to medication administration in an organization.
• Competency 3: Identify organizational interventions to promote patient safety.
• Identify existing organizational resources that could be leveraged to improve a safety improvement plan for safe medication administration.
• Competency 5: Apply professional, scholarly, evidence-based strategies to communicate in a manner that supports safe and effective patient care.
• Communicate in writing that is clear, logical, and professional, with correct grammar and spelling, using current APA style.
• Professional Context
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 quality improvements.
Scenario
For this assessment, you may choose from the following options as the subject of a root-cause analysis and safety improvement plan:
• The specific safety concern identified in your previous assessment pertaining to medication administration safety concerns.
• The readings, case studies, or a personal experience in which a sentinel event occurred surrounding an issue or concern with medication administration.
• Instructions
The purpose of this assessment is to demonstrate your understanding of and ability to analyze a root cause of a specific safety concern in a health care setting. You will create a plan to improve the safety of patients related to the concern of medication administration safety based on the results of your analysis, using the literature and
• professional best practices as well as the existing resources at your chosen health care setting to provide a rationale for your plan.
Use the Root-Cause Analysis and Improvement Plan Template [DOCX] to help you to stay organized and concise. This will guide you step-by-step through the root cause analysis process.
Additionally, 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 you understand ;what is needed for a distinguished score.
• Analyze the root cause of a patient safety issue or a specific sentinel event pertaining to medication administration in an organization.
• Apply evidence-based and best-practice strategies to address the safety issue or sentinel event pertaining to medication administration.
• Create a feasible, evidence-based safety improvement plan for safe medication administration.
• Identify organizational resources that could be leveraged to improve your plan for safe medication administration.
• Communicate in writing that is clear, logical, and professional, with correct grammar and spelling, using current APA style.
• Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like but keep in mind that your Assessment 2 will focus on safe medication administration.
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• Additional Requirements
• Length of submission: Use the provided Root-Cause Analysis and Improvement Plan template to create a 4-6 page root cause analysis and safety improvement plan pertaining to medication administration.
• Number of references: Cite a minimum of 3 sources of scholarly or professional evidence that support your findings and considerations. Resources should be no more than 5 years old.
• APA formatting: Format references and citations according to current APA style.
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• Resources
• Evidence-Based Practice
• Hande, K., Williams, C. T., Robbins, H. M., & Christenbery, T. (2017). Leveling evidence-based practice across the nursing curriculum. The Journal for Nurse Practitioners, 13(1), e17–e22.
• Abstract: Evidence-based practice (EBP) competencies represent essential components of nursing education at all levels. The transition of EBP learning goals from the baccalaureate to the master of science in nursing and doctor of nursing practice levels provides a blueprint for the development and advancement of student knowledge, skills, and attitudes. The purpose of this article is to describe 3 nursing curricula related to EBP competencies at the baccalaureate, master’s, and doctor of nursing practice levels (Hande, Williams, Robbins, & Christenbery, 2017).
• Sukkarieh-Haraty, O., & Hoffart, N. (2017). Integrating evidence-based practice into a Lebanese nursing baccalaureate program: Challenges and successes. International Journal of Nursing Education Scholarship, 14(1), 441–442.
• Abstract: Evidence-based practice (EBP) is defined as “the conscientious use of current best evidence in making clinical decisions about patient care.” This paper describes how we have developed the evidence-based practice concept and integrated it into two courses at two different levels of the BSN curriculum. Students apply EBP knowledge and process by using the PICO clinical question (Population, Intervention, Comparison and Outcome), whereby they observe a selected clinical skill, and then compare their observations to hospital protocol and against the latest evidence-based practice guidelines. The assignment for the second course requires students to pick a more complex clinical skill and to support proposed changes in practice with scholarly literature. Assessment of student learning and course evaluation has shown that the overall experience of integrating EBP projects into the curriculum is fruitful for students, clinical agencies, and faculty (Sukkarieh-Haraty & Hoffart, 2017).
• Rahmayanti, E. I., Kadar, K. S., & Saleh, A. (2020). Readiness, barriers and potential strength of nursing in implementing evidence-based practice. International Journal of Caring Sciences, 13(2), 1203–1211.
• This article provides methods for identifying the readiness, barriers, and potential strengths of implementing evidence-based practice.
• Lee, S. K. (2016). Implementing evidence-based practices improves neonatal outcomes. Evidence-Based Medicine, 21(6), 231.
• This journal article provides a framework for identifying and appraising research, as well as implementing change and practices based on research.
Quality and Safety
• Ambutas, S., Lamb, K. V., & Quigley, P. (2017). Fall reduction and injury prevention toolkit: Implementation on two medical-surgical units. Medsurg Nursing, 26(3), 175–179, 197.
• The implementation of a safety improvement project is examined in this article.
• Institute for Healthcare Improvement. (n.d.). Why is reducing harm – not just error – important to patient safety? [Video]. Retrieved from http://www.ihi.org/education/IHIOpenSchool/resources/Pages/Activities/Bates-Reducing-Harm-Important-To-Patient-Safety.aspx
• Based on the premise that human error may be reduced but not avoided in every health care situation, this video focuses on the importance of harm reduction to patient safety.
• Joint Commission. (2018). 2018 national patient safety goals. Retrieved from https://www.jointcommission.org/standards_information/npsgs.aspx
• The patient safety resources on this Web page may be helpful as you develop the improvement plan section of your assessment.
• Mills, E. (2016). The WakeWings journey: Creating a patient safety program. AORN Journal, 103(6), 636–639.
• This article summarizes the creation of a safety program to reduce sentinel events.
• U.S. Department of Health & Human Services. (n.d.). Retrieved from https://www.hhs.gov/
• Explore numerous resources related to quality and safety on this website as you develop your assessment submission.
Root-Cause Analysis
• Institute for Healthcare Improvement. (n.d.). Cause and effect diagram [Video]. Retrieved from http://www.ihi.org/education/IHIOpenSchool/resources/Pages/AudioandVideo/Whiteboard16.aspx
• Cause and effect (or fishbone) diagrams are often used in root-cause analyses; this video shows how to create them.
• Institute for Healthcare Improvement. (n.d.). Introduction to trigger tools for identifying adverse events. Retrieved from http://www.ihi.org/resources/Pages/Tools/IntrotoTriggerToolsforIdentifyingAEs.aspx
• Tools to identify adverse events and determine their causes are provided on this resource page.
• Galatzan, B. J. (2019). Exploring the content of the nurse-to-nurse change of shift hand-off communication (Publication No. 27666610) [Doctoral dissertation, University of Arizona]. http://library.capella.edu/login?qurl=https%3A%2F%2Fwww.proquest.com%2Fdocview%2F2336369734%3Faccountid%3D27965
• Abstract: An estimated 250,000 deaths occur annually are attributed to preventable medical errors. Approximately 100,000 of those deaths are related to miscommunication between healthcare providers. Miscommunication between healthcare providers during the transfer of care accounts for 80% of sentinel events occurring in the hospital setting. The hand-off communication continues to be one of the primary causes of sentinel events in healthcare in spite of the continued research focus over the past 10 years. The transfer of care communication between providers is called the “hand-off,” “change of shift report,” or “handover.” The hand-off for purposes of this study is defined as the process of transferring patient care, responsibility, and authority from one nurse to another at the change of shift. Specifically, we are concerned about the communication of clinical events (CE) experienced by the patient because CEs are precursors to a sentinel event. A CE is defined as a change in the patient’s condition in the following areas: bleeding, pain, fever, and changes in output, respiratory status, or level of consciousness (Galatzan, 2019).
• Minnesota Department of Health. (n.d.). Root cause analysis toolkit. Retrieved from https://www.health.state.mn.us/facilities/patientsafety/adverseevents/toolkit/
• The Minnesota Department of Health offers an extensive collection of resources related to root-cause analysis.
• The Joint Commission. (n.d.). Framework for conducting a root cause analysis and action plan. Retrieved from http://www.jointcommission.org/Framework_for_Conducting_a_Root_Cause_Analysis_and_Action_Plan/
• With resources for conducting a root-cause analysis and creating an action plan to address the results, this Web page will help you understand the steps and processes of RCAs and improvement plans for this assessment.

