Quality Improvement in Nursing Essay

In October 2005 the Quality and Safety Education for Nursing program was established. This program is funded by the Robert Wood Johnson Foundation. QSEN was developed specifically for future nurses to understand and be aware of key challenges such as the knowledge, skills, and attitudes that are essential to constantly advance the quality and safety of the way healthcare systems work. The goal for QSEN is to reshape the identity of nursing so it includes the recommendations by the Institute of Medicine so there is a commitment to the quality and safety proficiency (Dycus, 2009).

During hourly rounds assess the patients pain level and take necessary intervention to alleviate pain, reposition patients who need assistance and make sure that urinals and call light and telephone are within reach of the patient. Taking care of these needs in a timely manner will make the patient comfortable, which will reduce anxiety and stress levels in the patient and reduce the risk of falls. The nurse should always make sure that the environment is safe for the patient by keeping the area clutter free. Comfort measures like tightening the wrinkled bed, giving warm blanket, changing moist dressings or repositioning the tubes or other objects that bothering the patient can enhance their comfort level Monitor high risk patients with delirium, dementia, hypotension, medications, and other conditions which can increase the risk of fall. Providing safety companions for continuous observation and to help the patients will reduce the number of falls. Nurses should educate and encourage patients to use the call light and phone to call for help. Provide patients with appropriate assistive devices like cane, walker as needed to keep them steady. I believe the concept in this theory of comfort can be utilized to reduce the occurrence of falls in health care settings.

This requires critical thinking and reliance on one's one staff and healthcare system. The healthcare system has many safety measures, such as better medication and patient scanning systems, bed or chair alarms to alert staff, and the call-light system to let patient request staff in a timely manner. Though there are measures in place to try and limit errors they still happen. Even if a patient is on a bed alarm the patient could still fall while ambulating. Safety call-outs are a way to track what happen or almost happen and to further prevent such occurrences from happening again. It goes beyond just blaming one single to person

Patient falls in hospitals continue to be a major and costly problem. The definition of a patient fall is an unplanned descent to the floor, assisted or unassisted, with or without injury to the patient. The authors of this article wanted to investigate the effect “missed nursing care” has on patient fall rates and patient outcomes. The authors also looked at hospital staffing as it relates to patient falls and nursing staff having enough time to carry out all nursing responsibilities.

In the healthcare system, Core Measure sets are used to measure quality care. It consists of pneumonia, heart attack, immunizations, emergency department, sepsis, for infection prevention, and others. Evidence-based treatments are used to prevent occurrences using structures, processes, and outcomes. In nursing, they have adopted a similar method of performance measures, known as nursing-sensitive indicators. It includes falls, and this indicator is implemented in each unit of the hospital and managed by the manager and educator along with others like CAUTI and CALBSI. According to the American Hospital Association article (2015) “Falls with Injury,” Patient falls-an unplanned descent to the floor with or without injury to the patient affects between 700,000 and 1,000,000 patients each year.”

The basic reason for this study is to identify ways to improve the quality of healthcare among patients through bedside reporting method.This will better satisfaction and services delivered at the hospitals. The ever increasing specialization to improve patient outcomes and better health care delivery can contribute to the serious riskof fragmentation of care and problems with handoffs. These are some of the issues associated with emergency room reporting method (Radtke, 2013). There is need to evaluate the handoff method used in hospitals and understand which is the best way to use that increases patient satisfaction. Bedside handoff gives the patient an opportunity to contribute to his or her plan of care. It allows the nurse to visualize the client and as necessary questions regarding their health status. This is the reason there is a need to conduct research on bedside reporting.

The results of the study showed that significant increase in patient satisfaction scores, decreased call light usage, and reduction in patients fall rates. One-hour rounding shows higher satisfaction than two hour- rounding. Hypothesis supported the study because the research shows rounding can reduce patient call light usage (Meade, Bursell, Ketelsen , 2006). The theoretical framework that forms the basis of the research is that consistent nursing rounds can meet the basic needs of patient and ultimately reduce call light use and [pic]improve management of patient care while also[pic] increasing [pic]patient satisfaction and[pic] safety.

