Competency

Explain the basic models of quality improvement in healthcare.

Course Scenario

Chaparral Regional Hospital is a small, urban hospital of approximately 60 beds, and offers the following:

• Emergency room services
• Intensive care
• Surgical care
• Obstetrics
• Diagnostic services
• Some rehabilitation therapies
• Inpatient pharmacy services
• Geriatric services
• Consumer physician referral      services

Recently, the CEO has been hearing complaints from both patients and staff, varying from long wait times to rude physicians. You have been hired to design and implement a Quality Improvement Plan to help uncover quality problems and to satisfactorily resolve them.

Scenario Continued

The CEO has met with you to let you know that some members of the Board of Directors are questioning the value of developing a quality improvement plan. She has asked you to create an executive summary and an information sheet to be included in the next Board packet.

Instructions

Topics for the executive summary should include:

1. What is a Quality Improvement      plan?
2. Why do healthcare facilities      create improvement plans?
3. Why would you recommend the      facility create and implement a QI plan?

NOTE – APA formatting for the reference list, and proper grammar, punctuation, and form required.

After completing the Executive Summary, you will create a one-page information sheet for the Board that they can use to answer questions about QI plans.

1. The information sheet should give      your CEO and the Board of Directors enough information to have an educated      conversation with patients and other stakeholders on the value of QI      plans.
2. Make sure to use audience-specific      language and tone on your information sheet. Remember, you are writing      this information sheet for your CEO and the Board of Directors.
3. Be creative, and make your      information sheet fun and organized.

Consider the below case study:

Margret Spinner-Ramirez is a 66 y/o female Hispanic-American who speaks both Spanish and English fluently. She is retired, lives alone, and has Medicaid as her primary insurance.  Ms. Spinner-Ramirez was scratched by a stray cat that she feeds on her back porch daily. She has been cleaning the wound daily; however, after 2 days she went to her local ER for increased pain, redness, and swelling in her left lower leg wound where she was scratched by the stray cat.  Ms. Spinner-Ramirez explained she recently had her left knee replaced about 6 months ago and verbalized new difficulty with baring weight on that extremity to the point that she was having to use her cane again. Her vital signs at the ER visit were stable.  Her left leg wound was cleaned and redressed.  After 5 hours in the ER, Ms. Spinner-Ramirez was discharged to home on oral Keflex for her left lower leg infection and was instructed to call her primary care physician for a follow-up appointment. Five days later Ms. Spinner-Ramirez was taken back to the same ER via ambulance.  Her neighbor found her lethargic, short of breath, and was experiencing difficulty being able to move. A CT scan and blood work revealed that Ms. Spinner-Ramirez’s knee replacement in her left leg was infected secondary to the cat scratch. She was admitted as an inpatient for sepsis. She needed to have a second left knee replacement surgery with wound irrigation and debridement, which extended her inpatient stay to 3 weeks.  Once she was discharged to home she required six weeks of IV antibiotics, extensive rehab, and home health.

If you were in charge of a healthcare insurance company:

• Explain why insurance companies (which are considered payers) should or should not pay (reimburse) for injuries, extended costs, readmissions, or death (mortality) from a hospital-acquired infection or medical error. Support your why or why not?
• Describe two ways (initiatives) healthcare quality can be improved to help reduce errors and improve patient safety.
• Discuss how creating incentives for providers (healthcare organizations) can improve quality and reimbursements (payments) for services/care.

Textbook and other resources:

• Understanding Health Insurance
• What’s Behind the Health Insurance Rankings
• Hospitals will have to Pay for their Mistakes
• Medical Errors: Focusing More on What and Why, Less on Who
• National Business Coalition on Health: Health Care Purchaser Toolkit
• Agency for Healthcare Research and Quality

The Challenge and Potential for Assuring Quality Health Care for the 21s…

The Challenge and Potential for Assuring Quality Health Care for the 21st Century

All submissions must have a minimum of two scholarly references to support your work.

Examples of work to show mastery:

• 2-3 page paper – APA format

Prepare this assignment as a 1,500-1,750 word paper using the instructor feedback from the previous course assignments and the guidelines below.

PICOT Question 

Revise the PICOT question you wrote in the Topic 1 assignment using the feedback you received from your instructor.(assignment 1 is attached)

The final PICOT question will provide a framework for your capstone project (the project students must complete during their final course in the RN-BSN program of study).

Research Critiques

In the Topic 2 and Topic 3 assignments, you completed a qualitative and quantitative research critique on two articles for each type of study (4 articles total). Use the feedback you received from your instructor on these assignments to finalize the critical analysis of each study by making appropriate revisions.

The completed analysis should connect to your identified practice problem of interest that is the basis for your PICOT question.(assignments 2, 3 attached)

Refer to “Research Critiques and PICOT Guidelines – Final Draft.”(see attachment). Questions under each heading should be addressed as a narrative in the structure of a formal paper.

(Proposed Evidence-Based Practice Change

Discuss the link between the PICOT question, the research articles, and the nursing practice problem you identified. Include relevant details and supporting explanation and use that information to propose evidence-based practice changes.

General Requirements

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion(Rubric attached).

Practicum Discussion: Culturally aware nurses recognize that states of health are revealed differently across cultures and ethnicities. Culture and ethnic background will affect the way each individual responds to health, illness, and death (Stanhope & Lancaster, 2016). These nurses are also aware of their own biases, which may affect the care they provide to others (Stanhope & Lancaster, 2016). Because most nurses work in institutions with individual patients, they are accustomed to delivering culturally competent care on a one-on-one basis. When a public health nurse deals with a population, he or she must consider how the population culture affects the ways in which the community nurse may interact. This can be with regard to the provision of education or mass health care needs such as those required in a foodborne illness, if mass vaccinations are needed for a communicable disease outbreak, or if education is required to prevent heart disease. In addition to understanding the nuances of the culture of a population, community health nurses must understand the role genetics play in health. Some disorders, such as glaucoma and diabetes, have a genetic link, as do some cancers, such as breast and ovarian.

Please discuss the following questions in your Practicum Discussion:

Provide a few examples of community resources that should be put in place to assist your population in resolving their health care needs. What gaps in service do you see that affect your population?
Are there any cultural considerations that might inform your approach to caring for this population?
Does your population have a genetic predisposition to the health care problem you have identified?
Identify at least one evidence-based, culturally competent behavior change that would promote health for your selected population and for the specific health care problem you are addressing?

Anticipatory Guidance for Neonates to Adolescents Table

Anticipatory guidance helps family, caregivers, and others know what to expect according to the child’s growth and development. The guidance is done through collaboration between the healthcare provider and the caregiver. It is sometimes thought of as a type of counseling. Nurse practitioners working in pediatric primary care need to be experts on anticipatory guidance. There are excellent resources available and these are being updated as technologies and environments change.

This Assignment will demonstrate your ability to describe age-specific anticipatory guidance for the child and the family. Additionally, you will then have a reference table for quick glance created by you for future encounters with pediatric individuals and their families.

This assignment has a template that you will use to fill in the relevant elements of the anticipatory guidance per age group. The columns provide guidance to the specific areas such as safety and immunizations. If there is an area that is not applicable, such as oral health in infancy-newborn group, then place N/A in the box.