Sentinel Events
• The Joint Commission. (n.d.). Sentinel event policy and procedures. https://jointcommission.org/sentinel_event_policy_and_procedures
• This web page provides definitions, policies, and procedures related to Sentinel events that may help you to complete your assignment.
• The Joint Commission. (2017). The essential role of leadership in developing a safety culture [PDF]. Sentinel Event Alert, 57, 1–8. Retrieved from https://www.jointcommission.org/sea_issue_57/
• According to The Joint Commission, “Competent and thoughtful leaders…understand that systemic flaws exist and each step in a care process has the potential for failure simply because humans make mistakes.” This issue of Sentinel Event Alert discusses ways that effective leaders foster the development of a safety culture.

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Assessment 3 Instructions: Improvement Plan In-Service Presentation

• PRINT

• For this assessment, you will develop an 8-14 slide PowerPoint presentation with thorough speaker’s notes designed for a hypothetical in-service session related to the safe medication administration improvement plan you developed in Assessment 2.
As a practicing professional, you are likely to present educational in-services or training to staff pertaining to quality improvement (QI) measures of safety improvement interventions. Such in-services and training sessions should be presented in a creative and innovative manner to hold the audience’s attention and promote knowledge acquisition and skill application that changes practice for the better. The teaching sessions may include a presentation, audience participation via simulation or other interactive strategy, audiovisual media, and participant learning evaluation.
The use of in-services and/or training sessions has positive implications for nursing practice by increasing staff confidence when providing care to specific patient populations. It also allows for a safe and nonthreatening environment where staff nurses can practice their skills prior to a real patient event. Participation in learning sessions fosters a team approach, collaboration, patient safety, and greater patient satisfaction rates in the health care environment (Patel Wright, 2018).
As you prepare to complete the assessment, consider the impact of in-service training on patient outcomes as well as practice outcomes for staff nurses. Be sure to support your thoughts on the effectiveness of educating and training staff to increase the quality of care provided to patients by examining the literature and established best practices.
You are encouraged to explore the AONE Nurse Executive Competencies Review activity before you develop the Improvement Plan In-Service Presentation. This activity will help you review your understanding of the AONE Nurse Executive Competencies – especially those related to competencies relevant to developing an effective training session and presentation. This is for your own practice and self-assessment, and demonstrates your engagement in the course.
Demonstration of Proficiency
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
• Competency 1: Analyze the elements of a successful quality improvement initiative.
• Explain the need and process to improve safety outcomes related to medication administration.
• Create resources or activities to encourage skill development and process understanding related to a safety improvement initiative on medication administration.
• Competency 4: Explain the nurse’s role in coordinating care to enhance quality and reduce costs.
• List clearly the purpose and goals of an in-service session focusing on safe medication administration for nurses.
• Explain audience’s role in and importance of making the improvement plan focusing on medication administration successful.
• Competency 5: Apply professional, scholarly, evidence-based strategies to communicate in a manner that supports safe and effective patient care.
• Communicate with nurses in a respectful and informative way that clearly presents expectations and solicits feedback on communication strategies for future improvement.
• Reference
Patel, S., Wright, M. (2018). Development of interprofessional simulation in nursing education to improve teamwork and collaboration in maternal child nursing. Journal of Obstetric, Gynecologic, Neonatal Nursing, 47(3), s16-s17.
Professional Context
As a baccalaureate-prepared nurse, you will often find yourself in a position to lead and educate other nurses. This colleague-to-colleague education can take many forms, from mentoring to informal explanations on best practices to formal in-service training. In-services are an effective way to train a large group. Preparing to run an in-service may be daunting, as the facilitator must develop his or her message around the topic while designing activities to help the target audience learn and practice. By improving understanding and competence around designing and delivering in-service training, a BSN practitioner can demonstrate leadership and prove him- or herself a valuable resource to others.
Scenario
For this assessment it is suggested you take one of two approaches:
• 1 Build on the work that you have done in your first two assessments and create an agenda and PowerPoint of an educational in-service session that would help a specific staff audience learn, provide feedback, and understand their roles and practice new skills related to your safety improvement plan pertaining to medication administration, or
• 2 Locate a safety improvement plan through an external resource and create an agenda and PowerPoint of an educational in-service session that would help a specific staff audience learn, provide feedback, and understand their roles and practice new skills related to the issues and improvement goals pertaining to medication administration safety.

