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Title of Paper
Your name
HCA375 Continuous Quality Monitoring and Accreditation
Type Instructor Name Here
Type Date
HCA375 - WEEK 4 ASSIGNMENT
PART 1 DETAIL OF THE ADVERSE EVENT CHOSEN
Refer to the instructions in the Week 4 Assignment of your online course to understand what is expected in each row. This completed template should be between eight to ten pages in length. Include APA citations within the description row where appropriate. List your references in APA format according to the HYPERLINK https//awc.ashford.edu/Index.html Ashford Writing Center guidelines on the last page of this template.
DESCRIPTIONADVERSE EVENT The inappropriate prescribing of medication by the nurse to the patient of extreme depression. The overdose of psychiatric drug resulted on seizure. The event reflects the overdose of norepinephrine-serotonin reuptake inhibitors (SNRIs). The scenario reflects that the nurse failed to adopt adequate healthcare standards or to maintain quality that could assure patients welfare. HISTORICAL BACKGROUNDIn total 9 adverse event of medication error occurred during the last week with 20 interruptions. The mean time of interruption is recorded. The failure in medication events is recorded. Statistical software is used for analysis of data. The background provide practical implications of a delay in medicine administration due to interruption. In the nine medical events, 20 interruptions were recorded. The central cause of interruptions was a delay in medications preparation by nurses. The average delay in time is recorded as 2.5 minutes. It also reveal that 3.6 of the interruptions were due to clinical errors. The disruptions result in the delayed medical administration that undermines the patients right to quality service.LEGAL ACCREDITING AGENCY REQUIREMENTSInstitute of Medicine (IOM) stresses selecting the best practices that minimize the chances of errors in hospitals. The Medical Errors Reduction Act (2000) is applicable that identifies policies providing directives for appropriate medication handling. These healthcare policies restrict hospitals for avoiding the excessive and wrong use of medications. They provide the legal and regulatory framework for the hospitals. In the article, the authors explain medical errors indicates the failure of hospitals to adhere to the healthcare policies. Interruptions are due to the procedural errors caused by the negligence of the staff.
The principles of safe medication highlighted by Medication Error Prevention Act 2000 focuses on procurement, storage, supply, dispensing and prescribing guidelines. The hospitals are required to follow these principles. It stresses maintaining records of scheduled and non-scheduled medications. It explain that the purpose of medical administration is to promote quality and safety. The article explains that the event of errors undermines patients safety that is against the principles of Poisons and overdose.
Patient Safety and Error Reduction Act stresses on the need for advocating adequate medication systems and procedures. CQI TEAM COMMUNICATIONAn important step in the process of recognizing errors is to establish link between the leader/ manager and the nurses. The nurse leader will explain the principles of Patient Safety and Error Reduction Act states that every individual has the right to safe and high-quality care. The issues highlighted by the team related to the medicine
administration errors have relevance with the policies on quality healthcare of America.
The CQI team is responsible for the ongoing improvements of the healthcare services and the elimination of errors from the hospital settings. Necessary communication is established among team members so they could coordinate the issues on immediate basis. The team identify gaps and issues in the healthcare services and suggest solution for the problem.
This requires good interpersonal skills of the team leader for giving instructions and taking notice of the situation. Effective communication is crucial for maintaining continuous interaction with the team and staff. OPERATIONAL OR SAFETY PROCESSES The Patient Safety and Error Reduction Act is adopted that raise concerns about the promotion of safe health by uncovering the failures of hospitals to adopt procedural principles for efficient management of medications. The outcomes of the study reveal that the delay in nurses response causes interruptions that undermines the accuracy in medicinal administration.IMPACT OF THIS EVENT Patients right is violated in the hospital as the patient fails to receive quality service due to an interruption in medicinal administration. The event provides practical observations on the negligence of the patients right to safe treatment. The event had negative impact on the health of the patient as he experienced seizures due to overdose. This also increased the duration of his stay at the hospital. The nurse failed to offer required quality of care and left the patient unsatisfied.
