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Benchmark Assignment: Quality Improvement Initiative

Benchmark Assignment: Quality Improvement Initiative

In health care systems, the need to address safe patient care necessitates various management responses with regard to the problem in question. Quality improvement initiatives (QI) are actions undertaken by the stakeholders in a health care facility to bridge the gaps in realizing the goals of service delivery (Sadegh et al., 2013). The premise can also entail the implementation of innovative approaches to model and design various strategies aimed at addressing complex care interventions. According to Cullen (2018), assessing quality improvement initiatives is important to measure the performance of a health system to enhance the safety of patients seeking care services. In the institutions of care, quality improvement initiatives also entail an evaluation of the staff capacity and the availability of resources to handle populations seeking medical attention (Mikhail & Langabeer, 2018). Often, nursing population can be used as the yardstick to assess the quality of care since they spend the longest period with the patients (Hickey & Brosnan, 2017).    Thus, the context of safe staffing with respect to nurse-to-patient ratios needs to receive attention.

Selected Quality Measures Identification

Safe nurse-to-patient ratio is a quality initiative that most hospital leaders take into account in a bid to ensure quality care for patients. Health facility administrators often formulate strategies that address safe, effective and efficient approaches that guarantee quality care to patients. Hill and DeWitt (2018) illustrate that one of the most important approaches is to recruit adequate nursing staff and other care professionals to address patient acuity. Certainly, an interplay of many factors concerning nurse-patient ratios has often hampered the efforts to bridge the staffing gap. In many cases, care facilities lack adequate financial resources to implement nursing staff (Shekelle, 2013). Besides, access to competent and experienced nursing staff is a challenge due to the shortage of specialist nurses.

In this regard, the present article delves into the quality measures related to safe nurse-patient ratios in care setting. The premise is guided by the argument that patient-centered outcomes are compromised by inadequate nursing staff. The present nursing staff in care facilities is also overwhelmed by the high patient population. The occasion of unsafe nurse staffing is also exacerbated by the high rate of nurse turnover most of whom seek further studies or opt for institutions that offer better remuneration packages. According to Shekelle (2013), the recommended rate for nurse to patient ratio is at 1:4. However, the present health facility indicates a ratio of 1:8, which is far below the required standards. The high nurse to patient ratio is detrimental to both the institution and the clients seeking care services. It results to missed care due to untimely administration of medication and poor pain management (Sadegh et al., 2013; Lee et al., 2017). A project on nurse staffing entails addressing nursing skill mix in addition to a response on care hours as a way to look into the working patterns of nurses. Thus, the health facility can also focus on attracting high-quality nurses through redesigning the practice environment to improve patient safety.

Data Collection Plan

Data collection plan is an important aspect and a straight forward approach to indicate the patterns of nurse staffing in a care facility. The collected data will reflect aspects of patient care, particularly concerning prompt care, increase in falls, bed sores, and other infections (Hickey & Brosnan, 2017). Data on safe nurse to patient ratios can be collected through different approaches and comprises five steps.

The first step entails identifying the perceived speculated results on nurse staffing results and the ways to measure their actual number. The second step relates to developing a data gathering approach to ascertain the problem of the unsafe nurse to patient ratios in a care facility. The third step involves the analysis of the data collected in a bid to reflect on the nurse staffing deficits with respect to patient population seeking health services at the institution. Step four, on the other hand, entails relating the data collected to establish the extent of an inadequate number of nurses when compared to the patient population seeking medical attention. In the final step, the four steps are repeated to ensure the accuracy of the information collected. This also provides information that can be used to compare data from known databases to reflect the pattern of the nurse to patient ratio with recommended standards.

The manual data collection plan will be determined by observing the lifestyle, body and the environment of patient care. This provides qualitative data to gauge on adequate or poor staffing nursing patterns in a care facility (Hickey & Brosnan, 2017). It can be deduced that the behavior and the overall outlook of patients depend on the decisions they make from the information they receive as per the advice of nurses. In the event of inadequate personnel, the quality of life of patients is likely to be compromised due to insufficient education on self-care (Hill & DeWitt, 2018). The environment of care can also be altered and expose patients to hospital-acquired infections as opposed to when there is adequate nursing staff.