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• Instructions
The final deliverable for this assessment will be a PowerPoint presentation with detailed presenter’s notes representing the material you would deliver at ;an in-service session to raise awareness of your chosen safety improvement initiative focusing on medication administration and to explain the need for it. Additionally, you must educate the audience as to their role and importance to the success of the initiative. This includes providing examples and practice opportunities to test out new ideas or practices related to the safety improvement initiative.
Be sure that your presentation addresses the following, which corresponds to the grading criteria in the scoring guide. Please study the scoring guide carefully so you understand what is needed for a distinguished score.
• List the purpose and goals of an in-service session focusing on safe medication administration for nurses.
• Explain the need for and process to improve safety outcomes related to medication administration.
• Explain to the audience their role and importance of making the improvement plan focusing on medication administration successful.
• Create resources or activities to encourage skill development and process understanding related to a safety improvement initiative on medication administration.
• Communicate with nurses in a respectful and informative way that clearly presents expectations and solicits feedback on communication strategies for future improvement.
• There are various ways to structure an in-service session below is just one example:
• Part 1: Agenda and Outcomes.
• Explain to your audience what they are going to learn or do, and what they are expected to take away.
• Part 2: Safety Improvement Plan.
• Give an overview of the current problem focusing on medication administration, the proposed plan, and what the improvement plan is trying to address.
• Explain why it is important for the organization to address the current situation.
• Part 3: Audience’s Role and Importance.
• Discuss how the staff audience will be expected to help implement and drive the improvement plan.
• Explain why they are critical to the success of the improvement plan focusing on medication administration.
• Describe how their work could benefit from embracing their role in the plan.
• Part 4: New Process and Skills Practice.
• Explain new processes or skills.
• Develop an activity that allows the staff audience to practice and ask questions about these new processes and skills.
• In the notes section of your PowerPoint, brainstorm potential responses to likely questions or concerns.
• Part 5: Soliciting Feedback.
• Describe how you would solicit feedback from the audience on the improvement plan and the in-service.
• Explain how you might integrate this feedback for future improvements.
• Additional Requirements
• Presentation length: There is no required length; use just enough slides to address all the necessary elements. Remember to use short, concise bullet points on the slides and expand on your points in the presenter’s notes. If you use 2 or 3 slides to address each of the parts in the above example, your presentation would be 10–15 slides.
• Speaker notes: Speaker notes should reflect what you would actually say if you were delivering the presentation to an audience. Another presenter would be able to use the presentation by following the speaker notes.
• APA format: Use APA formatting for in-text citations. Include an APA-formatted reference slide at the end of your presentation.
• Number of references: Cite a minimum of 3 sources of scholarly or professional evidence to support your assertions. Resources should be no more than 5 years old.
Resources
Leadership Competencies
• American Organization of Nurse Executives. (2015). Nurse executive competencies [PDF]. Retrieved from https://www.aonl.org/nurse-executive-competencies
• The AONE nurse executive competencies may be a helpful resource as you design your presentation, especially with regard to communication and collaboration.
•
•
• Evidence and Value-Based Decision Making
• Gray, M. (2017). Value based healthcare. British Medical Journal, 356, 437.
• This article discusses both evidence-based decision making and value-based decision making and how to reduce unwarranted variation to maximize the value of health care.
• George, L. E., Locasto, L. W., Pyo, K. A., & Cline, T. W. (2017). Effect of the dedicated education unit on nursing student self-efficacy: A quasi-experimental research study. Nursing Education in Practice, 23, 48–53.
• Abstract: Although the Dedicated Education Unit (DEU) has shown initial promise related to satisfaction with the teaching/learning environment, few studies have examined student outcomes related to the use of the DEU as a clinical education model beyond student satisfaction. The purpose of this quantitative, quasi-experimental study was to compare student outcomes from the traditional clinical education (TCE) model with those from the DEU model. Participants were students enrolled in a four-year baccalaureate program in nursing (n = 193) who had clinical education activities in one of three clinical agencies. Participants were assigned to either the DEU or a TCE model. Pre-clinical and post-clinical self-efficacy scores were measured for each group using an adapted Generalized Self-Efficacy Scale (Schwarzer and Jerusalem, 1995). Both groups experienced a significant increase in self-efficacy scores post clinical education. The increase in self-efficacy for the DEU students was significantly greater than the increase in self-efficacy for the traditional students. Self-efficacy is considered an important outcome of nursing education because high self-efficacy has been linked to making an easier transition from student to nursing professional. This study supports the quality of the DEU as a clinical education model by examining student self-efficacy outcomes (George, Locasto, Pyo, & Cline, 2017.)
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•
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• Facilitating Learning
• Green, J. K., & Huntington, A. D. (2017). Online professional development for digitally differentiated nurses: An action research perspective. Nurse Education in Practice, 22, 55–62.
• Green and Huntington highlight five elements that are key to effective online professional development in this article describing an action-research project involving RNs in clinical settings.
• Moradi, K., Najarkolai, A. R., & Keshmiri, F. (2016). Interprofessional teamwork education: Moving toward the patient-centered approach. The Journal of Continuing Education in Nursing, 47(10), 449–460.
• The study discussed in this article involved the development of a framework of interprofessional framework competencies on which curricula and assessment tools could be based. Such an approach may be useful for you to consider as you develop your presentation.
• Rakhudu, M. A., Davhana-Maselesele, M., & Useh, U. (2016). Concept analysis of collaboration in implementing problem-based learning in nursing education. Curationis, 39(1), 1–13.
• In their effort to better understand and define collaboration in terms of problem-based learning, the authors observed the increasing importance of interprofessional collaboration to nursing education and other aspects of the health care profession.
• Hermann, C. P., Head, B. A., Black, K., & Singleton, K. (2016). Preparing nursing students for interprofessional practice: The interdisciplinary curriculum for oncology palliative care education. Journal of Professional Nursing, 32(1), 62–71.
• This article explains why interprofessional experiences for baccalaureate nursing students are essential to prepare them for interprofessional communication, collaboration, and teamwork

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Assessment 4 Instructions: Improvement Plan Tool Kit

