Quality Improvement Implementation

What do you consider to be the key issues for quality improvements in the NHS quality-improvement program as it goes forward?

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.

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.

Falls are a major cause of injury and death in the frail older population with Alzheimer’s disease. Residents in the long-term care settings experience falls for many reasons and are likely to endure injuries more than those in other settings. Preventing falls in this setting posed significant challenge, many have cognitive problems, aged related changes, chronic medical conditions, medication effects, and physical limitations requiring dedicated interdisciplinary efforts (Vance, 2011).

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

organizations that have been successful in implementing quality improvement programmes highlight the importance of active involvement of doctors and point to factors such as effective clinical and managerial leadership, preservation of clinician autonomy, support for training, and peer pressure as important in changing attitudes and increasing commitment

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

The successful aspect of this quality improvement plan was staff compliance to the checklist and selected EBP interventions. Collaboration with high management to improve quality and nurse performance lead to a developed system with the changing needs of performance improvement initiatives. The project keeps surgical knowledge up to date and relevant with the support from the staff and managers. The ability to provide feedback during huddle meeting intiated open communication. The quality management team reported the data that led the direction for implementing the quality checklist. Firstly, the nurse inclusion for routine surgical practice resulted in effective compliance, as every nurse was able to accomplish all the EBP standards on the surgical checklist. This enhanced a nurse buy in for efficient surgical patient care. The process worked due to agreement and helpfulness from all stakeholders. Secondly, nurses appreciated the training and additional education needed to become compliant for SSI reduction. This assisted in refreshing the knowledge of surgical information for seasoned and new nurses. Some nurses used the education session to accomplish their performance evaluation process. Thirdly, collaboration improves sharing of information between the nurses, surgeons and high management. Furthermore, increasing communication between the nurses, patients, and their family who then reported increased satisfaction with the surgical care. Lastly, the monitoring,

Quality Assurance and Performance Improvement (QAPI) communicates the following five elements: design and scope, governance and leadership, feedback, data systems and monitoring, performance improvement projects, and systematic analysis and systemic action. The purpose of this paper is to communicate issues surrounding these topics, as well as aging problems. Are the topics evidence based? Do they have supporting documentation to put them into practice at various facilities? Can executing the aforementioned items make a difference at institutions? Now, start the journey to see how each section can be applied to your workplace.

Despite the growing burden of diabetes and the lack of diabetes care providers, barriers and resistance for utilization of Advanced Practice Registered Nurses (ARPRNs) to provide diabetes care continues to exist. According to the Centers for Disease Control and Prevention (CDC) (2017), an estimated 30.3 million people have diabetes, with greater than 90% having Type Two Diabetes. In Saline County, Kansas, 12 % of the population has been diagnosed with diabetes (Robert Wood Johnson Foundation, 2016). A previous gap analysis identified the lack of outpatient diabetes education and management services in Saline County, Kansas. Follow-up SWOT (strength, weakness, opportunities and threats) identified barriers and potential solutions that must

Yasin and Alavi (1999) conducted a quantitative study to determine if Total Quality Management (TQM) can produce quality improvement

Riordan Manufacturing is a worldwide plastics manufacturer that is headquartered in San Jose, California. Their organization has over 500 employees and prides themselves on providing their customers with high quality merchandise to satisfy their plastics needs. They hold an ISO 9000 certification which is an organization that establishes and measures quality control. In order to meet or exceed the level of quality required under ISO standards, Riordan Manufacturing will need to have knowledgeable and skilled

The President Ralph Larsen has realized that Wengart has some major problems with the quality however he is focusing on the profitability instead of the longevity of the company. He needs to have the team focus on improving the quality problem or the company’s profits will continue to decrease. Larsen in the effort to improve the quality has decided to seek out help from an OD practitioner who suggests to Ralph to implement Top Quality Management (TQM). Larsen feels that this should be easy to implement and hands it off to Kent Kelly the Vice President. He feels that the TQM program was a matter of common sense (Brown, 2011, p. 365).

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.

Quality is never an accident it is always the results of high intention, sincere efforts, intelligent directions and skillful execution, it represents the wise choice of many alternatives.