THIS ASSIGNMENT SHOULD BE A CONTINUATION TO WEEK 1 JOURNAL ( DOCUMENT ATTACHED)


THIS ASSIGNMENT SHOULD BE A CONTINUATION TO WEEK 1 JOURNAL ( DOCUMENT ATTACHED)

THIS ASSIGNMENT SHOULD BE A CONTINUATION TO WEEK 1 JOURNAL ( DOCUMENT ATTACHED)
Chamberlain College of Nursing NR392 Quality Improvement in Nursing Week 1 Journal Template Directions: Prior to completing this template, carefully review Week 1 Journal Guidelines paying particular attention to how to name the document and all rubric requirements. After saving the document to your computer, type your answers directly on this required template and save again. This journal is due by Wednesday of Week 1 by 11:59 p.m. MT. Instructions for Week 1 Journal Select a nursing care issue for the Course Project (not workforce issues such as staffing) that could be impacted by improved quality. Identify the issue and state the desired outcome. Ask at least one question of your instructor that could help you do your best on Milestone 1. Return to the Grades area to read the instructor’s response Saturday or Sunday of Week 1 prior to submitting your Milestone 1. Due Wednesday of Week 1 by 11:59 p.m. MT. Your Name: Amarjeet Kaur Assignment Criteria Your Answers Identify the nursing care issue and state the desired outcome Nursing Care Issue: One of the issues in the current state of medication is the medication error which is defined by NIH as failure that might lead to harm on the patient (NIH.gov). In the current sector of healthcare this issue has become a great challenge. Mistakes involving medication are among the most common healthcare issues. Web have different kind of medication errors which include failure to perform any of 6 rights in medical administration, cross sensitivity, wrong diagnosis etc. Medication error can result from those involved in the chain such as prescriber, manufacturer, blood level monitoring, administering and lack of education to patients. The nurses should do safety check before administering medication as they are the last in the chain. We have areas where nurses are not in position of identifying errors where the doctors and pharmacists can pin point out the error. An example is where a pharmacist forgets to identify problem of cross sensitivity and misdiagnosing medication to patient. For the nurses they have got direct contact with patients and in acute setting they are ones who spend time with patient hence this result to medication error in most instances which make it a big issue. Desired Outcome: From NIH they have estimated that medication error results to 1 of 131 patient deaths and 1 of 854 inpatient death according to report by institute of medicine (Nih.gov).In case of medical error most people are held accountable especially nurses who are supposed to do last check before administration. The medication errors range from nothing happening to as far as death of patients. Even though there are steps which have been taken to avoid the medication error we still have serious errors being made by members of the care team. For the acute care facilities they have taken steps to prevent errors from arising where they have adapted the electronic medical record connected with pharmacy, wrist scanning bands before administering medication, having nurses to do verification and pharmacy reviewing PT. The nurses are trained to review the lab results, diagnostic results and patient’s diagnosis and understanding why certain medication are prescribed to patients before administering. At times the nurses might fail to do this which could result to an error. There was a situation where the patient INR was at 3.1 and patient was on 5mg of Coumadin where the goal was 2-3.Pharmacists made a mistake and ordered 3mg of Coumadin but it fails discontinuing 5mg making total of 8mg.Nurse failed to question order and administered 8mg and next INR which was 4.8.Though there was an error from pharmacy the nurse who administered was held accountable. This example indicates that though we have measures in place the 6 steps have to be followed where lab results have to be reviewed before medication. From the facility we have got several measures taken to avoid medical errors. We have got access to medical records for community pharmacy. This enables us to view the medication records of the patient. Compare it with home list the patient came with and ask question where we had any doubts. This eliminates problem of missed dosses and wrong prescription by the provider. Hospitals discourage use of home medication. The relatives have to take back medication bottles after comparing. In case the patient is taking medication which is not in pharmacy formulary then it has to verify the medication, label with barcode and nurses should lock it up in medication drawer and administer it to patients as directed until they are discharged. For insulin two nurses have to verify it prior to administration as well as heparin drip. Medications which are not scanned are reported to the manager at the end of the month where each nurse should have 98% of scanning rate. All medications entered should be verified by the pharmacists before administering them. Reporting error as early as possible leads to a better outcome to the patient. An example is where you mistakenly administer 60 units of short acting insulin instead of long acting insulin has to be reported immediately otherwise it could be detrimental to patient life. I encourage colleagues to talk with patients about home medication regimen on admission and question orders they have doubts with. In case of any error they should report in timely manner. Create a non-punitive environment for the staff which can encourage staff to report the issue without fear of being punished. Ask at least one question of your instructor that could help you do your best on Milestone 1 Question: Why do you think medical error should be taken with a lot of seriousness? Reference https://learn.ana-nursingknowledge.org/products/Preventing-High-Alert-Medication-Errors-in-Hospital-Patients, Retrieved, October 2016. https://www.ncbi.nlm.nih.gov/pubmed/24981217, Retrieved, October 2016. NR392 Week 1 Journal Template.docx November 2018 CJM
THIS ASSIGNMENT SHOULD BE A CONTINUATION TO WEEK 1 JOURNAL ( DOCUMENT ATTACHED)
