NUR 630 Topic 8 Overview of Quality in Health Care

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NUR 630 Topic 8 Overview of Quality in Health Care – Step-by-Step Guide

The first step before starting to write the NUR 630 Topic 8 Overview of Quality in Health Care, it is essential to understand the requirements of the assignment. The first step is to read the assignment prompt carefully to identify the topic, the length and format requirements. You should go through the rubric provided so that you can understand what is needed to score the maximum points for each part of the assignment. 

It is also important to identify the audience of the paper and its purpose so that it can help you determine the tone and style to use throughout. You can then create a timeline to help you complete each stage of the paper, such as conducting research, writing the paper, and revising it to avoid last-minute stress before the deadline. After identifying the formatting style to be applied to the paper, such as APA, you should review its use, such as writing citations and referencing the resources used. You should also review how to format the title page and the headings in the paper.

How to Research and Prepare for NUR 630 Topic 8 Overview of Quality in Health Care

The next step in preparing for your paper is to conduct research and identify the best sources to use to support your arguments. Identify the list of keywords from your topic using different combinations. The first step is to visit the university library and search through its database using the important keywords related to your topic. You can also find books, peer-reviewed articles, and credible sources for your topic from PubMed, JSTOR, ScienceDirect, SpringerLink, and Google Scholar. Ensure that you select the references that have been published in the last words and go through each to check for credibility. Ensure that you obtain the references in the required format, for example, in APA, so that you can save time when creating the final reference list. 

You can also group the references according to their themes that align with the outline of the paper. Go through each reference for its content and summarize the key concepts, arguments and findings for each source. You can write down your reflections on how each reference connects to the topic you are researching about. After the above steps, you can develop a strong thesis that is clear, concise and arguable. Next you should create a detailed outline of the paper so that it can help you to create headings and subheadings to be used in the paper. Ensure that you plan what point will go into each paragraph.

How to Write the Introduction for NUR 630 Topic 8 Overview of Quality in Health Care

The introduction of the paper is the most crucial part as it helps to provide the context of your work, and will determine if the reader will be interested to read through to the end. You should start with a hook, which will help capture the reader’s attention. You should contextualize the topic by offering the reader a concise overview of the topic you are writing about so that they may understand its importance. You should state what you aim to achieve with the paper. The last part of the introduction should be your thesis statement, which provides the main argument of the paper.

How to Write the Body for NUR 630 Topic 8 Overview of Quality in Health Care

The body of the paper helps you to present your arguments and evidence to support your claims. You can use headings and subheadings developed in the paper’s outline to guide you on how to organize the body. Start each paragraph with a topic sentence to help the reader know what point you will be discussing in that paragraph. Support your claims using the evidence conducted from the research, ensure that you cite each source properly using in-text citations. You should analyze the evidence presented and explain its significance and how it connects to the thesis statement. You should maintain a logical flow between each paragraph by using transition words and a flow of ideas.

How to Write the In-text Citations for NUR 630 Topic 8 Overview of Quality in Health Care

In-text citations help the reader to give credit to the authors of the references they have used in their works. All ideas that have been borrowed from references, any statistics and direct quotes must be referenced properly. The name and date of publication of the paper should be included when writing an in-text citation. For example, in APA, after stating the information, you can put an in-text citation after the end of the sentence, such as (Smith, 2021). If you are quoting directly from a source, include the page number in the citation, for example (Smith, 2021, p. 15). Remember to also include a corresponding reference list at the end of your paper that provides full details of each source cited in your text. An example paragraph highlighting the use of in-text citations is as below:

The integration of technology in nursing practice has significantly transformed patient care and improved health outcomes. According to Smith (2021), the use of electronic health records (EHRs) has streamlined communication among healthcare providers, allowing for more coordinated and efficient care delivery. Furthermore, Johnson and Brown (2020) highlight that telehealth services have expanded access to care, particularly for patients in rural areas, thereby reducing barriers to treatment.

How to Write the Conclusion for NUR 630 Topic 8 Overview of Quality in Health Care

When writing the conclusion of the paper, start by restarting your thesis, which helps remind the reader what your paper is about. Summarize the key points of the paper, by restating them. Discuss the implications of your findings and your arguments. End with a call to action that leaves a lasting impact on the reader or recommendations.

