Module 3 Assignment: Exploring EBP Quality Improvement

Examining EBP Quality Enhancement Nurses play a crucial role in the provision of patient care. They investigate evidence-based interventions that can be implemented to increase patient safety, quality, and efficiency. EBP quality improvement strategies permit health institutions to provide services that meet the requirements and expectations of people. Consequently, this study investigates the practice issues that can be addressed by EBP QI projects.
Potential Sites
Successful execution of programs based on evidence-based practice necessitates the use of suitable practice sites. As a registered nurse, one of the potential sites for an evidence-based practice quality improvement initiative is a tertiary hospital where I work. The tertiary setting is a large hospital that provides general and specialized care to patients from diverse backgrounds. The facility offers an extensive array of care services, including oncology, surgery, inpatient, outpatient, pediatric, intensive care, and obstetric care. The hospital serves individuals from all walks of life who require specialized or general care. The tertiary hospital is a private institution that was built to meet the growing healthcare requirements of various patient populations. The institution’s purpose is to be a pioneer in providing innovative care to its communities. The organization is a solitary entity.

You will find important health information regarding minority groups by exploring the following Centers for Disease Control and Prevention (CDC) links:

Minority Health: http://www.cdc.gov/minorityhealt/index.html
Racial and Ethnic Minority Populations: http://www.cdc.gov/minorityhealt/populations/remp.html

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A nursing home in my region is the second potential setting for an EBP-based quality improvement initiative. The nursing home is a mid-level organization that was founded to give general and specialized care to patients from diverse backgrounds. The home is a private organization that offers maternity, inpatient, outpatient, surgical, and pediatric care. The institution’s objective is to deliver high-quality, safe, and efficient patient-centered care to meet the needs of individuals, families, and the broader community.

The final feasible setting for the EBP quality improvement project is a community-based center specializing in the care of elderly people. The institution offers specialized care for elderly patients with various health issues. The center is a private organization that offers its services to all elderly people regardless of their ethnicity. As a means of boosting the health and well-being of senior patients, the center’s objective is to provide them with innovative, high-quality treatment.

Comparing Locations

There are a number of advantages and disadvantages associated with the aforementioned sites for an EBP quality improvement project. The tertiary hospital has a culture of using interventions based on evidence-based practice to provide patient care. Providers are urged to adopt best practices for optimizing care outcomes such as safety, quality, and efficacy (Platz, 2019). Additionally, the hospital has the financial and human resources to conduct EBP quality improvement projects. Additionally, the institution has sufficient personnel, which raises the likelihood of a successful execution of an EBP quality improvement effort. Teamwork is implemented extensively throughout the organization. According to Jolley (2020), cooperation facilitates the achievement of patient care outcomes including quality, safety, and efficacy. The environment has certain flaws, however. One of them is the healthcare providers’ heavy workload, which may make it challenging for them to conduct EBP quality improvement projects. The heavy workload is attributed to the large number of patients that employ the institution’s services. Additionally, the nursing home possesses other strengths. The fact that it was recently recognized among the top five nursing homes in the region for providing patients with high-quality care is one of them. In providing patient care, the nursing home also has a culture of teamwork and an emphasis on patient outcomes.

In addition, the hospital recently incorporated health information technologies to improve the safety and quality of patient treatment. Existing evidence demonstrates that health information technology improve the performance and competitiveness of health organizations by promoting safety, quality, and effectiveness (Kushniruk, 2019). However, the nursing home has the difficulty of inadequate resources, which may hinder the successful implementation of EBP quality improvement programs. For instance, the company has struggled to retain qualified personnel, which may impede the execution of the change. As a viable location for the execution of an EBP quality improvement project, the senior care center also possesses certain strengths. First, the location is renowned in the region for its superior geriatric care. It employs skilled and specialized healthcare professionals in geriatric care. Additionally, patient-centered care approaches are utilized in the provision of care. Patient-centered care is associated with outcomes such as increased adherence to therapy, patient happiness, and patient empowerment (Kuipers et al., 2019). However, the environment contains flaws, such as a limited personnel to undertake EBP quality improvement initiatives and financial difficulties for quality improvement programs. Therefore, the aforementioned factors should be considered while creating an optimal environment for performing the EBP quality improvement project.