WEEK 4 ASSIGNMENT
PART 2 - GRAPH THE DATA
You are tasked with graphing the data in Excel for your chosen event. The data is located in the classroom under the Week 4 Assignment Directions. Make sure to use only the data for your chosen event. The directions identify which columns of information to use depending on the chosen adverse event. Once you complete the graph in Excel, copy/paste your graph below.
Include an analysis of the data in paragraph format.
Discuss the frequency of the adverse event as compared to the increase or decrease of patient discharges. EMBED Excel.Chart.8 s What is the data telling youThe data depicts that 50 of the medication errors were due to negligence from the nurse. It also states that 10 of the errors were due to lack of coordination among nurse leader and the junior nurse and 20 errors were due to slow response. The remaining 20 errors were due to lack of nurse experience. The data reveals implications of medical errors caused by interruptions in hospital. The data followed a well-established goal for identifying the role of nurses in interruptions. It suggests that interruptions are the significant cause of medical errors. The preventing of the medical administration errors is an essential criterion for hospitals defined by the healthcare policies of Medication Error Prevention Act 2000. What possible factors in your opinion could be attributed to the changeThe possible factors that could have caused errors in medication include failure of the nurse to follow the guidelines presented on Patient Safety, incompetency of nurses, lack of experience, delayed response and inadequate coordination between leader and nurse (Siriwardena, 2009).
A Nursing care plan needs a revision because the patients health is extremely important and any error in judgment can produce detrimental effects. Revision for birth identifies all complexities that the patient has at that time. The rationale for revision at 1-2 months is to identify the changes in the physical and medical conditions of the patient. Similar criteria are used for 2-3 months and 2-3 years (Aronson, 2009).
The most appropriate action is to call the physician for the dose because administration of morphine involves serious legal concerns. The consultation of the physician will provide a better idea of choosing an appropriate course of action.
WEEK 4 ASSIGNMENT
PART 3 CQI TOOL
Choose one of the CQI Tools listed below to illustrate the use of the tool with your chosen Adverse Event.
Fish bone diagram
Limited infrastructure Training
Space in the hospital Skills buildings
Communication techniques Practicing
The CQI tool selected for the adverse event because it calrly identify the causes of medication errors. The fish bone diagrem is used for detemining the challenges faced by the nurse in proper administration of medicines. This is an effective tool used for adressing the causes of change outcome. By aadopting adequate stratgies and interventions it is possible to overcome the challenges for attaining high quality in the provision of healthcare services. In the current scenario the fish bone diagram is used for presenting solutions for building a professionaly competent nurrse who is capable of prescribing and administrating medications in appropriate manner. This suggests overcoming challenges such as lack of infrastructure, inadequate training and awareness. By provision of adequate training aand knowledge the nurse would be able to take responbsibility of providing right dosage.
Skills building and evaluation are part of plan that will familiarize nurses with the aaccurate procedures of medications. The evaluation involves determination of the skills and level of care delivery under the instructions of the nurse leader. It include observations of how student nurse responds to the instructions of the supervisor. It further involves assessment of the junior nurses knowledge associated with the emotional needs of the patients. The evaluation is also dependent on the determination of nurse awareness related to the physiological needs of the patients. Their competency depends on their performance skills and care delivery. Their ability to prioritize the tasks also reveals their level of competency and knowledge. The assessment also involves observation on how nurse responds to the supervisor and his awareness on the non-complex cases. The second level involve the evaluation of the initiation and management skills of the nurse. It uncovers the ability to deliver care to the patients according to their needs. It depends on nurse knowledge about medicines and safe administration of the practice. His ability to perform skills and deliver care in complex situations is also part of it. it further involve observations on the ability to manage workloads and priorities. The training also focuses on the ability to lead, plan and deliver appropriate care to the patients. It involve assessment of personal skills and knowledge, without the dependence on supervisors instruction. nurse dedication towards patient, families and community is an effective tool for evaluating performance level. An appropriate tool to measure the competency is to determine the responsibility of the nurse.
