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DNP-Patient Outcomes and Sustainable Change Essay
QUALITY AND SUSTAINABILITY
Patient safety is the essential foundation of delivering high-quality health care. It is viewed as the underlying umbrella of patient safety. According to the Institute of Medicine (IOM), patient safety is indistinguishable from delivering high quality health care. The organization defined it as “the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge.” Prevention of harm in its practices have mostly defined by negative outcomes of care that include mortality and morbidity (Mitchell, 2008).
This project discusses the role of quality and/or safety in nursing science with emphasis on quality and/or safety measures and description of their relationship and role in present-day nursing science and how it applies quality or safety measures in nursing science. In addition, it provided the components required to analyze a health care program’s outcome (GCU, 2020).
Defining Quality and Safety Measures
According to the World Health Organization (WHO), quality in nursing refers to “the extent to which health care services provided to individuals and patient populations improve desired health outcomes” (Salyers et al., 2017). For this to be achieved, nursing practice must be people-centered, equitable, efficient, timely effective and safe. While there are numerous ways of developing, assessing and assuring quality, the concept of quality in nursing care is difficult to measure.
In the healthcare setting, there are promises of providing quality care by nurses and desired by patients. Quality care has significant impact on patient experience and satisfaction. As the nursing environment becomes more complex, organization leaders must understand the role of quality in healthcare.
Regarding safety, it is yet an important component of high-quality healthcare. You cannot talk about quality healthcare without talking about safety. Multiple studies show that many patients are harmed in healthcare facilities, which increases their length of hospital stay or resulting in permanent injuries. In severe cases lack of safety in healthcare results in death. Studies show that this harm is not intentional, but as a result of the multifaceted and complex nursing environment with the outcome of a patient depending on a wide range of factors. Multiple strategies have however been developed to improve safety in healthcare.
Quality plays an important role in nursing practice. Healthcare organizations must provide quality healthcare services to meet the needs of their patients and the community in general. This not only improves the outcome of patients but also increases nurse satisfaction resulting in improved performance. Quality ensures that healthcare organizations provide patient centered services that take into consideration people’s aspirations and preferences as well as the culture of their community. It also ensures all patients receive equitable services regardless of their personal characteristics such as socioeconomic status, geographical location, ethnicity, race, or gender.
Quality in nursing also ensures that patients receive healthcare on time and without delays. Once patients are admitted in the healthcare system, they need to receive care as soon as possible. It also ensures efficiency in the healthcare system. This implies that healthcare is delivered in a manner that avoids wastage and maximizes all resources available. Quality ensures there is safety in delivering healthcare services to patients.
This involves delivering car that harm and risk to patients including reducing medical errors and avoiding preventable injuries. Providing quality care is therefore a critical part of strengthening health systems (Graban, 2018).
The roles of safety measures in nursing practice is to ensure reduce the likelihood of mistakes and limit harm though planning that promotes effective communication. Nurse practitioners, support staff and patients share a common goal; to achieve the best health outcome possible. Safety in healthcare promotes the well-being of the general community. Nurse practitioners and healthcare managers must understand their role in patient safety. Administrators must train all employees about safety in the healthcare setting and updater the regularly on any changes in policy. All employees in healthcare setting must adhere to the safety procedures developed by the organization.
There are various ways in which healthcare organizations apply quality and safety measures in the healthcare system. One way of ensuring safety quality and safety measures is by communicating safety among patients. Patients have historically played a passive role in their recovery process. Patients placed significant trust on healthcare providers and unquestioningly followed treatment plans.
However, today healthcare organizations emphasize on educating patients to help reduce medical errors. Once patients are admitted in the healthcare system, they receive specific information concerning their safety. Patients are encouraged to ask questions where they don’t understand to help prevent common healthcare errors that could lead to undesirable outcomes (Vincent & Staines, 2019).
