Overview

For your course project, you will be creating a healthcare quality improvement initiative in which you will describe the issue at the outset, the setting, the problem to be solved, the parties affected, and the importance of addressing the issue. You will recommend a concise implementation plan and describe in detail how you plan to evaluate if your implementation was successful.

The first step to completing your course project is to select a healthcare organization that releases public-facing data. In Module Three, you selected an organization and identified a publicly available set of data. For this assignment, you will need to choose an area that needs to be improved, a way to improve it, and a framework to utilize in your quality improvement initiative. You may change your selection of the initiative or the framework in your final project submission, which is due in Module Nine. This assignment helps you focus on this aspect of the final project and also maps to the second learning objective of this module.

Prompt

Specifically, you must address the following rubric criteria:

1. Selection of area of improvement: Describe an area of improvement related to your previously selected healthcare organization and its public-facing data that you will utilize for your course project.
2. Selection of method of improvement: Describe the method of improvement that you will utilize in your course project.
3. Selection of framework to use in improvement initiative: Identify which of the four problem-solving frameworks (tracers, root cause analyses [RCA], failure mode effect analysis [FMEA] studies, or plan-do-study-act [PDSA]) you will utilize for your course project by applying it to your improvement initiative.
4. Discuss your selections: Discuss why you selected the area of improvement, method of improvement, and framework.
5. Report sections: Describe the report sections you will include in your course project to describe your healthcare quality improvement initiative in a compelling and informative way.

Overview

For the purpose of this assignment, imagine that you are the chief quality officer for your healthcare organization. It is a Monday morning, and you have five issues to address (represented by the five scenarios listed below) during your department meeting. At the department meeting, you will identify a problem-solving framework to address three of the scenarios and the internal team needed to examine, investigate, and address each issue. You may select the three scenarios that seem more interesting or urgent to you.

1. The chief compliance officer at your organization has asked you if the small community clinic pharmacy that is a part of the organization is still maintaining uniform implementation of narcotic dispensing and documentation procedures. There have been no issues over the last six months after a quality improvement initiative was implemented, but it still needs to be a top priority for your department.
2. Over the weekend, a piece of a drill bit flew off the drill and landed in the tibial tissue field during surgery. The surgeon closed the repair area without removing the drill bit piece. The patient developed sepsis. You may want to review the focused professional practice evaluation standards from The Joint Commission.
3. The ongoing professional practice evaluation (OPPE) practices set by The Joint Commission for all healthcare providers in a medical practice facility were recently revised. Your organization must determine if they need to make any process changes to meet the updated standards.
4. One of your organizations facilities wants to use a security tag for newborns from time of birth to discharge, but it needs your departments approval before implementing this change.
5. The HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) Survey (also known as the CAHPS Hospital Survey, or Hospital CAHPS) for the last quarter indicates patients dissatisfaction with understanding their hospital bill and lack of knowledge about how to get clarification. HCAHPS is a standardized survey instrument and data collection methodology that has been in use since 2006 to measure patients perspectives of hospital care.

This assignment will help prepare you for your course project through the selection and application of problem-solving frameworks.

Prompt

For this assignment, you need to select and then apply the most appropriate problem-solving frameworks that will help you to address each issue or scenario. You can choose from these four frameworks: tracers, root cause analyses (RCA), failure mode effect analyses (FMEA), and plan-do-study-act (PDSA). You should consider whether you are dealing with a problem that has already taken place or trying to be proactive in your strategy for maintaining excellence in your healthcare facility. You will need to consider stakeholders, too. These are the healthcare professionals and interprofessional team members who may need to be working with you to address the scenario. These might include nurses, physicians, nurse practitioners, therapists, security staff, environmental personnel, billing staff, community board members, or others that you identify. What expectations will you have of these team members as part of your problem-solving strategy? Will they help or hinder your efforts, and why might this be so? Provide specific evidence from at least two scholarly sources to support your claims.

Specifically, you must address the following rubric criteria for three of the five scenarios:

1. Compare proactive and reactive problem-solving frameworks: Compare the value and advantages of proactive and reactive problem-solving frameworks in general (you do not need to discuss any of the scenarios).
2. Choose a problem-solving framework: Choose the problem-solving framework that will be the most helpful in addressing each of your three selected scenarios (you may choose which three scenarios out of the five you want to use, and you may use different frameworks for each scenario).
3. Categorize problem-solving frameworks as proactive or reactive: Explain why the problem-solving framework is proactive or reactive and how this helps in the investigative or review process for your three selected scenarios.
4. Apply problem-solving frameworks: Apply your selected framework to your three selected scenarios by describing what will be done at each stage of the framework.
5. Members of the organization: Examine the members of the organization you will need to participate in each step of the framework for your three selected scenarios.
6. Who are the vital interprofessional participants, and what should their contribution be to the investigative process?
7. How can you maximize the actions and inputs of each of the participants?
8. Justify the selection of problem-solving frameworks: Justify the selection of your problem-solving framework for each of your three selected scenarios.
9. Organizational goal: Identify one organizational goal that you think should be attained for each of your three selected scenarios.