How to Format the Reference List for NUR 630 Topic 8 Overview of Quality in Health Care

The reference helps provide the reader with the complete details of the sources you cited in the paper. The reference list should start with the title “References” on a new page. It should be aligned center and bolded, in sentence sentence care. The references should be organized in an ascending order alphabetically and each should have a hanging indent. If a source has no author, it should be alphabetized by the title of the work, ignoring any initial articles such as “A,” “An,” or “The.” If you have multiple works by the same author, list them in chronological order, starting with the earliest publication. 

Each reference entry should include specific elements depending on the type of source. For books, include the author’s last name, first initial, publication year in parentheses, the title of the book in italics, the edition (if applicable), and the publisher’s name. For journal articles, include the author’s last name, first initial, publication year in parentheses, the title of the article (not italicized), the title of the journal in italics, the volume number in italics, the issue number in parentheses (if applicable), and the page range of the article. For online sources, include the DOI (Digital Object Identifier) or the URL at the end of the reference. An example reference list is as follows:

References

Johnson, L. M., & Brown, R. T. (2020). The role of telehealth in improving patient outcomes. Journal of Nursing Care Quality, 35(2), 123-130. https://doi.org/10.1097/NCQ.0000000000000456

Smith, J. A. (2021). The impact of technology on nursing practice. Health Press.

NUR 630 Topic 8 Overview of Quality in Health Care Instructions

The purpose of this assignment is to apply the concepts you have learned in this course to a situation you have encountered. Choose one quality or patient safety concern with which you are familiar and that you have not yet discussed in this course. In a 1,250-1,500-word essay, reflect on what you have learned in this course by applying the concepts to the quality or patient safety concern you have selected. Include the following in your essay:

  1. Briefly describe the issue and associated challenges.
  2. Explain how EBP, research, and PI would be utilized to address the issue.
  3. Explain the PI or QI process you would apply and discuss why you chose it.
  4. Describe your data sources, including outcome and process data.
  5. Explain how the data will be captured and disseminated.
  6. Discuss which organizational culture considerations will be essential to the success of your work. This assignment uses a rubric.

Use a minimum of four peer-reviewed, scholarly sources as evidence.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. With your specialization being in Healthcare Quality, the next class should be HQS 610 Foundations of Quality Improvement and Patient Safety, which begins with HQS 610 Topic 1 DQ 1 Describe ethical issues that are commonly associated with continuous quality improvement.

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

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

NUR 630 Topic 8 Overview of Quality in Health Care Example

Advanced practice registered nurses are well-equipped with knowledge, skills, and competencies to identify and address problems in their settings. They often occupy leadership positions in facilities which further widens their scope. They influence nursing decisions, and healthcare improvement is one of their significant roles. APRNs identify problems in healthcare settings and address them using best evidence-based practices, research, and quality improvement models that best fit the situations. This essay explores the concepts of research, quality/process improvement, and evidence-based practice as they apply to an identified healthcare problem.

Problem and Associated Challenges

Pressure injuries are wounds that result from prolonged pressure on one side of the body. Pressure injuries are common in elderly and chronically ill patients with mobility problems (Borojeny et al., 2020). They occur when patients are poorly turned, and the skin and body eminences are exposed to friction and sheering pressure, causing loss of skin breakdown and subsequent ulcers. Intrinsic factors include fragile skin, poor blood flow to an area, muscle loss, spinal injuries, and malnutrition (Mervis & Phillips, 2019).

The developing wounds can be small or big and are gangrenous due to lost blood supply. Thus, pressure ulcers are often found in areas with body prominences with fewer muscle or connective tissues, such as heels, the back of the head, and the sacra coccygeal region. Some risk factors for the patient quality care issue include age (older adults), BMI, and pre-existing diabetes (Mervis & Phillips, 2020).

The healthcare intervention directed toward managing the problem is a routine two-hourly patient turning to ensure the patient has adequate blood circulation. Chen et al. (2023) note that with the rising cases of diabetes, overweight and obesity, and an aging population, the problem is a considerable challenge that should be addressed. Patient turning is also a tiring process, and two-hourly turning adds to nurses’ exhaustion and thus is hardly implemented.

