Measures
“We will find our baseline measurement using nurse surveys, audits and observation timings. We will track what steps are covered and how long each step takes and the number of occurrences of near misses due to inefficient handoffs relating to patient safety. We will also measure our patient baseline data from current patient satisfaction surveys” N. Guyse (personal communication, February 22, 2014). Currently we are inefficient and unsafe with handoff practices due to missing or incomplete information, multiple processes used between the nursing staff, and multiple report out processes being practiced on the floor. Multiple processes are causing confusion and incidental overtime. With multiple processes, information is being missed between nursing staff, which is a safety concern due to the increased errors. Our organization is working on the creation of one standardized process used between all employees to ensure that all handoffs are efficient and safe. “We have implemented a group report out for nursing staff in conjunction with the beside report outs” N. Guyse (personal communication, February 22, 2014).
Sample measures through patient and nurse satisfaction surveys and observations will be used to show if we are making improvements with the change. Run charts will be used to show if improvements are taking place over time and will help with improvements by depicting how well the handoff process is performing. They will help in determining when changes are
In every profession there are changes that propel how tasks are done; nursing is no stranger to this. One of the biggest changes that have come into nursing’s daily events is how report hand-offs are being done. Gone are the days of taped report that each off going nurse must tape about each patient and the oncoming nurse must listen to. Nurses are now being encouraged to move their report to the bedside, in front of the patient (Trossman, 2007). It is very important to know how this can affect the patient and even the nurse’s schedule. With every change, there are positives and negatives that can finalize the decision to keep or forego
What do you consider to be the key issues for quality improvements in the NHS quality-improvement program as it goes forward?
Traditionally, nursing shift-to-shift reports were organized methods of communication between only the oncoming and leaving nurse, designated to a location such as the central nursing station or nook of a hallway. Shift reports can be considered the foundation of how the day is going to plan out because it introduces the patient, diagnoses, complications, medications, consults, upcoming test and the entire plan of care. These reports are full of complicated and vital information and while set in certain locations that are vulnerable to interruptions, such as the nursing station, medical errors and miscommunication are more likely to be made. The Joint Commission’s 2009 and 2010 National Patient Safety Goals (Joint Commission, 2015) included two patient safety standards, first to encourage patients to be involved in their health care plan and second, to implement a standardized communication process for handoff reports between providers. Soon after in 2013, The Agency for Healthcare Research and Quality under the United States Department of Health and Human Services introduced a set of strategies to improve patient engagement along with safety and quality in patient care. Within these strategies the new method of nurse bedside shift report was developed, which suggests nurses to conduct shift-to-shift reports at bedside in the room of each patient, rather than out of the room. The benefits of this new method were
Quantitative data was collected as handovers at three sites were timed pre and post the practice change and this information was analyzed and presented in graphs demonstrating the any differences. Results were tabulated by numbers of patients and staff and average times computed by unit. The mean length of handover with traditional handover was 0.44 hours which deceased to 0.22 hours after the move to bedside handover. Data on the number of adverse patient safety outcomes during handover were gather pre and post implementation and tabulated. Qualitative data collected from nurse interviews, pre implementation of bedside handover indicted that they found the traditional handover to be “difficult and time consuming.” This data was presented in graphs, demonstrating the any differences with in the three sites. Nurses were also asked to estimate the time taken to complete shift handover pre and post implementation. Researchers used a mixed model, descriptive statistics to correlate results and draw conclusions.
