Quality Improvement Strategies Paper

I am a Nursing Student at the University of Massachusetts Boston and a resident of Roxbury. The purpose of this memo is to propose a healthcare policy on adequate nurse staffing levels. The State of Massachusetts is highly understaffed a situation which requires immediate measures to correct this disarray (MNA, 2017). The policy will involve an audit in all the public hospitals in Massachusetts this will help determine the number of nurses needed. This policy should be implemented as it will offer a solution to the long-term problem of limited nurses in health centers to a surplus of patients. Research indicates that nurses are essential for quality healthcare for both private and public health centers. Adequate nurse staffing levels are critical

Staffing needs affect the nursing department’s budget, staff productivity, the quality of care provided to patients and even the retention of nurses (Jooste, 2013). The nurse manager has to explain to the management of the benefits of change in providing adequate staffing all the time. Adequate staffing helps staff retention. Staff retention saves a lot of money in terms of orienting new people to the unit. Safe staffing always helps in the reduction of falls, infection rates, pressure ulcers, decrease hospital stays and death. Flexible and creative scheduling is essential for retaining staff and promoting a positive work climate (Grohar-Murray & Langan, 2011). Adequate staffing with good staffing ratio will help nurses to concentrate on their patient care which may help in a reduction in medical errors and lawsuits to the hospital.

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.

nurse staffing ensures quality nursing care for patients and can be a challenge for nurse

Appropriate nurse staffing is a complex topic that has arisen as a nationwide healthcare issue within the profession of Registered Nurses (RN). To truly understand the concept of staffing one must understand that staffing and scheduling are often at times used interchangeably although Mensik (2014) noted a distinct difference between the two (p. 2). The American Nurse Association [ANA] (2012) has defined appropriate nurse staffing “as a match of registered nurse expertise with the needs of the recipient of nursing care services in the context of the practice setting and situation” (p. 6). Scheduling, in contrast, involves taking into account factors such as a unit’s historical census numbers along with anticipated surgical volumes

The "Duke University Medical Center" (2005) website defines “quality improvement as a formal approach to the analysis of performance and systematic efforts for improvement”. Quality improvement programs are found in a variety of industries and are constructed differently. The medical field tends to use quality management to focus on patient and staff safety, reducing medical errors, and avoiding or decreasing morbidity and mortality rates. Health care organizations have been attempting to improve the quality of care for as long as “the nineteenth-century when obstetrician, Ignaz Semmelweis introduced hand washing to medical care, and Florence Nightingale who determined

The American Nurses Association supports a legislative model in which nurses are encouraged to create staffing plans specific to each unit. This approach will aide in establishing staffing levels that are flexible and can be changed based on the patients needs, number of admissions to the unit, discharges and transfers during each shift (“Nurse staffing plans,” 2013). This model will assist in keeping the unit staffed appropriately and organized in need of a change during each shift. Without an organized plan like this, a nurse may be required to take on a new admission and already have too big of a workload.

McLaughlin, C.P., & Kaluzny, A.D. (2006). Continuous Quality Improvement in Health Care, Third Edition, Jones & Bartlett Publishers, Sudbury, MA.

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 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.

Nurses are crucial in providing quality care in the health care industry. It is imperative to maintain the proper staffing ratio to ensure that nurses can maintain high quality care for their patients. Studies have shown that the increasing workload of nurses can be linked to increased patient deaths, medical errors, hospital-acquired infections, longer hospital stays, and many other complications. (National Nurses United n.d. ) Leaders and managers play a vital role in developing

One professional organization that has been stepping up to the plate in regards to this issue is the American Nurses Association (ANA) and its Constituent & State Nurses Associations (C/SNA). The American Nurses Association (n.d.) role in this issue is to promote legislation that holds hospitals responsibility for developing and executing valid and reliable staffing plans. These plans are not to be confused with mandated ratios, which require fixed nurse to patient ratios. These plans are strictly based on each hospital’s unit unique circumstance and should evolve as the unit grows and changes.

Examining planning for and effectively measuring the health care quality indicators make healthcare quality more transparent and provide information for quality improvement programs and initiatives in the healthcare system.

The major learning in this module for me has been in nurse scheduling. I found the issue with nurse scheduling most challenging and complex since they are an important component of healthcare (Maenhout & Vanhoucke, 2009). Arranging the nurses in an order so that they are available all the time for patient care together with looking into the concern that their personal requests and preferences are also maintained so that there are adequate job satisfaction and productivity from them is a daunting task. It requires a considerable amount of skill and experience to manage the entire nurse schedule efficiently without any conflict (Cavouras, 2006). The main purpose of nurse scheduling is about cost optimization while maintaining a benchmark level

Initiating change can be quite difficult especially when majority of the staff are satisfied with the status quo. Verbalizing a compelling vision can increase the urgency for change, asking for feedback and responding to their concerns and helping each staff transition through every phase of the change can solve the reluctance of the staff to change to self- scheduling. Communication breakdown can negatively impact the staff’s willingness to participate in th change process. The staff’s productivity and engagement in the change can be improve by maintaining an open communication that updates the stake holders with timely and accurate information. Nurses abusing the system is common across any scheduling framework as some staff put their personal wants before the unit’s needs and accumulate a lot of unworked hours without making up for it. Involving the staff in the initiative reduces this problem. Griesmer solved the problem by allowing each nurse to be the monitor of the month. The role is first given to the nurses who abused the system so they can understand the amount of effort the shift managers had to put in to create a schedule that accounts for everyone’s needs. . Eventually, the role becomes available to everyone and every nurse is required to be a MOM at least