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NURS 8302 Discussion: Quality Improvement Models SOLUTION

NURS 8302 Discussion: Quality Improvement Models SOLUTION

Walden University NURS 8302 Discussion: Quality Improvement Models SOLUTION-Step-By-Step Guide

 

This guide will demonstrate how to complete the Walden University NURS 8302 Discussion: Quality Improvement Models SOLUTION assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

 

How to Research and Prepare for NURS 8302 Discussion: Quality Improvement Models SOLUTION

 

Whether one passes or fails an academic assignment such as the Walden University NURS 8302 Discussion: Quality Improvement Models SOLUTION depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

 

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

 

How to Write the Introduction for NURS 8302 Discussion: Quality Improvement Models SOLUTION

The introduction for the Walden University NURS 8302 Discussion: Quality Improvement Models SOLUTION is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

 

How to Write the Body for NURS 8302 Discussion: Quality Improvement Models SOLUTION

 

After the introduction, move into the main part of the NURS 8302 Discussion: Quality Improvement Models SOLUTION assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

 

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

 

How to Write the Conclusion for NURS 8302 Discussion: Quality Improvement Models SOLUTION

 

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

 

How to Format the References List for NURS 8302 Discussion: Quality Improvement Models SOLUTION

 

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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Post a brief explanation of the quality improvement model you selected, including a description of the components that make up this model. Be specific. Then, explain how this quality improvement model might be implemented in you healthcare organization or nursing practice in response to an adverse event requiring quality improvement. Be specific and provide examples.

Sample Answer for NURS 8302 Discussion: Quality Improvement Models

Health care delivery is complex and faces numerous challenges. An adequate response to these challenges and ensuring that health care remains optimal requires continuous improvement of processes and outcomes. As a result, quality improvement initiatives to address a performance gap should be part of everyday practice. Quality improvement (QI) models should be applied to ensure that the process is systematic and procedural.

The Root Cause Analysis (RCA) Model

The RCA model is among the commonly applied models when the cause of an adverse problem needs to be explicit. RCA is founded on the premise that issues causing errors must be identified, and health care providers should avoid focusing on individual mistakes (Martin-Delgado et al., 2020). In this case, there is more to errors and other adverse events than what is generally seen. Karkhanis and Thompson (2020) explained that RCA has three main components: data, a multidisciplinary team, and error prevention. When a problem occurs, health care providers should collect relevant data through records’ analysis and participants’ interviews, among other strategies. The multidisciplinary team helps to analyze the problem in-depth from a team approach. Eventually, the identified error is eliminated, and appropriate measures to prevent future harm are implemented (Agency for Healthcare Research and Quality, 2019). The method identifies errors, responds effectively, and guides interventions to prevent future harm.

RCA Implementation in Response to an Adverse Event

The RCA model can be highly effective when responding to a medication error problem. A suitable example would be when a patient receives the wrong prescription. Implementing RCA in this situation would commence with data collection from the health care providers involved in the process. Next, a multidisciplinary team would analyze the problem to examine whether it was individual or administrative. The problem would then be fixed through technology adoption or training health care professionals to prevent recurrence.

Health care organizations should be committed to continuous quality improvement. For better outcomes, they should apply QI models to ensure that QI is systematic and procedural. The RCA model is highly effective in problem identification, analysis, and solution. It can be used in health care organizations and the broader nursing practice to guide quality improvement.

 

References

Agency for Healthcare Research and Quality. (2019). Root cause analysis. https://psnet.ahrq.gov/primer/root-cause-analysis

Karkhanis, A. J., & Thompson, J. M. (2020). Improving the effectiveness of Root Cause Analysis in hospitals. Hospital Topics, 99(1), 1-14. https://doi.org/10.1080/00185868.2020.1824137

Martin-Delgado, J., Martínez-García, A., Aranaz, J. M., Valencia-Martín, J. L., & Mira, J. J. (2020). How much of Root Cause Analysis translates into improved patient safety: A systematic review. Medical Principles and Practice, 29(6), 524-531. https://doi.org/10.1159/000508677

Sample Answer 2 for NURS 8302 Discussion: Quality Improvement Models

A brief explanation of the quality improvement model you selected, including a description of the components that make up this model.