WEEK 4 ASSIGNMENT
PART 4 - FUTURE PREVENTION
APPLYING PDSA - Worksheet
PHASEPHASE ACTIVITIESEXPLANATIONPLANProblem
Objective
Team members
Communication
Data collected
Pilot phaseThe adverse event caused seizures to the patient and delayed his process of recovery.
The objective is to adopt effective care plan that will eliminate the possibilities of medication errors.
The team members of the plan include nurse leader, nurses, staff and the administration.
The leader is responsible for establishing efficient communication procedures. The tools adopted for communication include projectors, sms, video conference and internet. Ability to work in a cooperative environment. Expressing motivation and concerns about the patient care. Expression of enthusiasm for work. Friendly behavior and positive attitude. Avoiding aggression or expression of displeasure with patients.
Data will be collected through COPE system that will record the errors each day. The number of medication errors performed by the nurses will be recorded automatically. Online medication administration records will be maintained. Entries are processed electronically that will save time and provide immediate access to the data.
Pilot testing is developed that will require setting of infrastructure for COPE. The applications will be modified and the systems will be used for storing data. The nurses will be provided guidance for referring the COPE in case of confusion. Every time they prescribe a medicine they will enter data.
Potential settings for pilot testing include a unit that directly admits the patients. One medicine unit will instruct nurse about drug doses. DOThree possible solutions
One solution to implement
Result of pilot (create own scenario
Methods of communicationAdoption of stewardship program involves a set of strategies employed for improving the administration of medications. Nurses have a crucial role in appropriately giving the medications to the patients that lead to their health enhancement and wellness. The stewardship programs have significant roles in transforming the practice of medications, making them more influential and error free. It suggests the initiation of the antibiotics for treating infections that are focused on reducing morbidity. I find that the purpose of the antibiotic stewardship in clinical settings is to avoid the risks of wrong and inappropriate administration of the medication. The hospitals are not paying much attention to improve the antibiotic use that will lead to further complications (Olans, Olans, DeMaria, 2016). Antibiotic stewardship is an effective approach for making the best use of the antibiotics. Providing awareness to nurses who directly interact with the patient, so they need to possess good understanding and awareness on the right directions of prescribing medications. There is a need for bridging the gap between nurses perceptions of the program and the actual use of medicines. The hospitals are unable to carry the successful implementation of the awareness program until they involve the nurses. The clinics and hospitals have unrecognized the role of nurse that exists in the guidelines.
The incorporation of the Computerized Provider Order Entry (CPOE) system for medical analysis on daily activities increases the possibilities of maximizing patients wellbeing. Although nurses are integral to the practice, there is a need for recognizing their roles. Their roles are crucial in the optimization of the medications use in in-patient and out-patient settings.
Standardizing height and wright measurements will also eliminate likelihood of medication errors. They are the healthcare providers who spent the most time with the patients, giving them the opportunity to observe the patients and assess their needs. There are many activities that the nurses are capable of performing on a daily basis such as prescribing the right dose and the time of taking medicine. The nursing knowledge on hygiene will help them in guiding the patients about washing hands, using equipments properly and avoiding contact with unhygienic tools. They tell them the need for taking more fluids and what can be done for avoiding the side effects. The common roles of nurses associated in the administration of the medications include the adoption of the right techniques.
Stewardship program.
Identification of the training requirements. Feedbacks suggested revising the process because nurses wanted to understand in simple language.
The tools adopted for communication include projectors, sms, video conference and internet.STUDYSummarize data
Observations and problems
Comparison of pilot plan to pilot results
Revisions needed to meet objectiveThe nurses need to adopt adequate models for administrating the right use of medications. Collaboration with colleagues and the staff assist them in creating mechanisms for evaluating assessing the patients need.