At the present, patients take part in their recovery planning. They have increasingly become more involved in the treatment progress. Therefore, they receive safer treatment as educated consumers because health advocates and care providers have helped them to develop the ability to notice potential problems and ask relevant questions. Even after leaving healthcare organizations, patients are able to monitor their situation and determine when something goes wrong. As a result, more patients are receiving quality treatment increasing their outcomes. Patient education has proved to be an effective approach in reducing medical errors that have historically dominated the healthcare systems around the world (Modi et al., (2019).
Contemporary nursing practice has become more patient centered. Whenever people talk about service quality, patient centered care is always mentioned. Initially the philosophy was considered to undermine the efforts of evidence-based practice. However, health advocates now consider patient centered care as an important framework for fostering desired wellness outcomes. It allows nurse practitioners to incorporate evidence-based practice in providing care to patients.
Patients feel more secure and trust the process, and they are fully aware of what to expect. This awareness makes it easy for healthcare providers to avoid making mistakes when dealing with patients. This also eliminated illegal activities I the healthcare systems as information is readily available.
Quality and Components Needed to Analyze a Health Care Program’s Outcomes
There are numerous components that can be used to analyze the outcomes of a particular healthcare program. One of these components is effectiveness. This involves providing healthcare services based on evidence-based guidelines and scientific knowledge. This helps to analyze patient outcomes by determining whether recommended hospital care is utilized for specific medical conditions such as prevention of surgical infection, heart attack and pneumonia care. Timeliness is another component needed to analyze the outcomes of healthcare programs. Patients need to receive medical care without any delays. In this quality measure, the patient reports on the timeliness of care and services they received in a particular healthcare facility (Brown, Dickinson & Kelaher, 2018).
Patient centeredness is another measure that is used to analyze the outcomes of health care programs. This component involves taking care of patients while considering their preferences. It can be measured through reviewing patient reports of services offered by an organization. It can also be analyzed by determining whether a healthcare organization provided care instructions after a patient has been discharged from hospital. In patient centered care, people are given instructions on how to care themselves at home. Failure to give these instructions shows that the healthcare facility or hospital does not offer patient centered care (Allen et al., 2016).
Another component that can be used to analyze the outcomes of a particular healthcare program is efficiency. This component involves providing services and care that minimizes wastage and maximizes the available resources. This component can be analyzed by utilization of hospital procedures and services as measured by the average hospital stay or hospital discharge rate. A low rate of discharge from the hospital shows lack of efficiency in delivering healthcare services to patients. In the same way, a high rate of hospital discharge is an indicator of an effective healthcare system. Either way, an efficient healthcare program must ensure patients receive quality healthcare services (Lamé & Dixon-Woods, 2018).
Equity is also an important component in analyzing outcomes of healthcare programs. This involves determining whether patients receive equitable services regardless of their personal characteristics such as socioeconomic status, geographical location, ethnicity, race, or gender. Hospitals can provide equitable services by ensuring they have equal number of beds for both genders and ensuring there is no discrimination in the healthcare setting. Electronic medical records can be used to determine the services provided for every patient who visited a particular hospital. Nurse to patient ration can also provide critical information for the analysis of outcomes of healthcare programs.
Patient safety remains the cornerstone in the provision of high-quality health care. Health care professionals, especially nurses are extremely important to the care, control, supervision and coordination that will help in reducing negative or adverse outcomes. The numerous government healthcare organizations in collaboration with healthcare professionals must continue to work on evaluating the impact of nursing care on positive quality indicators that include appropriate self-care and other measures of improved health status (Mitchell, 2008).
Analysis and Application
Description of the Healthcare Entity
Healthcare institutions exist in many varied forms depending on their origin, core values, goals, mission, and vision (Rajfur & Hys, 2018). Hospitals are part of the different types of healthcare institutions. A hospital is an institution established to offer health care services to society. As such, hospitals are equipped with advanced tools to be used by trained health practitioners who provided service delivery to the surrounding communities.