The quality improvement model selected for this assignment is the A3 model.  This model provides a very basic, yet structured approach towards problem-solving. The model was first applied by the Toyota corporation, many years ago, as a model for continuous improvement.  According to UNC Institute for Healthcare Quality Improvement (2021), the model received its name, based on the type/size of the paper, A3.  It is also known as SPS, which is Systematic Problem Solving and is based on the basic principles identified by Edward Demings PDCA (Plan Do Check Act) process (UNC Institute for Healthcare Quality Improvement, 2021). The A3 process involves includes a total of 11 distinct steps, including a step 0, which identifies the problem.  Steps 1 – 8 are planning steps, interestingly enough, embedded in these steps are Deming’s PDCA steps.  Step 9 is the do step and step 10 is the check step (Montana State University, n. d.).  At the end of the cycle, any identified opportunities for improvement are identified and the cycle is initiated again.

Explain how this quality improvement model might be implemented in your healthcare organization or nursing practice in response to an adverse event requiring quality improvement. Be specific and provide examples.

At my current organization, we use the A3 method for quality improvement initiatives.  We have a Lean Six Sigma Blackbelt at our organization and all of the directors and managers are at least certified Green Belts in the Lean Six Sigma training.  The A3 form/format is utilized for patient-related harms reported across the organization. This primarily includes Hospital Acquired Pressure Injuries (HAPI’s), Catheter-Associated Urinary Tract Infections (CAUTI’s), and Venous Thromboembolisms (VTE’s).  Although we follow a similar format previously described in the steps above for the A3, our organization asks specific questions for each step of the A3 process. This is very helpful when ensuring that clinicians do a deep dive into the reasons for the harm, as well as identifying opportunities to improve the quality of patient care and prevent further harm.

The most recent incident that we need to complete an A3 was for a harm on the Palliative Care unit.  A bedridden patient developed a HAPI, a stage 2 pressure injury on their right heel (Step 0). Upon review of the chart/patient flow, staff processes/procedures (Steps 1-8), the patient was not being turned every two hours per organizational policy.  It was further determined that the patient was boarded in the ED for 36 hours, prior to being admitted to the Palliative care unit.  Consequently, the ED had to take responsibility for the harm, considering that the patient had only been on the Palliative care unit for less than 24 hours.  Ultimately, the organization needs to ensure that all departments are following our policies related to turning identified patients, every 2 hours (Step 9).  Ongoing, the Performance Excellence Committee reviews data/patient records, to ensure that there are no additional harms (Step 10).  Once the A3 document is completed, it is reviewed with the harms team, and approval is sought for any changes in practice, protocol, policy, etc.

References

Montana State University (n. d.). Steps of the A3.  Retrieved from https://www.montana.edu/dsobek/a3/steps.html

Tromp, R. (n. d.).  A3 report.  Lean Six Sigma Group.  Retrieved from https://leansixsigmagroup.co.uk/a3-report/

UNC Institute for Healthcare Quality Improvement (2021).  Resources: A3.  Retrieved from https://www.med.unc.edu/ihqi/resources/a3/

Sample Answer 3 for NURS 8302 Discussion: Quality Improvement Models

The Plan-Do-Study-Act Cycle is the Quality Improvement Model that I have chosen for this discussion.  It has been utilized for continuous improvement as described by Edwards Deming (Nash et al., 2019).   This improvement model assumes that 15 percent of poor quality is due to people and 85 percent of poor quality is due to improper management, systems and processes (Nash et al., 2019).

Plan

Under this phase of the quality improvement model, we seek to understand the problem and where a gap in practice exists as well as establish an objective laying out what we are trying to accomplish.  In my clinical arena, we would be collecting and analyzing data to identify where a gap exists based on the data. It is possible that we find what we least expected or that the gap exists in a different place than expected.  From here we can plan how to carry out the cycle.

Do

Under this phase of the cycle, we use the gap that we’ve identified and the plan that we’ve made to educate and train staff to carry out the plan. We can start to make small scale changes and evaluate its effectiveness, challenges, and problems on a small scale to prepare for implementing in a much bigger scale.

Study/Check

In this phase of the quality improvement model, we evaluate the effects of the change and decide if it was successful or not. We evaluate whether and to what degree success was obtained or did the gap get larger. Here we can determine what changes need to be made and what steps should be taken next to achieve the objective that was set during the initial plan phase of the cycle.

Act

This is action phase of the cycle where we make changes based on what we have learned whether that is repeating what was done, making small modifications, or creating an entirely new plan and cycle. It is the ending as well as the beginning. In this phase, new gaps can be identified, or current gaps can be modified until the goal or objective is met (Nash et al., 2019).

