My Organization 's ' Door At Electrocardiogram ' Data From A National Registries And Clinical Practice Guidelines

Cardiogenic shock, according to Werden et al. (2012), is the most common cause of death from an acute myocardial infarction (AMI) and has a chance of mortality from thirty percent to eighty percent. Infarction-related cardiogenic shock (ICS) complicates approximately five to ten percent of acute myocardial infarctions (AMI) and remains the leading cause of death in patients hospitalized from an AMI (Kolte et al., 2014). Kolte et al. (2014) also states that the incidence of cardiogenic shock is higher in patients over the age of seventy-five, and has higher prevalence in women, Caucasians, Asians, and Pacific islanders. This paper will discuss the pathophysiology, clinical manifestations, tools used to diagnose, and therapeutic management of cardiogenic shock.

Over time the health care industry has become more complex. Health care is rapidly evolving and continuing to complicate our delivery of care, which in turn has the same effect on quality of care. This steady evolution and change results in nursing shortages and an increase in the prevalence of errors being made. In hopes of preventing these errors and creating safe and high quality patient care, with the focus on new and improved ways of thinking, The Quality and Safety Education for Nurses (QSEN) initiative was developed. The QSEN focuses on the following competencies: patient-centered care, quality improvement, safety, and teamwork and collaboration. Their initiatives work to prepare and develop the knowledge, skills, and attitudes that are necessary to make improvements in the quality and safety of health care systems (Qsen.org, 2014).

Keywords: The Joint Commission, Agency for Healthcare Research and Quality, Centers for Medicare and Medicaid Services, The American Nurses Association, Hospital Inpatient Quality Reporting,

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.

Quality Improvement (QI) is an organizational approach leading to the quality of patient care and patient services through use of specific guidelines, principles, and methods to ensure quality of care for every patient and health care facility throughout the world. Quality outcomes focus on the principles of quality management. These measurements investigate the quality of care, patient outcomes and consumer needs, through being part of the participant group. This quality improvement discussion will review the foundational frameworks of QI and explanation of each framework in detail. Included in this QI report will be

The Quality and Safety Education for Nurses (QSEN) Institute developed six core competencies: patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics (Quality and Safety Education for Nurses Institute, 2017). At my facility, it is clearly evident that they have adopted these six core competencies to improve patient quality and safety. My facility created the Office of Patient Experience which supports care that is safe, of high quality and high value. Patient satisfaction is a top priority which is why our guiding principle is known as “Patients First”. Through teamwork and collaboration, we deliver care that is patient-centered by working together in multidisciplinary rounds on the inpatient units. Also, the nursing education department supports quality, safety and consistent nursing care through a database of policies and procedures developed using evidence-based research. Lastly, the nursing informatics department is working towards making our EPIC system more patient-centered. They are doing this by decreasing the redundancy in charting for the nursing staff and finding ways to improve processes which automate tasks. This in turn will reduce the time that the nursing staff spends with their computer and increase the time that the nursing staff can spend with their patients.

With the new healthcare landscape, quality improvement has become a priority; and as required by current legislation, quality initiatives need to be implemented, monitored, and reported (Ransom, Joshi, & Nash, 2008). According to Dattilo and Constantino (2006), human factors play an important role in most errors despite the existence of other root causes. For example, short staffing, shift overlapping, staff level of training and qualifications, close supervision, and overall team and staff culture are all factors that may be the trigger points

This quality improvement discussion will review the purpose of quality management in health care industry and why it is needed. Included in this QI report will be an explanation of the

My experience in both my previous career in nursing and human resources has dealt with approaches in quality improvement in patient safety and different metrics in the turning up organizational behavior as well as up swinging the operations of the organizations respectively. We live in a rapidly changing world, and healthcare industry is not exempted from it. Because I will be playing an indispensable role in the future, I am very interested on the concept of quality improvement and what not and identify possible future challenges and draw lessons from healthcare organizations that has spearhead innovative changes to providing healthcare by pursuing the triple dimensions of the improvement of healthcare in general that is Improving the patient experience of care (including quality and satisfaction); Enriching the health of populations; and Reducing the per capita cost of health care.

Quality improvement is a systematic and continuous process which leads to improvements in healthcare services. The health services are then a reflection of the improving health status of a patient population (Health Resources & Services Administration, n.d.). Quality improvement strategies are the actions which a team will take to accomplish the goals of process improvement. The Institute of Medicine (2001) has developed a vision of six aims for improvement in healthcare which include, safe, effective, patient-centered, timely, efficient, and equitable care. Making improvements in these areas will better meet the needs of patients.

In the 1990’s, the American Nurses Association (ANA) identified indicators which brought about the development of the Nursing’s Patient Safety and Quality Initiative (Miller & Soule, 2008). These indicators were specific to nursing,

Coronary artery disease (CAD) is the commonest heart disease in the United States1. Approximately, 29% of patients with Myocardial Infarction ( MI ) present with ST- elevation Myocardial Infarction ( STEMI )2. STEMI is the result of complete occlusion of a major epicardial coronary artery due to thrombus formation. STEMI from a small coronary artery presenting as substantial EKG abnormalities similar to occlusion of a major artery and hemodynamic instability is a rare entity. The epidemiology, typical clinical presentation, outcomes, and optimal management in this group of patients are not sufficiently known.

The National Safety and Quality Health (NSQHS) standards ultimately were established to protect the public from harm and to develop and enhance the quality of care delivered by health care organisations (NSQHS 2012). These standards are used as a guideline to aid health care organisations to support the quality improvement programs using the NSQHS framework to ensure patient safety and quality care is being delivered. Standard 9 of the NSQHS specifically addresses the recognition and response to clinical deterioration in acute health care with the aim of early recognition of patient deterioration and suitable action is taken.

The purpose of this paper is to identify a quality safety issue. I will summarize the impact that this issue has on health care delivery. In addition, I will identify quality improvement strategies. Finally, I will share a plan to effectively implement this quality improvement strategy.

Safe, effective, patient-centered care delivered in a timely and efficient manner is the goal of quality healthcare. Unfortunately, the delivery of such quality faces serious concerns. The Institute of Medicine (2001) describes the quality gap in healthcare as having three types of problems, “overuse, underuse, and misuse” (p. 23). In recent years, emphasis on improving the quality of care has increased (IOM, 2001). Quality improvement methods, such as plan-do-study-act (PDSA), have successfully enabled health care providers to address the quality gap. The purpose of this paper is to identify a quality healthcare problem, discuss the quality improvement plan, and describe the strategy for implementing effective change using the PDSA method.