Quality Indicator Research Paper

5. Zwakhalen, S., Hof, C., & Hamers, J. (2012). Systematic pain assessment using an observational scale in nursing home residents with dementia: exploring feasibility and applied interventions. Journal Of Clinical Nursing, 21(21/22), 3009-3017. doi:10.1111/j.1365-2702.2012.04313.x

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

The long-term care services delivery system in the United States has changed substantially over the last 30 years . There are approximately 17,000 elderly and disabled persons are receiving care in nursing homes (NNHS, 2004). The number of people using nursing facilities, alternative residential care places, or home care services are projected to increase from 15 million in 2000 to 27 million in 2050 (HHS, 2003). Identifying the best nursing home that would fit their needs can be difficult and time-consuming. Although nursing homes usually provide certain basic care that patients need, some nursing home facilities provides special care for certain types of individuals with special needs. For example, people with dementia, AIDS, ventilator-dependents,

These agencies expect long-term care facilities to maintain an environment that will emphasize the importance of one’s quality of life and quality of care (Walsh, 2014).

Before any quality improvement plan (QIP) can be developed, the overall aim of the project must be determined to ensure the QIP stays on track. This includes deciding what is going to be measured, what the current baseline is, what the target will be and a timeline for accomplishing the goal (Health Quality Ontario, n.d.). Thus, the aim for this QIP is to reduce the rate of worsened pain in the VC from the current value of 20.2% of residents with worsened pain by 1% by the next quarter by educating nurses on the correct way to assess and document pain in the electronic system.

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.

Precisely some of the characteristics are generally based on the main levels of quality assurance such as with accuracy, accessibility, comprehensiveness, consistency.

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).

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.

This paper examines the quality of care received by the elderly with an emphasis on measurements for care, recommending additional tools to be adopted to measure the overall well-being for the elderly in order to gain a more comprehensive understanding of the quality of care for those living in senior care facilities.

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

Design and scope constitute element one. Pertaining to nursing homes, a quality improvement program should take aim at medical care, resident selection, and quality of life (Center for Medicare and Medicaid Services [CMS], n.d.). An initiative was developed to better diabetes care

The most common reason that people seek medical care is pain, and pain is the leading cause of disability (Peterson & Bredow, 2013, p. 51; National Institute of Health, 2010). Pain is such an important topic in healthcare that the United States congress “identified 2000 to 2010 as the Decade of Pain Control and Research” (Brunner L. S., et al., 2010, p. 231). Unfortunatelly, patients are reporting a small increase in satisfaction with the pain management while in the hospital (Bernhofer, 2011). Pain assessment and treatment can be complex since nurses do not have a tool to quantify it. Pain is considered the fifth vital sign, however, we do not have numbers to guide our interventions. Pain is a subjective expirience that cannot be shared easily. Since nurses spend more time with patients in pain than any other healthcare provider, nurses must have a clear understanding of the concept of pain (Brunner, et al., 2010). Concept analysis’ main objective is to clarify ideas, to enhance critical thinking, and to promote communication (Rodgers & Knafl, 2000). This paper will examine the concept of pain using Wilson’s Steps of Concept Analysis (Rodgers & Knafl, 2000).

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