Shaw et al. (2019) utilized rapid cycle PDSA quality improvement model to improve hypothermia in term and near-term infants delivered vaginally. After 4 PDSA cycles, the incidence of hypothermia dropped from 50% to zero at 1 hour of life (Shaw et al., 2019). A similar project utilizing the PDSA would be beneficial in my healthcare organization in the population mentioned above but could be expounded on to include premature infants who are also risk complications secondary to hypothermia. Shaw et al. (2019) found that regular feedback regarding success and correction of the previous PDSA cycles was important to continue to move forward with the quality improvement project. This model is ideal because the cycles required to achieve the necessary change will vary from hospital to hospital and can be affected by many variables but if continued the result will eventually be achieved. The expectation is not that the objective will be achieve after the first cycle, but that continuous improvement will be achieved. Healthcare is a dynamic field where change is the only constant and therefore, we must aim to be improving continuously an not stop the cycle once a goal is achieved.

References

Nash, D. B., Joshi, M. S., Ransom, E. R., & Ransom, S. B. (Eds.). (2019). The healthcare quality book: Vision, strategy, and tools (4th ed.). Health Administration Press

Shaw, S. C., Devgan, A., Anila, S., Anushree, N., & Debnath, H. (2018). Use of Plan-Do-Study-Act cycles to decrease incidence of neonatal hypothermia in the labor room. Medical Journal Armed Forces India, 74(2), 126–132. https://doi-org.ezp.waldenulibrary.org/10.1016/j.mjafi.2017.05.005

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Sample Answer 4 for NURS 8302 Discussion: Quality Improvement Models

This is insightful Brittany, there are different quality improvement strategies that can be employed to enhance effective patient outcomes. These approaches/strategies ought to adhere to the organizational objectives and the operational standards. The Plan-Do-Study-Act Cycle is considered one of the best quality improvement model used by different healthcare institutions (Nash et al., 2019). The model involves the application of the systematic processes for gaining valuable learning and knowledge for the continual improvement of the clinical processes, service delivery, and the products used in enhancing the treatment processes (Shaw et al., 2018). This model has been successfully used to facilitate processes undertaken by different healthcare providers. Under this phase of the quality improvement model, we seek to understand the problem and where a gap in practice exists as well as establish an objective laying out what we are trying to accomplish (McNicholas et al., 2019). Through the use of The Plan-Do-Study-Act Cycle, healthcare providers have been able to integrate all the elements required in the treatment processes and to determine the possible outcomes before undertaking the actual quality improvement program.

References

McNicholas, C., Lennox, L., Woodcock, T., Bell, D., & Reed, J. E. (2019). Evolving quality improvement support strategies to improve Plan–Do–Study–Act cycle fidelity: a retrospective mixed-methods study. BMJ quality & safety, 28(5), 356-365. http://dx.doi.org/10.1136/bmjqs-2017-007605

Nash, D. B., Joshi, M. S., Ransom, E. R., & Ransom, S. B. (Eds.). (2019). The healthcare quality book: Vision, strategy, and tools (4th ed.). Health Administration Press

Shaw, S. C., Devgan, A., Anila, S., Anushree, N., & Debnath, H. (2018). Use of Plan-Do-Study-Act cycles to decrease incidence of neonatal hypothermia in the labor room. Medical Journal Armed Forces India, 74(2), 126–132. https://doi-org.ezp.waldenulibrary.org/10.1016/j.mjafi.2017.05.005

Sample Answer 5 for NURS 8302 Discussion: Quality Improvement Models

Thanks for participating in this week’s discussion. Your discussion is remarkable and i enjoy reading it. Quality improvement models, as you have shown, are useful for monitoring and evaluating the efficacy and success of QI initiatives. A3, Lean of the PDSA (plan-do-study-act), and root cause analysis (RCA) are a few examples of quality improvement models. It’s great that you choose a quality improvement model. The efficacy of a quality improvement project can be assessed with the use of the brief, accurate, and useful A3 instrument. By using the A3 quality improvement approach, healthcare organizations may solve problems more effectively and quickly, plan more easily, build stronger teams, and experience better growth (Harolds, 2023).

