Assessment 1 Instructions: Enhancing Quality and Safety

For this assessment, you will develop a 3-5 page paper that examines a safety quality issue pertaining to medication administration in a health care setting. You will analyze the issue and examine potential evidence-based and best-practice solutions from the literature as well as the role of nurses and other stakeholders in addressing the issue.

Health care organizations and professionals strive to create safe environments for patients however, due to the complexity of the health care system, maintaining safety can be a challenge. Since nurses comprise the largest group of health care professionals, a great deal of responsibility falls in the hands of practicing nurses. Quality improvement (QI) measures and safety improvement plans are effective interventions to reduce medical errors and sentinel events such as medication errors, falls, infections, and deaths. A 2000 Institute of Medicine (IOM) report indicated that almost one million people are harmed annually in the United States, (Kohn et al., 2000) and 210,000–440,000 die as a result of medical errors (Allen, 2013).

The role of the baccalaureate nurse includes identifying and explaining specific patient risk factors, incorporating evidence-based solutions to improving patient safety and coordinating care. A solid foundation of knowledge and understanding of safety organizations such as Quality and Safety Education for Nurses (QSEN), the Institute of Medicine (IOM), and The Joint Commission and its National Patient Safety Goals (NPSGs) program is vital to practicing nurses with regard to providing and promoting safe and effective patient care.

You are encouraged to complete the Identifying Safety Risks and Solutions activity. This activity offers an opportunity to review a case study and practice identifying safety risks and possible solutions. We have found that learners who complete course activities and review resources are more successful with first submissions. Completing course activities is also a way to demonstrate course engagement.

Demonstration of Proficiency

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

• Competency 1: Analyze the elements of a successful quality improvement initiative.

• • Explain evidence-based and best-practice solutions to improve patient safety focusing on medication administration and reducing costs.
• Competency 2: Analyze factors that lead to patient safety risks.

• • Explain factors leading to a specific patient-safety risk focusing on medication administration.
• Competency 4: Explain the nurse’s role in coordinating care to enhance quality and reduce costs.

• • Explain how nurses can help coordinate care to increase patient safety with medication administration and reduce costs.
  • Identify stakeholders with whom nurses would need to coordinate to drive quality and safety enhancements with medication administration.
• Competency 5: Apply professional, scholarly, evidence-based strategies to communicate in a manner that supports safe and effective patient care.

• Communicate using writing that is clear, logical, and professional with correct grammar and spelling using current APA style.

References

Allen, M. (2013). How many die from medical mistakes in U.S. hospitals? Retrieved from https://www.npr.org/sections/health-shots/2013/09/20/224507654/how-many-die-from-medical-mistakes-in-u-s-hospitals.

Kohn, L. T., Corrigan, J., & Donaldson, M. S. (Eds.). (2000). To err is human: Building a safer health system. Washington, DC: National Academy Press.

Professional Context

As a baccalaureate-prepared nurse, you will be responsible for implementing quality improvement (QI) and patient safety measures in health care settings. Effective quality improvement measures result in systemic and organizational changes, ultimately leading to the development of a patient safety culture.

Scenario

Consider the hospital-acquired conditions that are not reimbursed under Medicare/Medicaid, some of which are specific safety issues such as infections, falls, medication errors, and other concerns that could have been prevented or alleviated with the use of evidence-based guidelines.

Choose a specific condition of interest surrounding a medication administration safety risk and incorporate evidence-based strategies to support communication and ensure safe and effective care.

For this assessment:

• Analyze a current issue or experience in clinical practice surrounding a medication administration safety risk and identify a quality improvement (QI) initiative in the health care setting.

Instructions

The purpose of this assessment is to better understand the role of the baccalaureate-prepared nurse in enhancing quality improvement (QI) measures that address a medication administration safety risk. This will be within the specific context of patient safety risks at a health care setting of your choice. You will do this by exploring the professional guidelines and best practices for improving and maintaining patient safety in health care settings from organizations such as QSEN and the IOM. Looking through the lens of these professional best practices to examine the current policies and procedures currently in place at your chosen organization and the impact on safety measures for patients surrounding medication administration, you will consider the role of the nurse in driving quality and safety improvements. You will identify stakeholders in QI improvement and safety measures as well as consider evidence-based strategies to enhance quality of care and promote medication administration safety in the context of your chosen health care setting.

Be sure that your plan addresses the following, which corresponds to the grading criteria in the scoring guide. Please study the scoring guide carefully so that you know what is needed for a distinguished score.

