Capella NURS-FPX4020 Assessment 4 Improvement Plan Tool Kit

Capella NURS-FPX4020 Assessment 4 Improvement Plan Tool Kit

Assessment 4: Improvement Plan Tool Kit

For this assessment, you will develop a Word document or an online resource repository of at least 12 annotated professional or scholarly resources that you consider critical for the audience of your safety improvement plan, pertaining to medication administration, to understand or implement to ensure the success of the plan.

Communication in the health care environment consists of an information-sharing experience whether through oral or written messages (Chard & Makary, 2015). As health care organizations and nurses strive to create a culture of safety and quality care, the importance of interprofessional collaboration, the development of tool kits, and the use of wikis become more relevant and vital. In addition to the dissemination of information and evidence-based findings and the development of tool kits, continuous support for and availability of such resources are critical.

Among the most popular methods to promote ongoing dialogue and information sharing are blogs, wikis, websites, and social media. Nurses know how to support people in time of need or crisis and how to support one another in the workplace; wikis in particular enable nurses to continue that support beyond the work environment. Here they can be free to share their unique perspectives, educate others, and promote health care wellness at local and global levels (Kaminski, 2016).

You are encouraged to complete the Determining the Relevance and Usefulness of Resources activity prior to developing the repository. This activity will help you determine which resources or research will be most relevant to address a particular need. This may be useful as you consider how to explain the purpose and relevance of the resources you are assembling for your tool kit. The activity is for your own practice and self-assessment, and demonstrates course engagement.

Demonstration of Proficiency

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

• Competency 1: Analyze the elements of a successful quality improvement initiative.

• • Analyze usefulness of resources for role group responsible for implementing quality and safety improvements with medication administration.

• Competency 2: Analyze factors that lead to patient safety risks.

• • Analyze the value of resources to reduce patient safety risk or improve quality with medication administration.

• Competency 3: Identify organizational interventions to promote patient safety.

• • Identify necessary resources to support the implementation and sustainability of a safety improvement initiative focusing on medication administration.

• Competency 5: Apply professional, scholarly, evidence-based strategies to communicate in a manner that supports safe and effective patient care.

• • Present reasons and relevant situations for resource tool kit to be used by its target audience.

• • Communicate resource tool kit in a clear, logically structured, and professional manner that applies current APA style and formatting.

References

Chard, R., & Makary, M. A. (2015). Transfer-of-care communication: Nursing best practices. AORN Journal, 102(4), 329–342.

Kaminski, J. (2016). Why all nurses can/should be authors. Canadian Journal of Nursing Informatics, 11(4), 1–7.

Professional Context

Nurses are often asked to implement processes, concepts, or practices—sometimes with little preparatory communication or education. One way to encourage sustainability of quality and process improvements is to assemble an accessible, user-friendly tool kit for knowledge and process documentation.

Creating a resource repository or tool kit is also an excellent way to follow up an educational or in-service session, as it can help to reinforce attendees’ new knowledge as well as the understanding of its value. By practicing creating a simple online tool kit, you can develop valuable technology skills to improve your competence and efficacy. This technology is easy to use, and resources are available to guide you.

Scenario

For this assessment, consider taking one of these two approaches:

1. Build on the work done in your first three assessments and create an online tool kit or resource repository that will help the audience of your in-service understand the research behind your safety improvement plan pertaining to medication administration and put the plan into action.
2. Locate a safety improvement plan (your current organization, the Institution for Healthcare Improvement, or a publicly available safety improvement initiative) pertaining to medication administration and create an online tool kit or resource repository that will help an audience understand the research behind the safety improvement plan and how to put the plan into action.

Preparation for Capella NURS-FPX4020 Assessment 4 Improvement Plan Tool Kit

Google Sites is recommended for this assessment; the tools are free to use and should offer you a blend of flexibility and simplicity as you create your online tool kit. Please note that this requires a Google account; use your Gmail or GoogleDocs login, or create an account following the directions under the “Create Account” menu.