EBP, Research, and PI in Addressing the Problem

EBP, research, and process improvement can be used to address this problem. Research is integral in determining the facility’s significant causes of pressure ulcers because the burden of the factors can vary significantly. Hagle et al. (2020) note that EBP, research, and QI help identify problems and their best management interventions and guide improvement. The research will also help select the evidence-based best practice to replace or support the current ineffective processes.

Process improvement is significant to this problem as it will help identify and address the areas needing improvement. It will also help utilize the research and evidence-based practice results and systematically improve them to produce the desired results. Thus, EBP, research, and PI would be integral in this problem and would help identify the causative factors in the facility, determine evidence-based best practices to manage the problem and guide the process of implementing and evaluating the desired change.

QI Process to Apply and Rationale

One of the most striking QI is the Six Sigma DMAIC QI Process. It is widely applied in healthcare settings to drive continuous improvement. The first step in this QI is “Define.” The step will require the care provider to define the problem or improvement opportunity and the goals for the project. A project charter stating the goals (patient-oriented) is developed at this stage. The second stage is Measure, which requires validation of the problem by measuring it. The results facilitate the third stage, analyze, which helps determine the root causes of the problem.

Activities such as root cause analysis and failure mode and effect analysis facilitate the third stage (Ahmed, 2020). Every facility is affected by these factors variably; thus, this step helps ensure the change process is specific to the facility by addressing its specific problem. The fourth step, improvement, requires the care providers to address the process performance identified at the beginning by addressing the root causes identified in the third stage and the management intervention selected (Monday, 2022).

The last step, control, entails interventions to enhance change sustainability in the facility, such as periodic evaluation, statistical and visual control, and mistake-proofing. These processes ensure continuous evaluation, facilitating continuous improvement by ensuring problem identification (“define” stage of the theory). The intention is to develop sustainable change subject to regular improvement to produce sustainable results. As mentioned earlier, pressure ulcers are multifactorial, and addressing some factors may not address others. The DMAIC process will ensure change implemented is periodically assessed and improved to ensure continued success in pressure ulcer prevention (Ahmed, 2021).

Data Sources

There are various essential sources of data for the issue identified. Pressure ulcers are hospital-acquired conditions; thus, the hospital-acquired conditions dashboard is an essential source of outcomes data (AHRQ, n.d.). Another vital data source at the federal level is the National Health Disparities Report produced annually by the hospital. The Agency for Healthcare Research and Quality identifies pressure ulcers as quality and safety issues. It produces data on the prevalence of pressure ulcers based on data reported by healthcare facilities (AHRQ, n.d.). Third-party agencies such as insurance agencies are also important sources of data. They receive data on patient care from hospitals and can thus be a good data source for the hospitals.  

The quality improvement dashboard, which shows the current programs and their performance, is a good process data source. The dashboard will also help monitor data and improve it where need be. The hospital also keeps records of hospital-acquired conditions, which are vital to managing this problem. According to Uslu and Stausberg (2021), healthcare records are essential to process and outcome data sources on healthcare projects. Care providers record their findings and care interventions as they implement them, making HER reliable. The care records in the electronic health records are also vital sources of healthcare data that will show both the outcomes and process implementation of the identified interventions. These data sources will thus be crucial to managing pressure ulcers.

Data Capturing ad Dissemination

The major problem with pressure ulcers is their effect on the quality of life of patients (they are often very painful and limit movement), lead to prolonged hospital stays (they take a long to heal), high healthcare costs, and poor patient outcomes (Mervis & Phillips, 2019). In addition to prevalence statistics, these factors will be the central focus of the data collection and dissemination. Nurses’ and physicians’ reports will be the primary data source on the prevalence and burden of pressure ulcers. The data will be collected/ analyzed from electronic health records. The data will be categorized, and patients with pressure ulcers with be selected and analyzed. Calculations such as the prevalence and incidence rate will also be derived from the HER. Data collection will inform the analysis ad utilization of the data.

