Quality Improvement and Patient Safety Initiatives
The Practice Issue The quality and safety of care for intensive care patients Patients are admitted for extended periods of time Evidence shows that this increases chances of negative outcomes. Early mobilization can be used to increase chances for positive outcomes Some barriers and challenges influence the implementation of the new practice approach. This presentation develops strategies to deal with the barriers to improve patient safety.
The practice problem that requires intervention is the care for patients in the ICU. The patients in intensive care are admitted for extended periods of time. According to research, the length of stay in the ICU increases the chances of negative outcomes. Patients tend to have a higher chance of readmission, mortality, and negative experiences (Schneider et al., 2016). The intervention that is recommended to deal with this problem is early mobilization of patients. Early mobilization reduces issues such as muscle atrophy and speeds up the recovery process. Therefore, patients have a higher chance of positive outcomes when this recommendation is implemented. However, there are some challenges and barriers that prevent the successful implementation of this practice approach. The purpose of this presentation is to demonstrate how quality can be improved to enhance patient safety. The presentation will evaluate some of macro and micro systems that effect the implementation of the intervention and the strategies that can be used to increase chances of success. 2
Macro Systems Unavailability of resources There may be a limitation of resources to implement the new approach successfully. Inadequate staff members Mobilization of patients may require new nurses. Lack of knowledge and skills on mobilization Nurses lack adequate training on effectively mobilizing patients.
The macro factors that influence the successful implementation of the new practice approach include the unavailability of adequate resources, inadequate staffing, and the lack of knowledge and skills to effectively mobilize the patients as recommended. First, the unavailability of resources could limit the effective implementation of new standards of practice that will help to improve patient safety. Secondly, the standard of mobilizing patients will require more working time for nurses. There is already a limitation of healthcare professionals. Adding more work will increase the problem of burnouts, which reduce the quality of care. Therefore, there may be need to add more personnel. Lastly, effective mobilization of patients may require training to be done effectively. Patients in the ICU are quite delicate. It is important that the nurses are equipped with the rights skills to manage such responsibilities. These are all macro factors that need to be handled on the organizational level. 3
Micro Systems Personal beliefs and attitudes Nurses’ beliefs and attitudes on early mobilization will affect how effectively they perform the intervention. Willingness to improve patient safety The nurses must naturally be willing to engage in the new practice model for effectiveness to be achieved. Personal beliefs on capabilities It is important that professionals believe in their capabilities to make a difference to the patients.
The micro factors are issues at the individual level that can affect the implementation of the new practice approach. According to Maclusky and Middleton (2010), transferring knowledge to practice can be challenging because of factors on the individual level such as personal beliefs and attitudes towards the new practice approach. The micro factors that can affect this project include personal beliefs and attitudes, willingness to improve patient safety, and the professionals’ personal beliefs of their capabilities. Nurses’ beliefs and attitudes on early mobilization will affect how effectively they perform the intervention. If nurses believe that they are actually making a difference then they are more likely to participate in the change. The nurses must naturally be willing to engage in the new practice model for effectiveness to be achieved. It is important that professionals believe in their capabilities to make a difference to the patients. They should understand the ways in which they are improving patient safety by practicing the recommended approaches. 4
Strategies for Resolving the Issue Involving external stakeholders Implementing this approach will need support from external stakeholders to help with the funding. Training and development Nurses need to be trained to increase understanding and confidence in the practice approach. Open communication There should be open and direct communication of information on the change to increase engagement.
The only way to achieve success when implementing new evidence based practice approaches is to develop strategies to deal with the challenges and barriers. The following are the strategies that can be used to deal with the barriers and challenges to this implementation. The first strategy is involving external stakeholders. Implementing this approach will need support from external stakeholders to help with the funding. There are governmental and non-governmental organizations that can assist in the funding of such a project to enhance patient safety. The second intervention is training and development. Nurses need to be trained to increase understanding and confidence in the practice approach. Training is one of the important strategies required in managing change because employees need to understand the new practice approaches before they can participate. Lastly, open communication is required for the success of this project. There should be open and direct communication of information on the change to increase engagement. 5
How it will Improve Quality and Patient Safety Increased consistency in patient mobilization Increased speed of recovery Reduced length of stay Improved patient outcomes; Lower readmission rates Lower mortality rates
Dealing with the barriers to the implementation of this evidence based approach will be helpful in improving care for the patients in intensive care. One of the changes that will be enabled is increased consistency in patient mobilization. Once the patients are mobilized more effectively, they will have a faster rate of recovery. Research shows that early mobilization is an effective way of improving the recovery process for the people in intensive care (Denehy, Lanphere & Needham, 2017). There will also be reduced lengths of stay because of the faster recovery processes. In the end, the patients will end up having better outcomes. The rates of readmission will be reduced significantly. Similarly, this practice approach can help to reduce the mortality rates for the ICU patients. Therefore, it is important to ensure that the barriers to the implementation of this project are effectively dealt with for the benefit of the patients in intensive care.
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