Consulting senior nurse or physician for prescribing right dose is another strategy for controlling errors. Nurses have significant roles in encouraging the transition from the intravenous drugs to oral antibiotics. Nurses identify the conditions of the patients and decide the right dosage.
The non-pilot results reflected that all methods are effective for the removal of medication errors and the enhancement of healthcare. Pilot results suggested revising the process by considering feedbacks of young nurses who need more training. It suggest considering patients needs on planning care management, managing activities in time, putting all efforts to enhance the quality of health and application of clinical rules, procedures and adhering to the policies of the hospital. The question determined the professional skills by assessing ability to determine the patients problems, administrating of the acquired professional skills and capability of using the equipment and keeping them in good condition.
Assigning challenging roles to young nurses because it is not adequate to rely on nurse leader. Better methods of training were suggested that assure utilization of funds in appropriate manner.
It stresses more on the knowledge and skills of the nurse. The concept of medical administration states the determination of the appropriate steps for listed according to the priority. The proper administration of the medications, injections and care are part of the process. The concept of the medical administration allow nurse to take efficient decisions regarding medications, treatments and tests. The assessment also involves observation on how nurse responds to the supervisor and his awareness on the non-complex cases.
Conducting evaluations at the end of week or month is more advisable for minimizing the prevalence of medication errors from the healthcare settings.
ACTRevised improvement plan
How to Implement the plan hospital wide
Plan for monitoring the improvement plan
Checks and balanceStaff nurses have critical roles in the stewardship functions whose role is unrecognized. In the practical clinical environment, nurses act as first responders to the antibiotics because they are acting as communicators and coordinators of care. They are monitoring the conditions of the patient for 24 hours and are the immediate responders to the patients. Through formal education and adequate skills set the nurses manages to administer medications in required doses that lead to the maximum health enhancement of the patient. The education and awareness of the health care provider regarding the program play a significant role in its effective use. The healthcare sector has established the formal stewardship program for the last fifteen years, focused on infection prevention and disease prevention.
The plan will be implemented by developing infrastructure and installing the COPE systems. This will require funds and resources from the stakeholders and investors. The hospital will explain interest of stakeholders for convicting them. A training program on medications and use of COPE system will be conducted. This will provide opportunities to the staff nurse to familiarize themselves with the techniques of avoiding errors in medications.
The nurse leader will be responsible for reviewing the COPE entries for assuring that the nurses are complying with the medication standards that fulfill the conditions of Patient Safety Act. Leader will also be responsible for determining the errors caused due to overdose, wrong prescription or other issues. The nurses engaged on errors will be called and asked to justify their act. In case of severe adversity such as patients death the standards of the Medication Error Act will be followed. Training is provided for
Considering patients needs on planning care management.
Managing activities in time.
Putting all efforts to enhance the quality of health.
Application of clinical rules, procedures and adhering to the policies of the hospital.
Application of the critical skills for identification of the problems faced by the patient.
Determination of the immediate changes in patients condition.
Solving problems of the patient in a friendly manner.
Relying on personal knowledge and skills.
Ability to motivate other colleagues.
Providing guidance and assisting them.
Helping beginner nurses.
Ability to work with team members in a collaborative manner.
Accepting feedbacks and suggestions and avoiding conflicts.
References
Aronson, J. (2009). Medication errors what they are, how they happen, and how to avoid them. An International Journal of Medicine, 102 (8), 513521.
Olans, R. N., Olans, R. D., DeMaria, A. (2016). The Critical Role of the Staff Nurse in Antimicrobial StewardshipUnrecognized, but Already There. CLINICAL PRACTICE.
Siriwardena, A. N. (2009). Using quality improvement methods for evaluating health care. Quality in Primary Care, 17, 1559.
C Competent
Nurse
nurse
Guidance and standards
Providing awareness
Instructing to follow standards
Removing overwork
Eliminating stress
Nurse capacity
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