Quality ImprovementCaitlyn PatrickOhio UniversityNRSE 4580Quality ImprovementQuality improvement is the process that a system undergoes to set goals so that patient care is continuously being improved for better quality patient outcomes (Taylor et al, 2018). Quality improvement is a cohesive process that is not only done by nurses, but incorporates physicians, insurances, families, staff at hospitals, and educators. The purpose of this paper is to discuss the quality improvement goals set in place that my current employer, Ohio Health, as well as provide examples of quality improvement goals within my organization. Quality Program GoalsThe organization that I work for currently has over 20,000 employees and over ten hospitals that are located within central Ohio. My organization has set programs quality improvement goals that are adopted system wide. Quality improvement happens when an entire system works together as a whole unit in order to provide consistent and quality care to the communities that are served (Huber, 2018). Throughout the system, there is a representative from each of the hospitals that make up our committee to make decisions on quality goals to be adopted system wide. Social workers, nurses, infection risk nurses, risk management personnel, and the quality representatives all meet to decide on the quality improvement goals throughout the system. The quality improvement goal that has been set into place is to provide the best care driven by evidence-based research so that the patient receives quality care throughout their hospitalization.Quality Improvement Projects and Methodology.Each hospital’s quality improvement representative will have meetings with the managers of every unit based upon previous audits that had taken place and decide what needs to be improved on. The manager will then meet with the charge nurses as well as the remainder of the staff and decide what action plans need to be set in place to fix issues, as well as who is going to be tracking the goal daily. The goal of quality improvement within systems is to improve the care of patients that we take care of so that patient safety is a top priority by following evidence-based research (LoBiondo-Wood & Haber, 2018). Nursing Input and Inservice Programs.Monthly meetings are held before our managers have met with quality committee each month. In the monthly meetings, effectiveness of previous goals that were being measured is evaluated and further input is asked from the staff on any ideas they may have to for improvement goals. Our manager has the ultimate final say in what goals are measured however nursing has an input on the quality improvement goal. Inservice programs are provided at each monthly staff meeting as well as readily available in different areas. The educator on the unit makes a PowerPoint bulletin that is played on the TV in our staff breakroom so it can be viewed on breaks, goals are briefly discussed at the morning huddle before coming on your shift, and it is sent in a newsletter found within your work email. The in-service information is easily accessible making the communication of the quality improvement goals effective.Evaluation of Quality Improvement Goals. The purpose on setting quality improvement goals is so that patient care and safety is the primary focus for nursing daily (Taylor et al,2017). My current facility has set a set time on each of the units daily to have a staff member present the five goals that have been focused upon for the current month. This daily meeting is very brief but shows if the goals have been met or not. If there is a goal that has not been met three consecutive days in a row, the staff must complete a “5 why” to breakdown the root cause and find a way to fix it. After completion of the analysis, the managers who are part of the GAMBA rounding will set a date to follow up on the goal to measure the effectiveness of new improvement plan. Quality Improvement Examples.There have been many quality improvements goals that have been set since working with my association for patient safety. The first example is primarily focused upon patient falls because I work on a Orthopedic surgical floor that recovers patients immediately after having shoulder repair/replacements, hip repair/replacements, knee repair/replacements, and spinal surgeries so fall prevention is of our top priorities. The goal to prevent falls is the constant evaluation of their fall risks and alerting staff to those who have a fall risk score of three or more. This scale is based upon their current medications, need for assistive devices, prior fall history, and their current mentation. If a patient has a score that is above a three, then they must have a yellow fall risk wristband, yellow socks, fall risk magnet on their door frame, and yellow tape on the floor in their doorway. If a patient has a fall risk of four then they must have everything listed above and either a bed alarm on, chair alarm on, and are not allowed to be left alone in the bathroom. Since adapting to this quality improvement standard, the falls within my unit have decreased substantially and we are currently on over thirty days without a fall. A second quality improvement goal is focused upon Intravascular access infections. Recently my organization had changed their catheters to having a “no spill” valve that would prevent any blood from leaking on a patient while insertion of an IV. Nurses had noticed there had been a couple of incidents that patients were diagnosed with phlebitis and had been septic from the infection identified from the IV site. The quality improvement team set goals systemwide to prevent this from happening again. The goal was to audit documentation that the IV site was being accessed and documented every four hours and that IV insertion sites were being used. Evidence based research has shown that any IV dressings to have blood residue, diaphoresis, or the loss of adhesive to the dressing have an increased risk of infection (O’Grady, 2017). The charge nurse would run an audit on documentation and access all the IV site appearances for each patient on the floor. Since implementing this quality goal, there has been improvement in site assessments and documentation in our charting system.In conclusion, the current organization that I work for has a quality improvement team that sets standards that every hospital has adapted system wide. The quality team is composed of a member from each of the hospital that focuses upon goals that our manager communicates to the staff on the unit. Two quality improvement measures that have been adopted on my unit is fall prevention and IV infection rates. The quality measures that are set in place are to improve the care that is given to our patients that we serve. ReferencesTaylor, E., Peikes, D., Geonnotti, K., McNellis, R., Genevro, J., & Meyers, D. (2018). Quality Improvement in Primary Care. Agency for Healthcare Research and Quality. Retrieved October 17, 2019, from https://www.ahrq.gov/research/findings/factsheets/quality/qipc/index.htmlO’Grady, N. (2017). Guidelines for Prevention of Intravascular Catheter-Related Infections. Center for Disease Control. Retrieved October 17,2019, from: https://www.cdc.gov/infectioncontrol/guidelines/bsi/recommendations.htmlLoBiondo-Wood, G., & Haber, J. (2018). Nursing research: methods and critical appraisal for evidence-based practice. St. Louis, MO: Elsevier.Huber, D. (2018). Leadership & nursing care management. (5th edition). St. Louis, MO: Elsevier.
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