DISCUSSION: QUALITY IMPROVEMENT INITIATIVE

QUALITY IMPROVEMENT INITIATIVE

Your organization has recently discovered there have been too frequent errors in medication distribution. After launching an investigation in the matter, and discovering the reasons for the errors, your organization is ready to launch a quality improvement initiative. What might this initiative entail? What is included, and how will it assist in eliminating these errors?

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The purpose of the Quality Improvement (QI) Plan is to provide a formal ongoing process by which the organization and stakeholders utilize objective measures to monitor and evaluate the quality of services—both clinical and operational—provided to the patients. The QI Plan, which often addresses general medical behavioral health and oral healthcare and services, defines and facilitates a systematic approach to identify and pursue opportunities to improve services and resolve identified problems (Health Resources and Services Administration, 2011).

For this Discussion, review the Learning Resources. Then, reflect on how adverse events impact your organization and/or nursing practice. Consider the use of quality improvement initiative in the error rate, using scholarly articles to analyze.

Reference:

U. S. Department of Health and Human Services Health Resources and Services Administration. (2011). Developing and implementing a QI plan. https://www.hrsa.gov/sites/default/files/quality/toolbox/508pdfs/developingqiplan.pdf

RESOURCES

Be sure to review the Learning Resources before completing this activity.

Click the weekly resources link to access the resources.

WEEKLY RESOURCES

TO PREPARE:Review the Learning Resources for this week, and reflect on the types of quality improvement (QI) initiatives that might be most relevant to your healthcare organization or nursing practice.

Select a QI initiative, you are most familiar with, that has received support from your senior leaders in your healthcare organization or nursing practice.

Consider how adverse events are handled in your healthcare organization or nursing practice. Reflect on how this may impact the public—as well as the internal—perspective on healthcare quality.

Find a scholarly article or one from the public press, published within the last 5 years, that recounts a serious error. Reflect on this error, and consider how it may relate to your healthcare organization or nursing practice.

BY DAY 3 OF WEEK 6

Post a brief explanation of the QI initiative you selected, and why. Be specific. Explain how adverse events are handled in your healthcare organization or nursing practice, including an explanation of how this may impact both public and internal perspectives on healthcare quality. Then, briefly describe the error rate from the article you selected, and explain how this may relate to your healthcare organization or nursing practice. Be specific and provide examples.

BY DAY 6 OF WEEK 6

Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days by expanding upon your colleague’s post or offering an alternative interpretation of the error rate described by your colleague.

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QUENNIE

Happy New Year! Manigong Bagong Taon!

Multimorbidity, defined as two or more chronic medical conditions, resulting in polypharmacy, which is often described as the long-term use of five or more prescribed drugs daily (Sivasamy et al., 2023). Pharmacokinetics: Drugs commonly prescribed to older people, such as antihistamines, can reduce oral secretions, and PPI, which reduce gastric acid secretion, both of which affect drug absorption. Pharmacodynamics: Haloperidol and amitriptyline together can cause major anti-cholinergic side effects.

Having a centralized national repository of medical records allows medical practitioners to be informed of the medications the patient is taking, so to avoid polypharmacy or even a prescribing cascade. A prescribing cascade occurs when additional adverse events are mistaken as a new medical condition, which leads to the addition of new drugs to treat it. This, in turn, places patients at risk of experiencing additional adverse drug events from the unnecessary treatment (Chen et al., 2019).

The US was one of the first countries to establish the National Medication Errors Reporting Program (MERP) to monitor medication error (Chen et al., 2019). Human error is inevitable. The best we can do is educate and train healthcare staff and patients about the use of medications. We currently utilize Omnicell at my organization. To be certain that I am giving the correct medication to the right patient, when I pull the medication, I make sure that it is exactly the medication I need. I scan the patient, and I go through the 5 rights: right name, right medication, right time, right dose, right route.

As healthcare staff, we must be vigilant and advocate for our patients by being careful what we give them is exactly what they need. For example, a new nurse pulled Narcan instead of Norco by pressing the wrong button. She was asking for a waste for the Norco from another nurse who thought that maybe there was a liquid Norco, so she looked and realized the new nurse pulled Narcan out instead.