Refer to the following links to help you get started with Google Sites:

• G Suite Learning Center. (n.d.). Get started with Sites. https://gsuite.google.com/learning-center/products/sites/get-started/#!/
• Google. (n.d.). Sites. https://sites.google.com
• Google. (n.d.). Sites help. https://support.google.com/sites/?hl=en#topic=

Capella NURS-FPX4020 Assessment 4 Improvement Plan Tool Kit Instructions

Using Google Sites, assemble an online resource tool kit containing at least 12 annotated resources that you consider critical to the success of your safety improvement initiative. These resources should enable nurses and others to implement and maintain the safety improvement you have developed.

It is recommended that you focus on the 3 or 4 most critical categories or themes with respect to your safety improvement initiative pertaining to medication administration. For example, for an initiative that concerns improving workplace safety for practitioners, you might choose broad themes such as general organizational safety and quality best practices; environmental safety and quality risks; individual strategies to improve personal and team safety; and process best practices for reporting and improving environmental safety issues.

Following the recommended scheme, you would collect 3 resources on average for each of the 4 categories focusing on safety with medication administration. Each resource listing should include the following:

• An APA-formatted citation of the resource with a working link.
• A description of the information, skills, or tools provided by the resource.
• A brief explanation of how the resource can help nurses better understand or implement the safety improvement initiative pertaining to medication administration.
• A description of how nurses can use this resource and when its use may be appropriate.

Remember that you must make your site ‘public’ so that your faculty can access it. Check out the Google Sites resources for more information.

Here is an example entry:

• Merret, A., Thomas, P., Stephens, A., Moghabghab, R., & Gruneir, M. (2011). A collaborative approach to fall prevention. Canadian Nurse, 107(8), 24–29.

• • This article presents the Geriatric Emergency Management-Falls Intervention Team (GEM-FIT) project. It shows how a collaborative nurse lead project can be implemented and used to improve collaboration and interdisciplinary teamwork, as well as improve the delivery of health care services. This resource is likely more useful to nurses as a resource for strategies and models for assembling and participating in an interdisciplinary team than for specific fall-prevention strategies. It is suggested that this resource be reviewed prior to creating an interdisciplinary team for a collaborative project in a health care setting.

Additionally, be sure that your plan addresses the following, which corresponds to the grading criteria in the scoring guide. Please study the scoring guide carefully so you understand what is needed for a distinguished score.

• Identify necessary resources to support the implementation and continued sustainability of a safety improvement initiative pertaining to medication administration.
• Analyze the usefulness of resources to the role group responsible for implementing quality and safety improvements focusing on medication administration.
• Analyze the value of resources to reduce patient safety risk related to medication administration.
• Present reasons and relevant situations for use of resource tool kit by its target audience.
• Communicate in a clear, logically structured, and professional manner that applies current APA style and formatting.

Example Assessment: You may use the following example to give you an idea of what a Proficient or higher rating on the scoring guide would look like but keep in mind that your tool kit will focus on promoting safety with medication administration. Note that you do not have to submit your bibliography in addition to the Google Site; the example bibliography is merely for your reference.

• Assessment 4 Example [PDF].

To submit your online tool kit assessment, paste the link to your Google Site in the assessment submission box.

Example Google Site: You may use the example Google Site, Resources for Improved Heparin Infusion Safety, to give you an idea of what a Proficient or higher rating on the scoring guide would look like for this assessment but keep in mind that your tool kit will focus on promoting safety with medication administration.

Note: If you experience technical or other challenges in completing this assessment, please contact your faculty member.

Additional Requirements for Completing Capella NURS-FPX4020 Assessment 4

• APA formatting: References and citations are formatted according to current APA style

Improvement Plan Tool Kit Sample Paper

Prevention of medication errors among nurses utilizes the best available evidence-based practice knowledge to achieve the best outcomes. Medication errors related to medication administration are caused by various factors that can be condensed into personal and contextual factors. The proposed plan was derived from three main themes: the use of technology, medication reconciliation, and interdisciplinary collaboration. This annotated bibliography presents the best resources to empower nurses and health organizations with the best knowledge and strategies to prevent medication administration errors. 

