Responses WK 1 Hello Everyone, This is a 4000 AWE course and

Responses WK 1

Hello Everyone, 

This is a 4000 AWE course and a Capstone course, there are different expectations for the course than you may have previously experienced. To the left of your screen, you will find the tab that says Writing Resources, which will help you with your writing expectations. 

For every Main Discussion and Practice Experience (Group Discussion), you are required to have cited references in your discussion and group posts, as well as your responses to your peers to support your comments.

Also, Per the rubric, you need to respond to 3 peers supported by cited references.

Response # 1

lindsey reed 

RE: Discussion – Week 1

COLLAPSE

Top of Form

Main Discussion Post: 

        The purpose of this discussion is to describe my definition of quality, apply it to the work of a major quality theorist, and identify a practice problem that could be improved through the elimination of wasteful practice. Merriam-Webster defines quality as “an inherent feature, a degree of excellence, superiority in kind, a distinguishing attribute” (n.d.). My definition of quality in healthcare refers to the desired patient outcomes directly linked to those providing current, competent, and skillful care. The domains of quality in healthcare include efficiency, effectiveness, safety, timely, equity, and patient-centeredness (AHRQ, 2020). The definition and examples of quality began in the late 1800s and worked their way into the business and healthcare model through quality control entrepreneurs. 

        Philip Crosby entered the quality field in 1952 and spent more than five decades stressing the importance of quality management (QP staff, 2010). Philips is known for his “doing it right the first time” approach and for promoting a standard of excellence (QP staff, 2010). Crosby focused on decreasing error rates and improving morale (QP staff, 2010). In healthcare, improving morale and decreasing errors promote quality care. Crosby believed that every one of his customers deserved exactly what was promised to them (QP staff, 2010). Crosby’s standards align with my definition of quality healthcare by providing patients with competent and skilled care, through doing it right and delivering the care that is promised on arrival at the hospital. 

        Wasteful practices can create a negative experience for the patient and practitioner alike. Efficiency is listed as one of the top domains of quality by the Institute of Medicine (AHRQ, 2020). A practice problem I have experienced as a practitioner within our healthcare system is our charting system. Our charting system requires the nurses in same-day surgery to chart the same assessments within two separate modules. There is no system interface therefore the modules do not cross over. The inefficiency in the charting system causes the same-day surgery nurses to have to chart the same thing multiple times in different locations. Eliminating the wasteful practice of duplicate charting could improve the experience for the practitioner and the patients. One of the sayings Crosby is known for is preventing the problem in the first place by eliminating the problem of finding, fixing, and fighting it (QP staff, 2010). My definition applies to that experience through the elimination of wasteful practice that provides skillful and competent care. Quality has different definitions depending on the setting and circumstances but ultimately focuses on superiority, eliminating wasteful practices, and promoting a degree of excellence. 

References:

Agency for Healthcare Research and Quality. (2020, June). Understanding Quality Measurement. https://www.ahrq.gov/patient-safety/quality-resources/tools/chtoolbx/understand/index.html

Merriam-Webster. (n.d.). Definition of Quality. Retrieved July 11, 2022, from https://www.merriam-webster.com/dictionary/quality

QP staff. (2010). Guru guide: Six thought leaders who changed the quality world forever. Quality Progress, 43(11), 14–21.

Bottom of Form

Response #2

Nicole Galloway 

RE: Discussion – Week 1

COLLAPSE

Top of Form

Quality is a metric used to determine a product or service’s ability to meet or exceed one’s expectations. It is dynamic, reliable, and measurable. It provides value to whoever receives the product or service (Spath, p. 3-4, 2018). Phillip B. Crosby once said, “Why spend all this time finding, fixing, and fighting when you could have prevented the problem in the first place” (QP staff, p. 14, 2010). Crosby was a leader in doing things the right way the first time, every time. By doing this, one is able to deliver what was promised, thereby increasing the quality of a service or product (QP staff, p. 14, 2010). As this relates to health care, patients want to be able to trust the health care provider to give the correct treatments that provide the patient with the best outcomes (Spath, p. 5, 2018).

One practice problem I have experienced in my current work setting is witnessing staff use the same needle with which they draw up the medication to also administer the medication to the patient. Specifically, this is happening with insulin. The syringes that the Department of Veteran’s Affairs (VA) provides come with a needle that is not removable. When I mentioned to my coworkers that the needle policy wasn’t best practice, I was met with an apathetic response best summed up as “that’s the way we do it here.” Unfortunately, many hospitals do not meet or maintain high levels of quality across all services and settings (Spath, p. 8, 2018). In the case of the VA, this seems to be primarily due to the difficulty in changing policies or procedures. This misses three of the six health care quality dimensions. With better, more efficient processes to change outdated equipment, policies, and procedures, our veterans would receive much better care. The quality dimensions in which this procedure fails patients include safety, effectiveness, and equity.