The backdrop, present state, goal, root cause, countermeasures, effect confirmation, and follow-up actions are just a few of the sections that make up the A3 tool. Adding background information gives a synopsis of the problem’s past. According to Harolds (2023), the goals of the quality improvement program outline the desired outcome, whereas the existing condition/state defines the detected problem. Countermeasures/recommendations outline a strategy for mitigating the identified problem, whereas root cause analysis studies the factors contributing to the problem. According to Harolds (2023) effect confirmation allows for a review of the quality improvement project’s effectiveness, while follow-up actions ensure that the evaluation phase is sustained.You’ve determined one method for applying the A3 tool in your medical environment. Another area where the plan might be strengthened is in the area of lowering hospital falls. The current situation should highlight any potential fall hazards, while the backstory should explain how the issue often manifests itself. While reducing the risk of falls should be the main objective, the analysis and root cause should also highlight the dangers of falls that are present in a healthcare environment. According to Montero-Odasso et al. (2022) the recommendations should focus on reducing fall risks by, for example, providing walking support and taking other appropriate action. While follow-up efforts should aim to implement the various mitigation measures as suggested by the quality improvement project, effect confirmation should assess whether the mitigation measures were successful in reducing falls.

 

References

Harolds, J. A. (2023). Quality and safety in healthcare, part XC: the A3 approach and Lean in healthcare.Clinical nuclear medicine,48(7), e358-e360.

Montero-Odasso, M., van der Velde, N., Martin, F. C., Petrovic, M., Tan, M. P., Ryg, J., … & Masud, T. (2022). World guidelines for falls prevention and management for older adults: a global initiative.Age and Aging,51(9), afac205.

Sample Answer 6 for NURS 8302 Discussion: Quality Improvement Models

Quality improvement implementation requires a planned and focused effort for the process to be a success. One of the approaches that can be used is quality improvement models. There are several models which can be used to guide quality improvement. As such, the kind of quality improvement model to be applied depends on the nature of the project. Some of the models include Root Cause Analysis, A3, Lean, and PDSA (Coughling et al.,2019). The chosen quality improvement model is Root Cause Analysis.  It is a systematic model which is used to identify the underlying causes of adverse events or problems. It involves several steps which, when followed, would support the full implementation. The steps involve problem definition, assembling of a team, data collection, identification of the immediate cause, prioritization of the root causes, developing action plans, implementation of solution, monitoring and feedback, and reporting (Boswell & Cannon, 2022).

Adverse events, such as medication error, which causes patient harm, can happen in healthcare settings. Root Cause Analysis as a quality improvement model can be implemented in response to this problem. The identification of the problem as a medication error triggers the need to initiate the quality improvement process to improve patient safety. A multidisciplinary team including physicians, pharmacists, and nurses is then assembled, followed by data collection in connection to the error committed (Rodziewicz & Hipskind, 2020). It is then important to explore the immediate causes of the problem and prioritize the root cause. For example, a cause such as an error in calculating the dosage can be prioritized. Such a step then leads to the development of action plans to address the problem, such as standardization of the dosage calculation tools as an intervention before implementing the initiative. The last steps will entail continuous monitoring and obtaining feedback from staff before documenting and reporting the whole process.

References

Boswell, C., & Cannon, S. (2022). Introduction to nursing research: Incorporating evidence-based practice. Jones & Bartlett Learning.

Coughlin, K., & Posencheg, M. A. (2019). Quality improvement methods–Part II. Journal of Perinatology, 39(7), 1000-1007. https://doi.org/10.1038/s41372-019-0382-1Links to an external site.

Rodziewicz, T. L., & Hipskind, J. E. (2020). Medical error prevention. StatPearls. Treasure Island (FL): StatPearls Pu

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In addition to the Root Cause Analysis (RCA) model, my colleague can enhance the implementation of the quality improvement process by incorporating a robust educational component. This involves developing targeted training programs and workshops for healthcare professionals involved in the identified adverse events, such as medication errors. The educational component aims to address knowledge gaps, enhance skills, and foster a culture of continuous learning and improvement within the healthcare organization.

To implement this strategy, my colleague can collaborate with educational specialists, clinical educators, and subject matter experts to design tailored training modules. These modules can cover topics such as medication safety protocols, dosage calculations, and best practices in administering medications (Rodziewicz & Hipskind, 2020). The training sessions should be interactive, incorporating case studies and real-life scenarios to engage healthcare professionals actively.

Furthermore, the educational component can extend beyond traditional classroom settings to include online modules and resources, ensuring accessibility for all staff members. Regular updates and refresher courses should be integrated to reinforce learning and keep healthcare professionals informed about the latest evidence-based practices and safety measures.

By incorporating education into the Root Cause Analysis model, this identifies the immediate causes of adverse events and  proactively works towards preventing future occurrences (Jones & Despotou, 2016). This strategy fosters a culture of continuous improvement and empowers healthcare professionals with the knowledge and skills needed to provide safer and higher-quality patient care. Additionally, the monitoring and feedback steps of the RCA model can be utilized to assess the effectiveness of the educational initiatives and make necessary adjustments for ongoing improvement.