Annotated Bibliography

Use of Technology to Prevent Medication Errors

Ahtiainen, H. K., Kallio, M. M., Airaksinen, M., & Holmström, A.-R. (2020). Safety, time and cost evaluation of automated and semi-automated drug distribution systems in hospitals: a systematic review. European Journal of Hospital Pharmacy. Science and Practice, 27(5), 253–262. https://doi.org/10.1136/ejhpharm-2018-001791

Medication errors impact patient safety, care costs, and efficiency of care. Various technological systems can be implemented to prevent prescription, dispensing, administration, monitoring, and storage errors. This article evaluates the superiority of the various systems used in medication error prevention. Centralized and hybrid systems are some of the systems evaluated in this systematic review. These systems are evaluated concerning costs, patient safety, and care efficiency. This high-level evidence source would provide critical insights into the main technology systems for medication error prevention.

Devin, J., Cleary, B. J., & Cullinan, S. (2020). The impact of health information technology on prescribing errors in hospitals: a systematic review and behavior change technique analysis. Systematic Reviews, 9(1), 275. https://doi.org/10.1186/s13643-020-01510-7

Health information technology can be used to prevent almost all types of medication errors, from prescription, dispensation, administration, monitoring, and storage. There are various types of health information technologies used. This journal article is from a systematic review study that analyzes behavior change techniques and health information technologies used to prevent medication errors, including prescribing errors.

Compared to paper order entries, using health information systems for prescriptions reduces medication errors. The role of clinicians in human-technology interaction is also discussed in this article. It is a helpful source of information on the best technologies to adopt to reduce medication errors. Nurses can benefit from the content of this source because it is a high-level evidence source.

Gates, P. J., Hardie, R.-A., Raban, M. Z., Li, L., & Westbrook, J. I. (2021). How effective are electronic medication systems in reducing medication error rates and associated harm among hospital inpatients? A systematic review and meta-analysis. Journal of the American Medical Informatics Association: JAMIA, 28(1), 167–176. https://doi.org/10.1093/jamia/ocaa230

The use of technology may not solve most medication errors. Unfortunately, technology use can precipitate other errors leading to medication errors at all stages. This source is a systematic review and metanalyses of articles that analyze both sides of technology use in medication errors. Studies evaluating the risks and benefits of technology use are discussed and evaluated.

Their findings are relevant to nursing practice and remind the reader that needs to carefully and judiciously interact with technology systems when attempting to prevent medication errors. This source is indispensable when considering technology systems as a strategy for preventing medication errors.

Vilela, R. P. B., & Jericó, M. de C. (2019). Implementing technologies to prevent medication errors at a high-complexity hospital: analysis of cost and results. Einstein (Sao Paulo, Brazil), 17(4), eGS4621. https://doi.org/10.31744/einstein_journal/2019GS4621

Reducing medication errors improves costs and patient care outcomes. Implementing these technologies also requires financial costs. This source is from a retrospective, descriptive-exploratory, quantitative study in Brazil that assessed the overall annual costs required to implement technology systems to prevent medication errors. Cost assessment is vital to a nurse administrator for planning and policy-making proposes.

Most healthcare projects require nurses’ input and their knowledge about costs makes their participation in health project planning, implementation, monitoring, and evaluation important. This source identifies 13 technologies that are required to prevent medication errors in prescription monitoring. The average costs in Rands are also presented in this source. Therefore, it is an important source for administrative and management nursing.

Medication Reconciliation for Prevent Medication Errors

Redmond, P., Grimes, T. C., McDonnell, R., Boland, F., Hughes, C., & Fahey, T. (2018). Impact of medication reconciliation for improving transitions of care. Cochrane Database of Systematic Reviews, 8(8), CD010791. https://doi.org/10.1002/14651858.CD010791.pub2

Medication reconciliation is the process of comparing patient medication lists to prevent the effects of medication errors. Medication discrepancies and patient care-related outcomes are some of the variables assessed in this article. This article discusses the evidenced-based outcomes of medication adverse effects, preventable adverse drug events (PADEs), unplanned hospitalizations, and hospital utilization. This source also asserts the need for and need for medication reconciliation at all points of transition of care. It is an excellent source to enable a nurse to understand the concept of medication reconciliation and how it impacts patient care outcomes and interprofessional approaches.