It may be common practice for some to reuse insulin needles, but this could have adverse effects. Contamination of the needle could occur if the medication vial is not properly cleaned. Damage to the needle tip could also occur, causing painful administration to the patient. Both could easily be avoided. The CDC recommends using a new sterile syringe and sterile needle to draw up medications (CDC, 2019). According to the World Health Organization (WHO), only single-dose vials and single-use needles and syringes should be used to prevent contamination and the spreading of harmful microorganisms (WHO, 2010). Using sterile needles is a standard, evidence-based practice that should be implemented in every setting.

References

Centers for Disease Control and Prevention. (2019). Medication Preparation Questions. https://www.cdc.gov/injectionsafety/providers/provider_faqs_med-prep.html

QP staff. (2010). Guru guide: Six thought leaders who changed the quality world forever. Quality Progress, 43(11), 14-21.

Spath, P. (2018). Introduction to healthcare quality management (3rd ed.). Health Administration Press.

World Health Organization. (2010). Best Practices for Injections and Related Procedures toolkit. https://www.ncbi.nlm.nih.gov/books/NBK138495/

Bottom of Form

Response # 3

18 hours ago

JULIE ROBINSON 

RE: Discussion – Week 1

COLLAPSE

Top of Form

Hello Dr. Wichman and class,

The purpose of this discussion is to define quality, apply it to the work of one prominent quality theorist and identify a practice problem that could have improved by eliminating the wasteful practice.

The quality of care at which healthcare services for individuals and populations increases the possibility of desired health outcomes and is compatible with current professional knowledge (Spath, 2018). To me, quality in healthcare is defined as an ongoing improvement process of care that never stops.

A quality management expert named Joseph M. Juran revolutionized how businesses operate and approach quality in the 20th century (QP staff, 2010). Joseph Juran is one theorist that applied science toward quality improvement. The effectiveness of quality relates to delivering treatment in ways that produce results backed by scientific evidence (AHRQ, 2020). The “Juran Trilogy” is the name for Juran’s most noteworthy contributions to quality improvement (American Institute for Healthcare Management, 2021). The trio discusses the three interconnected processes of quality planning, quality control, and quality improvement.

Wasteful practice can cause more harm to a patient and more time in a hospital setting. In the hospital where I work, I have seen patients receiving an overabundance or unnecessary antibiotics. In addition to being pricey, overuse of waste also has adverse side effects for patients (Moriates, 2016). We know that patients who use unnecessary antibiotics risk severe illnesses like Clostridium difficile colitis. The Pareto Principle is a “universal” phenomenon that Juran first identified in the early 1950s. It states that a small number of factors typically account for most of the effects of any set of factors contributing to an expected outcome (Spath, 2018). Medical care may result in errors and bad outcomes directly through treatment-related consequences or indirectly through the generation of excessive diagnoses or additional therapies. So, eliminating unnecessary waste or extra unnecessary treatments can improve the quality of care, which in turn can eliminate the wasteful practices being used.

References

AHRQ. (2020). Understanding quality measurement. Agency for Healthcare Research and Quality. Retrieved July 12, 2022, from https://www.ahrq.gov/patient-safety/quality-resources/tools/chtoolbx/understand/index.html

American Institute for Healthcare Management. (2021). Healthcare quality improvement is the quality foundation. Amihm.Org. Retrieved July 12, 2022, from https://www.amihm.org/healthcare-quality-improvement-the-quality-foundation/

Moriates, C. (2016, August 22). Overuse as a Patient Safety Problem | PSNet. Psnet.Ahrq.Gov. Retrieved July 13, 2022, from https://psnet.ahrq.gov/perspective/overuse-patient-safety-problem

Spath, P. (2018). Introduction to healthcare quality management, third edition (3rd ed.). Health Administration Press.

QP staff. (2010). Guru guide: Six thought leaders who changed the quality world forever. Quality Progress, 43(11), 14–21.

e: NURS_4220_Week1_PracticeExperience_Rubric

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List View

Excellent

Proficient

Basic

Needs Improvement

Required Content
Identified a measurable patient-centered practice problem related to quality or safety relevant to the practice setting. Described the problem and an explanation of why it was selected. Explained how the conversation with the key leader in the practice setting impacted the decision to address this particular practice problem. Supported the practice problem with relevant literature and the data that is available.