My name is Professor Cecilia Maier. I am one of the instructors for NR392, Quality Improvement in Nursing. There is no graded discussion in Week 1. Instead, you have a graded journal. The topic of the Week 1 journal is very similar to the topic of Course Project Milestone 1. Follow the rubric, and use the template provided for Week 1 Journal. Your journal is due Wednesday of Week 1. Your instructor will provide feedback on your journal contents by Friday of Week 1, to help you do a great job on your Milestone 1. I want to take a few minutes to go over your Week 1 assignment, Milestone 1. This is part one of your course project. This assignment is due Sunday, end of Week 1, by 11:59 PM Mountain Time. You can see that I have the Milestone 1 guidelines pulled up on the screen. You can find these guidelines by selecting Modules from the menu on the left-hand side of your screen, and then Week 1, Course Project Milestone 1. Your instructor will approve your Milestone 1 topic, or direct you to make revisions and communicate the changes to the instructor. You will continue to use the approved topic for Milestones 2 and 3, because each assignment builds off the previous one to develop the entire project. Be sure to use the templates provided for you for each Milestone. Before I continue, I have an important announcement. Professor Kendra Diesburg and I have completed each milestone assignment that will be featured in the three assignment helpful hints videos, posted throughout the session. To ensure that there is no unfair advantage, use of the topic central line-associated bloodstream infections, or CLABSI, is prohibited. Do not use this topic for your course project. Using word-for-word information from the example is considered plagiarism and may be an academic integrity violation. The examples are meant to serve as a guide, and give you an idea as to the information that should be included. Remember that all submitted work must be original to you. Now we can get started. The first section of the Milestone 1 assignment is nursing care issue and outcome. This is the section where you will put your selected topic as well as desired outcome. Please be sure to carefully read the assignment guidelines and rubric and note that workforce issues, such as staffing or the nursing shortage, are not appropriate for this assignment. Please be sure to choose a topic that is nursing care related. Some examples include RN to RN handoff communication, or bedside report, medication errors, or falls. When developing your desired outcome, you want to ensure it contains a measurable component. Measurability ensures that you will be able to determine if an improvement has been made in the evaluation phase. Looking at my Milestone 1 example, you can see that I have selected the topic of central line-associated bloodstream infections, or CLABSIs. For my desired outcome, you can see that I want to reduce the number of CLABSIs by 75% over the next 12 months. This section really is meant to be this simple. You do not have to include any additional information other than your topic and the desired outcome. The next section of the assignment is details of the issue. [BLANK_AUDIO] Like the title says in this section, you will be providing details of your selected nursing care issue. What makes your topic an issue of concern? Why is it important that this issue be addressed? What impact does it have on patients and/or staff on your unit or at your facility? Looking at my example, for the topic of CLABSI, I have written, a central line-associated bloodstream infection occurs when bacteria are introduced into the body via central line. This can occur either during placement, or during the maintenance of the central line. Infections caused by central lines can be quite serious, as many patients with central lines are at an already increased risk for developing an infection. Infections associated with central lines are even associated with death. Additionally, CLABSIs cost the healthcare system hundreds of millions of dollars to identify and treat. CLABSIs are preventable through meticulous attention to detail. Finally, we finish up with a section called Reason Issue Selected. This is where you state why you have selected this topic as your course project. What makes this topic important to you or your facility? In my example, I wrote, I selected this issue because at the January 2019 staff meeting, it was shared that my unit had an increase in the number of CLABSIs. In 2017, we had five identified CLABSIs, and in 2018, we had ten identified CLABSIs. All infections were noted to be diagnosed greater than one week following placement, which my facility relates to maintenance rather than placement. This issue in the number of infections is significant, and a serious patient safety issue, as infection can spread rapidly in already compromised patients. This concludes the Milestone 1 helpful hints video. I hope you have found this recording to be beneficial. Please be sure to contact your instructor with any questions or concerns. Thank you for listening.
THIS ASSIGNMENT SHOULD BE A CONTINUATION TO WEEK 1 JOURNAL ( DOCUMENT ATTACHED)
Purpose To apply lessons in quality improvement in nursing to a real-world nursing issue. This Course Project will use the Six Sigma DMAIC process. Course Outcomes The Course Project enables the student to meet the following Course Outcomes (COs): CO1: Identify the role of the BSN nurse in the quality improvement process as a member of the collaborative interprofessional team. (POs 2 and 7) CO2: Discuss effective processes and strategies to improve quality in nursing. (POs 2 and 8) Points The entire Course Project is worth 600 points. Milestone 1 is worth 150 points of this total. Due Date Submit your completed NR392 Milestone 1 by Sunday, 11:59 p.m. MT, end of Week 1. Requirements and Guidelines Quality improvement is an important issue in professional nursing today. In Milestone 1, the student will define a nursing care issue (not a workforce issue such as staffing) from a current or former workplace or clinical setting that could be impacted by improved quality, and state the desired outcome of the improvement in quality. The student will then provide details about this issue, as well as explain the reason this issue was selected. Milestone 1 is due at the end of Week 1. Download the required Milestone 1 Template (Links to an external site.)Links to an external site.. Save it to your computer in Microsoft Word 2013 (or later) as a .docx file with the file name: Your Last Name NR392 Milestone 1.docx. After you have developed your responses, type your responses directly in your saved Milestone 1 Template.
THIS ASSIGNMENT SHOULD BE A CONTINUATION TO WEEK 1 JOURNAL ( DOCUMENT ATTACHED)
Chamberlain College of Nursing NR392 Quality Improvement in Nursing Course Project Milestone 1 Template Directions: Prior to completing this template, carefully review Course Project Milestone 1 Guidelines paying particular attention to how to name the document and all rubric requirements. After saving the document to your computer, type your answers directly on this required template and save again. This assignment is due by Sunday end of Week 1 by 11:59 p.m. Mountain Time. Your Name: Amarjeet Kaur Assignment Criteria Your Answers: (NOTE: See Milestone 1 Grading Rubric for details required in each area.) Nursing Care Issue and Desired Outcome 50 points Nursing Care Issue: Desired Outcome: Details of the Issue 50 points Reason Issue Selected 50 points NR392 Course Project Milestone 1 Template.docx 9/27/2018 CJM

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