Chiewchantanakit, D., Meakchai, A., Pituchaturont, N., Dilokthornsakul, P., & Dhippayom, T. (2020). The effectiveness of medication reconciliation to prevent medication error: A systematic review and meta-analysis. Research in Social & Administrative Pharmacy: RSAP, 16(7), 886–894. https://doi.org/10.1016/j.sapharm.2019.10.004

This article is a systematic review of randomized controlled trials and other studies with metanalysis that aimed at assessing the effectiveness of medication reconciliation on medication error prevention. This article describes the importance of medication in low-resource settings and low-income countries. Other factors that are needed to support medication reconciliation to help in medication error prevention are discussed in this article. It is a high-level evidence source, and its findings are credible for application in practice.

Kreckman, J., Wasey, W., Wise, S., Stevens, T., Millburg, L., & Jaeger, C. (2018). Improving medication reconciliation at hospital admission, discharge, and ambulatory care through a transition of the care team. BMJ Open Quality, 7(2), e000281. https://doi.org/10.1136/bmjoq-2017-000281

This article explains the process and importance of medication reconciliation in care transitions, including ambulatory care. The need for incorporation of medication reconciliation in the family medicine hospitalist services is explained in this study. This article also brings a new concept of creating a transitional care team to oversee medication reconciliation in settings where care transitions are frequent and interdisciplinary collaboration is critical.

The need to give medication reconciliation at admission, discharge, and follow-up are presented in this paper through research. This source is credible and evidence-based, thus the need to incorporate it into our practice. Most of the findings support the need to perform medication reconciliation in care transitions.

Wheeler, A. J., Scahill, S., Hopcroft, D., & Stapleton, H. (2018). Reducing medication errors at transitions of care is everyone’s business. Australian Prescriber, 41(3), 73–77. https://doi.org/10.18773/austprescr.2018.021

This narrative review article by Wheeler et al. (2018) explains the responsibility that every clinical should have in medication reconciliation. In this resource, the patient is seen as the one constant in the continuum of care provision in every clinical setting. This article emphasizes the need for every healthcare professional to meet the patient at any point of care to perform medication reconciliation and communicate promptly in cases of discrepancies.

The benefits are seen in patients with literacy issues, complect medication regimens, older patients, and patients with mental illnesses. This resource also describes the process of improving patient-centered care, improving medicines communication during transitions, and the concept of shared care programs. Therefore, this article has high-yield evidence that would change your perception of medication reconciliations.

Interdisciplinary Collaboration and Medication Error Prevention

Manias, E. (2018). Effects of interdisciplinary collaboration in hospitals on medication errors: an integrative review. Expert Opinion on Drug Safety, 17(3), 259–275. https://doi.org/10.1080/14740338.2018.1424830

Collaboration between more than one field of specialization is referred to as interdisciplinary collaboration. This source explores the effects this collaboration can have on medication errors. This integrative review identified five interdisciplinary collaboration areas involved in medication errors.

These areas were the pharmacist’s participation in the team, tools of team communication such as logs and guidelines, collaborative review of medication lists at admission and discharge, collaborative workshops and conferences, and role differentiation. This article also explored future research and practice regarding medication safety and interdisciplinary collaboration. This article gives the nurse an overview of key areas of multidisciplinary teams that nurse leadership must focus on to implement effective teams and coronations.

Irajpour, A., Farzi, S., Saghaei, M., & Ravaghi, H. (2019). Effect of interprofessional education of medication safety program on the medication error of physicians and nurses in the intensive care units. Journal of Education and Health Promotion, 8, 196. https://doi.org/10.4103/jehp.jehp_200_19

Medication errors are also a problem in acute care settings. This article assessed the effect of interprofessional education on patient safety in intensive care units (ICUs), including adverse events and medication errors. This quasi-experimental study article recommends interprofessional education as opposed to single-professional education. The link between interprofessional education and interprofessional collaboration is expressed in this article as the key to reducing medication errors. The findings include statistical significance test results and are credible.

Khalil, H., & Lee, S. (2018). The implementation of a successful medication safety program in primary care. Journal of Evaluation in Clinical Practice, 24(2), 403–407. https://doi.org/10.1111/jep.12870

Medication safety programs can also be tailored to meet the safety needs of the institution. This article describes a medication safety program that was implemented in one of the Australian hospitals to prevent medication errors. Key elements of the pragma included interprofessional education, the formation of medication safety teams, and the implementation of safety guidelines. The role of teamwork and interdisciplinary education is emphasized in this article. The result on outcomes, such as the clinician’s knowledge, behavior, satisfaction, and confidence, are presented in this article. This is a scholarly, evidence-based source that evaluates the interdisciplinary approach from a program perspective.

