Response to peers # 1 100-150 words each
Continuous quality improvement (CQI) is indispensable in navigating the complexities of the healthcare industry, and nurses play a pivotal role in ensuring its implementation. In my past position as a nurse in a busy hospital emergency department, applying CQI was imperative to enhance patient care and streamline processes (Coles et al., 2020). One example of how I applied CQI was through the implementation of a standardized triage process. Recognizing the variability in triage assessments leading to potential delays in care, I collaborated with fellow nurses and healthcare providers to develop a standardized triage protocol based on evidence-based guidelines and best practices. Through regular audits and feedback sessions, we monitored the effectiveness of the protocol, identified areas for improvement, and made necessary adjustments to optimize patient flow and prioritize care delivery (Coles et al., 2020). To support CQI in this example, we utilized the Plan-Do-Study-Act (PDSA) cycle, a quality improvement method commonly used in healthcare settings. The PDSA cycle enabled us to systematically plan, implement, evaluate, and adjust our triage protocol in an iterative process (Breton et al., 2023). By collecting data on key performance indicators such as waiting times, patient satisfaction scores, and clinical outcomes, we were able to measure the impact of our interventions and make informed decisions to drive continuous improvement. For nurses new to healthcare, a pertinent nurse practice issue to address through CQI could be medication administration errors. By implementing a CQI approach, nurses can systematically analyze the root causes of errors, develop strategies to mitigate risks, and monitor the effectiveness of interventions over time. Utilizing quality improvement methods like the PDSA cycle can facilitate ongoing monitoring and refinement of medication administration processes to enhance patient safety and quality of care (Breton et al., 2023).
references:
Breton, M., Gaboury, I., Martin, E., Green, M. E., Kiran, T., Laberge, M., … & Descoteaux, S. (2023). Impact of externally facilitated continuous quality improvement cohorts on Advanced Access to support primary healthcare teams: protocol for a quasi-randomized cluster trial. BMC Primary Care, 24(1), 97.
Coles, E., Anderson, J., Maxwell, M., Harris, F. M., Gray, N. M., Milner, G., & MacGillivray, S. (2020). The influence of contextual factors on healthcare quality improvement initiatives: a realist review. Systematic reviews, 9, 1-22.
Response to peers #2 100-150 words each
Continuous quality improvement (CQI) is being able to analyze and process the need for improvement. For example, improvements to safety, operations, outcomes, systems and work environment would ultimately improve patient care. Where I work, I have notice that is can be difficult for the floor nurse to provide daily wound care when it is extensive wounds. To improve the care for these patients I would address this with the manager and administration and request a wound nurse see the patient more regularly. For example, instead of the once a week they see them now that they come at least 2-3 times a week for patient with extensive wounds. The reason is I have patient with so many and severe that I have spent over 40 minutes doing wound care for one patient that my other patients had to wait causing medication to be late as we had no extra help on the floor. This is not safe for any patients or the nurse to be stuck in a room for that long without back up. A tool that would help assess this issue would be the model for improvement as we could ask ourselves what are we trying to accomplish? Better wound care; How will this change be known? You would see wound care being done more often which would show in better, faster wound healing for the patient; and what changes can be made to make this improvement? I would suggest having the wound round more frequent for the more several wounds that need more attention. CQI is a great tool to ensure the highest care is being given to our patients and will help the healthcare facilities with constant assessment on improvement needs.
Agency for Healthcare Research and Quality. (2020, January). Section 4: Ways to Approach the Quality Improvement Process (continued). Ahrq.gov. https://www.ahrq.gov/cahps/quality-improvement/improvement-guide/4-approach-qi-process/sect4part2.html
Harkness, T. & Pullen, R. (2019). Quality improvement tools for nursing practice. Nursing Made Incredibly Easy!, 17 (3), 47-51. doi: 10.1097/01.NME.0000554602.68360.ed.
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