The data collection plan is also based on the analysis of diagnosis-related groups (DRGs). The latter denotes a case-mix of patients which categorizes clients as per their diagnoses, demographic characteristics, and treatments administered to them. In a nutshell, the DRGs provide data on the number of doctors, nurses and medical products used to offer given care to patients (Woo, Milworm & Dowding, 2017). Further, the DRGs provides feasible data on the number of care providers required to support prompt as well as quality care. The project on safe nurse-patient ratios will rely on the data from DRGs to provide a measure and indicators on the minimum number of nurse staffing ratios that can affect the quality of patient care in a given facility.

Nurse’s Role in Correct Data Collection

Nurses are integral in providing information related to patient safety in a care facility. The professionals avail data that can be used in the analysis of staffing by acuity indicators. In other words, nurses are the health professionals that have close proximity to patients, and as such, they provide actual information on the number of patients under their care. They can inform hospital administrators if the number of patients they attend to are more or less based on their ability to provide the service. Acuity in a care setting is ranked as per the severity of illness rated based on minor to major and extreme conditions. A nurse ratio of 1:4 is the recommended scale to solve thrilling severity of patient conditions. The measure indicates the level of flexibility of a hospital to provide care to patients with complicated illnesses. Studies by Hill and DeWitt (2018) and Lee et al. (2017) affirm that nurse leaders and advanced registered nurses use aggregate data to measure as well as monitor the trends in quality care to patients. The information gathered is incorporated into data collected from administrative and multiple clinical databases from the facility, which will further be used to analyze the trends or to support research in the given health facility.

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Professional, Ethical, and Regulatory Standards Implementation

The project implementation requires quality improvement actions based on the ethical and regulatory standards of nurse

Benchmark Assignment Quality Improvement Initiative

Benchmark Assignment Quality Improvement Initiative

staffing. Related standards and criteria need to conform to the federal regulations on a number of health professionals required in care facilities (Woo, Milworm & Dowding, 2017). The safe nurse-to-patient ratios program as well addressing the number of licensed registered nurses and practical nurses that conforms to the regulatory requirement of health facilities of a state become necessary. The effectiveness of a quality improvement initiative depends on the employment of nurses with competency in their area of specialty to optimize patient outcomes (Mikhail & Langabeer, 2018). However, confidentiality of the sensitive information reported by nurses on the administrative practices of a given facility must be guaranteed as a remedy to victimization.

The American Nurse Association (ANA) recommends specific rates of nurse-to-patient ratios in different departments of a health facility. In the critical unit, a ratio of 1:2 is recommended while at the emergency department the regulatory body expects 1:4. Further research by Lee et al. (2017) suggests that the standard criteria of the ANA guide on the implementation of the quality initiative. The stipulated recommended ratios will guide nurse staffing.

Communication to Stakeholders

Implementation of the quality improvement initiative can be well achieved through effective communication to stakeholders. The initial process will require the provision of accurate and adequate information for justification on the implementation of safe nurse-to-patient ratios (Wong, 2015). Stakeholders will be informed on the current state of the nurse-to-patient ratios so that they evaluate the need for quality improvement. As part of the quality improvement team, I will schedule a meeting with the stakeholders where the facts and figures related to the safe patient care will be availed. I will also collect feedback from key stakeholders regarding the program and compile a report that will steer the implementation process.

Interprofessional Collaboration

The implementation of the safe nurse-to-patient ratios will depend on the leadership skills emulated by the stakeholders in the given health facility. According to Laureani, Brady and Antony (2013), nurse leaders and the project management team must display leadership skills to inspire other nurses as they strive to improve patient care. Besides, the leaders need to create a staffing plan that aims to respond to unpredictable nursing turnover as part of the improvement initiative to address patient acuity. The stakeholders will also be expected to communicate progress to all team members and highlight areas where the program should be given priority (Laureani, Brady & Antony, 2013). However, as part of stakeholder engagement, leaders must portray interprofessional collaboration so that the program is accepted within the care facility. Cullen (2018) posits that successful implementation of the program depends on how the leaders define the financial requirement, emulate time management skills and address potential challenges that might impede achievement of safe patient care.

Conclusion

In conclusion, the need to improve quality in healthcare necessitates the introduction of systematic approaches to prioritize on actions required for care delivery. Safe nurse staffing in health facilities is essential in improving the well-being of patients. However, in addressing the nurse staff deficit, the stakeholders will need to employ skilled and competent professionals. Further, it will be vital to assess the acuity in the selected hospital and allocate nurses based on the severity of patients’ illnesses. All these approaches are aimed at minimizing medication errors as well as to improve the quality of health outcomes.