References:

Chen, Y., Wu, X., Huang, Z., Lin, W., Li, Y., Yang, J., & Li, J. (2019). Evaluation of a medication error monitoring system to reduce the incidence of medication errors in a clinical setting. Research in Social and Administrative Pharmacy, 15(7), 883–888. https://doi.org/10.1016/j.sapharm.2019.02.006

Vignesh Sivasamy, King Fan Yip, Kaysar Mamun, & Kiat Wee Lim. (2023). A review of the effectiveness of interventions to reduce medication errors among older adults in Singapore. Proceedings of Singapore Healthcare, 32. https://doi.org/10.1177/20101058231172232

LAURA

Quality Improvement Initiative

Initiatives for quality improvement are methodical, data-driven strategies aimed at enhancing both the safety and quality of healthcare delivery. Initiatives to increase quality are concentrated on providing timely, safe, equitable, efficient, and patient-centered care. Analyzing medical data as well as the methods and procedures utilized in the delivery of care might serve as the basis for such initiatives. This results in the identification of areas that require improvement as well as the processes and systems that can be fixed to raise the standard of patient care.

A Brief Explanation of the QI Initiative Selected

The decrease in hospital readmission rates is the QI project that I have chosen for this discussion. Hospital readmissions occur when a patient returns to the hospital within 30 days of being released from the hospital (Gupta et al., 2019). High rates of readmission to hospitals present a serious problem for medical facilities and staff. High rates of hospital readmission also put a burden on healthcare resources and jeopardize patient outcomes. High readmission rates pose a danger to patient safety since they can result in unfavorable outcomes like increased stress levels and high death rates (Wadhera et al., 2019). Because it aims to address the several drawbacks connected to high readmission rates, a quality improvement project to lower hospital readmission rates is therefore a wonderful idea. By delivering high-quality care and improving patient outcomes, lowering hospital readmission rates guarantees lower healthcare costs (Wadhera et al., 2019).Initiatives aimed at enhancing quality are motivated by the necessity to assure the safe provision of medical care. According to Gupta et al. (2019), the six main objectives of patient care are to guarantee that medical treatment is equitable, timely, safe, effective, and patient-centered. As part of a quality improvement program, lower hospital readmission rates are linked to higher patient satisfaction and better medical results.

How Adverse Events are Handled in the Healthcare Organization or Nursing Practice

Including an Explanation of How This May Impact Both Public and Internal

Perspectives on Healthcare Quality.

Unforeseen incidents frequently occur in the healthcare industry, and the way these incidents are managed can greatly influence the public’s and internal perceptions of the quality of service. According to Young et al. (2019), an adverse event is any unplanned or unforeseen incident that causes harm to a patient or causes them to become temporarily or permanently disabled. A healthcare provider must notify the patient and their family about an unfavorable event that has occurred. According to Hernández et al. (2023), the healthcare practitioner also needs to pay attention to the patient’s and their family’s worries and complaints regarding the adverse event. Following discussions with the patient and their family, a system of documentation has been established. The medical facility mandates that all adverse events be reported, noted, and documented. The counseling department provides emotional support to patients and their families, assuring them that all feasible measures will be made to mitigate the negative impact of the unfavorable incident. Transparency is ensured by the healthcare facility through communication with patients and their families, which increases patients’ trust in the hospital. Acknowledging and accepting culpability by acknowledging a negative incident According to Rodziewicz and Hipskind (2020), maintaining communication guarantees that patients and their values are acknowledged and honored. Healthcare practitioners are aware of the need to be open and honest. Negative occurrences should be reported, noted, and documented to identify areas that need improvement (Hernández et al., 2023). This is important because it guarantees that by fixing system flaws or other error sources that caused the unfavorable outcomes, they can be prevented in the future. Healthcare personnel understand that they won’t be criticized or shamed, according to the internal perspective on this. Nonetheless, it is expected of all healthcare workers to accept ownership and responsibility for their actions. The public gains greater faith in the healthcare organization when such incidents are disclosed and addressed because they know that ongoing quality improvement programs will be implemented to prevent such incidents in the future (Rodziewicz & Hipskind, 2020).