The healthcare entity to be considered in this analysis is a mission hospital called AIM Healthcare Center. AIM healthcare center was started over ten years ago by a group of Christian missionaries. The cost of accessing healthcare services is very high thus poor people can barely access the best quality care. The founders identified a need to have a hospital facility that will provide healthcare services to the less privileged people in society. Furthermore, most of the poor people do not have healthcare insurance coverage and thus are unable to access quality healthcare services.
AIM healthcare center specializes in pediatric healthcare care services as well as treating teenagers aged 18 years and below. The founders of the mission hospital identified that young children and teenagers from less privileged communities do not have access to reliable healthcare services. Most of the patients served by the AIM healthcare center are from the African-American and Hispanic communities.
Most of the financial resources utilized to run the facility come from donations made by individuals and various independent NGOs. The Methodist church is also a major contributor to the Hospital’s operations. Several insurance companies also support AIM’s initiatives to provide affordable healthcare services by offering healthcare covers at subsidized prices, exclusively to the less privileged communities.
The entity under consideration has a workforce that comprises 120 medical doctors, 300 nurse practitioners, and 200 support staff. Some employees at the hospital are members of the AIM missionaries’ group who have specialized in medical studies. AIM healthcare center is accredited by the Liaison Committee on Graduate Medical Education as an affiliate of the Association of Children’s Hospitals. The institution is now ranked among the best mission hospitals that offer outstanding healthcare services to children and teenagers.
Such recognition has attracted more partners and philanthropists who support the hospital to offer a better quality of healthcare to its patients. It is essential to focus on providing healthcare services to the younger generations because they are still undergoing growth and development. Conditions that fail to be treated or managed from early ages can be fatal in future years (Ruggles, et.al., 2019).
Entity Success and Failure due to Quality Outcomes
The success of the AIM healthcare center over the years can be attributed to the high level of commitment to its patient’s safety. Quality outcomes and patient safety measures are meant to promote the effectiveness of healthcare services offered. Patient Safety policy refers to all strategies put in place to prevent any harm to the patients served at the facility. Quality healthcare policy refers to the strategies put in place to ensure that all patients receive the best healthcare services (Brown et.al., 2018). AIM healthcare center promotes patients’ safety and the quality of healthcare services by upholding several operational principles.
The healthcare entity ensures that the patients are offered the right medication, the right dosage, and through the right procedures. The institution has adopted modern technology, including nursing informatics systems, that promotes the entire process of healthcare service delivery. Prescriptions are not made without multiple verification. The use of technology to conduct activities such as diagnostic analysis and prescription has minimized errors.
Another safety measure that has promoted the success of the AIM healthcare center is putting more emphasis on risk mitigation strategies. The hospital has established a department that deals with risk identification and mitigation. Risks that arise in healthcare organizations harm the quality of services as well as on the safety of patients. As such, it is very important to identify and trace the root cause of various errors within a hospital environment to promote the safety of the patients (Mossialos, et.al., 2017). Risk mitigation policies and corrective measures must be applied to prevent and resolve errors in hospitals. The existence of a risk management department at the AIM healthcare center is a critical success factor.
Despite the almost excellent services offered at the AIM healthcare center, the hospital also faces some challenges that may lead to failure if they are not addressed in time. Hospital-acquired infections (HIA) have been a problem at the hospital for several years. Policies that were implemented to address this issue have had little if no effect; the infection rates have increased over the years. The hospital incurs a lot of unnecessary costs to treat hospital-acquired infections since the cost is entirely transferred to the hospital.
The high number of patients frequenting the hospital is overwhelming for the staffers, thus, the patient handling is poor at times. There was a discovery that the catheters used in the wards and ICU are the major cause of HAI at the hospital. If this problem remains unaddressed, the hospital may be heading to failure.
Safety Area that Nursing Science Can Impact
Nursing science can have a significant impact on hospital-acquired infections that are a threat to patient’s safety. HAIs pose a significant challenge to the hospital and should be addressed immediately. Some variables that should be considered while applying nursing science include the use of antibiotics, hygiene measures, the hospital environment, as well as the use of sterilized equipment.