The complexity and type of information, method of communication and caregivers of this program impact the effectiveness of the handoff and patient safety. Healthcare has evolved with time thereby becoming more specialized
A realistic goal of this study is to reduce the fall related to a delay in answering the call light to less than the standard national data base that can be found in National Database of Nursing Quality Indicators (NDNQI). The nurse will be able to compare the data obtained on the unit to similar hospital units by referencing (benchmarking) to the national data from NDNQI. There will be a follow up study and gradual modification of the plan in order to achieve the outcome. The team has to set
The purpose of this BSR project is to assess the nurse’s performance during their handoff report and develop some strategically possible solutions that may improve a patient quality of care, safety, and satisfaction. Communication plays such an important role between nurses and patients to emphasize that an “Effective workforce planning and policymaking require better data collection and an improved
The nurse is challenged with the care of patients over a lifespan. Each stage of life brings its own physical and emotional changes which directs the care needs. The care needs of the pediatric patient will be much different from the needs of the geriatric population. The geriatric population has very specific needs which has prompted the government to establish the Quality Assurance & Performance Improvement (QAPI) program. The QAPI provides the framework for nursing facilities to develop and implement changes which address deficiencies the facility was found to have. Also, the QAPI program requires practices and policy be put in place to monitor care of the residents. The purpose of this paper is to list some of the changes the elderly go through as they age, and demonstrate these changes in a quality improvement project. After review of literature, I will discuss the challenges, barriers, and solutions as related to quality improvement. Lastly, I will discuss the quality of care for the geriatric in the future.
Change of shift in the nursing profession is unique (Caruso, 2007). Information is transferred between nurses verbally and through written communication. In many facilities shift report from one shift to another involved sitting down and getting all your orders from a caredex and then talking with the previous nurse face to face going over pertinent information regarding their patients. This type of report usually happens in a report room or sometimes in the hallways or other common
As a hospital, quality care should be a priority for patients that are going to be treated for a sickness, or any type of procedure that is going to take place. A lot of times a patient gets an infection while they were at the hospital, on top of being treated for what they original came in for. Health facilities should be environments of healing, which they are, but they also have tons of various types of germs and infections, which grasp onto individuals that have weak immune systems/are sick. Some infections that are at hospitals are Tuberculosis, VRE, VAP, C-Diff, UTI, and MRSA. Preventive measures to stop the spread of the infections is lacking tremendously in the work and aim to provide safety for all patient’s health. The work
After the interview with my nurse manager, I came up with the PICO question which states: “Does the computerized physician order entry (CPOE) system reduce the number of medication errors compared to the common paper system being used today?” This question is important and I selected it because the population that the Belvoir Community hospital serves includes army officers of all ages both active and retired including their spouses and children. This group includes two sub groups of highly vulnerable persons which include the very young and the very old, who have a high-risk effect for medication errors because the potential adverse drug event is three times greater than an adult hospitalized patient (Levine et al., 2001). CPOE is not a panacea, but it does represent an effective tool for bringing real-time, evidence-based decision support to physicians. Nurses are the last defense level of protection against medication errors, and are solely responsible for the dispensing, administering, and monitoring of medications. In healthcare, computers can be used to help facilitate clear and accurate communication between health care professionals. When using a CPOE system it allows physicians to type in prescriptions right into the device or computer which significantly lessens any mistakes that can occur when
As a part of quality improvement (QI) it is excellent practice for healthcare organizations to gather and analyze data in order to identify areas strength plus areas of weakness to promote improvement in patient care. Hospitals gather and use data to improve patient care. If the facility in this scenario gathered data on NSI’s as part of QI and then presented this information to the staff it could recognize strengths and point of areas of weaknesses. Quality improvement can lead to increases with staff satisfaction. Knowledge of this areas and lead to educational needs and staff awareness which can empower the staff to do better in areas of weakness. In the case scenario, awareness could have led to improvement in restraint use, pressure
employee. This is part of day to day management and is intended to ensure that
iConsultant is committed to implementing appropriate quality management systems and processes to enable the delivery of the highest practicable quality products and services. Dyson Limited engaged iConsultant to strategize a total quality transformation for the company to overcome its current quality challenges and hone its competitiveness in the world market.
The well-established quality improvement method, response surface methodology (RSM), is a powerful and efficient technique to find an optimum operating condition of a response including systematic and continuous steps in the quality engineering literature. The RSM combines both optimization and statistical methods for designing, analyzing, modelling, and solving an optimal controllable factor setting in many engineering applications to seek a second-order fitted model for the response with three main properties, such as a sequential, efficient and flexible design. The rotatability concept is also taken into consideration the design criterion in the RSM to provide the prediction variance assumption in the bounded convex design space and it