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Perform Problems

A number of practice issues within the selected healthcare institutions are investigated. Infection prevention is one of the practical issues explored in the tertiary institution. Infection prevention and control are essential components of any healthcare facility. The mission of health organizations is to ensure that patients receive high-quality, safe, and effective care that minimizes their risk of disease and harm. To avoid infections among patients and healthcare workers, healthcare practitioners are expected to adopt evidence-based interventions such as the use of aseptic methods (Greenhalgh et al., 2020). The second practice issue examined by the tertiary institution was patient care safety. Medication mistakes and the prevalence of falls among hospitalized patients were examined as indicators of service quality. The hospital analyzes the indicators that indicate the safety and quality of patient care to determine the safety and quality of patient care (Alshammari et al., 2018). The assessment of data linked with safety indicators could have driven the adoption of practice adjustments to ensure that patients receive care that addresses their actual and potential requirements. One of the practice problems investigated in the nursing home was nurse burnout. Burnout among nurses is a serious problem that jeopardizes patient safety and care quality (Rezaei et al., 2018). Increased workload, a shortage of healthcare providers, and difficulties in establishing a work-life balance are risk factors for nursing burnout. Studies have demonstrated that burnout is connected with unfavorable outcomes such as prescription mistakes, higher staff turnover, and low job satisfaction rates among healthcare providers. It also raises the likelihood that patients will receive substandard care (Lahana et al., 2017). I also investigated 30-day readmission rates among patients with chronic illnesses as a second practice issue. The readmission rates of patients with chronic diseases are indicative of the quality and security of care provided by a facility. It is the obligation of healthcare practitioners and institutions to lower the rate of readmission among patients with chronic conditions. Reduction in the rate of readmissions indicates that the care provided to patients is safe, effective, and of high quality (Berre et al., 2017).

It also refers to the provision of care that reduces the disease’s impact on the sufferers. Safety issues, including prescription errors and patient falls, were investigated as a practice problem at the care center for senior people. Due to their health status, elderly patients are at significant risk for safety problems such as falls. Due to the adverse effects of the drugs, medication use also increases the risk of falling. In addition to dementia, geriatric adults may encounter numerous health issues that enhance their risk of falling. Due to their advanced age, geriatric patients also have diminished pharmacologic and pharmacotherapeutic processes (Ezaz et al., 2018). Nurses and other healthcare professionals should ensure that their practice promotes medication safety. As a result, it became essential to investigate the aforementioned safety concerns at the senior care facility.

Possibility of the Issues

The aforementioned issues may be the subject of EBP quality improvement efforts. As stated previously, infection prevention and control is a crucial factor in determining the quality and safety of patient treatment. Due of the covid19 pandemic, health organizations today face obstacles in accomplishing their infection prevention objectives. Consequently, the majority of healthcare institutions in severely affected areas struggle to provide enough personal protective equipment for the safety of healthcare providers and patients (Adhikari et al., 2020). The tertiary institution offers specialist care to patients in the region impacted by covid19. Consequently, it is essential to investigate how infection prevention and control might be done within the organization utilizing interventions supported by scientific evidence. Important is the promotion of safety and quality in nursing and healthcare. In order to maximize the safety and quality of care outcomes, it is the obligation of health facilities to offer a safe environment. Patient safety issues, such as prescription errors, burnout, and falls, impact their health and wellness (Smith & Plunkett, 2019). Interventions based on empirical evidence can be utilized to address the aforementioned practice issues. For instance, technologies that prevent and reduce medication errors and patient falls can be investigated. Institutional initiatives, such as provider education and counseling services, can assist in addressing the issue of burnout among healthcare professionals (Prout et al., 2019). Therefore, the aforementioned practice issues can be possible areas of emphasis for EBP quality improvement efforts.