Maintaining high levels of hygiene is very important especially when addressing HAIs. Most of HAIs are contracted by patients due to poor handling of equipment by nurse practitioners (Percival, et.al., 2015). Hospitals are required to provide amenities that promote the cleanliness of their staff members. This includes the provision of hand sanitizers and other disinfectants used in cleaning the hands before and after conducting any activity. Patients should also be provided with similar facilities to ensure they do not increase contamination.
Maintaining a clean environment at the hospital is yet another way of reducing contamination and infection levels (Vincent & Staines, 2019). The working environment should always be kept clean and tidy. The standard guidelines for handling hospital equipment and sterilization procedures must be observed. Devices such as intravenous needles and syringes as well as catheters must be disposed of properly to promote patient safety and enhance the quality of care given. Finally, the last variable that must be considered is antibiotics.
Antibiotics can either promote the quality of care or negatively affect the patients depending on how they are administered. As such, it is necessary to focus on progressive management of health conditions to ensure that antibiotics yield the desired results.
Nurses are not entirely to blame for the high rates of hospital-acquired infections in various hospitals. Patients also play a role in the contraction of HAIs due to carelessness and ignorance (Percival, et.al., 2015). In most cases, a language barrier affects communication between nurses and patients. For instance, most of the patients treated at the AIM healthcare center are Hispanics who barely understand or speak English. This makes it very difficult for nurses to give instructions to the patients who often do contrary to what is expected. Cultural diversity can also hinder the implementation of quality and safety measures.
High patient turnover rates can also affect the policy implementation process at the AIM healthcare center. The healthcare practitioners often have to work long hours hence the quality of services offered declines due to exhaustion and stress. It is not ethical to turn patients away just because a shift is over. Nurses and doctors at AIM hospital are committed to serving all patients and this may at times be at the expense of their well-being. As a result, the quality of services offered is affected.
Financial constraints also limit the policy implementation process in the healthcare sector (Cheng, et.al., 2018). More financial resources are required to implement any policy and process changes. AIM healthcare sector operates based on support from well-wishers and subsidized rates charged on patients. The finances generated by the company are barely enough to sustain operations. As such, the facility faces a challenge of balancing between quality-service delivery and allocating resources for process change implementation.
Various stakeholders in the healthcare sector must work together to ensure that safety and quality policies are implemented successfully. In this case, the facility can collaborate with first aid organizations such as Red Cross society to transfer minor cases away from the hospital. This will reduce the workload for nurses and lower operational costs. The hospital can also partner with various medical training institutions to initiate internship programs for nursing students. Nursing students can offer support to nurse practitioners at the hospital thus reducing their workload by handling minor tasks (Allen, et.al., 2016). Healthcare departments established can also be engaged to ensure the hospital receives some support for the government. Finally, collaborating with the healthcare managers at the hospital can promote the policy implementation process to promote safety and quality.
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I, (Bola Odusola-Stephen), verify that I have completed (10) clock hours in association with the goals and objectives for this assignment. I have also tracked said practice hours in the Typhon Student Tracking System for verification purposes and will be sure that all approvals are in place from my faculty and practice mentor.
