NURS 8302 Week 8 Discussion: Quality Improvement Models
Walden University NURS 8302 Week 8 Discussion: Quality Improvement Models-Step-By-Step Guide
This guide will demonstrate how to complete the Walden University NURS 8302 Week 8 Discussion: Quality Improvement Models 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 Week 8 Discussion: Quality Improvement Models
Whether one passes or fails an academic assignment such as the Walden University NURS 8302 Week 8 Discussion: Quality Improvement Models 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 Week 8 Discussion: Quality Improvement Models
The introduction for the Walden University NURS 8302 Week 8 Discussion: Quality Improvement Models 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 Week 8 Discussion: Quality Improvement Models
After the introduction, move into the main part of the NURS 8302 Week 8 Discussion: Quality Improvement Models 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 Week 8 Discussion: Quality Improvement Models
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 Week 8 Discussion: Quality Improvement Models
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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Sample Answer for NURS 8302 Week 8 Discussion: Quality Improvement Models
Breakdown of QI Models
In order to determine which QI model should be used for an adverse event. I had to review the following QI models several times to really determine which model would serve the team best for an adverse event.
Root cause analysis (RCA) is a structured method used to analyze serious adverse events. It is a model that identifies and analyze those factors that contributes to a specific outcome or problem (Knox, et al., 2015). It is an essential tool for quality improvement. The following QI tools can be used within a healthcare setting or practice to identify the different factors that are at play with a given performance issues: 5 Whys, fishbone diagrams, and fall-out ((Knox, et al., 2015).
The Plan-Do-Study-Act (PDSA) Worksheet is a useful tool for documenting a test of change (IHI, 2021). The PDSA cycle is shorthand for testing a change by developing a plan to test the change (Plan), carrying out the test (Do), observing and learning from the consequences (Study), and determining what modifications should be made to the test (Act) (IHI, 2021). PDSA & Plan-Do-Check-Study (PDCA) are used interchangeably. However, “checking” in PDCA involves comparing the results to the expected results, followed by thee question, “How do the results compare to what was expected?” As far as “study” in PDSA, it is the deeper introspection of results, followed by the question, “What can we learn based on the results?” PDSA involves an in-depth analysis of results, rather than just comparing with the expected results.
The Lean concept, according to Nash et al., (2017), is a way to specify the meaning of value, to align steps, processes in the best sequence, to conduct activities without interruption whenever someone requests them, and to perform the activities more effectively (Nash, et al., 2017). Lean is a process that helps to avoid the following types of waste: overproduction, waiting, unnecessary transport, overprocessing, excess inventory, unnecessary movement, and defects (Nash, et al., 2017).
A3 is a structured problem solving and continuous improvement approach, first employed at Toyota and typically used by lean manufacturing practitioners (Sobek, n.d.). A3 provides a simple and strict approach systematically leading towards problem solving over structured approaches. There are ten steps to the A3 process, according to UNC School of Medicine (2021):
- Step 0: Identify a problem or need
- Step 1: Conduct research to understand the current situation
- Step 2: Conduct root cause analysis
- Step 3: Devise countermeasures to address root causes
- Step 4: Develop a target state
- Step 5: Create an implementation plan
- Step 6: Develop a follow-up plan with predicted outcomes
- Step 7: Discuss plans with all affected parties
- Step 8: Obtain approval for implementation
- Step 9: Implement plans
- Step 10: Evaluate the results
In summary, the A3 process is rooted in the basic PDCA cycle. However, I found this model somewhat challenging. Steps 1-8 are the Plan step (with step 5 planning the Do step and step 6 planning the Check step). Step 9 is the Do step, and step 10 is the Check step. Based on the evaluation, another problem may be identified and the A3 process starts again (Act) (UNC School of Medicine, 2021).
Quality Improvement Model Selected
The quality improvement model that might be implemented in my HCO or nursing practice in response to an adverse event requiring quality improvement would be “Root Cause Analysis. For example, if a patient was given the wrong blood transfusion and suffered a severe blood reaction, a root cause analysis supported by QI tools, 5 Whys and the cause and effect or fishbone diagrams would be the best model/QI tool combination that should be implemented by the QI team to visually diagram the possible cause of this medication error. The team will be able to truly diagnose the problem rather than focusing on symptoms or the patient’s reaction to her blood transfusion.
References
Agency for Healthcare Research and Quality (AHRQ). (2020). Health literacy universal precautions toolkit, 2nd Edition. Plan-Do-Study-Act (PDSA) Directions and Examples. Retrieved from https://www.ahrq.gov/health-literacy/improve/precautions/tool2b.html
Institute of Healthcare Improvement (IHI). (2021). Plan-Do-Study-Act (PDSA) worksheet. Institute for Healthcare Improvement, Cambridge, Massachusetts, USA
Knox, L., Levine, J., Sommers, B., Michaels, L., & Fries, E. (2015). Module 11: Using root cause analysis to help practices understand and improve their performance and outcomes. Agency for Healthcare Research and Quality.
