NURS 8302 Quality and Safety in Healthcare and Nursing Practice

Sample Answer for NURS 8302 Quality and Safety in Healthcare and Nursing Practice Included After Question

By Day 3 of Week 1

Post a brief description of any previous experience with quality and safety. Then, explain how your role as the DNP-prepared nurse represents a function of quality and safety for nursing practice and healthcare delivery. Be specific and provide examples.

By Day 5 of Week 1

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 suggesting an additional alternative perspective on quality and safety.

A Sample Answer For the Assignment: NURS 8302 Quality and Safety in Healthcare and Nursing Practice

Title: NURS 8302 Quality and Safety in Healthcare and Nursing Practice

Previous Experience with Quality and Safety

Quality and safety in nursing play a vital role in the care provided to patients and their outcomes.  Preventable errors have caused adverse patient outcomes; however, the staff has been facing increased stress, burnout (BO), and compassion fatigue (CF) in the past few years since the COVID pandemic. The rapid spread of the COVID – 19 took the medical professionals by surprise, causing emotional and physical strain, decreased physical and mental health well-being, and decreased performance.

During March 2020 and April 2020, the American Nurse Association surveyed nurses’ concerns and experiences, and there was a concern of 74% lack of proper personal equipment, 64% were concerned about family and friends, and around 85% expressed actual fear of going to the workplace (Judith et al., 2020). As an emergency room nurse in a level two trauma center, we recently found ourselves with an increase in staffing shortage due to illness, lack of support/resources, increased CF, BO, and the COVID Mandate.   

Unfortunately, the lack of staffing has impacted the quality of care provided to the patients and imposed a safety issue for the patients. With staff shortages, the risk of adverse events occurring is high. Unfortunately, healthcare safety remains an issue despite the patient safety movements for the past years (Barkell & Snyder, 2021). There have been several preventable medication errors, one which clearly should have been prevented. Nurses did not pay adequate attention to drug and administration orders because they were distracted by the effects of the staffing shortage, lack of pay, and exhaustion.

One of the staff gave the wrong patient the medication intended for another patient. Fortunately, a non-lethal dose was given, and no adverse events occurred;  however, this could have been a much different outcome. The nurse felt horrible about the medication error and is aware of the potential poor outcome. Still, unfortunately, as she says, she is burning the candle at both ends (M. Levy, personal communication, November 25, 2021). Common errors occur, policies and procedures to prevent these events are essential to be established.

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Role as A DNP-Prepared Nurses

As a well-prepared graduate of a DNP-FNP program, as mentioned in the Walden Handbook (2017), my advanced education can improve the community, professional, and personal life outcomes. Increased knowledge, problem-solving skills, effective communication,  and leadership focus on older policies and procedures, updating current healthcare directives and needs while keeping up with the continuous healthcare changes.

I can impact the stakeholders within and outside the community, establishing methods and processes to improve patient care and cultural diversity while maintaining respect,  integrity, compassion, understanding, and professionalism towards all stakeholders. Giardino & Hickey (2020) mentioned that the advanced education and structure would provide the tools needed to provide positive changes and outcomes. With the tools learned, one can make positive changes in healthcare, improving patient outcomes and staff satisfaction.

NURS 8302 Quality and Safety in Healthcare and Nursing Practice
NURS 8302 Quality and Safety in Healthcare and Nursing Practice

References

Barkell, N. P., & Snyder, S. S. (2021). Just culture in healthcare: An integrative review. Nurs Forum, 56(1), 103-111. https://doi.org/10.1111/nuf.12525

Giardino, E. R., & Hickey, J. V. (2020). Doctor of nursing practice students’

            perceptions of professional change through the DNP program. Journal of

Professional Nursing36(6), 595–603. https://doi-10.1016/j.profnurs.2020.08.012

Judith, E. A., Courtney, M. G., Bengt, B. A., & Eamonn, A. (2020). Nurse reports of stressful situations during the COVID-19 pandemic: Qualitative analysis of survey responses. International Journal of Environmental Research and Public Health, 17(8126), 8126-8126. https://doi.org/10.3390/ijerph17218126

Kohn, L.T., Corrigan, J.M, & Donaldson, M.S. (Eds). (200). To err is human: Building a safer health system. National Academies Press.