Patients depend on healthcare professionals through the use of call lights. Many different factors can affect a patient’s ability to function independently such as “cognitive impairments, visual loss, and decreased mobility” patients turn to call lights for assistance (Huey-Ming, 2010). Unfortunately, if a nurse or certified nursing assistant is occupied risks occur and can ultimately lead to injuries of patients due to help not received at that given moment. In the journal titled Perspectives of Patients and Families About the Nature of and Reasons for Call Light Use and Staff Call Light Response Time written by Huey- Ming Tzeng, patients felt “staff responsiveness to call lights often affect nurse-patient communication, patient

Quality improvement is referred to as “the use of data to monitor the outcomes for care processes and use improvement methods to design and test changes to continuously improve the quality and safety of health care” (Sherwood & Barnsteiner, 2012). Data is used as the reflection of quality care that is provided by nurses and presents whether or not improvement is needed. In order for nurses to be mindful of the care that they give, they must be taught a systematic process of defining problems, identifying possible causes of those problems, and methods for trying out new solutions to prevent those problems (Sherwood & Barnsteiner, 2012). Currently, quality improvement measures are being utilized throughout hospitals to reduce the risk of patient falls and fall injuries.

In addition, high risk participants received education relating to falls which involved nurses instructing participants not to get out of bed without assistance, to press the call-bell for assistance and how to use the call-bell. As part of this study protocol, participants in the intervention group received usual care which include: fall risk assessment, placing the call-bell, TV remote control, eyeglasses, dentures, and hearing aids within the patient’s reach. Other interventions that have been used were bed and chair alarms, bed was in the lowest position at all time except when care was being provided and bed brakes were locked at all times. The patient’s elimination needs were scheduled every two hours, bedside commode was provided for frequent elimination needs, the patient was not left unattended while on bedside commode or in the bathroom. For a safe bathroom environment toilets was raised, toilet seats were secure, and handrails was strong enough to support patients, and patient was also instructed to pull the call light if feeling dizzy or in need of any assistance . Furthermore, the room temperature was

A patient fall is one of the unit-based nursing-sensitive indicators in 6 East, a 22-bed adult unit in a 594-bed tertiary hospital in downtown Charleston, SC. The majority of the patients’ population in this unit is pre and post liver transplant, renal transplant, pancreas transplant, nephrology, urology, and general medicine. The fall rates in 6 East were 6.09 total falls per 1,000 patient days during the 1st quarter of 2015 and 7.56 on the 2nd quarter. These statistics were tremendously beyond the 3.28 total falls per 1,000 patient days of the National Database of Nursing Quality Indicators (NDNQI) benchmark of hospitals of > 500 beds. The significant fall rates in the unit accounted about 35% of the total falls on the hospital during the first half of the year. Although the hospital has a fall prevention program and policy, there is a knowledge gap among nurses and patient care technicians (PCT) regarding fall prevention due to lack of proper education reinforcement. This has led to an increase of staff non-compliance with the policy and fall rates in the unit. Furthermore, with the unit having high staff turnover rates, the newly hired staff members are not getting a proper staff education on fall prevention. Therefore, these newly hired staff members are unable to implement the fall prevention strategies and procedures efficiently.

Lily was a 65 year old lady with stage 5 CKD, she had recently begun hemodialysis treatment three times a week as an inpatient and had been responding well to treatment. During dialysis treatment on the morning of the first day, Lily’s observations showed that she was: tachycardic, hypotensive, tachypnoeaic, had an oxygen saturation level of 88% and was becoming confused and drowsy. It became apparent that Lily had become hypovolaemic. The hypovolaemic shock seen in this patient was of a particular critical nature due to the fact that her dialysis treatment had moved her rapidly through the first two stages of shock with her compensatory mechanisms failing very quickly (Tait, 2012). It was also much harder to identify the early signs of

Nursing-sensitive indicators can be an important tool in identifying patient care issues that could potentially arise during a hospital stay. By analyzing the data on specific nursing-sensitive indicators, the quality of patient care can be optimized and patient satisfaction can be improved. The American Nurses Association (ANA) and the National Database of Nursing Quality Indicators (NDNQI) are two sources of information and guidelines for nurses and nurse managers to use in planning patient care and workloads for each nursing unit. The use of available resources, staffing by acuity and patient needs, appropriate referral indicators, and cooperation

Integrating Quality Improvement Standards into Everyday Practice Gathering information for standards of practice in nursing can be an overwhelming and daunting task, as there are so many different regulatory boards. Each one with a unique focus on certain topics that are imperative to nursing. Staying current is a huge advantage but putting those standards into practice is what makes the difference. A nurse’s career can be hectic and very busy so staying current with standards of care may not be on the top of the list however, it is required by law that these regulations be up held. By following these standards and regulations, the nurse is protected.

Healthcare providers strive to improve service quality by implementing various quality management programs. Customers tend to seek for higher quality of care when choosing treatments, providers, and health plans. For healthcare organizations that desire to provide high quality care and compete in the global market, choosing a quality management program to implement is critical for performance and efficiency. Many studies have been conducted to analyze the effectiveness of such programs. Lean, Six Sigma and Total Quality Management (TQM) are three programs that will reviewed by three different case studies in efforts to understand them and to compare and contrast their capabilities.