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NURS FPX 4020 Assessment 1: Enhancing Quality and Safety

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Capella University

NURS-FPX 4020 Improving Quality of Care and Patient Safety

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Enhancing Quality and Safety in Medication

Quality and safety education for nurses (QSEN) elaborates on the challenge of nurse training with the knowledge and skills needed to constantly enhance the safety and quality of the healthcare systems. Nurses must find new ways to keep up with an ever-changing healthcare environment that resulted in innovative collaborative efforts. Therefore, to address these varied demands and obstacles a standard collaboration is required. It aims to provide an innovative clinical education delivery model for quality enhancement and better patient outcomes. One of the adverse issues is medication administration errors. Medication administration errors (MAEs) can occur during the prescription, storage, and drug delivery processes. Minor errors can even risk a patient’s life, and those who perpetrate them can face consequences. The workload can increase the chances of medication errors (MAEs) in a healthcare organization. These evidently insignificant errors have an emotional and mental impact causing sadness, anxiety, and fear among the medical staff. It has been estimated that these errors can bring high costs to the hospitals and increase financial strain (Chauhan et al., 2020)

A Scenario of Medication Error

In 2014, a medicine administration error was reported at Vila Hospital, California. According to an estimate, the patient died because of the negligence of the hospital’s medical staff. Taking into account the legal consequences, the California Department of Public Health (CDPH) imposed a $75,000 (USD) penalty. The error occurred because of an overdose of Levophed (hypertension medication). Unfortunately, the dose provided was 3K units higher than the original intravenous (IV) doses.  However, MAEs occur due to insufficient medical training and education of workers, a shortage of protection for high-alert medications, rushed and inexperienced nursing activity, and patient sensitivity. In the reported case, the nurse failed to double-check the medicine label, which stated that Levophed should be administered if the blood pressure (BP) fell below 65.

Elements and Initiatives of Quality Improvement

The repercussions and scope of medication errors are disturbing. Extensive researches and decisive efforts guarantee that these errors can be reduced but cannot be eliminated. However, patient safety is essential in any medical facility, and it is regarded as the primary source of income for all healthcare practitioners. Researchers identify all errors that impacted negatively the development of health outcomes of patients. Governments must actively engage in the establishment of laws and practices for human well-being. The identification of problems, the process to deal with the problems, and the evaluation of outcomes are successful implementations of quality improvement initiatives. This will aid in the eradication of errors that risk the patient’s safety (Lame et al., 2020).

Improving Quality of Care and Patient Safety

In a study, a tertiary child patient’s general anesthesia diagnostic imaging service underwent a quality improvement initiative. Regular educational meetings with medical workers, printed reminders, visual presentations, frequent feedback in the clinical areas that carried out the processes, and knowledge sharing on displayed run charts were drivers. Therefore, to address the interventions, the multidisciplinary team formulated a series of change tests. Data is gathered and documented in a database using a neutral and independent data collector. Run charts and statistical process control approaches help analyze the data (Evered et al., 2018).

In view of the challenges surrounding pharmaceutical errors, a project aiming at improving treatment quality and drug management was launched at a teaching hospital in the discipline of Acute Care for Elders. The approach involved incorporating a medical physician into the acute care elder initiative. Hence, its key objectives are to reduce the program’s growing number of medication errors. The aim is to follow the happenings of dosage changes, inappropriate therapy, and the prevention of bad effects from incorrect medication. The outcomes of this initiative were unexpected as the number of suggestions linked to drug adjustments increased significantly. As a consequence of this initiative, participants were able to argue that including a clinical chemist in care centers was critical and would result in considerable improvements in adult care (Wondmieneh et al., 2020).

NURS FPX 4020 Assessment 1: Improving Quality of Care and Patient Safety

It is critical to remember that pharmaceutical errors can cause patient illness and even death. Furthermore, these errors and gaps can pose negative impacts on the healthcare facility and result in an increase in institutional and public costs. Medical mistakes are not only financially costly but they also cost the trust of patients in the health service. Further, it impairs patient happiness and degrades morale among healthcare personnel, who frequently feel powerless to improve the situation (Koyama et al., 2020).

Factors Leading to Patient Safety Risks

A variety of factors can jeopardize patients’ safety. When this safety is threatened, the patient’s life is endangered, which is the most important component in all healthcare activities and processes. Therefore, at all levels of treatment, patient safety is crucial. Fox et al. (2019) stated that patient safety risk is affected by the following factors:

  1. Lack of nurse collaboration.
  2. Poor communication.
  3. Errors during surgery.
  4. Drug dosage errors.

These are the criteria that influence whether a healthcare facility provides acceptable patient care. A minor blunder can confuse the care providers with far-reaching consequences (Fox et al., 2019).

Patient Safety and Organizational Interventions

Nurses who are always looking for ways to improve in these areas are continually updating outdated techniques. They assist healthcare organizations to make quality breakthroughs. Corporations should provide nurses with suitable knowledge about action plans and new innovations that can result in changes. This applies particularly to the risks and benefits associated with a change that seeks to enhance outcomes. According to the American Nurses Association (ANA), the nurse practitioner at the center of care is the best indicator of a hospital’s health (Mulac et al., 2021).

NURS FPX 4020 Assessment 1: Improving Quality of Care and Patient Safety

Nurses are critical in providing proper healthcare to particular patients. Nursing staff in a healthcare facility must be aware of a variety of things. These variables serve as a measuring parameter for patient satisfaction. Nurses assist with the quality process for patients i.e., correct medication is written up in the correct dosage and given to the correct patient at the correct time and through the correct route. Many hospitals use a single-dose approach to limit or reduce the possibility of administration errors. To avoid medication errors, nurses must follow correct medication administration procedures, which include at least the five right rules; the right patient, drug, dose, route, and timing. They must also complete and use correct documentation when the patient receives the drug and medication on time (Khaja, 2020).