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For this assessment, you will develop a Word document or an online resource repository of at least 12 annotated professional or scholarly resources that you consider critical for the audience of your safety improvement plan, pertaining to medication administration, to understand or implement to ensure the success of the plan.
Communication in the health care environment consists of an information-sharing experience whether through oral or written messages (Chard, Makary, 2015). As health care organizations and nurses strive to create a culture of safety and quality care, the importance of interprofessional collaboration, the development of tool kits, and the use of wikis become more relevant and vital. In addition to the dissemination of information and evidence-based findings and the development of tool kits, continuous support for and availability of such resources are critical. Among the most popular methods to promote ongoing dialogue and information sharing are blogs, wikis, websites, and social media. Nurses know how to support people in time of need or crisis and how to support one another in the workplace; wikis in particular enable nurses to continue that support beyond the work environment. Here they can be free to share their unique perspectives, educate others, and promote health care wellness at local and global levels (Kaminski, 2016).
You are encouraged to complete the Determining the Relevance and Usefulness of Resources activity prior to developing the repository. This activity will help you determine which resources or research will be most relevant to address a particular need. This may be useful as you consider how to explain the purpose and relevance of the resources you are assembling for your tool kit. The activity is for your own practice and self-assessment, and demonstrates course engagement.
Demonstration of Proficiency
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
• Competency 1: Analyze the elements of a successful quality improvement initiative.
• Analyze usefulness of resources for role group responsible for implementing quality and safety improvements with medication administration.
• Competency 2: Analyze factors that lead to patient safety risks.
• Analyze the value of resources to reduce patient safety risk or improve quality with medication administration.
• Competency 3: Identify organizational interventions to promote patient safety.
• Identify necessary resources to support the implementation and sustainability of a safety improvement initiative focusing on medication administration.
• Competency 5: Apply professional, scholarly, evidence-based strategies to communicate in a manner that supports safe and effective patient care.
• Present compelling reasons and relevant situations for resource tool kit to be used by its target audience.
• Communicate in a clear, logically structured, and professional manner, using current APA style and formatting.
• References
Chard, R., Makary, M. A. (2015). Transfer-of-care communication: Nursing best practices. AORN Journal, 102(4), 329-342.
Kaminski, J. (2016). Why all nurses can/should be authors. Canadian Journal of Nursing Informatics, 11(4), 1-7.
Professional Context
Nurses are often asked to implement processes, concepts, or practices – sometimes with little preparatory communication or education. One way to encourage sustainability of quality and process improvements is to assemble an accessible, user-friendly tool kit for knowledge and process documentation. Creating a resource repository or tool kit is also an excellent way to follow up an educational or in-service session, as it can help to reinforce attendees’ new knowledge as well as the understanding of its value. By practicing creating a simple online tool kit, you can develop valuable technology skills to improve your competence and efficacy. This technology is easy to use, and resources are available to guide you.
Scenario
For this assessment, consider taking one of these two approaches:
• 1 Build on the work done in your first three assessments and create an online tool kit or resource repository that will help the audience of your in-service understand the research behind your safety improvement plan pertaining to medication administration and put the plan into action.
• 2 Locate a safety improvement plan (your current organization, the Institution for Healthcare Improvement, or a publicly available safety improvement initiative) pertaining to medication administration and create an online tool kit or resource repository that will help an audience understand the research behind the safety improvement plan and how to put the plan into action.
• Preparation
Google Sites is recommended for this assessment – the tools are free to use and should offer you a blend of flexibility and simplicity as you create your online tool kit. Please note that this requires a Google account; use your Gmail or GoogleDocs login, or create an account following the directions under the “Create Account” menu.
Refer to the following links to help you get started with Google Sites:
• G Suite Learning Center. (n.d.). Get started with Sites. Retrieved from https://gsuite.google.com/learning-center/products/sites/get-started/#!/
• Google. (n.d.). ;Google Sites. Retrieved from https://sites.google.com
• Google. (n.d.). ;Sites help. Retrieved from https://support.google.com/sites/?hl=en#topic=
• Instructions
Using Google Sites, assemble an online resource tool kit containing at least 12 annotated resources that you consider critical to the success of your safety improvement initiative. These resources should enable nurses and others to implement and maintain the safety improvement you have developed.
It is recommended that you focus on the 3 or 4 most critical categories or themes with respect to your safety improvement initiative pertaining to medication administration. For example, for an ;initiative that concerns improving workplace safety for practitioners, you might choose broad themes such as general organizational safety and quality best practices; environmental safety and quality risks; individual strategies to improve personal and team safety; and process best practices for reporting and improving environmental safety issues.
Following the recommended scheme, you would collect 3 resources on average for each of the 4 categories focusing on safety with medication administration. Each resource listing should include ;the following:
• An APA-formatted citation of the resource with a working link.
• A description of the information, skills, or tools provided by the resource.
• A brief explanation of how the resource can help nurses better understand or implement the safety improvement initiative pertaining to medication administration.
• A description of how nurses can use this resource and when its use may be appropriate.
• Remember that you must make your site public so that your faculty can access it. Check out the Google Sites resources for more information.
Here is an example entry:
• Merret, A., Thomas, P., Stephens, A., ;Moghabghab, R., Gruneir, M. (2011). A collaborative approach to fall prevention. Canadian Nurse, 107(8), 24-29. Retrieved from www.canadian-nurse.com/articles/issues/2011/october-2011/a-collaborative-ap
• This article presents the Geriatric Emergency Management-Falls Intervention Team (GEM-FIT) project. It shows how a collaborative nurse lead project can be implemented and used to improve collaboration and interdisciplinary teamwork, as well as improve the delivery of health care services. This resource is likely more useful to nurses as a resource for strategies and models for assembling and participating in an interdisciplinary team than for specific fall-prevention strategies. It is suggested that this resource be reviewed prior to creating an interdisciplinary team for a collaborative project in a health care setting.
• Additionally, 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 you understand what is needed for a distinguished score.
• Identify necessary resources to support the implementation and continued sustainability of a safety improvement initiative pertaining to medication administration.
• Analyze the usefulness of resources to the role group responsible for implementing quality and safety improvements focusing on medication administration.
• Analyze the value of resources to reduce patient safety risk related to medication administration.
• Present compelling reasons and relevant situations for use of resource tool kit by its target audience.
• Communicate in a clear, logically structured, and professional manner that applies current APA style and formatting.
• Example Assessment: You may use the following example to give you an idea of what a Proficient or higher rating on the scoring guide would look like but keep in mind that your tool kit will focus on promoting safety with medication administration. Note that you do not have to submit your bibliography in addition to the Google Site; the example bibliography is merely for your reference.
• Assessment 4 Example [PDF].
• To submit your online tool kit assessment, paste the link to your Google Site in the assessment submission box.
Example Google Site: You may use the example Google Site, Resources for Safety and Improvement Measures in Geropsychiatric Care, to give you an idea of what a Proficient or higher rating on the scoring guide would look like for this assessment but keep in mind that your tool kit will focus on promoting safety with medication administration.
Note: If you experience technical or other challenges in completing this assessment, please contact your faculty member.
Additional Requirements
• APA formatting: References and citations are formatted according to current APA style
Resources