One way informatics can be especially valuable is in capturing data to support quality improvements in practice. Nurse leaders play a pivotal role in leading and managing quality initiatives that impact patient outcomes, safety, and health care organizations’ compliance with regulatory agencies. For this assignment, you will locate 1-2 quality measures and determine how that measure will be incorporated in nursing and provider documentation. You will formulate requirements and a plan for collecting and reporting the data. You will also reflect on how you would lead and manage such a project.
In a paper of 1,500-1,750 words, address the following:
Identify the selected quality measure(s).
Describe your plan for collecting the data related to the measure. What key information/fields would be needed in the database for you to capture the needed data? How would this data be mapped to the quality measure(s)?
What role would the advanced registered nurse play in ensuring the correct data is captured? Which additional systems and staff members would need to be involved in the design and implementation process and team?
What professional, ethical, and regulatory standards must be incorporated into the design and implementation of the plan?
How would you communicate any necessary changes related to your plan to any affected stakeholders?
Describe the leadership skills and project management knowledge you would employ to successfully collaborate with the interprofessional team in this scenario to ensure your facility is providing evidence-based care to its patients?
You are required to cite 5-10 sources to complete this assignment. Sources must be published within the last five years and appropriate for the assignment criteria and nursing content.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite.

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Benchmark – Effective Approaches in Leadership and Management – Rubric

Rubric Criteria

Total 150 points

Criterion

1. Unsatisfactory

2. Less Than Satisfactory

3. Satisfactory

4. Good

5. Excellent

Professional Standards of Practice to Rectify Issue or Maintain Professional Conduct (B)

Professional Standards of Practice to Rectify Issue or Maintain Professional Conduct (D3.4)

0 points

How professional standards of practice should be demonstrated in this situation to help rectify the issue or maintain professional conduct is not discussed.

16.88 points

A summary of how professional standards of practice should be demonstrated in this situation to help rectify the issue or maintain professional conduct is presented. The summary is incomplete. More information is needed. There are significant inaccuracies.

17.78 points

A general discussion of how professional standards of practice should be demonstrated in this situation to help rectify the issue or maintain professional conduct is presented. There are some gaps in the discussion; some information is needed. There are minor inaccuracies. Rationale is needed for support.

20.03 points

A discussion of how professional standards of practice should be demonstrated in this situation to help rectify the issue or maintain professional conduct is presented. Minor detail is needed for clarity or accuracy. Rationale provides adequate support.

22.5 points

A through discussion of how professional standards of practice should be demonstrated in this situation to help rectify the issue or maintain professional conduct is presented. An understanding of the importance of professional standards of practice in resolving issues and maintaining professional conduct is demonstrated. Strong rationale supports discussion.

Ensuring Professionalism Through Diverse Health Care Settings (B)

Ensuring Professionalism Through Diverse Health Care Settings (C1.1)

0 points

Discussion on what additional aspects managers and leaders would need to initiate to ensure professionalism throughout diverse health care settings while addressing the selected issue is omitted. The discussion fails to meet the assignment criteria.

22.5 points

A partial summary on what additional aspects managers and leaders would need to initiate to ensure professionalism throughout diverse health care settings while addressing the selected issue is presented. The summary contains significant omissions. There are inaccuracies.

23.7 points

A general discussion on what additional aspects managers and leaders would need to initiate to ensure professionalism throughout diverse health care settings while addressing the selected issue is presented. It is unclear how some of the aspects continue to address the selected issue, or the aspects do not appear to relate to a diverse health care setting.

26.7 points

A discussion on what additional aspects managers and leaders would need to initiate to ensure professionalism throughout diverse health care settings while addressing the selected issue is presented. Overall, the aspects presented address the selected issue and relate to a diverse health care setting. The items proposed in the discussion generally support professionalism in diverse health care settings.

30 points

A detailed discussion on what additional aspects managers and leaders would need to initiate to ensure professionalism throughout diverse health care settings while addressing the selected issue is presented. The aspects presented clearly continue to address the selected issue and relate to a diverse health care setting. The items proposed in the discussion support the exemplification of professionalism in diverse health care settings.

Paper Format (use of appropriate style for the major and assignment)

Paper Format (use of appropriate style for the major and assignment)

0 points

Template is not used appropriately, or documentation format is rarely followed correctly.

2.25 points

Appropriate template is used, but some elements are missing or mistaken. A lack of control with formatting is apparent.

