This prospective, pre-post quality improvement (QI) project was conducted at the University of Pittsburg Medial Center, Presbyterian Hospital, a tertiary academic medical center in Medical Intensive care unit (MICU). A multidisciplinary team consisted of physicians, pharmacists, and nurses, assessed in detail twenty-seven possible non-pharmacologic interventions that display positive impact on delirium. The remaining nine non-pharmacological interventions were combined into a protocol entitled “Give your patient M.O.R.E.” This acronym can be defined as music, opening of blinds, reorientation and cognitive stimulation, and eye/ear protocols. The purpose was to determine if the implementation of the evidence-based non-pharmacological protocol
This paper will propose how TriCity Medical Center will monitor performance, achieve regulatory and accreditation compliance, and improve overall organizational performance. It will describe ways TCMC will communicate with leadership to ensure alignment of organizational goals and gain buy-in from staff to achieve compliance with the standards and requirements issued by regulatory and accreditation bodies. Also it will determine how compliance with the regulations and development of risk- and quality-management systems for the organization contributes to the organization’s overall performance-management system.
I am writing to obtain permission to conduct an evidence-based quality improvement project using a pretest/posttest design in your facility with the purpose of evaluating the effectiveness of an educational intervention regarding the importance and use of the nurse driven protocol on nurses ' knowledge and CAUTI rates.
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
What do you consider to be the key issues for quality improvements in the NHS quality-improvement program as it goes forward?
Quality Improvement (QI) is an organizational approach that leads to the quality of patient care and services through use of specific set of guidelines, principles, and methodology. This is so that there is assurance that quality care is provided for every patient. Principles of quality improvement focus on measurements. These measurements involve data collection used to improve the quality of care, and patient outcomes. Any good quality improvement program ensures strengthening the systems through analyzes and processes.
According to Mc Donnell & Timmons (2012), “Acute delirium is a preventable, treatment, disorder of consciousness and cognition that commonly presents across many healthcare settings, including older care facilitates, medical and surgical ward, intensive care units and children’s ward”(p.2488). In their article, A quantitative exploration of the subjective burden experienced by nurses when caring for patients with delirium, Mc Donnell and Timmins outline a descriptive study. Even though prevention and treatments are well recognized, dealing with delirium can be very difficult. The purpose of this study is to examine the subjective burden nurses experience when caring for patients with delirium and to identify the individual aspects of delirium that nurses find most difficult to deal with. In the introduction of the article, the authors argue that beyond qualitative studies there is insufficient practical research on the impact and burden of delirium on nurses in practice (Mc Donnell & Timmins, 2012). This argument outlines the premise behind the research. It is not a research question, but a statement of belief upon which they draw in framing the purpose and focus of their research. The authors articulate their recognition of the fact that many researchers have only focused on the diagnosis, treatment, and prevention for delirium. In addition, they also recognized that nurses often lack knowledge and understanding
Delirium is a serious condition that can affect patients in and outside the hospital. With its presence being unknown to many nurses and providers, delirium has significant long term complications that can last well beyond discharge. Noise, medication, and infection are significant in the development and progression of delirium and these are more than abundant within intensive care patients. The importance of nurse’s knowledge cannot be stressed enough regarding the assessment, symptoms, and interventions of delirium, in an effort to decrease its occurrence
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.
Delirium in the Intensive Care Unit (ICU) has become a genuine phenomenon and can be problematic for the patient and the staff caring for them. Delirium occurs when a patient is placed in an unfamiliar environment and has to endure the stress of not just the hospitalization but the stimuli of the environment, which can cause disturbances in consciousness. Patients can become confused, anxious, and agitated; making this difficult for the staff to correctly diagnosis and care for them. Sleep deprivation and environmental factors along with neurotransmitters are strongly related to the occurrence of ICU delirium. ICU staff needs to become more educated on prevention, detection, and proper treatment for the patient experiencing this
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
Quality improvement is defined by Kelly (2012) as “a systematic process of organization wide participation and partnership in planning and implementing continuous improvement methods to understand, meet, or exceed customer needs and expectations and improve patient outcomes” (p.477). The women’ unit can receive thirty patients from age eighteen to late adulthood. The unit is a receiving facility for everyone Baker acted in the state of Florida. Like any other organization, change is always happening in the women’s unit. One of the areas that need improvement on the unit is a reduction in the number of seclusion and restraint that we do every month. Patients that are violent and present a danger to either
In the United States alone there are 98,000 deaths per year caused by low quality health care (Ignatavicius & Workman, 2013, pg. 2). This statistic is disturbing because the errors that resulted in death were errors that were preventable. The intent of this chapter is to bring awareness to health care providers that are able to make a change in the quality of health care. In current practice patients are subjected to medication errors, preventable hospitalizations, premature death, and poor care provided due to racial, ethical, or low-income factors.
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
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.
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