Johansen, J. S., Havnes, K., Halvorsen, K. H., Haustreis, S., Skaue, L. W., Kamycheva, E., Mathiesen, L., Viktil, K. K., Granås, A. G., & Garcia, B. H. (2018). Interdisciplinary collaboration across secondary and primary care to improve medication safety in the elderly (IMMENSE study): study protocol for a randomized controlled trial. BMJ Open, 8(1), e020106. https://doi.org/10.1136/bmjopen-2017-020106

Unplanned readmission, especially drug-related readmissions, can be reduced through interdisciplinary collaborative approaches. The authors of this article implemented a study abbreviated as IMMENSE that utilized an integrated medicines management (IMM) model to improve medication safety. In their program study, various approaches that required interdisciplinary collaboration were implemented. These were medication reconciliations.

Medication review, patient education and counseling about medications, and post-discharge follow-up. The outcomes of these interdisciplinary activities that were explored were readmission rate, mortality, stroke, fractures, medication changes, medication appropriateness, length of hospital stay, and health-related quality of life (HRQoL). This article evaluated interdisciplinary approaches to patient safety from different perspectives. The robustness of the information from this study is enough to adopt the findings into practice. The source is credible because it is scholarly and peer viewed.

Conclusion

This annotated bibliography summarizes various sources that can provide crucial information to improve nurses’ knowledge and attitude and guide their skills in medication error prevention through technology, medication reconciliation, and interdisciplinary collaboration. The resources summarized are all journal articles from studies conducted by healthcare professionals in various health subfields.

The sources were published in the past five years. They have been sourced from various known journal databases. Their methodologies are well, and the journals are peer-reviewed. Therefore, all the sources can be deemed credible and relate to medication error prevention. A total of 12 sources have been presented in this resource.

References

Ahtiainen, H. K., Kallio, M. M., Airaksinen, M., & Holmström, A.-R. (2020). Safety, time and cost evaluation of automated and semi-automated drug distribution systems in hospitals: a systematic review. European Journal of Hospital Pharmacy. Science and Practice, 27(5), 253–262. https://doi.org/10.1136/ejhpharm-2018-001791

Chiewchantanakit, D., Meakchai, A., Pituchaturont, N., Dilokthornsakul, P., & Dhippayom, T. (2020). The effectiveness of medication reconciliation to prevent medication error: A systematic review and meta-analysis. Research in Social & Administrative Pharmacy: RSAP, 16(7), 886–894. https://doi.org/10.1016/j.sapharm.2019.10.004

Devin, J., Cleary, B. J., & Cullinan, S. (2020). The impact of health information technology on prescribing errors in hospitals: a systematic review and behavior change technique analysis. Systematic Reviews, 9(1), 275. https://doi.org/10.1186/s13643-020-01510-7

Gates, P. J., Hardie, R.-A., Raban, M. Z., Li, L., & Westbrook, J. I. (2021). How effective are electronic medication systems in reducing medication error rates and associated harm among hospital inpatients? A systematic review and meta-analysis. Journal of the American Medical Informatics Association: JAMIA, 28(1), 167–176.  https://doi.org/10.1093/jamia/ocaa230

Irajpour, A., Farzi, S., Saghaei, M., & Ravaghi, H. (2019). Effect of interprofessional education of medication safety program on the medication error of physicians and nurses in the intensive care units. Journal of Education and Health Promotion, 8, 196. https://doi.org/10.4103/jehp.jehp_200_19

Johansen, J. S., Havnes, K., Halvorsen, K. H., Haustreis, S., Skaue, L. W., Kamycheva, E., Mathiesen, L., Viktil, K. K., Granås, A. G., & Garcia, B. H. (2018). Interdisciplinary collaboration across secondary and primary care to improve medication safety in the elderly (IMMENSE study): study protocol for a randomized controlled trial. BMJ Open, 8(1), e020106. https://doi.org/10.1136/bmjopen-2017-020106

Khalil, H., & Lee, S. (2018). The implementation of a successful medication safety program in primary care. Journal of Evaluation in Clinical Practice, 24(2), 403–407. https://doi.org/10.1111/jep.12870