2.37 points

Appropriate template is used. Formatting is correct, although some minor errors may be present.

2.67 points

Appropriate template is fully used. There are virtually no errors in formatting style.

3 points

All format elements are correct.

Argument Logic and Construction

Argument Logic and Construction

0 points

Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.

5.63 points

Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.

5.93 points

Argument is orderly but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis.

6.68 points

Argument shows logical progression. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.

7.5 points

Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.

Mechanics of Writing (includes spelling, punctuation, grammar, language use)

Mechanics of Writing (includes spelling, punctuation, grammar, language use)

0 points

Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.

5.63 points

Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied.

5.93 points

Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed.

6.68 points

Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech.

7.5 points

Writer is clearly in command of standard, written, academic English.

Leadership Style to Address Issue

Leadership Style to Address Issue

0 points

A leadership style to address the chosen issue is omitted. The proposed item is not a leadership style.

16.88 points

A leadership style to address the chosen issue is partially summarized. The characteristics of the leadership style are vaguely presented. It is unclear why this style could be successful in this setting.

17.78 points

The characteristics of the identified leadership style are described. A general explanation of why this style could be successful in this setting is presented. There are some gaps in the explanation. More information or rationale is needed.

20.03 points

The characteristics of the identified leadership style are described. An explanation of why this style could be successful in this setting is presented. Some rationale is needed for support.

22.5 points

The characteristics of the identified leadership style are clearly described. A detailed explanation of why this style could be successful in this setting is presented. Strong rationale is provided for support.

Selected Issue, Setting, and Impact on Patient Safety

Selected Issue, Setting, and Impact on Patient Safety

0 points

The issue described does not meet the assignment criteria. The description of the issue and its impact to quality of care and patient safety is omitted.

16.88 points

A partial summary of the issue is presented. How it impacts quality of care and patient safety is unclear. There are omissions of key information.

17.78 points

A general description of the issue is presented. A summary of how it impacts quality of care and patient safety is presented; more information is needed. There are some inaccuracies.

20.03 points

A description of the issue is presented. How the issue impacts quality of care and patient safety is presented. Some detail is needed for clarity or accuracy.

22.5 points

A clear description of the issue is presented. How the issue impacts quality of care and patient safety is detailed and accurate.

Differing Roles and Approaches of Nursing Leaders and Nursing Managers (B)

Differing Roles and Approaches of Nursing Leaders and Nursing Managers (C1.3)

0 points

Explanation of the differing roles and approaches for nursing leaders and nursing managers is omitted.

16.88 points

A partial explanation of the differing roles and approaches for nursing leaders and nursing managers is presented. It is unclear how the roles and approaches relate to the selected issue, or how they would promote patient safety and quality care. Rationale using theories, principles, skills, and nursing manager or nursing leader roles is not used.

17.78 points

A general explanation of the differing roles and approaches for nursing leaders and nursing managers is presented. A general summary of how the roles and approaches relate to the selected issue, and how they would promote patient safety and quality care, is provided. Some rationale using theories, principles, skills, and nursing manager or nursing leader roles is used.

20.03 points

An explanation of the differing roles and approaches for nursing leaders and nursing managers is presented. An explanation of how the roles and approaches relate to the selected issue, and how they would promote patient safety and quality care, is provided. Rationale using theories, principles, skills, and nursing manager or nursing leader roles is used. Some detail is needed for accuracy or clarity. More rationale is needed in some areas. The explanation demonstrates a general understanding of the of nursing leadership and management roles in the promotion of patient safety and quality care.

22.5 points

A detailed explanation of the differing roles and approaches for nursing leaders and nursing managers is presented. A well-developed explanation of how the roles and approaches relate to the selected issue, and how they would promote patient safety and quality care, is provided. Rationale using theories, principles, skills, and nursing manager or nursing leader roles is used. The explanation demonstrates insight into exercising the roles of professional nursing leadership and management in the promotion of patient safety and quality care.

Thesis Development and Purpose

Thesis Development and Purpose

0 points

Paper lacks any discernible overall purpose or organizing claim.

5.63 points

Thesis is insufficiently developed or vague. Purpose is not clear.

5.93 points

Thesis is apparent and appropriate to purpose.

6.68 points

Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.

7.5 points

Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.

Documentation of Sources

Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)

0 points

Sources are not documented.

3.38 points

Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.

3.56 points

Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.

4.01 points

Sources are documented, as appropriate to assignment and style, and format is mostly correct.

4.5 points

Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.

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