When patient safety is compromised, it is critical to get to the root of the issue in order to determine how to ensure patient safety and avoid risks in the future. Nurses can use analytical techniques to determine root causes related to various types of errors. Medication error is a typical error that can be subject to process improvement in general, and root cause analysis in particular. This process came out of NASA after the Space Shuttle Columbia disaster and has been adopted by the health care industry. This week, you analyze a case related to medication error, and you examine how root cause analysis is applied to prevent future error and formulate process improvement plans.

Learning Objectives

Students will:

• Analyze the composition of a root cause analysis team      in relation to effective practice
• Critique the effectiveness of the performance      improvement charts in identifying contributing factors
• Apply findings from a root cause analysis to prevent      future errors
• Apply a quality improvement process to an improvement      plan

Learning Resources 

Required Readings

Spath, P. (2013). Introduction to healthcare quality management (2nd ed.). Chicago, IL: Health Administration Press.

· Chapter 4, “Evaluating Performance” (pp. 73–110)

· Chapter 5, “Continuous Improvement” (pp. 111–130)

· Chapter 6, “Performance Improvement Tools” (pp. 131–162)

Note: Although these chapters are previously assigned readings, please review them in preparation for this week’s material.

Yoder-Wise, P. S. (2015). Leading and managing in nursing (6th ed.). St. Louis, MO: Mosby.

· Chapter 17, “Leading Change” (pp. 305–320)

· Chapter 23, “Conflict: The Cutting Edge of Change” (pp. 431–447)

Required Media

Laureate Education (Producer). (2016a). Root cause analysis at Downtown Medical [Interactive file]. Baltimore, MD: Author.

Laureate Education (Producer). (2016b). RCA dramatization 1 [Video file]. Baltimore, MD: Author.

Note: The approximate length of this media piece is 4 minutes.

Case scenario involving medication error including pharmacy, physician, and nurse—interdepartmental collaboration.
Interactive media—students select options that generate chart based on choices
(Voiceover reads the document aloud—include a downloadable pdf).

Discussion: Root Cause Analysis

Review the case scenario included in this week’s media resources, and examine the process flow chart, cause/effect diagram, and Pareto chart related to the case scenario. 

In the scenario, the nurse manager and the director of pharmacy blame each other for the error. The facilitator (quality assurance person) asks everyone to avoid blaming and focus on applying the tools to analyze the data and get to the root cause of the error. While all of these tools contribute, for this Discussion, select one tool to analyze.

By Day 3

Post each of the following:

• Analyze the composition of the RCA team. Explain what      knowledge they can contribute to the RCA.
• Describe the collaboration in the case study that led      to effective problem solving. Identify the evidence you observe in the      scenario that demonstrates effective collaboration and the avoidance of      blaming.
• Explain the team’s process in testing for and      eliminating root causes that were not contributing.
• Select one of the performance improvement charts      presented in the scenario and critique its effectiveness by explaining how      it contributes to identifying the root cause and determining a solution to      prevent repeat medication errors.
• Identify the contributing factors, and discuss how to      prevent this kind of error from occurring in the future.

Support your response with references from the professional nursing literature. Your posts need to be written at the capstone level (see checklist)

Notes Initial Post: This should be a 3-paragraph (at least 350 words) response. Be sure to use evidence from the readings and include in-text citations.  

Practice Experience: Stakeholder Analysis

The next step in the process is to begin identifying the challenges and impediments to implementing a quality improvement plan. In the analysis consider the individuals affected by the change as well as the cost of implementing the quality improvement plan.

By Day 4

Post a description of some of the proposed action steps for implementing improved practice, and explain where potential challenges might compromise your proposed improvement project. Describe what resources are needed for your solution, and explain whether or not those resources are cost-effective. Continue to collaborate with the selected individuals in your practice environment as needed in the development of the Practice Experience Project, and share this information with your group.

 

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Discussion: The Nurse’s Role in Promoting Quality Health Care

As you have noted in this course and in your practice, nurses have an integral role in promoting a just culture focused on patient safety in their health care organizations. Determining resources to prevent error and improve patient safety can often be a battle, and this scenario illustrates how one organization makes strides to make sure resources are available in the interest of patient safety. As you review the scenario, consider the nurse’s role in promoting a just culture in your practice setting.

By Day 3

Post a description of the role of the staff nurse for promoting quality in a high-performing health care organization. Define the organizational culture of your health care organization, or one with which you are familiar, and identify the leadership style of the CEO and CNO in your organization. Explain how your senior leadership supports—or does not support—changes that require financing/budget to support patient safety. Describe the strategies you might be able to implement to move your health care organization to a high-performing organization.