Collaboration and Teamwork
• Bird, H. (2017). How to enhance practice in a digital world. Community Practitioner, 90(4), 22–24.
• There are new tools of leadership and communication in practice today, and this article explains how these new tools can enhance best practices in nursing.
• Barton, G., Bruce, A., & Schreiber, R. (2018). Teaching nurses teamwork: Integrative review of competency-based team training in nursing education. Nurse Education in Practice, 32, 129–137.
• Abstract: The aim of this review is to critically analyse empirical published work reporting on teamwork education interventions in nursing, and identify key educational considerations enabling teamwork competency in this group. CINAHL, Web of Science, Academic Search Complete, and ERIC databases were searched and detailed inclusion-exclusion criteria applied. Studies (n=19) were selected and evaluated using established qualitative-quantitative appraisal tools and a systematic constant comparative approach. Nursing teamwork knowledge is rooted in High Reliability Teams theory and Crew or Crisis Resource Management sources. Constructivist pedagogy is used to teach, practice, and refine teamwork competency. Nursing teamwork assessment is complex; involving integrated yet individualized determinations of knowledge, skills, and attitudes. Future initiatives need consider frontline leadership, supportive followership and skilled communication emphasis. Collective stakeholder support is required to translate teamwork competency into nursing practice (Barton, Bruce, & Schreiber, 2018).
• Schmutz, J. B., Meier, L. L., & Manser, T. (2019). How effective is teamwork really? The relationship between teamwork and performance in healthcare teams: A systematic review and meta-analysis. BMJ Open, 9(9).
• This article investigates the relationship between teamwork and clinical performance and potential moderating variables of this relationship.
• Doren, M. (2017). Working collaboratively—teaching collaboration. Transformations: The Journal of Inclusive Scholarship & Pedagogy, 27(2), 180–194.
• This article may give you some ideas for a skills practice activity to include in your Improvement Plan In-Service Presentation.
• Rosen, M. A., DiazGranados, D., Dietz, A. S., Benishek, L. E., Pronovost, P. J., & Weaver, S. J. (2018). Teamwork in healthcare: Key discoveries enabling safer, high-quality care. American Psychologist, 73(4), 433–450.
• The authors discuss best practices related to teamwork and team improvement, some of which may help you think about how best to present the information in your tool kit.

Wikis
• Malamed, C. (n.d.). Using wikis for learning and collaboration. Retrieved from http://theelearningcoach.com/elearning2-0/using-wikis-for-elearning/
• This article may be helpful as you think about how to put together your tool kit for your assessment.
• MindTools. (n.d.). How to create a wiki: Setting up a collaborative online workspace. Retrieved from https://www.mindtools.com/pages/article/how-to-create-a-wiki.htm
• MindTools provides a practical overview of wikis, including their history and purpose, as well as how to build them.
Blogs
• National Council of State Boards of Nursing, Inc. (2018). A nurse’s guide to the use of social media. https://www.ncsbn.org/
• This article discusses the uses of social media in nursing.
Google Sites
Refer to the following links to help you build your tool kit:
• G Suite Learning Center. (n.d.). Get started with Sites. Retrieved from https://gsuite.google.com/learning-center/products/sites/get-started/#!/
• Google. (n.d.). Google Sites. Retrieved from https://sites.google.com
• Google. (n.d.). Sites help. Retrieved from https://support.google.com/sites/?hl=en#topic=
• Resources for safety and improvement measures in geropsychiatric care. (n.d.). Retrieved from https://sites.google.com/view/safetyimprovementmeasures/home

Building Professional Efficacy and Visibility
• Kaminski, J. (2016). Why all nurses can/should be authors. Canadian Journal of Nursing Informatics, 11(4), 1–7.
• This editorial urges nurses to be active contributors to ongoing research, journals, blogs, and other outlets to increase visibility of their valuable perspectives on health care.
• George, L. E., Locasto, L. W., Pyo, K. A., & Cline, T. W. (2017). Effect of the dedicated education unit on nursing student self-efficacy: A quasi-experimental research study. Nursing Education in Practice, 23, 48–53.
• Abstract: Although the Dedicated Education Unit (DEU) has shown initial promise related to satisfaction with the teaching/learning environment, few studies have examined student outcomes related to the use of the DEU as a clinical education model beyond student satisfaction. The purpose of this quantitative, quasi-experimental study was to compare student outcomes from the traditional clinical education (TCE) model with those from the DEU model. Participants were students enrolled in a four-year baccalaureate program in nursing (n = 193) who had clinical education activities in one of three clinical agencies. Participants were assigned to either the DEU or a TCE model. Pre-clinical and post-clinical self-efficacy scores were measured for each group using an adapted Generalized Self-Efficacy Scale (Schwarzer and Jerusalem, 1995). Both groups experienced a significant increase in self-efficacy scores post clinical education. The increase in self-efficacy for the DEU students was significantly greater than the increase in self-efficacy for the traditional students. Self-efficacy is considered an important outcome of nursing education because high self-efficacy has been linked to making an easier transition from student to nursing professional. This study supports the quality of the DEU as a clinical education model by examining student self-efficacy outcomes (George, Locasto, Pyo, & Cline, 2017).
Evaluating Resources
• The Library of Congress. (n.d.). Evaluating Internet resources: An annotated guide to selected resources. Retrieved from https://www.loc.gov/rr/business/beonline/selectbib.html
• This Web page collects resources related to evaluating the reliability and relevance of information from electronic sources. The format of this page may also be a helpful model for the resource list you are assembling.
• Think Critically About Source Quality.
• This Capella University Library guide offers a method to help you determine which resources to include in your tool kit.

