Quality Assurance And Performance Improvement

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.

As we age, our brain and nervous system go through natural changes. An aging adult may experience memory loss, decreased touch sensation, change in the perception of pain, change in sleep pattern, decreased coordination and increased risk for infection (Ignatavicius, 2013, p. 912) .

Quality improvement data is followed in all health care setting. The use of Cerner EHRs allows data to be obtained from patient charts to analyze core measures. According to the joint commission influenza and pneumococcal vaccinations measures should be addressed in all hospital in-patients (The Joint Commission, 2015). Data can be retrieved on those patient who were diagnosed with pneumonia to determine if they received the vaccinations for pneumonia and influenza. As well as tracking the time frame between diagnosis and treatment, and additionally the patient outcome. This is captured through the documentation of the clinical staff. The information can be analyzed to determine the quality improvement changes that need to be implemented to improve patient outcomes.

The training will educate and support nursing facility operators and staff regarding the requirements of participation for nursing homes as it relates to the QAPI plan, process and roles and responsibilities. The training will outline the elements and goals of our QAPI plan set forth in the facilities. The plan/program consist of weekly risk meetings, monthly COR, quarterly QAPI.

Quality Assurance/Performance Improvement (QAPI) “an initiative that goes beyond the current Quality Assessment and Assurance provision, and aims to significantly expand the intensity and scope of current activities in order to not only correct quality deficiencies, but also to put practices in place to monitor all nursing home care and services to continuously improve performance”.

Nursing home facility is for patients who need extended care because they are very sick or unable to function without continued nursing and supportive services in a formal health care facility. These patients are sick and/or are in need of assistance but they are not ill enough that they require the intense treatment and care offered at a hospital. About forty-seven percent of all nursing home facility care is paid for by Medicaid and residents and their families pay approximately one-third of the cost for the facility services. In recent years the length of time one stays at a nursing home has greatly decreased. Even with the decrease in stay there is still a fifty percent chance of an individual in his/her lifetime having to spend some time in a nursing facility. Both of these previous mentioned trends is reflective of the nursing facilities moving toward becoming more technologically sophisticated as well as being able to function as more of a

Several studies conducted under the auspices of the U.S. Department of Health and Human Services have examined quality of care and quality of life for residents that reside in nursing homes facilities. According to various sources, most residents of a nursing facility can have an improved quality of life. Nursing home facilities are moving towards the trend of facilities to be structured and set up to have an image of a “home-like” setting rather than an institution. Margaret P. Calkins, Ph.D., is a nationally recognized expert that specializes in assisting

Accreditation is a major component of quality improvement in the health care field. If accreditation is to remain an important part of quality improvement, there will need to be a few changes in the system. In order to prove that accreditation will ensure accountability to the system, it will need to evolve in response to the market and adapt to constant changes in the healthcare system. One of the future changes that accreditation could improve on is proliferation of new products and services, (Ransom, 2008). The fast dissemination of electronic and administrative data have given the freedom to practice ambulatory care and ancillary services, this is something that accreditation does not take in to consideration. In addition, accreditation

The key issues for quality improvement in the National Health Service (NHS) quality-improvement program as it goes forward is improving health outcomes for patients by collecting and reviewing data, so as to improve business operations in healthcare and also recognize opportunities (McLaughlin, Johnson, & Sollecito, 2011). Besides, NHS also improves other programs such as providing more high quality services to meet customers’ satisfaction and community expectation, creating the necessity of the funds, and striving to be one of the top health care providers in medical industry. Established in 2013, NHS has been achieving many satisfactory results in a short time and step by step satisfying the needs of clients and expanding strengths to

These subcategories of the traditional approach failed to push for standards of care and quality to excel. Instead, the constant problems continued to exist even as the number of residents and the financial cost of this influx grew to new heights. It wasn’t until after Medicaid began covering the costs of long-term care facilities, such as nursing homes, in the 60s where the quality of care residents were receiving began to be loudly complained about. “Landmark[ed] report in 1986 [was published by the Institute of Medicine (IOM)] calling for major revisions in the way quality is monitored at nursing homes…the report led to the 1987 Nursing Home Reform Act” (Werner & Konetzka, 2010, p. 81). From this act, the requirement of nursing homes to be inspected and regulated by the Medicaid or Medicare

Aging risk factors, dependency on caregivers, and different types of abuse make it difficult to detect abuse in the elderly. A lack of adequate nutrients, or a poorly designed diet can lead to older adults having inactive lifestyles. The more a person is inactive the less muscle tone and flexibility they have. In addition, weaken muscles in the legs and arms make older adults unstable and prone to falls or bumping themselves into furniture, doors and other objects. More importantly, when older adults do not eat properly they are at risk of decreased intake of needed vitamins that are usually obtained in their diet; this can lead to less energy to do activities for daily living, like bathing or grooming themselves. Also, when older adults are

As an older individual there are many physical changes that occurs during this stage of life. Older individuals live independently and maintain close relationships with family and friends. Most individual’s personalities remain relatively stable throughout their lives. Depression is less prevalent than depression in younger adults. Becoming older can cause hearing impairment. 37 percent of women and 48 percent of men over the age of 75 have impaired hearing. Also there is a decline in vision. It will start to become difficult to read small print, seeing in sim light, or even finding objects. Some aging adults may even need

Comment by Kaplan, Heather: I cut a bit which give us 1000 words to add in descriptions of our examples that we will highlight and then add some additional examples and flesh out some other areas (where I indicated)I really think the most important part of this will be weaving in the examples!

As we age our bodies get older and with that usually comes more brittle bones, less energy, worse cognitive function, and sometimes uncomfortable sleeping patterns.

There is a wide range of physiological, psychological, and psychosocial changes associated with the aging process. Physiological effects are part of the aging process of the human body. Organ performance declines over an individual’s life span and can lead to heart disease, digestive issues, cognitive, vision, and hearing impairment. Psychosocial comprises social, mental health and emotional needs of an individual. Cognitive impairment is one of the major physiological changes that affects health issues in the aging. Cognitive impairment relates to a lesser degree of cognitive deficiency that is associated with a decreased quality of life that often progresses to dementia (Derouesne, 2002). Anxiety and depression can develop in the aging when dealing with physical health issues, loss of a loved one, or caring for a spouse with health issues.