Walden University. (2017). 2016-2017 Walden University student

            handbook. https://catalog.waldenu.edu

A Sample Answer 2 For the Assignment: NURS 8302 Quality and Safety in Healthcare and Nursing Practice

Title: NURS 8302 Quality and Safety in Healthcare and Nursing Practice

Experience with Quality and Safety

Quality and safety are the driving force behind delivering and promoting optimal care (Stalter & Mota, 2018). My primary role as a clinical nurse is to provide high-quality, patient-centered care using evidence-based practice. Before giving any care or medication dispensing, I include EBP into the routine. In my current role, I noticed that my colleagues rely on post-education, and I feel that approach is integrated at the wrong time, which is usually after an incident or error has occurred. I strongly believe in pre-education and promoting evidence-based practice in nursing.

I work on a 23-bed Med-Surg unit, and Friday mornings are the busiest surgical days. On this morning, a nurse administered a patient scheduled for Coronary Artery Bypass Graft (CABG) 20 units of Aspart and 15 units of Regular for a blood sugar of 206. Unfortunately, the patient had been NPO after midnight before the day of surgery. In the meantime, as we continued to make rounds and administer morning medications on the unit, the nurse received a call from the telemetry unit that the patient heart rhythm converted from normal sinus rhythm to ventricular tachycardia. The staff quickly went to the bedside and noted the patient to be diaphoretic, lethargic with a heart rate sustaining in the 130-150’s.

Immediately we had to call the rapid response team for further assistance. After the team arrived and was given a full report on the patient, the team administered IV antiarrhythmic medication to aid with the heart rate and a bolus of IV fluids for the blood pressure. Then, of course, the surgery was postponed, and the patient was transported to the ICU for closer observation. At shift change, the nurses had to report on what happened and how the patient received such a high insulin dose. Any high-alert medications must have two verifiers; only one nurse verified and administered the drug, which led to the error above.

After further investigation, it was a computer error because it did not prompt the alert box for an additional signer. In addition, the nurse who administered the medication was new to the unit. I’m not making any excuses; however, the nurse should have verified the insulin order with the charge nurse or the ordering provider. Also, the ordering provider should have discontinued the order before surgery, which could have prevented the error. Therefore, thorough education and the implementation of evidence-based practice are imperative in nursing.

Role as a DNP-Prepared Nurse

As a DNP-Prepared nurse, I intend to integrate evidence-based practice by developing our organizational culture that supports best practice and promotes opportunities for staff to enhance their clinical skills and knowledge. With the healthcare system being so complex, as a DNP-prepared nurse, promoting a healthy work environment is an effective solution to promoting quality improvement and being proactive in preventing errors or glitches before they occur (Abdul, Jarrar & Don, 2015).

In addition, I would advocate for the implementation of evidence-based practice throughout the nursing unit and organization by educating nurses on skills, such as critical appraisal and translation of research findings into practice (Tu & Wang, 2011). Furthermore, in my role as a DNP-prepared nurse, I can use error prevention strategies by continuously monitoring outcomes and completing root cause analysis when errors occur, including the input from clinical staff and the leadership team.

References:

Abdul, R.H., Jarrar, M., & Don, M.S. (2015).  Nurse level of education, quality of care and

     patient safety in the medical and surgical wards in Malaysian private hospitals: A cross-

     sectional study. Global Journal of Health Sciences.7(6):331-337. doi: 10.5539/gjhs.v7n6p33.

Stalter, A., & Mota, A. (2018). Using systems thinking to envision quality and safety    

     in healthcare, Nursing Management. Volume 49(2): doi:

    10.1097/01.NUMA.0000529925.66375.d0.

Tu, Y.C., & Wang, R.H. (2011). High-quality nursing health care environment: The patient      safety perspective. Hu Li Za Zhi 58(3): 93-8. https://pubmed.ncbi.nlm.nih.gov/21678259

A Sample Answer 3 For the Assignment: NURS 8302 Quality and Safety in Healthcare and Nursing Practice

Title: NURS 8302 Quality and Safety in Healthcare and Nursing Practice

SAMPLE 2

Patient safety has been the forefront issue in healthcare for the longest time.  Quality and safety measures are integral components of healthcare.  The boom of technology made the growth in knowledge of healthcare challenging to ascertain; they both have been profound.  More than 70 publications in leading peer-reviewed journals have documented serious quality shortcomings during the last decade alone (Institute of Medicine, 2001).  Deprived of critical access to basic health care, more than 40 million Americans remain without health insurance (U.S. Census Bureau, 2000 as cited in Institute of Medicine, 2001).

