Throughout your practicum experience, you have been designing and implementing a project. You will now assess that experience. Prior to beginning this paper, discuss the topics below with your preceptor. Include their feedback as well as your own. In a 1,500-1,750-word document, discuss the following topics

Throughout your practicum experience, you have been designing and implementing a project. You will now assess that experience. Prior to beginning this paper, discuss the topics below with your preceptor. Include their feedback as well as your own. In a 1,500-1,750-word document, discuss the following topics

Throughout your practicum experience, you have been designing and implementing a project. You will now assess that experience. Prior to beginning this paper, discuss the topics below with your preceptor. Include their feedback as well as your own. In a 1,500-1,750-word document, discuss the following topics

Advanced nursing students carry out practicum projects to enhance their leadership abilities and solve problems associated with patient safety and quality of care. The practicum experience through the designing and execution of projects aims at the attainment of the American Organization of Nurse Executives (AONE) competencies in clinical settings as a leader (Andrew et al., 2022). Patient safety protocols like the World Health Organization’s Surgical Safety Checklist (SSC) are one of the most appropriate evidence-based approaches to improve the safety of patients in surgical areas. Hospitals and providers who comply with these protocols have increased levels of patient and quality care outcomes. The implementation of my practicum project in a surgical room setting allowed me to develop nursing competencies needed in providing leadership to enhance compliance to the Surgical Safety Checklist and developing organizational abilities to improve the overall adherence to these protocols. The purpose of this paper is to assess the practicum project’s experience based on the need to improve the time-out process in the surgical unit at a pediatric hospital.

ORDER A PLAGIARISM-FREE PAPER HERE

Leadership Project, Its Focus & Implementation Site

Patient safety during surgical procedures is essential as requires a collaborative and inter-professional approach, particularly when handling pediatric patients who are minors and need consent from parents or guardians. Safety processes and practices are core to the delivery of quality care to patients (Andrew et al., 2022). The leadership project was the improvement of the surgical time-out process to enhance adherence and compliance to the surgical safety checklist as mandated by the World Health Organization (Brown et al., 2021). The focus of this project was to improve the quality of care by reducing possible and susceptible safety events when the inter-professional team in such units fails to have a clearly-defined Surgical Time Out process. The site of the project was the Congenital Heart Surgery Operating Room at the Texas Children’s Hospital. While the organization prides itself as the creator of a healthier future for children and women and its heart surgery unit is considered one of the best in the country, it had never implemented the surgical safety compliance as mandated by WHO as one of the best practices to improve and guarantee patient safety.

Discovery of the Need for the Project

Compliance with safety protocols and regulations is essential for any organization that seeks to have quality outcomes. Under the present process at the unit, surgical time out (safety checklist) happens before any case proceeds to the incision or in the theater. The need for the project arose due to the last Joint Commission survey results which showed that the staff in the operating room (OR) were not present during a timeout. Further, even when present, they were not paying attention to the timeout process and requirements. Everyone was in a silo doing their own business and failing to pay attention leading to the missing of critical information by the staff (Wagner, 2018). The conduct of the staff in the unit presents significant safety worries. Ignoring information could lead to adverse events like surgical site infections, leaving objects in a patient’s body, and even operating on the wrong if not even a wrong patient (Gillespie et al., 2018). The implication is that the discovery of the need for the project was critical because patient safety remains a core aspect of improved quality of care and better patient care experience.

Surgical site infections (SSIs) are among the most prevalent types of hospital-acquired infections (HAIs). Studies and surveys show that close to 300,000 surgical site infections occur each year and this accounts for over 20% of all HAIs (Monahan et al., 2020). The negative clinical outcomes linked to the SSIs include morbidity and mortality along huge financial cost burden emanating from an increased stay in hospitals, additional costs of procedures and medications, and strain on the hospital personnel. Further, these adverse events harm patient care experience. Findings show that close to 60% of SSIs are preventable (Kuo et al., 2020). As such, the discovery has made SSI a core target of the institution’s quality control measures that constitute the need for increased safety measures through the implementation of the surgical safety checklist (SSC). Therefore, the other need for this project was to improve overall safety and lower the unit’s and patient’s susceptibility to infections and other adverse events.