NURS FPX 4020 Assessment 1: Enhancing Quality and Safety Essay

NURS FPX 4020 Assessment 1: Enhancing Quality and Safety

Enhancing Quality and Safety

Patient safety and quality care are two of the most significant challenges faced by health care facilities, nurses, physicians, and other health care professionals. Poor quality and issues to patient safety will lead to morbidity, mortality, increased cost of care and hospital stay, lower patient satisfaction, and job satisfaction, and other issues. Some of the most common patient safety issues are medication administration errors, poor patient handling, delayed care, hospital-acquired infections, patient falls, and other issues. The purpose of this paper is to analyze the medication administration issue relating to patient safety, best evidence-based practices, and analyze coordination between nurses and stakeholders.

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Patient-safety risk focusing on medication administration

Medication administration is a critical process where nurses play a key role. However, stakeholders such as physicians, pharmacists, informatics nurses, and other health care professionals contribute to it as the process includes medication prescription, dosage calculation, medication dispensing, and error monitoring. Error in any of the stages will lead to medication administration errors. This will result in adverse events. For example, the prescription error rate varied from 6% to 77.2% (Korb-Savoldelli et al., 2018), dispensing errors varied from 1.2% to 46% (Kumar et al., 2019), and wrong dosage and omission error varied from 8% to 26% in health care (Palese et al., 2019). Suclupe et al. (2020) found in their study that 6-25% of errors were caused by nurses. This indicates that human errors are a major factor.  NURS FPX 4020 Assessment 1: Enhancing Quality and Safety Essay

Another factor is interferences during medication administration. Interferences from patients or their families disturb the normal work process, which results in medication mix-up and delayed administration. Thomas et al. (2017) pointed out that nurses feel excessive cognitive load when there are distractions and interruptions. Frequency interruptions reduce throughput and efficiency, which culminates into errors. Also, conversations with other nurses during administration increase the risk of medication errors (Huckels-Baumgart et al., 2017). For example, nurses discussing about other patients during administration can lead to confusion.

Nurse to patient ratio is another major factor as an increased number of patients per nurse increases burnout in nurses. Burnout leads to lower cognitive functioning and leads to poor decision-making and errors (Montgomery et al., 2020). Another major factor is poor communication between nurses, physicians, informatics nurses, and pharmacists as misinformation regarding dosage or wrong patient records in EHRs result in medication errors. These can result in adverse effects (Tsegaye et al., 2020). In their study, Tsegaye et al. (2020) found that the prevalence of administration errors was due to wrong assessment (27%), wrong evaluation (26.7%), and wrong time (38.7%). A significant relationship between lack of training, failure to adhere to administration rights, unavailability of guidelines, and medication errors was observed (Tsegaye et al., 2020). For example, the use of abbreviations, no knowledge regarding change of packaging and FDI regulations, and guidelines by IOM and QSEN result in medication errors (Montgomery et al., 2020).

Risk factors include mortality, morbidity, and adverse effects. Every year, 7000 to 9000 patients in the US die due to medication errors (Tariq et al., 2021). The errors lead to increased hospital stay cost o $40 billion per year with more than 7 million patients affected by the issue (Thomas et al., 2017). Further, risk factors such as high volume, inexperienced staff, poor follow-up, monitoring, and policy enforcement, poor handwriting, errors in EHRs, workplace culture, external stress, and verbal orders contribute to the risk to patient safety (Tariq et al., 2021). NURS FPX 4020 Assessment 1: Enhancing Quality and Safety

Evidence-based and best practice solutions

The first EBP solution is to train and educate nurses and health care staff to follow the guidelines provided by IOM and QSEN. The guidelines include being vigilant and verify medication with EHRs, check for allergies, assess the medication before administration, diligently calculate dosage (Armstrong, 2019), use memory aids and checklists, avoid workarounds, avoid conversations during administration, consider one patient at a time, clarify an unclear prescription, and avoid abbreviations (Pop & Finocchi, 2016). The process reduces cost as it prevents adverse effects of medication on patients.

The second EBP is to implement a physician order entry system with medication error reporting and communication system to reduce prescription, dispensing, and administration errors (Thompson et al., 2018). The system is completely electronic where nurses, physicians, and pharmacists are directly connected to compare medication with prescription and EHR to detect any discrepancies. Further, implementing technology such as bar-code-based medication administration where each drug has a unique barcode helps in preventing dispensing errors and dosage errors (Thompson et al., 2018). Also, the use of voice tags to find the content of the syringe during dosage calculation reduces dosage errors (Wu et al., 2020). The process reduces cost as it prevents delay in care, hospital stay, wastage of medicine due to wrong dosage calculation, and morbidity. Trakulsunti et al. (2020) found that checklists and communication between nurses and pharmacists regarding the change in packaging information and dosage reduce confusion, which reduces delay in administration.

The issue of interruptions can be solved by using different color tabards with messages on them. For example, red tabard with a sign “please do not approach, I am administering medication”, yellow tabards with a sign “only patients with an emergency can approach”, and a green tabard with sign “approach only after medication administration” help in preventing errors (Palese et al., 2019). Also, this increases the efficiency of nurses (Verweij et al., 2016). Apart from these EBP interventions, interprofessional collaboration strategies to promote effective and assertive communication and shared decision-making reduces medication errors (Manias, 2018). The protocol reduces cost as nurses will work efficiently with low medication errors. For example, nurses who are administering multiple patients are at higher risk of committing errors.

Coordinated care among nurses to improve quality and patient safety

Burnout is common among nurses. As a result, communication and a supportive work environment are critical. Nurses can coordinate with each other during medication administration to handle any interruptions (Hammoudi et al., 2017). For example, a nurse can attend a patient of another nurse or external patient for the time being till the assigned nurse completes his or her administration to reduce mix-ups and confusion. Also, communicating with other nurses to identify allergies in a patient to create a patient-specific medication order prevents adverse effects (Huckels-Baumgart et al., 2017). For example, a patient might have an allergy to aspirin. A nurse can discuss with other nurses to find a suitable alternative to prevent allergies. This further reduces health care costs as the patient will not suffer from any negative outcomes (Bradley et al., 2016).

