(Solved) MSN FP-6016 Quality Improvement Initiative Evaluation | Homework Solution

MSN FP-6016 Quality Improvement Initiative Evaluation

Prepare an evaluation (5-7 pages) of an existing QI initiative to determine if the initiative is effective.

Introduction

Too often, discussions about quality health care, care costs, and outcome measures take place in isolation—various groups talking among themselves about results and enhancements. Nurses are critical to the delivery of high-quality, efficient health care. As a result, they must develop their skills in reviewing and evaluating performance reports. They also need to be able to communicate outcome measures related to quality initiatives effectively. Patient safety and positive institutional health care outcomes mandate collaboration among nursing staff members to ensure the integration of their perspectives in all quality care initiatives.

Overview

Too often, discussions about quality health care, care costs, and outcome measures take place in isolation—each group talking among themselves about results and enhancements. Because nurses are critical to the delivery of high-quality, efficient health care, it is essential that they develop the proficiency to review, evaluate performance reports, and be able to effectively communicate outcome measures related to quality initiatives. MSN FP-6016 The nursing staff’s perspective and the need to collaborate on quality care initiatives are fundamental to patient safety and positive institutional health care outcomes.

Instructions

Imagine you have been asked to prepare and deliver an analysis of an existing QI initiative at your workplace. The QI initiative you choose to analyze should be related to a specific disease, condition, or public health issue of personal or professional interest to you, or you may use the hospice information provided in the Vila Health: Data Analysis activity in this assessment. The purpose of the report is to assess whether the specific quality indicators point to improved patient safety, quality of care, cost and efficiency goals, and other desired metrics. MSN FP-6016 Your target audience is nurses and other health professionals with specializations or interest in your chosen condition, disease, or public health issue.
In your report, you will:

• • Analyze a current QI initiative in a health care setting. MSN FP-6016 
    • Identify what prompted implementation of the QI initiative.
    • Evaluate problems that arose during the initiative or problems that were not addressed.
  • Evaluate the success of a current QI initiative through recognized benchmarks and outcome measures as required to meet national, state, or accreditation requirements. 
    • Identify the core performance measurements related to successful treatment or management of the condition. MSN FP-6016
    • Evaluate the impact of the quality indicators on the health care facility.
  • Incorporate interprofessional perspectives related to the success of actions used in the QI initiative as they relate to functionality and outcomes.
  • Recommend additional indicators and protocols to improve and expand outcomes of a current quality initiative.
  • Ensure your analysis conveys purpose, in an appropriate tone and style, incorporating supporting evidence and adhering to organizational, professional, and scholarly writing standards.
  • Be sure to address all of the bullet points. MSN FP-6016 You may also want to read the Quality Improvement Initiative Evaluation Scoring Guide to better understand the performance levels that relate to each grading criterion. Additionally, be sure to review the Guiding Questions: Quality Improvement Initiative Evaluation [DOCX]document for additional clarification about things to consider when creating your assessment.

Additional Requirements

Your assessment should also meet the following requirements:

• • Length of submission: A minimum of five but no more than seven double-spaced, typed pages, not including the title page and References section.
  • Number of references: Cite a minimum of four sources of scholarly or professional evidence that support your evaluation, recommendations, and plans. Current source material is defined as no older than five years unless it is a seminal work. MSN FP-6016 Review the Nursing Master’s Program (MSN) Library Guidefor guidance.
  • APA formatting: Resources and citations are formatted according to current APA style. Review the Evidence and APA section of the Writing Center for guidance.

Competencies Measured

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

• • Competency 2: Plan quality improvement initiatives in response to routine data surveillance. 
    • Recommend additional indicators and protocols to improve and expand outcomes of a quality initiative.
  • Competency 3: MSN FP-6016 Evaluate quality improvement initiatives using sensitive and sound outcome measures. 
    • Analyze a current quality improvement initiative in a health care setting.
    • Evaluate the success of a current quality improvement initiative through recognized benchmarks and outcome measures as required to meet national, state, or accreditation requirements.
  • Competency 4: Integrate interprofessional perspectives to lead quality improvements in patient safety, cost effectiveness, and work life quality. 
    • Incorporate interprofessional perspectives related to the success of actions utilized in a quality improvement initiative as they relate to functionality and outcomes.
  • Competency 5: Apply effective communication strategies to promote quality improvement of interprofessional care. Get Exploration Document Homework Help Now!! MSN FP-6016
    
    • Convey purpose, in an appropriate tone and style, incorporating supporting evidence and adhering to organizational, professional, and scholarly writing standards.

Quality Improvement Initiative Evaluation

Capella University

MSN FP-6016

September 2020

Quality Improvement Initiative Evaluation

Patient safety is a priority in any healthcare setting. Hospitals utilize quality improvement (QI) initiatives to improve the quality of patient care, deliver the highest level of quality care to our patients safely, focus on patient health outcomes while attaining cost efficiencies.