• Explain factors leading to a specific patient-safety risk focusing on medication administration.
• Explain evidence-based and best-practice solutions to improve patient safety focusing on medication administration and reducing costs.
• Explain how nurses can help coordinate care to increase patient safety with medication administration and reduce costs.
• Identify stakeholders with whom nurses would coordinate to drive safety enhancements with medication administration.
• Communicate using writing that is clear, logical, and professional, with correct grammar and spelling, using current APA style.

Additional Requirements

• Length of submission: 3-5 pages, plus title and reference pages.
• Number of references: Cite a minimum of 4 sources of scholarly or professional evidence that support your findings and considerations. Resources should be no more than 5 years old.
• APA formatting: References and citations are formatted according to current APA style.

Portfolio Prompt: Remember to save the final assessment to your ePortfolio so that you may refer to it as you complete the final Capstone course.

SCORING GUIDE

Use the scoring guide to understand how your assessment will be evaluated.

Resources: Collaboration and Leadership

Collaboration and Leadership

Falls, E., & Hensel, D. (2012). Characteristics that perinatal nurse managers desire in new nurse hires. The Journal of Continuing Education in Nursing, 43(4), 182–187.

This article may be helpful with identifying ways to coordinate and lead quality and safety measures related to the assessment.

McInnes, S., Peters, K., Bonney, A., & Halcomb, E. (2015). An integrative review of facilitators and barriers influencing collaboration and teamwork between general practitioners and nurses working in general practice. Journal of Advanced Nursing, 71(9), 1973–1985.

This literature review may be a useful source for evidence and best practices to integrate into your assessment.

Strech, S., & Wyatt, D. A. (2013). Partnering to lead change: Nurses’ role in the redesign of health care. AORN Journal: The Official Voice of Perioperative Nursing, 98(3), 260–266.

This article examines competencies that may help nurses collaborate more effectively to improve patient outcomes.

Resources: Quality Improvement Initiatives

Quality Improvement Initiatives

Allison, J. (2016). ;Ideas and approaches for quality-assessment and performance-improvement projects in ambulatory surgery centers. ;AORN Journal, 103(5), 483–488.

This article focuses on approaches and indicators customary to the services and operations of an ambulatory surgery center, going beyond reviewing data from routine outcome measures and explaining the effect these ideas can have on improving quality of care.

Coles, E., Wells, M., Maxwell, M., Harris, F. M., Anderson, J., Gray, N. M., . . . MacGillivray, S. (2017).; The influence of contextual factors on healthcare quality improvement initiatives: What works, for whom and in what setting? Protocol for a realist review. ;Systematic Reviews, ;6, 168–178. Retrieved from https://systematicreviewsjournal.biomedcentral.com…

This article examines ways in which the context of a quality improvement initiative plays a role in its success or failure and should help you consider the context of your proposed quality improvement initiative.

Institute for Healthcare Improvement. (n.d.). ;Reliability series part 1: What is reliability? ;[Video]. ;Retrieved from http://www.ihi.org/education/IHIOpenSchool/resourc…

This video discusses the relationship between reliability and quality in health care.

Lawton, R., Carruthers, S., Gardner, P., Wright, J., & McEachan, R. R. C. (2012). ;Identifying the latent failures underpinning medication administration errors: An exploratory study. ;Health Services Research, 47(4), 1437–1459.

This examination of underlying systemic causes of medication errors may be useful as you consider QI best practices and ways to coordinate care to increase safety and quality.

Quality and Safety Education

Dolansky, M. A., & Moore, S. M. (2013). Quality and safety education for nurses (QSEN): The key is systems thinking. Online Journal of Issues in Nursing, 18(3), 71–80.

The need for implementing systemic quality improvement practices to improve patient safety and quality is discussed in this article.

Lyle-Edrosolo, G., & Waxman, K. (2016). Aligning healthcare safety and quality competencies: Quality and safety education for nurses (QSEN), the Joint Commission, and American Nurses Credentialing Center (ANCC) Magnet® standards crosswalk. Nurse Leader, 14(1), 70–75.

This article attempts to align the language used in three quality and safety standards and reduce confusion for health care professionals.

Masters, K. (2016). Integrating quality and safety education into clinical nursing education through a dedicated education unit. Nurse Education in Practice, 17, 153–160. doi:10.1016/j.nepr.2015.12.002

Masters discusses how nursing students’ participation in a dedicated safety and quality educational unit resulted in higher project evaluations than those of students who participated in traditional clinical rotations.

Rosenblum, R. K., & Sprague-McRae, J. (2014). Using principles of quality and safety education for nurses in school nurse continuing education. The Journal of School Nursing, 30(2), 97–102.

This article, which examines evidence-based and best-practice strategies for improving the care offered by school nurses, may help you identify useful strategies for your assessment.

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