Select a current health policy issue relevant to nursing practice (e.g., access to care, staffing ratios, scope of practice, reproductive health, end-of-life care, health equity, public health policy, mental health legislation, patient safety regulations, or emerging technologies in health care). Be sure to follow the rubric closely!

In a 46 page scholarly paper, analyze the selected issue by addressing the following components:

1. Description of the Health Policy Issue

• Clearly describe the policy issue, including its background and relevance to nursing and health care delivery.
• Identify the population(s) most affected.
• Discuss the political and/or legislative context influencing this issue at the local, state, national, or global level.

1. Ethical Analysis

• Apply at least two ethical principles (e.g., autonomy, beneficence, nonmaleficence, justice, fidelity, veracity) to the issue.
• Examine ethical dilemmas or conflicts that may arise in clinical or organizational decision-making.
• Discuss how ethical frameworks guide nurses in promoting safe and effective care related to this policy.

1. Legal Considerations

• Identify relevant laws, regulations, or professional standards that impact the policy issue.
• Analyze how legal requirements influence nursing practice, patient safety, and accountability.
• Discuss potential legal consequences of noncompliance for nurses or health care organizations.

1. Personal and Professional Values

• Reflect on how personal values, professional nursing values, and the ANA Code of Ethics influence responses to the policy issue.
• Examine how nurses manage conflicts between personal beliefs and professional obligations.
• Discuss the importance of values-based decision-making in ethically complex health care environments.

1. Implications for Nursing Practice and Advocacy

• Analyze the implications of the policy issue for nursing roles, responsibilities, and patient outcomes.
• Describe the nurses role in health policy advocacy and political engagement related to the issue.
• Propose at least one evidence-based strategy nurses can use to influence policy or improve health care delivery.

1. Conclusion

• Summarize key insights from the analysis.
• Reinforce the importance of integrating ethics, law, and policy in nursing decision-making.

Paper Requirements

• Length: 46 pages, excluding title page and references
• Format: APA 7th edition
• Spacing: Double-spaced
• Font: 12-point Times New Roman
• Margins: 1 inch
• References:
• Minimum of 5 scholarly sources
• At least 3 peer-reviewed nursing or health related journal articles
• Current sources (within the last 57 years, unless foundational)
• Writing Style:
• Scholarly, professional tone
• Clear organization with APA-level headings

PICOT question: In long-term care facilities with elderly Residents, will implementing pressure ulcer prevention protocols and education compared to current standard practice reduce the incidence of pressure ulcer related injuries by 25% within 3 months?

*** expected outcomes of implementing pressure prevention protocols and education***

Objective

• Identify appropriate expected outcomes for your project.
• Identify the strategies to implement your project.

Deliverables

• Write a 3-4 page (not including the title and reference pages).
• APA formatted paper with an introduction and conclusion.
• APA headings for each section of the paper.
• At least 5 peer-reviewed references.

Step 1: Capstone Project

• Write a paper identifying the Expected Outcomes, Approach, and Budget for your capstone.

Step 2: Consider

• Expected Outcomes at least 5
• What specific questions will your project address?
• How are these questions related to one another?
• Approach
• What will you actually do to address the actionable questions?
• What will you do to create improved outcomes?
• Budget

Step 3: Write

• Write a paper that addresses the criteria above.
• Use the template attached below.

This case study comes from the Apply It: Critical Thinking Exercise section of the chapter. Read the case study, then choose ONE of the discussion questions. Create a post of at least 100 words, that includes the following information…

briefly describe the health issue presented, and answer one case study question

include a link to a resource that supports the information you discussed

provide TWO (2) word-part breakdowns of associated medical terms relating to the health issue (explaining the word root, the combining form, the suffix, and the prefix)

Then post one response to a classmate of at least 30 words, expanding on the content of their post, and provide one additional word part breakdown in your response (different from those in your initial post and different from any term detailed in the classmates post).

Case Study:

Leg muscles save back muscles … Mandatory OSHA meeting Tuesday at noon. Bring lunch, states the company memo. Sandor Padilla, a 28-year-old cargo loader, sighs, Third meeting this year, and its not even June yet! He has only two minutes to reach the tarmac. Oh well, cargo waits for no man, he thinks as he jogs off to work.

Sandor enjoys his job. It keeps him fit but lets his mind follow more creative avenues. Today, his thoughts stray to his daughter Reinas fifth birthday party, just two weeks away. A pony or a clown? Hot dogs or tacos? he muses. Single parenting has its moments. As he is busy thinking of other things, the heavy crate slips, driving him into a squatting position that injures his thigh muscles. His cry of pain brings Janet Wilson, his supervisor, running to help.