Further, burden-sharing and shared decision-making increase throughput, which is critical in managing burnout. Coordinating with nurses regarding health complications, adverse effects, guidelines by organizations, and dosage calculation increases drug administration competencies and knowledge (Pop & Finocchi, 2016). Also, assisting and educating other nurses to understand the use of EHRs, medication error reporting systems, and other technology increases skills and knowledge (Huckels-Baumgart et al., 2017). It is important in decreasing costs and errors (Manias, 2018). For example, a nurse can assist another nurse in reporting and logging information regarding mismatch in prescription and dispensed drug result in adverse effect prevention.

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Stakeholders and safety enhancement

The nurse needs to coordinate between stakeholders such as informatics nurses, pharmacists, physicians, therapists, nurse leaders, patients, and nurse specialists such as anesthesiologists. Patients are important stakeholders as they help the nurses and physicians in assessing the condition by providing information relating to their health history, allergies, and other details (Abukhader & Abukhader, 2020). Also, their consent in selecting a treatment is critical. For example, nurses have to inform the patients about medication errors to select an EBP intervention (Bradley et al., 2016).

Informatics nurses are important as they feed data into EHRs and coordinate with others to check any discrepancies in information stored and medication. Also, they help in error reporting and correcting processes (Hammoudi et al., 2017). The physicians are the central part of medication administration along with nurses and pharmacists as they prescribe medications and dosage. Coordinating with them to prevent and correct any medication error is critical. Failing to coordinate with them will result in errors during administration (Manias, 2018). The pharmacist’s role in medication administration prevents most of the errors as they dispense the medicine. They can evaluate medicine and dosage by comparing with the patient EHR data to prevent errors (Abukhader & Abukhader, 2020). Finally, nurse leaders are also important as manage all the resources and conflicts. For example, they will resolve any issues in practice by coordinating with everyone.

References

Abukhader, I., & Abukhader, K. (2020). Effect of medication safety education program on intensive care nurses’ knowledge regarding medication errors. Journal Of Biosciences And Medicines, 08(06), 135-147. https://doi.org/10.4236/jbm.2020.86013

Armstrong, G. (2019). QSEN safety competency: the key ingredient is just culture. The Journal Of Continuing Education In Nursing, 50(10), 444-447. https://doi.org/10.3928/00220124-20190917-05

Bradley, C., Luder, H., Beck, A., Bowen, R., Heaton, P., & Kahn, R. et al. (2016). Pediatric asthma medication therapy management through community pharmacy and primary care collaboration. Journal Of The American Pharmacists Association, 56(4), 455-460. https://doi.org/10.1016/j.japh.2016.03.007

Hammoudi, B., Ismaile, S., & Abu Yahya, O. (2017). Factors associated with medication administration errors and why nurses fail to report them. Scandinavian Journal Of Caring Sciences, 32(3), 1038-1046. https://doi.org/10.1111/scs.12546

Huckels-Baumgart, S., Niederberger, M., Manser, T., Meier, C., & Meyer-Massetti, C. (2017). A combined intervention to reduce interruptions during medication preparation and double-checking: a pilot-study evaluating the impact of staff training and safety vests. Journal Of Nursing Management, 25(7), 539-548. https://doi.org/10.1111/jonm.12491

Korb-Savoldelli, V., Boussadi, A., Durieux, P., & Sabatier, B. (2018). Prevalence of computerized physician order entry systems–related medication prescription errors: A systematic review. International Journal Of Medical Informatics, 111, 112-122. https://doi.org/10.1016/j.ijmedinf.2017.12.022

Manias, E. (2018). Effects of interdisciplinary collaboration in hospitals on medication errors: an integrative review. Expert Opinion On Drug Safety, 17(3), 259-275. https://doi.org/10.1080/14740338.2018.1424830

Montgomery, A., Azuero, A., Baernholdt, M., Loan, L., Miltner, R., & Qu, H. et al. (2020). Nurse burnout predicts self-reported medication administration errors in acute care hospitals. Journal For Healthcare Quality, Publish Ahead of Print. https://doi.org/10.1097/jhq.0000000000000274

Palese, A., Ferro, M., Pascolo, M., Dante, A., & Vecchiato, S. (2019). “I am administering medication—please do not interrupt me”: red tabards preventing interruptions as perceived by surgical patients. Journal Of Patient Safety, 15(1), 30-36. https://doi.org/10.1097/pts.0000000000000209

Pop, M., & Finocchi, M. (2016). Medication errors: a case-based review. AACN Advanced Critical Care, 27(1), 5-11. https://doi.org/10.4037/aacnacc2016172

Tariq, R., Vashisht, V., Sinha, A., & Scherbak, y. (2021). Medication dispensing errors and prevention. Retrieved 17 March 2021, from https://www.ncbi.nlm.nih.gov/books/NBK519065/.

Thomas, L., Donohue-Porter, P., & Stein Fishbein, J. (2017). Impact of interruptions, distractions, and cognitive load on procedure failures and medication administration errors. Journal Of Nursing Care Quality, 32(4), 309-317. https://doi.org/10.1097/ncq.0000000000000256

Thompson, K., Swanson, K., Cox, D., Kirchner, R., Russell, J., & Wermers, R. et al. (2018). Implementation of bar-code medication administration to reduce patient harm. Mayo Clinic Proceedings: Innovations, Quality & Outcomes, 2(4), 342-351. https://doi.org/10.1016/j.mayocpiqo.2018.09.001

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

Verweij, L., Smeulers, M., Maaskant, J., & Vermeulen, H. (2016). Quiet please! drug round tabards: are they effective and accepted? A Mixed-Method Study. Journal Of Nursing Scholarship, 46(5), 340-348. https://doi.org/10.1111/jnu.12092

NURS FPX 4050 Assessment 1 Preliminary Care Coordination Plan

Care coordination is defined as the process in which the care protocols and information regarding the treatment of a certain patient is shared among all the personnel involved in the recovery process (“Care Coordination,” 2014). An example of such coordination is the collaboration between different doctors regarding certain aspects about the treatment of a specific patient.

The importance of proper care coordination can be understood just by its definition. The progress that a previous doctor has made on the condition of a patient has to be efficiently relayed and delineated to the professional who is taking over. If the previous doctor fails to actively convey the status of the patient, the following professional can make changes, prescribe medications or perform activities that could have been previously performed, hence proving detrimental. Poor care coordination planning can lead to devastating results and can cost the patients financially as well as emotionally.  NURS FPX 4050 Assessment 1 Preliminary Care Coordination Plan

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NURS FPX 4050 Assessment 1 Preliminary Care Coordination Plan

In this paper, the purpose is to explain a health concern and then come up with some rational goals which can be achieved by the healthcare sector in the bid to improve the standard of care given to the patients suffering from said health concern. The community resources shall also be enumerated as a part of the solution.

