NR 451 Week 4: Evaluating Quality Patient Outcomes

NR 451 Week 4: Evaluating Quality Patient Outcomes

For this week’s discussion, we are discussing quality improvement and change. These improvements are not only necessary to decrease the occurrence of harm and or wrongful death but also to improve the quality of life for our patients.  Data can aid in the evaluation of effectiveness, cost, and planning delivery of care. It gives insight into the allocation and utilization of resources and also assesses the accessibility of care for our patients in varied settings. These considerations allow for concerns in economic matters, ethical matters and social diversities.  When discussing an example of data that reflects poor quality of care, I would like to use a personal experience with my own hospital setting. I do this, not because I feel the place I work is a poor place, but we experienced something that I believe is probably widespread and I think many could benefit. We were required to do an error prevention class for the hospital. The wrongful death and harm statistics were from our very own organization.

Our facility went to great effort years ago discussing how we should not multitask and the do not disturb zone while preparing medications. Unfortunately, as any good plan there is a lack of follow thru. Not only are we interrupted , but the phones attached to each nurse is a disruption. All alarms go to our phones and parents call expecting nurses to answer. The alarms have frequent false alarms.

The EPIC system has a great PER to review patients’ information, but many nurses continue the unsafe practice of getting report without reviewing orders, medications, and history. It is frustrating for nursing not to use tools provided that are set up for patient safety.

Our management is very young. Lacking knowledge of how to train, and fail to oversee policy and procedures that are not followed. Concerns are handed down to them to oversee budget. Decreasing overtime and disciplinary actions on attendance. I know these are the focus of upper management, but will this every change to improve care provided? Over loading nurses with increased acuities of patients leads to corners to be cut leading to unsafe practices. The impact on the nursing professional of increased workload discourages nurse from changing overall practices.

These were people, families in our community effected directly by errors within our health system……. deaths in some cases, by mistake of personnel. It is an eye opener to see charts, graphs and data that reflect errors that you yourself could have easily made. We have had a huge shift in error prevention and culture for error identification. We were shown that a 15% spike in error was seen during our go live with a new software system. This data absolutely identified areas of much needed improvement, more than that …….it identified that change was essential, our patients lives depended on it. We don’t talk about the astonishing numbers that reflect medical error and wrongful death enough. It is not easy to talk about. We are all human, but when you understand that your own life, the lives are your family members receiving care are at stake when healthcare has a “glitch”, it is a whole new perspective. In our assigned article this week it states,” today we may be doing what we can, but tomorrow we can improve”,(Hughes,2008).

Quality improvement is definitely a part of daily workflow, because every day we can make strides to perform better, be more efficient, more cost effective. As nurses, we are in actual one on one contact with patients, more than other discipline in healthcare, (ANA,2015). We spend more time, often develop the relationship aspect of healthcare and are looked to for education, intervention, avocation and support by our patients and their families. We bring the “human” to the very technical, often harsh reality of healthcare. I read an article of the influence of quality improvement and how it effects not only our patients by our own work. I feel this sums up the need to change through improvement. “As advances are made, patient’s needs and expectations of healthcare are changing as well. It is part of the dedication to the nursing profession to develop quality and safety measures, identify gaps of knowledge, share innovations of quality and performance improvement initiatives, incorporate technologies to impact workflow efficiency, safety, and cost,” (Weston&Roberts,2013).

I read that, jotted in down, and when typing it, I read it out loud about