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NRSG 314 Unit 3-Discussion Board CTU

NRSG 314 Unit 3-Discussion Board CTU

Continuous quality improvement is very important to ensure patient safety is consistently evaluated and improved. The goal of continuous quality improvement is to incrementally improve processes, systems and outcomes (O’Donnell & Gupta, 2022). Health care providers must monitor processes and outcomes in order to ensure they are providing the best outcomes and safest care environment.  It is only by observing and researching that problems and dangers can be identified. Identifying the baseline of quality is important to ensure progress is made (Sherwood & Barnsteiner, 2021).If things were always done the same way, with no effort to improve, healthcare would not progress and would fail patients continually. Focusing CQI processes on specific interventions can really highlight areas that need improvement.

     In the Neonatal Intensive Care Unit central lines are common and necessary to treat many neonates. Central lines are necessary, but also a high risk source of significant infection. Central line infections are often fatal in neonates. In an effort to minimize central line infections, the unit that I work in implemented a CLABSI bundle. CLABSI bundles are used in most intensive care units and have been shown to reduce central line infections significantly. In one study, CLABSI infections fell from 8.4 infections per 1000 central catheters to 1.8 infections per 1000 central catheters with the implementation of a CLABSI bundle (Bierlaire, 2021). The CLABSI bundle that we implemented included removal of umbilical catheters by day ten, sterile line handling for all interventions and chlorhexidine infused caps on all ports. I am unsure of our exact rate of CLABSI before the bundle was implemented. After 30 days of implementation of our CLABSI bundle, there were zero line infections. This zero infection rate continued for four months, followed by one infection in the fifth month and then back to zero in month six. Using the CQI process, we then decided to use the bundle in PIV access to see if this decreased infections. Evaluation after implementation proved that all line infection rates were impacted by CLABSI bundles. Using the CQI process, it was decided that this was a very effective process and has greatly improved the safety of the patients in the unit that I work in.

References

NRSG 314 Unit 3 Discussion Board CTU
NRSG 314 Unit 3 Discussion Board CTU

      Bierlaire, S., Danhaive, O., Carkeek, K., & Piersigilli, F. (2021). How to minimize central line-associated bloodstream infections in a neonatal intensive care unit: a quality improvement intervention based on a retrospective analysis and the adoption of an evidence-based bundle. European journal of pediatrics, 180(2), 449–460. https://doi.org/10.1007/s00431-020-03844-9

    O’Donnell, B., & Gupta, V. (2022). Continuous Quality Improvement. In StatPearls. StatPearls Publishing.

    Sherwood, G., & Barnsteiner, J. (2021). Quality and Safety in Nursing (3rd Edition). Wiley Global Research (STMS).

Primary Discussion Response is due by Thursday (11:59:59pm Central), Peer Responses are due by Saturday (11:59:59pm Central).

Primary Task Response: Within the Discussion Board area, write 250 words that respond to the following questions with your thoughts, ideas, and comments. This will be the foundation for future discussions by your classmates. You are required to use 1 scholarly resource in addition to your textbook. Be substantive and clear, and use examples to reinforce your ideas.

  • How does continuous quality improvement (CQI) play a role in patient safety and patient outcomes?
  • Provide an example from your clinical experiences or clinical setting that used CQI to improve patient outcomes.

Responses to Other Students: Respond to at least 2 of your fellow classmates with at least a 100-word reply about their Primary Task Response regarding items you found to be compelling and enlightening. To help you with your discussion, please consider the following questions:

  • What did you learn from your classmate’s posting?
  • What additional questions do you have after reading the posting?
  • What clarification do you need regarding the posting?
  • What differences or similarities do you see between your posting and other classmates’ postings?

Discussion Board Rubric

The Discussion Board Grading Rubric is a scoring tool that represents the performance expectations for the discussion. This grading rubric is divided into components that provide a clear description of what should be included within each component of the discussion. It is the road map that can help lead your discussion. Discussion Board Grading Rubric

For assistance with your assignment, please use your text, Web resources, and all course materials.

The iterative nature of continuous quality improvement makes it an ideal process for breaking a large-scope project in the workplace and splitting it into manageable chunks. Specific subfamilies of CQI include Lean, Six Sigma, and TQM; utilizing these methods to improve patient safety/outcomes is a must in the current healthcare climate (Sherwood & Barnsteiner, 2021). Similar to the Scientific Method, CQI allows nursing staff to set a specific improvement goal for patients (example: reducing diabetic complications/readmissions), then beta test in a smaller and more controllable population/environment. Finally, after review of the data collected, the original hypothesis can be verified or disproven before being revised/expanded for a full rollout (Dzidowska et al., 2021).

At my workplace, I was involved in the development and testing of a revised Post Operative phone call implementation, created to reinforce discharge education, improve patient recovery after surgery as well as to reduce the incidence of readmission. The process began with my department leaders noticing a trend of low Press-Gainey Scores (used to measure patient satisfaction with admissions, physician investment, recovery/discharge process, etc). This led to the formation of a committee dedicated to gathering information regarding patient likes/dislikes with the care process. After further investigation, it was found that the underperforming satisfaction scores were being grossly impacted by scores in areas not relating to our department (Pre & Post-op/PACU), such as patient unhappiness with general admission process, visitation policies, and physician involvement/bedside manner. This information was then used to justify adding additional patient education before and after surgery, patient “teach-back” (where the patient would repeat the education given), as well as additional follow-up phone calls at regular intervals after discharge to ensure patient follow-through with nursing instructions given at the facility.

References

Sherwood, G., & Barnsteiner, J. (2021). Quality and Safety in Nursing (3rd Edition). Wiley Global Research (STMS). https://coloradotech.vitalsource.com/books/9781119684459

Dzidowska, M., Lee, K. S. K., Wylie, C., Bailie, J., Percival, N., Conigrave, J. H., Hayman, N., & Conigrave, K. M. (2020). A systematic review of approaches to improve practice, detection and treatment of unhealthy alcohol use in primary health care: a role for continuous quality improvement. BMC Family Practice, 21(1), 1–22. https://doi-org.coloradotech.idm.oclc.org/10.1186/s12875-020-1101-x