DNP-Patient Outcomes and Sustainable Change Essay
QUALITY OF RESPONSE NO RESPONSE POOR / UNSATISFACTORY SATISFACTORY GOOD EXCELLENT Content (worth a maximum of 50% of the total points) Zero points: Student failed to submit the final paper. 20 points out of 50: The essay illustrates poor understanding of the relevant material by failing to address or incorrectly addressing the relevant content; failing to identify or inaccurately explaining/defining key concepts/ideas; ignoring or incorrectly explaining key points/claims and the reasoning behind them; and/or incorrectly or inappropriately using terminology; and elements of the response are lacking. 30 points out of 50: The essay illustrates a rudimentary understanding of the relevant material by mentioning but not full explaining the relevant content; identifying some of the key concepts/ideas though failing to fully or accurately explain many of them; using terminology, though sometimes inaccurately or inappropriately; and/or incorporating some key claims/points but failing to explain the reasoning behind them or doing so inaccurately. Elements of the required response may also be lacking. 40 points out of 50: The essay illustrates solid understanding of the relevant material by correctly addressing most of the relevant content; identifying and explaining most of the key concepts/ideas; using correct terminology; explaining the reasoning behind most of the key points/claims; and/or where necessary or useful, substantiating some points with accurate examples. The answer is complete. 50 points: The essay illustrates exemplary understanding of the relevant material by thoroughly and correctly addressing the relevant content; identifying and explaining all of the key concepts/ideas; using correct terminology explaining the reasoning behind key points/claims and substantiating, as necessary/useful, points with several accurate and illuminating examples. No aspects of the required answer are missing. Use of Sources (worth a maximum of 20% of the total points). Zero points: Student failed to include citations and/or references. Or the student failed to submit a final paper. 5 out 20 points: Sources are seldom cited to support statements and/or format of citations are not recognizable as APA 6th Edition format. There are major errors in the formation of the references and citations. And/or there is a major reliance on highly questionable. The Student fails to provide an adequate synthesis of research collected for the paper. 10 out 20 points: References to scholarly sources are occasionally given; many statements seem unsubstantiated. Frequent errors in APA 6th Edition format, leaving the reader confused about the source of the information. There are significant errors of the formation in the references and citations. And/or there is a significant use of highly questionable sources. 15 out 20 points: Credible Scholarly sources are used effectively support claims and are, for the most part, clear and fairly represented. APA 6th Edition is used with only a few minor errors. There are minor errors in reference and/or citations. And/or there is some use of questionable sources. 20 points: Credible scholarly sources are used to give compelling evidence to support claims and are clearly and fairly represented. APA 6th Edition format is used accurately and consistently. The student uses above the maximum required references in the development of the assignment. Grammar (worth maximum of 20% of total points) Zero points: Student failed to submit the final paper. 5 points out of 20: The paper does not communicate ideas/points clearly due to inappropriate use of terminology and vague language; thoughts and sentences are disjointed or incomprehensible; organization lacking; and/or numerous grammatical, spelling/punctuation errors 10 points out 20: The paper is often unclear and difficult to follow due to some inappropriate terminology and/or vague language; ideas may be fragmented, wandering and/or repetitive; poor organization; and/or some grammatical, spelling, punctuation errors 15 points out of 20: The paper is mostly clear as a result of appropriate use of terminology and minimal vagueness; no tangents and no repetition; fairly good organization; almost perfect grammar, spelling, punctuation, and word usage. 20 points: The paper is clear, concise, and a pleasure to read as a result of appropriate and precise use of terminology; total coherence of thoughts and presentation and logical organization; and the essay is error free. Structure of the Paper (worth 10% of total points) Zero points: Student failed to submit the final paper. 3 points out of 10: Student needs to develop better formatting skills. The paper omits significant structural elements required for and APA 6th edition paper. Formatting of the paper has major flaws. The paper does not conform to APA 6th edition requirements whatsoever. 5 points out of 10: Appearance of final paper demonstrates the student’s limited ability to format the paper. There are significant errors in formatting and/or the total omission of major components of an APA 6th edition paper. They can include the omission of the cover page, abstract, and page numbers. Additionally the page has major formatting issues with spacing or paragraph formation. Font size might not conform to size requirements. The student also significantly writes too large or too short of and paper 7 points out of 10: Research paper presents an above-average use of formatting skills. The paper has slight errors within the paper. This can include small errors or omissions with the cover page, abstract, page number, and headers. There could be also slight formatting issues with the document spacing or the font Additionally the paper might slightly exceed or undershoot the specific number of required written pages for the assignment. 10 points: Student provides a high-caliber, formatted paper. This includes an APA 6th edition cover page, abstract, page number, headers and is double spaced in 12’ Times Roman Font. Additionally, the paper conforms to the specific number of required written pages and neither goes over or under the specified length of the paper.
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