Nash, D. B., Joshi, M. S., Ransom, E. R., & Ransom, S. B. (2019). The healthcare quality book: Vision, strategy, and tools (4th ed.). Health Administration Press.
Sobek, D. K. (n.d.). Steps of the A3 process. Montana State University. Retrieved from https://www.montana.edu/dsobek/a3/steps.html
UNC School of Medicine. (2021). A3. Institute for Healthcare Quality Improvement. Retrieved from https://www.med.unc.edu/ihqi/resources/a3/
What is the most effective method for implementing quality improvement? When creating a plan, what specific strategies and/or models should be used? You have spent the last seven weeks researching quality improvement in healthcare and nursing practice, and you will continue your research by examining specific quality improvement models. What models would be most effective in your nursing practice or healthcare organization?
Because healthcare is complex and diverse, quality improvement cannot be a one-size-fits-all approach. There are numerous strategies and methods for implementing quality improvement to meet an organization’s complex and diverse needs.
Choose one quality improvement model to investigate and analyze for this Discussion. Consider how the chosen model might be implemented in your healthcare organization or nursing practice. Examine the effectiveness of this model and consider how it might be used to address the consequences of adverse events in nursing practice.
To Prepare:
- Review the Learning Resources for this week, and reflect on the different quality improvement models presented.
- Select one quality improvement model from the following to focus on for this Discussion:
- Root Cause Analysis (RCA)
- A3
- Lean
- Plan, Do, Study, Act (PDSA)
- Reflect on the quality improvement model you selected, and consider how it might be implemented in your healthcare organization or nursing practice.
By Day 3 of Week 8
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.
By Day 6 of Week 8
Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days who selected a different quality improvement model than you. Suggest an additional strategy on how your colleague may implement the quality improvement model they selected in their healthcare organization or nursing practice.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your
colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!
Submission and Grading Information
Grading Criteria
To access your rubric:
Week 8 Discussion Rubric
Post by Day 3 of Week 8 and Respond by Day 6 of Week 8
To Participate in this Discussion:
Week 8 Discussion
Read Also: NURS 8302 Week 6 Assignment 1: Organizational Culture Assessment Tool
Sample Answer 2 for NURS 8302 Week 8 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
Sample Answer 3 for NURS 8302 Week 8 Discussion: Quality Improvement Models
Your overview of the implementation of a Root Cause Analysis (RCA) as a quality improvement model is insightful. The systematic approach it provides for identifying the underlying causes of adverse events or problems is crucial in enhancing patient safety within healthcare settings.
The stepwise process you outlined—from problem definition to assembling a multidisciplinary team, data collection, identification of immediate causes, prioritization of root causes, action plan development, implementation, monitoring, feedback, and reporting—captures the comprehensive nature of the RCA model.
Using a real-life example of addressing a medication error demonstrates the practical application of RCA in response to specific problems that can lead to patient harm. The involvement of a multidisciplinary team, including physicians, pharmacists, and nurses, reflects the collaborative nature necessary for effective quality improvement.
Prioritizing root causes, such as errors in dosage calculation, and implementing interventions like standardizing dosage calculation tools, showcases the targeted and strategic approach of RCA in addressing identified issues.
Continuous monitoring, feedback collection, and the documentation/reporting steps highlight the importance of ongoing evaluation and learning from the implemented interventions.
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 Publishing. https://www.ncbi.nlm.nih.gov/books/NBK499956/
Sample Answer 4 for NURS 8302 Week 8 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 Publishing. https://www.ncbi.nlm.nih.gov/books/NBK499956/
Rubric Detail
Select Grid View or List View to change the rubric’s layout.