The purpose of the Quality Improvement Initiative is to first focus on patient safety and to foster a deliberate and thoughtful approach to the provision of services by providing a common framework for measurement, assessment, improvement, and maintenance of performance in accordance with the corporation’s mission, vision, and values (Ohio Health, 2020).

Healthcare acquired infections (HAIs) are infections patients get in the hospital while receiving care for another condition. The U.S. Department of Health and Human Services (HHS) (2020) states, MSN FP-6016 “the HHS has identified the reduction of HAIs as an Agency Priority Goal and is committed to reducing the national rate of HAIs” (para.4-5).

Analyze Current Quality Improvement Initiative

Infection control and prevention interventions are at the core of the safe care concept, and understanding a process before attempting to improve it is critical in any quality improvement initiative. Common HAIs that patients get in hospitals include central-line associated bloodstream infections (CLABSI), clostridium difficile (c-diff) infections, pneumonia (PNA), methicillin-resistant Staphylococcus aureus (MRSA) infections, surgical site infections, with catheter-associated urinary tract infections (CAUTI) the most common of HAIs(The Center for Diease Control, 2019).

The Ohio Health organization has infection prevention policies that are OhioHealth hospital-specific policies. Ohio Health implemented a CAUTI prevention bundle, within policy and procedures, that consists of hand hygiene, wearing personal protective equipment, MSN FP-6016 use of disposable gloves, cleansing of urethral meatus before catheter insertion using sterile saline, assessment of catheter need, aseptic urine sampling technique, and correct draining bag positioning(Ohio Health, 2017).

The Committee on Hospital Infection Prevention (CHIP) oversees the planning, organization, development, and evaluation of the hospital-wide infection control program for all Ohio Health hospitals based on the guidelines of The Joint Commission(Ohio Health, 2017).

The goal is to minimize the hazards of healthcare-associated infections and infection potentials by instituting and maintaining measures for the prevention, investigation, reporting, and control of infections. The neurocritical care (NCC) and intensive care unit (ICU) population is at exceptionally high risk for catheter-associated urinary tract infections (CAUTIs) due to length of stay, chronic disability, immobility, agitation, and confusion(Busl, 2019). These units tend to have higher CAUTI rates in the United States (U.S.) than other patient care units(Busl, 2019).

Ohio Health NCC and ICUs have QI guidelines in place for CAUTI prevention, but omit some of the causes that can lead to CAUTI(Ohio Health, 2017). MSN FP-6016 The Center for Disease Control (CDC) (2019) reports, “many of these infections are preventable, and common reasons that lead to

HAIs are an improper use of catheters, such as convenience, a break in sterile technique inserting a foley, improper hygiene and handwashing by hospital staff spreading germs and bacteria from other hospitalized patients and understaffing, which can lead to patients not receiving the attention they need for foley care leading to infection and worsening health(pp.34-41 ).

Recognized Benchmarks and Outcome Measures

The National Healthcare Safety Network(NHSN) is the nation’s most widely used healthcare-associated infection(HAI) tracking system. Since 2009, infection data has been reported to the NHSN to track the national progress of reducing HAIs MSN FP-6016 (The U.S. Department of Health and Human Services,2020). Ohio Health follows guidelines set forth by The Joint Commission and the CDC for the prevention of HAIs (G.Howard, personal communication, September 17, 2020).

Ohio Health completes monthly reporting plans, and collected outcome data is entered using their Center for Medicare & Medicaid Services (CMS) Certification Number (CCN), which is then sent directly to the NHSN HAIs tracking system(G. Reid, personal communication, September 17, 2020).

The Ohio Health NCC is compared to other neurocritical care units(NCC) with > 15 beds in hospitals with > 500 beds, and the data is calculated taking the number of foleys per 1000 patient days, so this accounts for our actual size of 32 beds(G.Howard, personal communication, September 17, 2020). The expected number of CAUTIs from July 2017 – February 2018 was 17, and Ohio Health’s NCC had 32; this is about two extra infections per month.

The expected number of foley days from July 2017 – February 2018 was 3980, and the NCC had 4858, which is about 98 extra foley days a month MSN FP-6016 (G. Howard, personal communication, September 17, 2020). These numbers revealed CAUTI was higher than the national benchmarks( (G. Howard, personal communication, September 17, 2020).

Education was heightened on the NCC unit to monitor proper hand hygiene, use of foaming stations outside of rooms, and adequate patient foley catheter care( G.Howard, personal communication, September 17, 2020). The Agency for Healthcare Research and Quality(AHRQ) (2015) recommends, “units identify the number of symptomatic CAUTIs attributable each month, the CAUTI rate, and days since last CAUTI as metrics for outcome measures, so the patient care team and administrators will be able to use NHSN data for benchmarking purposes” (para.6-8).