The first aid station ices his leg to reduce swelling and pain. After the supervisor completes the incident report, Sandor is taken to the emergency room. Dr. Basra, the orthopedic specialist on call, diagnoses a tendon strain resulting in a torn left rectus femoris. A myorrhaphy is required to treat this injury. After several days in the hospital, Sandor is sent home with a Vicodin prescription for pain and orders for physical therapy sessions three times a week. He is not expected to return to work for at least 90 days.

AirFreight Systems receives the first report of injury and compares it with the supervisors incident report. Ruling: Safety Violation. No Liability. Return to work in 30 days or dismissal.

Discussion Questions:

1. On what basis do you think AirFreight determined that this was a safety violation?
2. Use lay terms to explain Sandors injury and the treatment that was required.
3. Sandor knows how to handle heavy loads safely; however, the crate may have slipped because he was busy thinking about his daughters birthday party and not about his work. Could the responsibility for this accident be considered negligence on Sandors part? Do you think Sandor should be held responsible or is blameless in this situation?
4. It was determined that AirFreight was not responsible for the accident. Therefore, do you think the company should take away Sandors job if he does not return in 30 calendar days?

The assignment instructions are outlined in the attached PDF titled NURS 230 Instructions: Disease Prevention Education Project. This is a two-part assignment. The first component requires creating an infographic using Canva; please use a Canva template to ensure a polished and visually appealing design. The second component is a 23 page written paper. Detailed instructions for both parts are provided in the attached PDF. Additionally, screenshots of the grading rubric have been included for reference and should be followed closely.

Although I am paying for slides, this is a two-part assignment, and I am unable to customize the order accordingly. Therefore, I am paying for additional slides to account for the 23 page written paper in addition to the infographic slide.

The assignment instructions are outlined in the attached PDF titled NURS 230 Instructions: Disease Prevention Education Project. This is a two-part assignment. The first component requires creating an infographic using Canva; please use a Canva template to ensure a polished and visually appealing design. The second component is a 23 page written paper. Detailed instructions for both parts are provided in the attached PDF. Additionally, screenshots of the grading rubric have been included for reference and should be followed closely.

Although I am paying for slides, this is a two-part assignment, and I am unable to customize the order accordingly. Therefore, I am paying for additional slides to account for the 23 page written paper in addition to the infographic slide.

The project examines bowel regime related to skin intergrity, which elaborates on how a structured bowel management can help prevent skin break down in patient who are at risk of incontinence-related dermatitis and pressure injuries.

Case Study –Productivity

Jennifer Broadwater is the director of womens health for a regional nonprofit healthcare system. She has doctoral preparation in executive leadership. Prior to her current appointment, Broadwater served as a nurse manager at a small private hospital for 2 years after graduation.

Historically, Broadwaters department has run smoothly and efficiently, and it was one of the premier departments within the organization. Over the past three months, some nurses have begun requesting transfers to other departments, while others have resigned to seek employment outside the organization. The CNO is concerned and would like Broadwater to make this her top priority.

The department consists of 175 full- and part-time employees: 88 BSN RNs, 61 ADN RNs, 24 patient care technicians, and 2-unit secretaries. In the past, staff members have worked well together. Recently, nonproductive turnover has increased, resulting in additional stress among staff members and creating a negative, distrusting culture. Due to the departure of many seasoned nurses and the arrival of new nurses, staff members report feeling overwhelmed with the task of orienting new nurses and interacting with nursing students. Additionally, staff members believe that patients may not be receiving proper care.

Staffing and Resource Management

An in-depth staff analysis reveals certain nurses with a pattern of callouts. Broadwater reports to her CNO that she will need to address productivity, accountability, and productive turnover versus nonproductive turnover. Broadwater considers the best use of her staffing mix to maximize efficiency and productivity. The hospital has Magnet designation and a shared governance model, using relationship-based care as its professional practice model. Broadwater is concerned that the shared governance model and the relationship-based care model may not be translating to the day-to-day operations of patient care delivery. Broadwater is considering an alternative nursing care delivery model that might be used with the current staffing mix to enhance productivity and better meet the needs of staff members and patients.

Case Study Questions

1. Broadwaters department uses a decentralized budgeting process. Using the eight steps identified earlier in Chapter 8 in the procedures for decentralized budgeting, identify how Broadwater would use her understanding of her staffing mix, patient care needs, and shared governance model to best address department problems.
2. Using the staffing mix, how might Broadwater maximize her professional nursing capacity, considering the need to increase her BSN RN pool?

In a 3 page paper, develop a plan for improving productivity, accountability, and productive turnover versus nonproductive turnover within a unit functioning within a shared governance model. Be sure to address the case study questions noted above.Your scholarly paper should include a cover page, a narrative with an introduction, a body, a conclusion, and a reference page. Use APA format and provide examples supporting your position. Include 3-5 scholarly references within the last 5 years, unless a landmark publication, with in-text citations to enhance the credibility of your ideas, thoughts, and opinions.