Assignment: Identify a problem; it may be related to structure, process, or an outcome

Assignment: Identify a problem; it may be related to structure, process, or an outcome

Assignment: Identify a problem; it may be related to structure, process, or an outcome

Identify a problem; it may be related to structure, process, or an outcome. Be clear in your problem and be cautious to not identify multiple problems. Identify a quality improvement methodology from Hughes (2008), Chapter 44: Tools and Strategies for Quality Improvement and Patient Safety, that you will use to frame your improvement initiative. Identify the key stakeholder to the problem/improvement initiative. Why is it important to identify/engage stakeholders?Discuss the root cause of the problem. You might use the formal root cause analysis (RCA) process to do this or simply your determination of the root cause. Describe your planned improvement steps. It will be important here that your steps match those of whatever quality improvement methodology you choose. For example, if you choose to use a Plan, Do, Study, Act methodology, this section of your paper would be writing about what you would be doing (relative to your problem) in the planning phase, in the doing phase, in the study phase, and in the act phase. If you include a figure with your paper, please research APA Style for figures and the correct location in your paper.Finally, describe how you would evaluate the effectiveness of your actions/improvement initiative. In other words, how would you know you were successful?

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Improvement Model Assignment

Quality improvement (QI) in nursing practice is an essential aspect that healthcare organizations need to embrace to ensure continuous improvement for patients to receive safe and quality healthcare services. The Institute of Medicine (IOM) definition of QI refers to the correlation between the expected patients’ health outcomes and improved health services (Hughes, 2008). As healthcare organizations continue to engage in QI, most are implementing different technologies to reduce medication errors. However, these technologies also pose various risks since, in most cases, the healthcare organizations focus more on the technology solutions forgetting to assess the risks associated with healthcare technology. The paper will identify a problem and ways health care organizations can improve it.

Problem Identification

Bar-Coded Medication Administration (BCMA) is a system used by healthcare organizations for inventory control that uses barcodes to prevent prescription errors. According to Mulac et al. (2021), BCMA’s initial aim was to ensure that patients receive the right medication prescriptions within the right period by documenting and validating medications electronically. However, the major issue associated with BCMA is that most healthcare providers do not counter-check the medication administration accuracy, which may pose a great threat to patient health safety if the system workflow process fails.

Quality Improvement Methodology

The most appropriate quality improvement methodology associated with BCMA to assist healthcare providers in counter-checking on medication administration accuracy is the Plan-Do-Study-Act (PDSA) model (Hughes, 2008). The PDSA worksheet is an essential tool in healthcare that helps healthcare organizations document a change test to improve such change effectiveness. Hence, when evaluating the BCMA issue in healthcare, the PDSA model will help plan the change test, carry out the planned test, observe the change consequences and identify the most appropriate modification to improve the change.

Key Stakeholders and Reasons for their Engagement

The main stakeholders in the quality improvement are the nurses, physicians, pharmacists, healthcare management, the BCMA vendors, and the patients. Using the social-marketing perspective, incorporating all stakeholders affected by a technological device during quality improvement trials is essential (Hybarger et al., n.d). That is because different technology users have different views on ways to implement a change. Hence, through engaging a proactive key stakeholder assessment, nurses, physicians, pharmacists, and patients who are the BCMA system end-user should be part of the improvement. Also, the PDSA model recommends engaging internal and external stakeholders to help the quality improvement team identify the positivity and negativities of an improvement

Problem Root Cause

The main problems associated with BCMA prescription errors can occur at any stage. However, when these errors occur during the medication’s early stages, especially in order, the healthcare providers can easily detect them by 50 percent compared to the administration stage at 2 percent (Mulac et al., 2021). Therefore, the main reason BCMA prescription errors become less detected during administration is mainly associated with healthcare providers’ failure to counter-check medication administration accuracy.

Planned Improvement Steps

In improving the BCMA issue on medication administration errors, the most appropriate improvement is to engage the Point-of-Care (POC) Scan (Yang et al., 2019). For the effectiveness of the POC scan, there will be a need to engage the five rights, which include the right patient, right dose, right drug, right time, and right route. Hence, the most appropriate model to assess POC feasibility will be the PDSA model, whose steps include;

Planning Phase

The planning phase will incorporate five considerations, the first being recruitment of the quality improvement team. The team recruited should know the problem and the major opportunities that may arise from such a problem. Hence, in the case of BCMA, the team should involve nurse informaticists, pharmacists, nurses, a human resource manager, and a nurse leader who will be in charge of the change. The next consideration will involve drafting an aim statement to identify what the project team wants to achieve by the end. Also, brainstorming will be important to help the team understand the BCMA problem more to understand and analyze the causes.

Do Phase

The Do phase will require the change team to implement the action plan. But, first, they will need to continue collecting data to assess the project’s feasibility. In that case, they will need to use a flow chart to capture occurrences, including documentation of general observations, unexpected effects, and problems encountered.

Study Phase

The study phase will involve the evaluation of any change occurrence from the implementation through the reflection of phases one and two. Also, the team will evaluate the most efficient change and how the change may have led to the rise of other issues. In such a case, the project team can use control charts to assess and review the improvement.

Act Phase

The stage will require the project team to evaluate the BCMA issue project’s initial plan and outcomes to assess whether it was a success. If they identify any queries, the team will need to start from stage one to try out new plans. However, if the plan is successful, the team will celebrate the success and document the lessons for future reference.

Evaluation of Implementation Effectiveness

The implementation effectiveness evaluation will be through administering a survey to the patients and healthcare providers after two months of project implementation. The reason for incorporating the two stakeholders is to ensure objectivity is obtained to prevent future occurrence of BCMA medication administration inaccuracy.

Conclusion

The identified problem regards the BCMA medication administration inaccuracy and issue caused by nurses’ failure to counter-check medication administration. In improving the project quality, the Point-of-Care scan when administering medication will be effective. However, in evaluating the intervention’s feasibility, the Plan-Do-Study-Act model will be more appropriate for the project team.

References

Hybarger, K., Steigmeyer, C., Lee, B., & Woolley, L. (n.d.). Quality improvement process using Plan, Do, Study, Act (PDSA) – Planning for action. https://www.in.gov/health/files/Quality_Improvement_Process_Using_PDSA_Presentation.pdf

Hughes, R. G. (2008). Tools and strategies for quality improvement and patient safety. Patient safety and quality: An evidence-based handbook for nurses. (AHRQ Publication No. 08-0043, Vol. 3, pp. 1-39). Rockville.

Mulac, A., Mathiesen, L., Taxis, K., & Granås, A. G. (2021). Barcode medication administration technology use in hospital practice: a mixed-methods observational study of policy deviations. BMJ quality & safety, 30(12), 1021-1030. http://dx.doi.org/10.1136/bmjqs-2021-013223

Yang, M., Liu, Y., & Jiang, X. (2019). Barcoded point-of-care bioassays. Chemical Society Reviews, 48(3), 850-884. https://doi.org/10.1039/C8CS00303C