The AHRQ(2015), further states, “comparing your unit’s CAUTI rate with other units of the same patient type and acuity gives the team “apples to apples” information about how their patient outcomes compare to other units” (para.8).

Interprofessional Perspectives related to Initiative Functionality and Outcomes

Interprofessional collaboration is critical in promoting quality and safe patient care and is fundamental for successfully delivering patient-centered care. A team approach ensures that healthcare personnel and others who take care of catheters are given periodic in-service training regarding techniques and procedures for urinary catheter insertion, maintenance, and removal MSN FP-6016 (Ohio Health, 2017).

Provide education about CAUTI, other complications of urinary catheterization, and alternatives to indwelling catheters. The CDC (2017) reports,” this builds consensus on current process strengths and shortcomings, and also creates team recognition of areas of improvement targeted to a process and not at people(para.11).

Ohio Health has incorporated the CAUTI Workgroup, OhioHealth Nursing Policy, and Procedure Committee that includes NCC, ICU nurse managers, clinical educators, chief nursing officer(CNO), and the Ohio Health medical director(G. Howard, personal communication, September 17, 2020). MSN FP-6016

The Ohio Health CAUTI workgroup follows recommendations set forth by Refer to Perry and Potter’s Clinical Nursing Skills reference text for specific care instructions, The Joint Commission, and the CDC(G. Howard, personal communication, September 17, 2020).

This writer conducted personal telephone communication with Gina Howard, MSN, director of Ohio Health Riverside Methodist Hospital NCC. Gina Howard provided this writer with information about their unit studies on CAUTI due to the patient population and the higher incidence of CAUTIs in the NCC. This writer located policy and procedure from the Ohio Health employee websites.

Additional Indicators and Protocols to Improve/Expand Quality Outcomes

The AHRQ has initiated a Toolkit To Reduce CAUTI and Other HAIs in Long-Term Care Facilities. This toolkit helps long-term care (LTC) facilities reduce catheter-associated urinary tract infection (CAUTI) and improve practices to prevent healthcare-associated infections (HAIs) (Agency for Healthcare and Quality, 2015). MSN FP-6016

The toolkit was developed during a 3-year project that involved a national quality improvement collaborative designed to reduce CAUTIs and enhance patient safety culture and practices in LTC facilities and provides resources to enhance leadership and staff engagement, teamwork, and safety culture, to facilitate consistent use of evidence-based practices MSN FP-6016 (Agency for Healthcare and Quality, 2015).

Ohio Health utilizes a CAUTI prevention bundle and still found gaps in care such as breaks in sterile technique inserting a foley, improper hygiene, and handwashing by hospital staff, and lack of proper care due to understaffed units. The Toolkit To Reduce CAUTI and MSN FP-6016 Other HAIs in Long-Term Care Facilities may offer new protocols to improve and expand quality outcomes of the Ohio Healths CAUTI quality initiative.

Other specific process or protocol changes that may be beneficial would be a two registered nurse(RN) insertion checklist. MSN FP-6016 The purpose of the second RN is to watch the primary RN’s sterile technique. This specific process would hold staff accountable for following a specific protocol. Both nurses would document their names in a CAUTI detailed document.

Conclusion

The creation of care bundles was one of the innovations to ensure a set of standard interventions was performed in 100% of the patients. Even with the implementation of bundles, team leaders and staff members must be diligent with the protocols and processes to reduce the number of patients at risk for HAIs. Health care professionals need to be engaged in their patient care and make care safer by following clinical best practices and creating a culture of safety.

References

Agency for Healthcare Research and Quality. (2015). MSN FP-6016 Toolkit for reducing catheter-associated urinary tract infections in hospital units: implementation guide. https://www.ahrq.gov/hai/cauti-tools/guides/implguide-pt4.html

Busl, K. (2019). Healthcare associated infections in the neurocritical care unit. Current Neurology and Neuroscience Reports. Springer Link. https://doi.org/10.1007/s11910-019-0987

CDC. Healthcare infection control practices advisory committee. (2019). MSN FP-6016 Guideline for prevention of catheter-associated urinary tract infections 2009 [PDF]. Center for Disease Control.. https://www.cdc.gov/infectionconrol/pdf/guidelines/cauti-guidelines-H.pdf

Ohio Health. (2017). Committee on Hospital Infection Prevention. Policy and Procedure. https://ohesource.ohiohealth.com/departments/clinicalqualitysafety/CAUTI

Ohio Health. (2020). Process Improvement and Patient Safety Plan. Policy and/or Procedure. https://ohesource.ohiohealth.com/infocentral/CareConnect/careprocess improvement and patient_safet_plan

U.S. Department of Health and Human Services. (2020). MSN FP-6016 Healthcare Associated Infections. https://health.gov/our-work/health-care-quality/health-care-associated-infections