Another critical aspect of the need for the project was to develop leadership skills based on the AONE competencies and staff motivation by the organizational leaders. The staff could derive benefits from the project as they interact with the leaders to know and appreciate best practices in surgical units to improve the process and safety measures (AONE, 2018). As such, the project required effective leadership strategies to ensure that all accepted it and were part of the solutions to improve overall safety and compliance with the safety checklist.

Measuring the Project Outcomes and Its Sustainability

Project outcomes are important to determine the effects of an initiative, particularly in safety compliance in surgical units. In this case, the project’s overall outcomes would be measured and determined by a host of factors. The outcome of the project would be measured by its scope, adherence, and compliance to the timeout process, increased skills’ ability as well as an effective understanding of the role of the procedures to reduce adverse events in the facility (Wagner, 2018). The scope would entail ensuring that nurses and members of the inter-professional team in the facility attend the timeout before any surgical procedure begins. The changes and improvements made would be implemented through an in-depth discussion and participation of all providers and members of the team so that all are aware of them and the expected practice standards in the unit.

The next aspect of measurement of the project would be ensuring an effective timeout process that consists of three sections; pre-brief, timeout, and debrief. All involved in the process would undergo these aspects based on their roles. For instance, the timeout requires that everyone stops all they will be doing and pay attention to the requirements, description of their roles and responsibilities, and all necessary information to the team members for effective delivery of safety protocols and procedures. Those who fail to adhere to these provisions will not be allowed in a case, even when they show up later. Those who fail to stop whatever they are doing will lead the stop of the timeout process. As such, all realized that it is effective and best to pay attention to ensure that the process does not take long.

Sustainability of a quality and safety project in any setting like the operating room in a surgical unit is essential for long-term outcomes, care quality improvement, and patient satisfaction. Sustainable projects are those that integrate all stakeholders and have participatory processes as well as assessments (Tan et al., 2020).  As such, the process to enhance compliance and adherence to the surgical safety checklist that includes having effective timeout sessions would be sustainable as it will become part of the best practices in the facility and unit.

Real and Potential Barriers

The planning, designing and implementation of evidence-based practices (EBP) interventions through practicum projects can present significant challenges and barriers. These barriers have an impact on the attainment of the set goals and may lead to delays in the implementation process. In this case, barriers included effective communication from the surgeon about the need for implants, equipment, and supplies to the nurse (Wagner, 2018). The other barrier to the implementation was the cancellation of procedures due to a lack of materials. To address this barrier, the surgeon filled out a pre-brief sheet to indicate all the necessary items for each case. Another barrier entailed nurses’ perception that surgeons and other providers would not comply with the process. Nurses had to reach out to the surgeon so that they could collect information in the pre-brief sheet and drop it in the OR for the following day’s scheduled surgical procedures.

Success of the Project

The implementation of the project was successful because of the outcomes and impacts that it had on the need to adhere to and comply with the timeout requirements as part of the surgical safety checklist process. Nurses complied with the set guidelines and continue to follow instructions. The surgeons do not like being stopped and this implores nurses in the room to pay attention by stopping whatever they are doing so that there is an effective timeout process. Surgeons and nurses do not like having their cases canceled due to their failure to communicate their needs and implants on time. The collaboration among the professionals ensures that they work well with the registered nurse first assistants (RNFAs).

Goals Set for Myself and AONE Competencies to be Attained

The goals that I set for the project entailed working collaboratively with stakeholders and getting their buy or acceptance of this process. I also set to enhance adherence to the surgical safety checklists to enhance accountability and patient advocacy. According to the AONE, a collaborative approach to work enables nurses in executive roles and practice units to enhance patient care experience which entails quality and satisfaction, improving population health, and reducing the cost of care for all patients (AONE, 2018). The implementation of these interventions would lead to a reduction in adverse safety events and improve overall care delivery for nurses. The competencies that hope to attain during the process include enhancing communication skills, improving professionalism, and attainment of better business skills.

Summary of Project Experience Associated with the Goals and AONE Competencies

The implementation of the practicum project allowed me to develop effective communication skills and develop a better outlook on professionalism in nursing care practice, especially when dealing with inter-professional team players who are keen on quality outcomes and better patient experience. The project’s experience demonstrates that nurse executives can design and implement change based on the AONE competencies in their practice area as effective leaders (AONE, 2018). For the project to be accepted, I had to get approval from all stakeholders and explained to them the need for changes. These included surgeons, residents, and colleagues as well as anesthetic nurses, perfusionists, and operating room staff and leaders. I had meetings with them to explain the project’s requirements while emphasizing the outcomes of the last Joint Commission survey where the facility was cited for failure to implement the protocols.