Kreckman, J., Wasey, W., Wise, S., Stevens, T., Millburg, L., & Jaeger, C. (2018). Improving medication reconciliation at hospital admission, discharge, and ambulatory care through a transition of the care team. BMJ Open Quality, 7(2), e000281. https://doi.org/10.1136/bmjoq-2017-000281

Manias, E. (2018). Effects of interdisciplinary collaboration in hospitals on medication errors: an integrative review. Expert Opinion on Drug Safety, 17(3), 259–275. https://doi.org/10.1080/14740338.2018.1424830

Redmond, P., Grimes, T. C., McDonnell, R., Boland, F., Hughes, C., & Fahey, T. (2018). Impact of medication reconciliation for improving transitions of care. Cochrane Database of Systematic Reviews, 8(8), CD010791. https://doi.org/10.1002/14651858.CD010791.pub2

Vilela, R. P. B., & Jericó, M. de C. (2019). Implementing technologies to prevent medication errors at a high-complexity hospital: analysis of cost and results. Einstein (Sao Paulo, Brazil), 17(4), eGS4621. https://doi.org/10.31744/einstein_journal/2019GS4621

Wheeler, A. J., Scahill, S., Hopcroft, D., & Stapleton, H. (2018). Reducing medication errors at transitions of care is everyone’s business. Australian Prescriber, 41(3), 73–77. https://doi.org/10.18773/austprescr.2018.021

Capella NURS-FPX4020 Assessment 4 Improvement Plan Tool Kit Scoring Guide

CRITERIA	NON-PERFORMANCE	BASIC	PROFICIENT	DISTINGUISHED
Identify necessary resources to support the implementation and sustainability of a safety improvement initiative focusing on medication administration.	Does not identify necessary resources to support the implementation and sustainability of a safety improvement initiative focusing on medication administration.	Identifies resources, but the necessity or support for the safety improvement initiative focusing on medication administration is unclear.	Identifies necessary resources to support the implementation and sustainability of a safety improvement initiative focusing on medication administration.	Identifies necessary resources to support the implementation and sustainability of a safety improvement initiative focusing on medication administration. Organizes resources logically for ease of use.
Analyze usefulness of resources for role group responsible for implementing quality and safety improvements with medication administration.	Does not analyze usefulness of resources for role group responsible for implementing quality and safety improvements with medication administration.	Summarizes but does not analyze usefulness of resources for role group responsible for implementing quality and safety improvements with medication administration.	Analyzes usefulness of resources for role group responsible for implementing quality and safety improvements with medication administration.	Analyzes usefulness of resources for role group responsible for implementing quality and safety improvements with medication administration. Provides specific examples of utility in the context of a specific health care setting.
Analyze the value of resources to reduce patient safety risk or improve quality with medication administration.	Does not analyze the value of resources to reduce patient safety risk or improve quality with medication administration.	Describes resources to reduce patient safety risk or improve quality with medication administration.	Analyzes the value of resources to reduce patient safety risk or improve quality with medication administration.	Analyzes the value of resources to reduce patient safety risk or improve quality, identifying those that may be most valuable for reducing patient safety risk or improving quality with medication administration.
Present reasons and relevant situations for resource tool kit use by its target audience.	Does not present reasons and relevant situations for resource tool kit use by its target audience.	Lists reasons or situations for resource tool kit use, but they are not compelling or their relevance to the target audience is unclear.	Presents reasons and relevant situations for resource tool kit use by its target audience.	Uses persuasive, engaging language to present compelling reasons and relevant situations for resource tool kit use by its target audience.
Communicate resource tool kit in a clear, logically structured, and professional manner that applies current APA style and formatting.	Communicates a resource tool kit in an unclear, illogically structured, and unprofessional manner that does not apply current APA style and formatting and contains many errors and/or incorrect citations.	Communicates online resource kit using a Word Doc or Google Sites in an unclear and disorganized structure and unprofessional manner that minimally follows APA style and formatting.	Communicates resource tool kit in a Word doc in a clear, logically structured, and professional manner that applies partially follows APA style and formatting.	Communicates online resource tool kit using a Google Sites in a clear and organized structure, and professional manner that applies nearly flawless, current APA style and formatting throughout.