18 (36%) – 20 (40%)

Initial post is exceptional containing well developed and insightful analysis that brings connections to nursing practice into the discussion.

15 (30%) – 17 (34%)

Initial post contains reasonable analysis that brings insight into the discussion.

12 (24%) – 14 (28%)

Initial post contains minimal analysis that brings limited insight into the discussion.

0 (0%) – 11 (22%)

Initial post lacks analysis and/or that brings little or no insight into the discussion.

Response Posts
Entered the discussion thread on 3 separate days. Wrote at least two posts to two separate peers.

Responses are appropriate to the topic, substantive, and promoted discussion by one or more of the following:
• contributing insight to move the discussion forward.
• offering substantial and/or different points of view and asks questions to add to discussion
• including extra references or websites for peers to consider
• relating discussion to different areas of practice and applying concepts to practice

**Additional points may be deducted for late posting per the University late policy.

15 (30%) – 15 (30%)

Response posts add substantial ideas and perspectives that invite further analysis and discussion. Participated 3 or more days in the classroom and responded to more than 2 classmates.

12 (24%) – 13 (26%)

Response posts are proficient and provide adequate analysis and discussion. Participated 3 days in the classroom and responds to at least two classmates.

11 (22%) – 11 (22%)

Response posts are limited and provide minimal analysis and discussion. Participated less than 3 days in the classroom and/or responds to less than two classmates.

0 (0%) – 10 (20%)

Response posts are inadequate and provide no analysis of discussion and/ or there is no participation in the classroom.

Professional Writing: Clarity, Flow, and Organization

4.5 (9%) – 5 (10%)

Content is free from spelling, punctuation, and grammar/syntax errors. Writing demonstrates very well-formed sentence and paragraph structure. Content presented is completely clear, logical, and well-organized.

4 (8%) – 4 (8%)

Content contains minor spelling, punctuation, and/or grammar/syntax errors. Writing demonstrates appropriate sentence and paragraph structure. Content presented is mostly clear, logical, and well-organized.

3.5 (7%) – 3.5 (7%)

Content contains moderate spelling, punctuation, and/or grammar/syntax errors. Writing demonstrates adequate sentence and paragraph structure and may require some editing. Content presented is adequately clear, logical, and/or organized, but could benefit from additional editing/revision.

0 (0%) – 3 (6%)

Content contains significant spelling, punctuation, and/or grammar/syntax errors. Writing does not demonstrate adequate sentence and paragraph structure and requires additional editing/proofreading. Key sections of presented content lack clarity, logical flow, and/or organization.

Professional Writing: Context, Audience, Purpose, and Tone

4.5 (9%) – 5 (10%)

Content clearly demonstrates awareness of context, audience, and purpose. Tone is highly professional, scholarly, and free from bias, and style is appropriate for the professional setting/workplace context.

4 (8%) – 4 (8%)

Content demonstrates satisfactory awareness of context, audience, and purpose. Tone is adequately professional, scholarly, and/or free from bias, and style is consistent with the professional setting/workplace context.

3.5 (7%) – 3.5 (7%)

Content demonstrates basic awareness of context, audience, and purpose. Tone is somewhat professional, scholarly, and/or free from bias, and style is mostly consistent with the professional setting/workplace context.

0 (0%) – 3 (6%)

Content minimally or does not demonstrate awareness of context, audience, and/or purpose. Writing is not reflective of professional/scholarly tone and/or is not free of bias. Style is inconsistent with the professional setting/workplace context and reflects the need for additional editing.

Professional Writing: Originality, Source Credibility, and Attribution of Ideas

4.5 (9%) – 5 (10%)

Content reflects original thought and writing and proper paraphrasing. Writing demonstrates full adherence to reference requirements, including the use of credible evidence to support a claim, with appropriate source attribution (when applicable) and references.

4 (8%) – 4 (8%)

Content adequately reflects original writing and paraphrasing. Writing demonstrates adequate adherence to reference requirements, including the use of credible evidence to support a claim, with appropriate source attribution (when applicable) and references.

3.5 (7%) – 3.5 (7%)

Content somewhat reflects original writing and paraphrasing. Writing somewhat demonstrates adherence to reference requirements, including the use of credible evidence to support a claim, with appropriate source attribution (when applicable) and references.

0 (0%) – 3 (6%)

Content does not adequately reflect original writing and/or paraphrasing. Writing demonstrates inconsistent adherence to reference requirements, including the use of credible evidence to support a claim, with appropriate source attribution (when applicable) and reference.

Total Points: 50

Name: NURS_4220_Week1_PracticeExperience_Rubric