Support your response with references from the professional nursing literature. Your posts need to be written at the capstone level (see checklist)

Notes Initial Post: This should be a 3-paragraph (at least 350 words) response. Be sure to use evidence from the readings and include in-text citations.  

Practice Experience: Developing a Quality Improvement Plan

Storyboard Instructions

The Practice Experience Project Storyboard is a brief, visual summary of a completed quality improvement initiative. The storyboard highlights key aspects of a quality improvement effort by documenting the Practice Experience Project from beginning to end. 

The course template uses a PowerPoint format to complete this assignment. You only need to provide two slides, no more. The first slide is the summary of your project; the second slide is the reference page. You will need to choose the most pertinent information from your practice experience and Capstone Paper to complete the Storyboard. No voiceover is required.  

The completed storyboard is submitted for grading and also serves as the main post for the Week 6 Practice Experience discussion.  

 

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Milestones in Public Health
 

Class, there are many milestones in public health, but two that always come to my mind are vaccination and seat belts! The world’s first vaccine for smallpox was created by Edward Jenner in the late 1700s. Since then, vaccines have been developed for many other preventable diseases. According to Research America (n.d.), the CDC estimates that over the last 20 years, 700,000 children’s deaths have been prevented because of routine vaccination. That’s a large number!

Similarly, the number of motor vehicle deaths per year has largely decreased since the implementation of seat belts. I find this interesting! While developing a vaccine is complicated, as we see from the seatbelt example, an intervention does not need to be complicated to be successful. Hundreds of thousands of lives were saved by a simple invention to ensure people remained safe in their car!

What are some of your favorite public health milestones? Or milestones that you believe were important for public health?

References

Research America. (n.d.). Public Health Milestones. Retrieved from https://www.researchamerica.org/advocacy-action/public-health-thank-you-day/public-health-milestones

Please Use APA format, and include references below 5 years and 150 word

 

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NSG3036 W2 Project

Research Template Name

Cite both articles reviewed in APA style:

***In the template, any direct quotes from the articles needs to only include the page number.

Week 2 Template	Quantitative Article	Qualitative Article
Summarize the two assigned articles. In a paragraph, describe in your own words what the study was about and what the researchers found.
Identify and describe the problem for each article

Identified the purpose statement for each article
Identified hypothesis and/or research questions depending on the methodology used in the articles.
After analyzing, discusseach article’s significance to nursing practice.
Identify two details to support the study being quantitative or qualitative

 

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Signature Assignment Title: The Holistic Patient Assessment

Part 1: Choose an adult (over the age of 18) friend or relative and perform a holistic health assessment. Clearly document your holistic health assessment data

Your assessment should include the following parts:

• Health History
• Physiological Assessment
• Psychological Assessment
• Social Assessment
• Cultural Assessment
• Developmental Assessment
• Spiritual Assessment

Part 2: Interpret the findings in your holistic health assessment data according to pathophysiologic disease states.  

• Choose one physiologic abnormality and discuss possible pathophysiologic reasons for the abnormality.  
• Look at the abnormality on a holistic basis.  
• How does this abnormality impact the other areas of the patient’s life, especially those areas discussed in this course?
• Discuss the client’s stress and coping mechanisms.  
• Are they healthy?  
• What improvements could be made?

Part 3: Create a teaching plan that addresses the client holistically by applying the assessment data you have analyzed.  

• Describe at least one client goal for each of the categories (physical, psychological, social, cultural, developmental, and spiritual).
• How will you teach the client about the goal?  
• How will you evaluate your teaching?  

Part 4: Prepare a PowerPoint presentation for your patient teaching.  

• You should have at least six slides (one for each type of goal – physical, psychological, social, cultural, developmental, and spiritual), in addition to the title slide, objective slide, and references slide.  
• Please be sure to have at least one scholarly source in the PPT.

Assignment Expectations:

• Length: Essay of 1500 words; PP of 12 content slides (and include a title, objective, and reference slides – these do not count towards the required content slides)
• Structure: PP as noted above. Essay: Include a title page and reference page in APA format. These do not count towards the minimum word count for the essay part of the assignment. Your essay must include an introduction and a conclusion. 
• References: Use appropriate APA style in-text citations and references for all resources utilized to answer the questions. A minimum of three scholarly sources plus the textbook are required.

 

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