Assignment: Quality Improvement and Patient Safety Initiatives
The vice president of nursing, Dr. Sasha Mendez, has had a lot of complaints from patients and their families about the difficulties they experience navigating the system at her organization; e.g., going from the E.R. to admissions. Dr. Mendez's nursing specialty area is psych/mental health. As such, she is very concerned about the stress this is causing the patients.
What are the macro systems that are affecting patient satisfaction at Dr. Mendez's facility? What micro systems should she also analyze to look at how the patient moves through-from entry, to possible admission, to possible discharge? How do these systems relate? What impacts each system?
The concepts presented in Week 8 serve as a foundation for this week as you continue to look at factors within an organization's environment that are barriers and facilitators for implementing change. In this Discussion, you examine the macro and micro systems within the organization (of your practicum setting) and identify changes that may need to take place to facilitate quality improvement and achievement of patient safety outcomes.
To prepare:
• Reflect on the issue you have been addressing through your EBP Project.
• Identify the macro and micro systems that influence the issue. Review the McClusky and Middleton (2010) article for an example of this process.
• Determine the desired outcomes of resolving the EBP Project issue and how resolving it will improve quality and patient safety. (Note: Next week you will evaluate these outcomes. You may want to view the Week 10 Discussion as you prepare.)
• What procedures/processes would need to be modified to achieve the desired outcomes?
Format your assignment according to the following formatting requirements:
1. The answer should be typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides.
2. The response also include a cover page containing the title of the assignment, the student's name, the course title, and the date. The cover page is not included in the required page length.
3. Also Include a reference page. The Citations and references should follow APA format. The reference page is not included in the required page length.
Required Readings
Brooks, P., Spillane, J.J., Dick, K., & Stuart-Shor, E. (2014). Developing a strategy to identify and treat older patients with postoperative delirium. AORN Journal, 99(2), 256-276. (see attached file).
Jarden, R.J. & Sutton, L.J. (2014). A practice change initiative to improve the provision of enteral nutrition to intensive care patients. British Association of Critical Care Nurses, 20(5), 242-254.
McCluskey, A. & Middleton, S. (2010). Delivering an evidence-based outdoor journey intervention to people with stroke: Barriers and enablers experienced by community rehabilitation teams. BMC Health Services Research, 10(18). doi: 10.1186/1472-6962-10-18.
Murfet, G.O., Allen, P., & Hingston, T.J. (2014). Maternal and neonatal health outcomes following the implementation of an innovative model of nursepractitioner-led care for diabetes in pregnancy. Journal of Advanced Nursing, 70(5), 1150-1163 (see attached file).
PIICOT Question
In patients in extended intensive care within an urban acute care facility in Eastern United States, how does early mobilization as recommended by National Institute of Health and Care Excellence clinical guidelines on rehabilitation of patients after critical illness impact early transfers from intensive care as measured 6 months post-implementation when compared to the current standard of care including minimal mobilization of patients?
P: Adult patients
I: in extended intensive care within an urban acute care facility
I: increased mobilization of the patients
C: minimal mobilization of the patients
O: early transfers of the patients from intensive care
T: 6 months.