Quality Improvement Plan For Improving Performance

pain is the usual cause for persons to look for treatment. Inadequate pain management can cause delay in healing process. It can also leads to prolonged hospital stay. The acute pain management theory describe how nurse can manage pain with minimal effects from the pharmacological interventions and use of alternative methods of pain management (Good &Moore, 1996) The main factors are in the management of pain are Pharmacological, non-pharmacological, patient participation, education and different interventions. Effective pain management involves the application of non-pharmacological interventions and usage of pain medications. (McEwen & Willis, 2014). The pain management theory deals with management of pain in daily basis. It offers the knowledge about alternate methods in pain

NHS quality improvement programs main purpose is to collect and review data entered in order to recognize the opportunities to improve business operations in healthcare. To bring changes in quality, it is necessary to respond to patient’s ideas and implement them for the better results. The key issues that are to be considered for quality-improvement NHS program, as it moves forward are the needs for the patients, necessity of the funds for quality improvements, needs of the service providers and expectations of the community. Outcomes for people and also change expertise. And to improve business operations in healthcare and also recognize opportunities.

Appropriate assessment and management of pain should be paramount to nurses working in the elderly care sector.

This paper attempts to explain some areas of potential improvement for the Veteran Affairs (VA) organization in a surgical department. Describe the data that needs to be collected and the tools to be use. Also, it will be identified and compared the types of information collected based on the different tools used. Presenting the Quality Improvements (QI) tools needed to accomplish the goal and describe the information obtained from it. In addition, establish how are these tools helpful for the health care organizations.

“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).

To provide the best care for their elderly patients, nurses must incorporate pain assessment into their daily care of patients. Pain assessment is a key aspect of the nurse’s role. There are many factors to consider when assessing patients’ pain such as if they are verbal or non-verbal, what language they speak, their age and their cultural background. There are many tools that a nurse can use to assess a patient’s pain but one of the most common tools is the 0-10 scale. This tool can be asked verbally by asking what

Healthcare workers, especially nurses, have for ultimate goal to provide the best care possible for patients. Caring for patients does not only include making sure that they are safe and well-taking care of but it also requires for nurses to act as patients’ advocate and ensure that the best methods are used to provide care. Nurses contribute to ensuring that the patients are as comfortable as possible and help prevent or reduce pain as much as they can (Dearholt.& Dang, 2012, p. 12P). People have a different reaction to pain. For some patients being pain-free might be one their ultimate goal while they are in the hospital and if a nurse can help achieve that goal that will significantly contribute in making the

However, a better understanding of the factors that affect such knowledge and attitudes and of the discrepancy between attitudes and practice can provide useful information to be included in education programs for nurses and to inform policy on the provision of pain management. On the other hands (Rushton, Eggett, and Sutherland, 2003) stated that nurses do not use evidence-based practice in pain management consistently. Until recently there was no standard of care by which to judge the adequacy of pain management. Study findings support the premise that many nurses have inadequate knowledge about pain theory, assessment, and management strategies, especially pharmacological and non-pharmacological strategies. Importantly, study findings suggested that nurses do not objectively assess pain or individualize care plans for patients with pain complaints. In particular, nurses expect patients to tolerate pain, do not differentiate well between acute and chronic pain, consistently overestimate the incidence of narcotic addiction and malingering (i.e., false pain complaint), and tend to rate patients ' pain and related needs lower than patients themselves. Pain assessment is the first step in effective pain management and is an independent nursing function. It has been estimated that a significant number of problems with pain management relate to inadequate assessment (Clark et al., 1996). The research evidence suggests that nurses ' attitudes and beliefs constitute significant

: In a similar research on cancer patients, Cohen, Ellis, Ownby, Rude, & Bailey (2003) performed a retrospective study to determine whether application of JCAHO standards has been followed while caring for the patients with pain or not. The study was performed in 5 hospital in a large city in Southwest, USA. A total of 150 patients were selected both from inpatient and outpatient department. All patients were from diverse population with a mean age of 57 years. The sample consisted total of 117 charts, 80 from inpatient and 37 from out patients. Data was collected between August and November 2000. Review of charts were done to check for followed documentation criteria for assessment, management and reassessment of pain in patients with cancer. This

Since the Institute of Medicine’s widespread reports, To Err Is Human (2000) and Crossing the Quality Chasm (2001), revealed widespread incidence of medical errors in U.S. hospitals, there has been a great deal of effort to measure and improve the quality of hospital care. Progressive input has been made in establishing quality indicators and risk adjustment components to compare quality across organizations, and in analyzing processes and cultures in high-performing hospitals. There is a vast amount of knowledge to learn about the infrastructure of hospital performance. Health care organizations performance measures may include which hospitals are

In conclusion pain management is an important impact on patient practice as well as education and knowledge. Although the study did prove to have been beneficial I found the results to be inconclusive as they were generally biased according to the perception of the patient on the individually nurses’ influence and actions toward the management of pain. Every nurse in each generation can learn the same information and the same execution it is what the nurse chooses to apply of his or her own attitude that will determine how the patients will perceive their care and this is with any study being performed on the nursing practice with patient.

Failure modes and effects analysis (FMEA) is a systematic method to evaluate process improvement plans. The purpose of the FMEA is to identify ways the plan might fail and what impact the failure would have on the process. In the scenario of the task, the hospital had a moderate sedation policy that was not followed and this resulted in the death of Mr. B. The process improvement plan for this sentinel event involves a policy change to the moderate sedation policy that includes the use of a checklist with a time-out component. The FMEA for this process improvement plan will evaluate the use of the checklist since it contains all elements of the new policy with-in the procedure checklist. A team will be chosen for the FMEA that

Quality pain management is an ongoing, interdisciplinary process that encompasses clinically important outcomes in postoperative patients in both early and long-term recovery, however, quality is compromised because pain it is suggested that pain is vastly under-treated in the postoperative setting (329). Nurses routinely perform comprehensive pain assessments, pain screenings, patient response to treatment, and develop plans of care that include the patient and their families with the ultimate goal of decreasing healing time, avoiding of adverse effects, and increasing satisfaction with the care received (329). While these goals are admirable, they are increasingly difficult to achieve because pain assessment is ambiguous and dependent on

The education strategy developed for this QIP is aimed at ensuring nurses are accurately assessing and documenting pain. The nurses are not being required to learn a brand new skill; rather this strategy is aimed at changing how nurses are completing this task in their practice. Planned change must be a “well thought out and deliberate effort to make something happen” (Marquis & Huston, 2012, p. 163). Therefore, the application of Kotter’s eight-step change model (1995) will help to implement this change.

Nursing is the holistic helping of persons with their self-care activities in relation to their health. I agree Vargina Henderson in her definition of nursing and nurses role, According to Henderson, 1966 “Nursing is primarily assisting the individual in the performance of those activities contributing to health and its recovery, or to a peaceful death”. Varginia Handerson, 1964 stated that “the nurse must get inside the skin of each her patient in order to know what he needs”. from this statement I conclude that nurses play an important role in promoting patient quality of care. Nurses play an important role to promote pain management practices for patients, a critical component of the nurse’s role in pain management is pain assessment, medications administration, organizing and delivering patient care activities, advocating for patient rights, educating patients and contact with physicians regarding changes in patient conditions; these nursing functions are critical in the management of pain. So, we can’t imagine nursing discipline without nursing