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Stakeholder Importance in Quality Improvement

Nurses are the nucleus of attention when it comes to increasing the quality of a healthcare facility. Stakeholders, on the other hand, are fundamental to advancing these initiatives. Patients, clinicians, physicians, managers, nurse leaders, cashiers, and financial and non-financial executives are crucial in enhancing the quality and lowering the expenses of hospitals. In any healthcare company, basic procedure incorporates practically all of these stakeholders. It is because they are all involved in the process at some point. Executives define that the strategies are the driving force behind improvement initiatives (Bloemhof et al., 2021). The managers and leaders are liable for ensuring that these strategies and policies must be followed to bring efficiency and effectiveness.

NURS FPX 4020 Assessment 1: Improving Quality of Care and Patient Safety

The Patient-Centered Outcomes Study Institute (PCORI) and other groups demand that stakeholders must be involved in the research process. According to reports, medical groups, employees (nurses, management, physicians, and professional workers), and governments require effective agendas and plans to execute long-term quality results for patients in routine and system optimization. Stakeholders can contribute to the successful execution of a plan for lowering MAEs by providing resources, funding, and medical expertise. Clinicians, physicians, and nurses are all responsible for carrying out quality improvement (Mohr et al., 2018). The three staff members (executive, managers, and nurses) are in charge of carrying out the strategies and procedures. These stakeholders are in charge of implementing the necessary adjustments to improve the quality of care in a healthcare facility. Stakeholders are also important in enhancing healthcare quality and safety because their engagement allows them to define safety and quality targets and assess program success. Individual stakeholders must be identified since they may assist shape identity and motivating community members to develop and participate in quality improvement (QI) activities (Paul et al., 2022).

Conclusion

The nursing staff and clinical pharmacist play a vital role in ensuring accurate and error-free medication delivery. Health systems must improve their quality by empowering their management and staff, particularly nursing staff, and educating stakeholders who play a critical role in quality enterprises. Therefore, the rise in medication errors is the cause of healthcare failures that can result in fatalities. Healthcare practitioners and medical staff are responsible for diagnosing and administering medication and should follow up with their patients to be aware of any undesirable side effects of the prescription.

References

Bloemhof, J., Knol, J., Van Rijn, M., & Buurman, B. M. (2021). The implementation of a professional practice model to improve the nurse work environment in a Dutch hospital: A quasi‐experimental study. Journal of Advanced Nursing77(12), 4919-4934. https://doi.org/10.1111/jan.15052

Chauhan, A., Walton, M., Manias, E., Walpola, R. L., Seale, H., Latanik, M.,& Harrison, R. (2020). The safety of health care for ethnic minority patients: A systematic review. International Journal for Equity in Health19(1), 1-25. https://doi.org/10.1186/s12939-020-01223-2

Evered, L., Silbert, B., Knopman, D. S., Scott, D. A., DeKosky, S. T., Rasmussen, L. S.,& Nomenclature Consensus Working Group. (2018). Recommendations for the nomenclature of cognitive change associated with anesthesia and surgery—2018. Anesthesiology129(5), 872-879. https://doi.org/10.3233/jad-189004

Fox, A. D., & Sheridan, D. J. (2019). Timely medication administration guidelines. Nursing202049(11), 58-59. https://doi.org/10.1097/01.nurse.0000580708.32769.67

Hutton, M., Brull, R., & Macfarlane, A. J. R. (2018). Regional anesthesia and outcomes. BJA Education18(2), 52. https://doi.org/10.1016/j.bjae.2017.10.002

Khaja, S. (2022). Increasing patient involvement through self-administration of medication. Therapeutic Advances in Drug Safety13, 20420986221124699. https://doi.org/10.1177/20420986221124699

Capella 4020 Assessment 1

Koyama, A. K., Maddox, C. S. S., Li, L., Bucknall, T., & Westbrook, J. I. (2020). Effectiveness of double checking to reduce medication administration errors: A systematic review. BMJ Quality & Safety29(7), 595-603. https://doi.org/10.1136/bmjqs-2013-002118

Lamé, G., & Dixon-Woods, M. (2020). Using clinical simulation to study how to improve quality and safety in healthcare. BMJ Simulation & Technology Enhanced Learning6(2), 87. https://doi.org/10.1136/bmjstel-2018-000370

Mohr, L. D., & Coke, L. A. (2018). Distinguishing the clinical nurse specialist from other graduate nursing roles. Clinical Nurse Specialist32(3), 139-151. https://doi.org/10.1097/nur.0000000000000373

Mulac, A., Mathiesen, L., Taxis, K., & Granås, A. G. (2021). Barcode medication administration technology use in hospital practice: A mixed-methods observational study of policy deviations. BMJ Quality & Safety30(12), 1021-1030. https://doi.org/10.1136/bmjqs-2021-013223

Capella 4020 Assessment 1

Paul, P., Gupta, S., Nath, R., & Gadre, S. (2022). Is the incidence of medication administration errors in a tertiary care hospital a secret factor in our health-care system? Journal of Current Medical Research and Opinion5(09), 1366-1371. https://doi.org/10.52845/cmro/2022/5-9-1

Wondmieneh, A., Alemu, W., Tadele, N., & Demis, A. (2020). Medication administration errors and contributing factors among nurses: A cross-sectional study in tertiary hospitals, Addis Ababa, Ethiopia. BMC Nursing19(1), 1-9.  https://doi.org/10.1186/s12912-020-0397-0