Dissemination of the data will be vital for project monitoring and process improvement. The data will be disseminated through the healthcare dashboard. Care providers will access the data through the institution’s computers and see the real-time data and changes over time through electronic health records. The data will also be disseminated through organizational continuing education forums, notice boards, and written reports to the executive leaders in the hospital (). Data sharing aids in subsequent actions, such as decision-making and implementing corrective actions, hence the need for an elaborate data dissemination plan.

Organizational Culture Considerations

Organizational culture considerations are vital to EBP implementation. The first consideration is the organization’s leadership structure and its impact on quality improvement. The leadership structure and the leaders’ support for EBP are integral to its survival. It is essential to understand the processes required by the facility for successful EBP implementation (Bernardes et al., 2020). Some institutions require a complete proposal, while some require a proposal so that the leaders can support it with their contributions from the beginning.

Familiarizing with the EBP approval and implementation process is thus integral. Another important factor is determining the organization’s response to change and whether it accepts or resists change (Bernardes et al., 2020). Change resistance can hinder change implementation, and determining the degree to which staff is ready to embrace change is significant. It is also important to consider organizational readiness for change and the compatibility of the proposed change with the healthcare facility.

Conclusion

EBP, research, and quality/process improvement are vital in identifying problems and their management and guiding the management process. The problem of interest is pressure ulcers. The problem arises from poor blood supply to pressure ulcers. Many intrinsic and extrinsic factors, including a high BMI and diabetes, can be associated with the problem. The DMAIC QI process can be used to address the problem in the facility. QI models help ensure organization and focus in change implementation. Organizational readiness for change and resistance to change are important organizational culture considerations before implementing the desired change interventions.

References

Agency for Healthcare Research and Quality (AHRQ), (n.d.). Preventing Pressure Ulcers in Hospitals.: Hospital Resources. Retrieved April 11, 2023, from https://www.ahrq.gov/patient-safety/settings/hospital/resource/pressureulcer/tool/index.html

Ahmed, S. (2019). Integrating the DMAIC approach of Lean Six Sigma and theory of constraints toward quality improvement in healthcare. Reviews on environmental health, 34(4), 427-434.

Bernardes, A., Gabriel, C. S., Cummings, G. G., Zanetti, A. C. B., Leoneti, A. B., Caldana, G., & Maziero, V. G. (2020). Organizational culture, authentic leadership and quality improvement in Canadian healthcare facilities. Revista brasileira de enfermagem, 73. https://doi.org/10.1590/0034-7167-2019-0732

Borojeny, L. A., Albatineh, A. N., Dehkordi, A. H., & Gheshlagh, R. G. (2020). The incidence of pressure ulcers and its associations in different wards of the hospital: a systematic review and meta-analysis. International Journal of Preventive Medicine, 11. https://doi.org/10.4103/ijpvm.IJPVM_182_19

Chen, F., Wang, X., Pan, Y., Ni, B., & Wu, J. (2023). The paradox of obesity in pressure ulcers of critically ill patients. International Wound Journal. https://doi.org/10.1111/iwj.14152

Hagle, M., Dwyer, D., Gettrust, L., Lusk, D., Peterson, K., & Tennies, S. (2020). Development and implementation of a model for research, evidence-based practice, quality improvement, and innovation. Journal of Nursing Care Quality, 35(2), 102-107. https://doi.org/10.1097/NCQ.0000000000000422

Mervis, J. S., & Phillips, T. J. (2019). Pressure ulcers: Pathophysiology, epidemiology, risk factors, and presentation. Journal of the American Academy of Dermatology, 81(4), 881-890. https://doi.org/10.1016/j.jaad.2018.12.069

Monday, L. M. (2022). Define, Measure, Analyze, Improve, Control (DMAIC) Methodology as a Roadmap in Quality Improvement. Global Journal on Quality and Safety in Healthcare, 5(2), 44-46. https://doi.org/10.36401/JQSH-22-X2

Uslu, A., & Stausberg, J. (2021). Value of the electronic medical record for hospital care: update from the literature. Journal of Medical Internet Research, 23(12), e26323. https://doi.org/10.2196/26323