The process allowed me to enhance my advocacy skills and professional approach to issues dealing with patients and requiring nurses’ interventions. The cancellation of procedures can be devastating to patients and even providers. Therefore, the experience in the project showed that effective communication skills are important to ensure that all providers do not forget the requirements, implants, and other resources for surgical procedures to be successful. The other advocacy aspect is that the right procedure would be carried out since all universal precautions would be covered and verified during the timeout process.

Conclusion

Leadership projects to enhance safety through effective surgical timeouts are essential in attaining and complying with safety checklists. The practicum project offered me a chance to understand the core competencies of nurses to improve overall care outcomes for patients under their care. These competencies are critical for nurses to adhere to set provisions and best practices across the care and patient continuums.

References

American Organization of Nurse Executives (AONE) (2018). AONE Nurse Executive

Competencies. Chicago, IL: Author. http://www.aone.org/resources/nurse-leader-competencies.shtml

Andrew, L., Dare, J., Robinson, K., & Costello, L. (2022). Nursing practicum equity for a

changing nurse student demographic: a qualitative study. BMC nursing, 21(1), 1-8. DOI: 10.1186/s12912-022-00816-2

Brown, B., Bermingham, S., Vermeulen, M., Jennings, B., Adamek, K., Markou, M., … &

Hibbert, P. (2021). Surgical safety checklist audits may be misleading! Improving the

            implementation and adherence of the surgical safety checklist: a quality improvement

project. BMJ open quality, 10(4), e001593. http://dx.doi.org/10.1136/bmjoq-2021-001593

Gillespie, B. M., Harbeck, E. L., Lavin, J., Hamilton, K., Gardiner, T., Withers, T. K., &

Marshall, A. P. (2018). Evaluation of a patient safety program on Surgical Safety Checklist Compliance: a prospective longitudinal study. BMJ open quality, 7(3), e000362. http://dx.doi.org/10.1136/bmjoq-2018-000362

Kuo, Y. W., Jerng, J. S., Lin, C. K., Huang, H. F., Chen, L. C., Li, Y. T., … & Hung, K. Y.          (2020, December). In-Hospital Patient Safety Events, Healthcare Costs, and Utilization:

An Analysis from the Incident Reporting System in an Academic Medical Center. Healthcare, 8(4), 388. DOI: 10.3390/healthcare8040388

Monahan M, Jowett S, Pinkney T, Brocklehurst P, Morton DG, Abdali Z, et al. (2020) Surgical

site infection and costs in low- and middle-income countries: A systematic review of the economic burden. PLoS ONE, 15(6): e0232960. https://doi.org/10.1371/journal.pone.0232960

Tan, J., Ngwayi, J. R. M., Ding, Z., Zhou, Y., Li, M., Chen, Y., … & Porter, D. E. (2021).

Attitudes and compliance with the WHO surgical safety checklist: a survey among surgeons and operating room staff in 138 hospitals in China. Patient Safety in Surgery, 15(1), 1-12. DOI: https://doi.org/10.1186/s13037-020-00276-0

Wagner, J. (2018). Leadership and influencing change in nursing. University of Regina Press.

BUY A CUSTOM PAPER HERE

Assessment Description
Throughout your practicum experience, you have been designing and implementing a project. You will now assess that experience. Prior to beginning this paper, discuss the topics below with your preceptor. Include their feedback as well as your own. In a 1,500-1,750-word document, discuss the following topics:

Describe your leadership project, its focus, and the site where it was implemented. How did you discover the need for this project?
Discuss how the outcomes of your project will be measured? Is your project one that is sustainable or is it designed to be a single occurrence?
Did you encounter any real or potential barriers during your practicum experience related to your project?
Evaluate the success of your project. If you were not able to implement your project, discuss why. What are the next steps for the project?
What were the goals you set for yourself and the AONE competencies you hoped to achieve?
Summarize your project experience related to those goals and AONE competencies.
Use a minimum of two peer-reviewed resources (published within the last 5 years) as evidence to support your views.