The healthcare system is complex, so working collaboratively with other disciplines, like pharmacy, physical therapy, doctors, nurses, etc. is essential.  However, physician groups, hospitals, and other healthcare organizations operate as silos, often providing care without the benefit of complete information about the patient’s condition, medical history, services provided in different settings, or medications prescribed by other clinicians (Institute of Medicine, 2001).

As a charge nurse and DNP-prepared nurse, I can support quality and safety measures.  Right now, just trying hard will not cut it.  We have to bridge the gap and cross the chasm.  Mistakes happen; we are only human.  It is estimated that as many as 98,000 people die in any given year from the medical errors that occur in hospitals (Kohn et al., 2000).  The problem is not necessarily that we have bad people in healthcare, but we have a broken system. 

Just culture relates to how mistakes should be addressed.  Human error and systemic problems are considered in addressing the conduct of individual people instead of universally applying blame and punishment (Ungvarsky, 2023).  It advocates fair sentencing for conduct that is deliberately reckless or that flouts safety rules and precautions.  Just culture is seen as a way to encourage accountability and identify problem areas that need correction.  A strong and effective just culture is a cornerstone of any organization, especially regarding patient safety.  It promotes voluntary error reporting so we can address safety-related events promptly, instead of simply assigning blame (Logroño et al., 2023). 

References:

Institute of Medicine (U.S.) Committee on Quality of Health Care in America. (2001). Crossing the quality chasm: A new health system for the 21st centuryLinks to an external site.Links to an external site.. National Academies Press.

Logroño, K. J., Al-Lenjawi, B. A., Singh, K., & Alomari, A. (2023). Assessment of nurse’s perceived just culture: a cross-sectional study. BMC Nursing22(1), 1–9. https://doi.org/10.1186/s12912-023-01478-4

Kohn, L. T., Corrigan, J. M., & Donaldson, M. S. (Eds). (2000). To err is human: Building a safer health systemLinks to an external site.Links to an external site.. National Academies Press.

Ungvarsky, J. (2023). Just culture. Salem Press Encyclopedia of Health.

A Sample Answer 4 For the Assignment: NURS 8302 Quality and Safety in Healthcare and Nursing Practice

Title: NURS 8302 Quality and Safety in Healthcare and Nursing Practice

Thank you for sharing your perspective on the crucial role of healthcare providers, particularly nurses, in ensuring quality and safety in patient care. It’s indeed a profession that carries a significant amount of responsibility, and your dedication to maintaining high standards is commendable.

Your experience highlights the importance of effective safeguards to prevent medical errors. The example you provided regarding medication reconciliation is particularly insightful. The implementation of external medication reconciliation and the double-check process you follow in your current role demonstrate a proactive approach to mitigating risks and ensuring patient safety. It’s inspiring to see healthcare professionals actively working towards improving systems and processes to enhance the quality of care.

The mention of HEDIS as a tool for determining clinical quality is noteworthy. It’s encouraging to hear about the integration of such systems to assess and uphold high standards of healthcare delivery. As the landscape of healthcare continues to evolve, these tools become increasingly vital in providing evidence-based care and continuously improving the quality of services (Al-Jabri et al., 2021).

Additionally, your reference to the role of a Doctor of Nursing Practice (DNP) prepared nurse is crucial. As healthcare systems become more complex, having advanced practitioners who can navigate and contribute to policy changes and system improvements is invaluable. DNPs are well-equipped to drive positive changes in healthcare delivery, and your emphasis on their ability to implement these changes is well-founded (López-Hernández et al., 2020).

In your future endeavors, continue to champion patient safety and quality care, and your commitment will undoubtedly contribute to the advancement of healthcare practices. Thank you for your dedication to this noble profession and your ongoing efforts to make a positive impact on patient outcomes.

References 

Al-Jabri, F., Kvist, T., Sund, R. et al. Quality of care and patient safety at healthcare institutions in Oman: quantitative study of the perspectives of patients and healthcare professionals. BMC Health Serv Res 21, 1109 (2021). https://doi.org/10.1186/s12913-021-07152-2

López-Hernández, L.B.; Díaz, B.G.; Zamora González, E.O.; Montes-Hernández, K.I.; Tlali Díaz, S.S.; Toledo-Lozano, C.G.; Bustamante-Montes, L.P.; Vázquez Cárdenas, N.A. Quality and Safety in Healthcare for Medical Students: Challenges and the Road Ahead. Healthcare 2020, 8, 540. https://doi.org/10.3390/healthcare8040540