Stroke

Strokes are among the leading causes of death worldwide. When ranked in numbers, stroke falls in second place with a mortality rate of 5.5 million persons annually (Donkor, 2018). The danger of strokes is not only portrayed by the mortality rate, but also by the aftereffects manifested on those who survive it. 50% of all survivors were seen to become chronically disabled (Donkor, 2018).

Strokes are categorized into two major types. These include ischemic strokes and hemorrhagic strokes. The former is caused by the obstruction of the blood flow to a part of the brain. The interruption of the blood flow causes the loss of functioning. Hemorrhagic stroke, on the other hand, is caused by the bursting or rupturing of a blood vessel (Donkor, 2018).

NURS FPX 4050 Assessment 1 Preliminary Care Coordination Plan

Identification of Best Practices for Stroke

Thus concludes the identification of the health concern. When it comes to the best practices that can be applied for stroke patients, there are a few which are enumerated thus.

The patients who are seen to have a large vessel occlusion are to be examined for endovascular intervention (Khaki & Tadi, 2021). The patients who are suspected of having a severe ischemic stroke should be taken in for a neurological workup.

Aside from the specific and particular measures taken for the care and management of strokes, antiplatelet and statins are the primary constituents that serve as the mainstay of the said management (Khaki & Tadi, 2021).

There are different other factors that play a part in the treatment and accommodation of a stroke patient. The cultural, social and psychosocial needs have to be incorporated and included in the treatment in order to facilitate a recovery process devoid of trauma and undeterred by mental discomfort.  NURS FPX 4050 Assessment 1 Preliminary Care Coordination Plan

NURS FPX 4050 Assessment 1 Preliminary Care Coordination Plan

The needs referred to can include the accommodation and consideration of the various idiosyncrasies that come with a person’s cultural background etcetera. People of different cultures tend to react differently to treatments and the various stages of the recovery process.

Similarly, the needs from the social and psychosocial aspect can entail giving proper mental support to the patient during treatment. The presence of friends and family members can help along with the treatment, and this is a psychosocial dynamic because it relates to social factors viz. the people, and the psychological factors viz. the effects on the mental state of the patient. The importance of psychosocial factors in medications treatments is unequivocal (Xu, Mercury, Zhang, & Xu, 2008), hence the need to address these three areas.

Goals to be established to address Stroke Care

In order to make sure that the care for strokes is carried out properly, there are certain goals that can be established that the professionals or the institute have to meet. There are different strategies that have been put forward in a bid to improve the quality of the care given to stroke patients. By utilizing these strategies, we can formulate goals and objectives that can be set as a standard for all to meet. For example, a certain strategy put forward in a medical journal (Baatiema et al., 2020) was the computerization and digitization of medical practices. Utilizing this strategy, we can create a goal for the organization. It can be said that the hospital, or the professional, must digitally enter and save the information and important details of a certain stroke patient in order to facilitate better care coordination among professionals and transitions between different places.

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NURS FPX 4050 Assessment 1 Preliminary Care Coordination Plan

Apart from this goal viz. the computerization of the medical practice, a few others can be enumerated as well. Increasing the workforce and the number of professionals is another goal that is necessary to address the treatment of strokes. While the exact number will be different for each institution, it is necessary to have an adequate number of professionals to tend to the patients (Baatiema et al., 2020).

Furthermore, another goal that can be established is the development of a standardized set of clinical guidelines and treatment protocols for all professionals to follow in a certain institution (Baatiema et al., 2020). The standardization of protocols leads to better collaboration and care coordination since all the professionals are on the same plane as far as the treatment steps are concerned.

Community Resources

Community resources can play a major in the passive recovery of stroke patients. After a stroke, the recovery of the patient and the transition to the normal style of living can be a difficult process. However, in this study, the reason for enumerating these community resources is to explain how care can be continued even after the transition from hospital to home. In other words, the various community resources help in the recovery process of the patient even after they have left the hospital or the medical institution.

NURS FPX 4050 Assessment 1 Preliminary Care Coordination Plan

One of the reasons for prescribing community resources to a patient is the deracination of any trauma that might linger. Hence, it was seen that walking groups (White & South, 2012) and other exercising activities with other people is a good way to help patients recover from their potentially depressive state. The community resources in play here are the parks and gardens which are accessible to the public.

Similarly, cooking and eating sessions (White & South, 2012) are another example of treatment based on community resources. Doing these activities with other people can be helpful for the patients. People are also a part of community resources, hence such activities are justifiably a part of community resource-centered treatment.

Literacy classes (White & South, 2012) are also a type of community resource that can help patients in their recovery process.

NURS FPX 4050 Assessment 1 Preliminary Care Coordination Plan

References

Baatiema, L., de‐Graft Aikins, A., Sarfo, F. S., Abimbola, S., Ganle, J. K., & Somerset, S. (2020). Improving the quality of care for people who had a stroke in a low‐/middle‐income country: A qualitative analysis of health‐care professionals’ perspectives. Health Expectations, 23(2), 450–460. https://doi.org/10.1111/hex.13027

Donkor, E. S. (2018). Stroke in the21stCentury: A Snapshot of the Burden, Epidemiology, and Quality of Life. Stroke Research and Treatment, 2018, 1–10. https://doi.org/10.1155/2018/3238165

Khaki, A. S., & Tadi, P. (2021). Cerebrovascular Disease [Statpearls]. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK430927/

White, J., & South, J. (2012). Health together: how community resources can enhance clinical practice. British Journal of General Practice, 62(602), 454–455. https://doi.org/10.3399/bjgp12x653804

Xu, J., Mercury, J., Zhang, Z., & Xu, F. (2008). Psychological, social and behavioural factors that influence drug efficacy: a noteworthy research subject in clinical pharmacology. British Journal of Clinical Pharmacology, 66(6), 901–902. https://doi.org/10.1111/j.1365-2125.2008.03300.x. NURS FPX 4050 Assessment 1 Preliminary Care Coordination Plan Essay