Error Rate From the Selected Article and How This May Relate to the Healthcare

Organization or Nursing Practice.

I chose a news statement issued on January 9, 2022, by the Michigan Department of Attorney General for this section. According to the report, a nurse was accused of seriously injuring a vulnerable adult’s physical and emotional health. The report claims that the nurse discovered two incorrect medication doses that had been given to a resident of the Grand Rapids home for veterans where she worked while carrying out her duties as a licensed practical nurse (LPN) (Michigan Department of Attorney General, 2021). However, the nurse decided not to notify her doctor or supervisor of the mistake right away, which resulted in the patient suffering severe bodily and psychological damage. The frequency of these pharmaceutical errors is not mentioned in the paper. Even though this was an isolated instance, incidents like this still happen frequently, and considerable work needs to be done to stop them from happening again. The incidence of such severe prescription errors jeopardizes the health and well-being of patients who are in danger, as the article reports (Michigan Department of Attorney General, 2021). Furthermore, according to Rodziewicz, Houseman, and Hipskind (2018), these disputes cost healthcare institutions thousands or even millions of dollars in legal fees and compensation. The inability to report a medication error upon discovering it could have been due to various reasons, such as the inability to take responsibility for the patient’s health decline, fear of hospital management’s repressive responses, fear of legal liability, fear of punishment, fear of being perceived as incompetent, or a combination of these (Rodziewicz, Houseman & Hipskind, 2018). This story highlights the need, in my healthcare setting, for an honest and open system that allows medical personnel to report prescription errors without fear of reprisal, blame, or ineptitude. The healthcare organization should implement a plan that guarantees healthcare workers’ freedom to disclose such incidents even when they accept accountability for their acts (Rodziewicz & Hipskind, 2020). It is advisable to promote the reporting of medication errors as it facilitates transparency and offers a foundation for quality improvement initiatives aimed at averting such incidents in the future. (Hernández etal., 2023). Instead than placing as much emphasis on stigmatizing and assigning blame, it would be better to fix system flaws or get rid of things that encourage prescription errors.

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Conclusion

The provision of safe, effective, equitable, efficient, timely, and patient-centered care is the main goal of quality improvement activities. Reducing hospital readmission rates is one such effort, which is crucial since it improves patient outcomes, better patient satisfaction, lower medical expenses, and better care quality are a few benefits.An efficient reporting mechanism, open and honest contact with patients and their families, and the recording and documentation of such occurrences can all help manage adverse health impacts in healthcare more skillfully. Adhering to such protocols improves openness and helps healthcare organizations pinpoint areas where quality has to be improved (Gupta et al., 2019).

Reference

Gil-Hernández, E., Carrillo, I., Tumelty, M. E., Srulovici, E., Vanhaecht, K., Wallis, K. A., …

& Mira, J. J. (2023). How different countries respond to adverse events whilst

patients’ rights are protected.Medicine, Science and the Law, 00258024231182369.

Gupta, S., Zengul, F. D., Davlyatov, G. K., & Weech-Maldonado, R. (2019). Reduction in

hospitals’ readmission rates: role of hospital-based skilled nursing facilities.INQUIRY: The Journal of Health Care Organization, Provision, and Financing,56, 0046958018817994.

Michigan Department of Attorney General. (2021, September 1).Nurse charged over failure

to properly respond to medication error. SOM – State of Michigan.https://www.michigan.gov/ag/news/press-releases/2022/09/01/nurse-charged-over-

failure-to-properly-respond-to-medication-error

Rodziewicz, T. L., & Hipskind, J. E. (2020). Medical error prevention. StatPearls. Treasure Island (FL): StatPearls Publishing

Rodziewicz, T. L., Houseman, B., & Hipskind, J. E. (2018). Medical error reduction and

prevention.

Wadhera, R. K., Yeh, R. W., & Maddox, K. E. J. (2019). The hospital readmissions reduction

program—time for a reboot.The New England Journal of Medicine,380

(24), 2289.

Young, I. J. B., Luz, S., & Lone, N. (2019). A systematic review of natural language

processing for classification tasks in the field of incident reporting and adverse event

analysis. International journal of medical informatics,132, 103971.