Stakeholders

In the above-mentioned health care system, the launch of EBP quality improvement projects necessitates the permission of multiple stakeholders. The institution’s ethics and review board would need to approve the proposal before it could be implemented. The responsibility of the ethics and review board is to ensure that EBP quality improvement programs are safe and protect the needs of the organization’s stakeholders. The board evaluates the feasibility of proposed projects inside the company. In addition, it investigates whether the proposed projects safeguard the needs and rights of the vulnerable, such as patients. In addition, it assures compliance with institutional, state, and federal regulations during project implementation. The institution’s senior managers and leaders are an additional stakeholder required for project approval. The project should have the backing of senior management and leaders. They should concur that the project increases safety and care quality in the institution. Approvals will need to be sought from the nursing home’s quality assurance department. The nursing home has a department of quality assurance that oversees the execution of programs for quality improvement. The department will ensure that the project aligns with the organization’s mission, vision, and strategic goals. Additionally, approval should be sought from the organization’s upper management. The initiation of the EBP quality improvement initiative in the geriatric care center would necessitate clearance from the institution’s upper management. To ensure the quality and safety of patient care, the senior management is entrusted with authorizing and monitoring quality improvement interventions. Therefore, authorization to conduct the investigation will be sought from them at the center.

Similarities and Dissimilarities in Stakeholder Needs

There are parallels and distinctions between the stakeholder requirements of the selected organizations. One similarity across stakeholder requirements is their emphasis on determining the quality improvement initiatives’ safety. The stakeholders determine whether projects infringe the rights of the organization’s most vulnerable members. The other similarity between the criteria of stakeholders is that they are all concerned with determining whether the providers would accept or reject the initiatives. The ethics and review committee is concerned with the ethical issues of the projects, whilst senior management and leadership are more concerned with the projects’ viability. Senior management and leadership investigate the financial viability and organizational viability of proposed projects.

Proposed Practice Environment and Issue

The tertiary hospital is the intended health care environment for my hypothetical presentation to stakeholders. The hospital is suitable for the study due to its well-documented history of evidence-based practice projects. Additionally, the institution has highly qualified personnel who are likely to support the project. In order to address challenges such as resistance to change throughout the implementation of a project, well-informed staff members are essential. Medication mistakes are the proposed healthcare concern to be presented to healthcare stakeholders. Medication errors pose a significant threat to public health. Medication errors put patients at risk for unintended damage. Medication errors also result in undesirable effects such as increased healthcare costs, hospital stays, and healthcare resource consumption (Asensi-Vicente et al., 2018). Nurses have an important role in preventing pharmaceutical mistakes. They investigate evidence-based solutions that can be implemented in practice to develop a safety and quality culture (Marvanova & Henkel, 2018). For safety, quality, and efficacy, the tertiary hospital should therefore conduct quality improvement activities to address the problem of pharmaceutical errors.

Conclusion

The venues chosen for the EBP quality improvement program are a tertiary care facility, a nursing home, and a geriatric care center. The institutions face a variety of issues, including staff fatigue, medication errors, infection prevention and control, and patient falls. Prior to implementing EBP quality improvement activities, approvals must be secured from various stakeholders. Therefore, the emphasis of EBP quality improvement programs should be on enhancing the safety, quality, and effectiveness of care.

The John Hopkins Model

The John Hopkins model is the selected framework for implementing the evidence-based practice quality improvement project. The model uses a problem-solving approach to decision-making. The model has been considered appropriate for enabling nurses to appraise evidence, which is considered the most challenging aspect of the EBP process (Ryan, Shope, & Morse, 2017). The model is also considered effective for implementing the quality improvement project because it is designed to meet the needs of a practicing nurse.

Proposed Practice Problem

Patient fall is a major problem in acute inpatient care. This problem is used as a major determinant for evaluating the quality of nursing care. This means that despite improving other aspects, such as bedside care, the failure to address patient falls may affect the quality of healthcare outcomes and overall perspective on nursing care. Prioritizing addressing patient falls in acute care can enhance nursing outcomes in the facility.

Identifying the risk factors contributing to patient falls is crucial in developing effective strategies for addressing this practice problem. Several challenges contribute to the risk of patients falling in acute care. However, implementing a quality improvement project can help in identifying the specific challenges that increase the risk of falling and subsequently create tailored solutions to address the problem in the hospital.

References

Ryan, L.P., Shope,B., & Morse, E. (2017). The Johns Hopkins Evidence Based Practice (EBP) Model: Learning the Process and Appraising the Evidence. Journal of Perianesthesia Nursing, 32(4). https://doi.org/10.1016/j.jopan.2017.06.098