Content
Name: NURS_8302_Week8_Discussion_Rubric
| Excellent
90–100 |
Good
80–89 |
Fair
70–79 |
Poor
: 0–69 |
||
| Main Posting:
Response to the Discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources. |
Points Range: 40 (40%) – 44 (44%)
Thoroughly responds to the Discussion question(s). Is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources. No less than 75% of post has exceptional depth and breadth. Supported by at least three current credible sources. |
Points Range: 35 (35%) – 39 (39%)
Responds to most of the Discussion question(s). Is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module. 50% of the post has exceptional depth and breadth. Supported by at least three credible references. |
Points Range: 31 (31%) – 34 (34%)
Responds to some of the Discussion question(s). One to two criteria are not addressed or are superficially addressed. Is somewhat lacking reflection and critical analysis and synthesis. Somewhat represents knowledge gained from the course readings for the module. Cited with fewer than two credible references. |
Points Range: 0 (0%) – 30 (30%)
Does not respond to the Discussion question(s). Lacks depth or superficially addresses criteria. Lacks reflection and critical analysis and synthesis. Does not represent knowledge gained from the course readings for the module. Contains only one or no credible references. |
|
| Main Posting:
Writing |
Points Range: 6 (6%) – 6 (6%)
Written clearly and concisely. Contains no grammatical or spelling errors. Adheres to current APA manual writing rules and style. |
Points Range: 5 (5%) – 5 (5%)
Written concisely. May contain one to two grammatical or spelling errors. Adheres to current APA manual writing rules and style. |
Points Range: 4 (4%) – 4 (4%)
Written somewhat concisely. May contain more than two spelling or grammatical errors. Contains some APA formatting errors. |
Points Range: 0 (0%) – 3 (3%)
Not written clearly or concisely. Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style. |
|
| Main Posting:
Timely and full participation |
Points Range: 9 (9%) – 10 (10%)
Meets requirements for timely, full, and active participation. Posts main Discussion by due date. |
Points Range: 8 (8%) – 8 (8%)
Meets requirements for full participation. Posts main Discussion by due date. |
Points Range: 7 (7%) – 7 (7%)
Posts main Discussion by due date. |
Points Range: 0 (0%) – 6 (6%)
Does not meet requirements for full participation. Does not post main Discussion by due date. |
|
| First Response:
Post to colleague’s main post that is reflective and justified with credible sources. |
Points Range: 9 (9%) – 9 (9%)
Response exhibits critical thinking and application to practice settings. Responds to questions posed by faculty. The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives. |
Points Range: 8 (8%) – 8 (8%)
Response has some depth and may exhibit critical thinking or application to practice setting. |
Points Range: 7 (7%) – 7 (7%)
Response is on topic and may have some depth. |
Points Range: 0 (0%) – 6 (6%)
Response may not be on topic and lacks depth. |
|
| First Response: Writing |
Points Range: 6 (6%) – 6 (6%)
Communication is professional and respectful to colleagues. Response to faculty questions are fully answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English. |
Points Range: 5 (5%) – 5 (5%)
Communication is mostly professional and respectful to colleagues. Response to faculty questions are mostly answered, if posed. Provides opinions and ideas that are supported by few credible sources. Response is written in standard, edited English. |
Points Range: 4 (4%) – 4 (4%)
Response posed in the Discussion may lack effective professional communication. Response to faculty questions are somewhat answered, if posed. Few or no credible sources are cited. |
Points Range: 0 (0%) – 3 (3%)
Responses posted in the Discussion lack effective communication. Response to faculty questions are missing. No credible sources are cited. |
|
| First Response: Timely and full participation |
Points Range: 5 (5%) – 5 (5%)
Meets requirements for timely, full, and active participation. Posts by due date. |
Points Range: 4 (4%) – 4 (4%)
Meets requirements for full participation. Posts by due date. |
Points Range: 3 (3%) – 3 (3%)
Posts by due date. |
Points Range: 0 (0%) – 2 (2%)
Does not meet requirements for full participation. Does not post by due date. |
|
| Second Response: Post to colleague’s main post that is reflective and justified with credible sources. |
Points Range: 9 (9%) – 9 (9%)
Response exhibits critical thinking and application to practice settings. Responds to questions posed by faculty. The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives. |
Points Range: 8 (8%) – 8 (8%)
Response has some depth and may exhibit critical thinking or application to practice setting. |
Points Range: 7 (7%) – 7 (7%)
Response is on topic and may have some depth. |
Points Range: 0 (0%) – 6 (6%)
Response may not be on topic and lacks depth. |
|
| Second Response: Writing |
Points Range: 6 (6%) – 6 (6%)
Communication is professional and respectful to colleagues. Response to faculty questions are fully answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English. |
Points Range: 5 (5%) – 5 (5%)
Communication is mostly professional and respectful to colleagues. Response to faculty questions are mostly answered, if posed. Provides opinions and ideas that are supported by few credible sources. Response is written in standard, edited English. |
Points Range: 4 (4%) – 4 (4%)
Response posed in the Discussion may lack effective professional communication. Response to faculty questions are somewhat answered, if posed. Few or no credible sources are cited. |
Points Range: 0 (0%) – 3 (3%)
Responses posted in the Discussion lack effective communication. Response to faculty questions are missing. No credible sources are cited. |
|
| Second Response: Timely and full participation |
Points Range: 5 (5%) – 5 (5%)
Meets requirements for timely, full, and active participation. Posts by due date. |
Points Range: 4 (4%) – 4 (4%)
Meets requirements for full participation. Posts by due date. |
Points Range: 3 (3%) – 3 (3%)
Posts by due date. |
Points Range: 0 (0%) – 2 (2%)
Does not meet requirements for full participation. Does not post by due date. |
|
| Total Points: 100 | |||||
Name: NURS_8302_Week8_Discussion_Rubric