DNP- Patient Outcomes and Sustainable Change

I need help responding to the attached 3 posts in 200 words each

PEER RESPONSES FOR Patient Outcomes and Sustainable Change

QUESTION: Reflecting on the “IHI Module PS 101: Introduction to Patient Safety,” summarize why it is essential to improve patient safety. Use one of the articles from this week’s topic Resources and describe the framework or theory that was used to improve the patient outcome. What outcome measures were identified and how did they align with the improvement project? Explain how the authors learned from the error or unintended events to ensure patient safety. Provide supporting evidence.

Dr. Mary Sizemore

Thank you for your response. You provided some good information regarding the quality of care and patient safety. In my practice, many facilities work to improve patient outcomes through the use of electronic health records to reduce errors with medication prescribing. Consider ordering a new medication for a patient. What are some measures you can take as a provider to reduce possible errors with the process?

Kristen Williams

Dec 2, 2022, 12:11 PM

The Institute for Healthcare Improvement (IHI) Module PS 101: Introduction to Patient Safety provides the structural foundation of the vital role patient safety has in a healthcare institution. High reliability was a central theme of the module. A culture of safety is when the employees share a central belief that a healthcare organization supports root cause analysis in patient care (Leape, 2021). It is a significant theme that humans have a predisposition to error, and it is vital to create systems and a safety culture to have a safe environment for patients. It is crucial to develop systems to track and analyze errors as they occur to improve future outcomes by creating safer systems.  

When people interact with a healthcare system, they are often at their most valuable state. The number of people dying from medical errors in 2018 was equivalent to a daily jumbo crash (Leape, 2021). Our society would not stand for one plane crash a day, yet often a place whose purpose is to heal hurts. Although humans are prone to error, it is essential to create policies, procedures, and phycological safety to increase safety when people seek healthcare. A facility that commits to embedding safety into policy and procedures and a culture of phycological safety are often referred to as a high-reliability organization (HRO).    

Education and empowerment of staff are essential components of building physical safety. Haley & Fritz (2019) used a framework of education and empowerment to improve the rate of urinary tract infections (UTI) in a long-term care (LTC) facility. Haley & Fritz (2019) assessed that evidenced-based signs and symptoms were not consistently utilized in obtaining urine samples to diagnose UTIs. A culture of safety examination showed improvement that could be made. Education and empowerment were done to improve the signs and symptoms used to initiate obtaining a urine sample (Haley & Fritz, 2019). Phycological safety is a vital foundation within an HRO and essential to improving the safety of patients. Having the central theme of an organization as a root cause analysis of errors to improve future outcomes is essential. Haley & Fritz (2019) looked for opportunities for improvement and changed systems to improve patient outcomes. 

References

Haley, T., & Fritz, S. (2019). Treat the resident, not the urine: Using patient safety to reduce urinary tract infections and overuse of urine culture in long-term care. 
American Journal of Infection Control, 
47(6), S8. 

https://doi.org/10.1016/j.ajic.2019.04.148

Leape, L. L. (2021). 
Making healthcare safe. Springer International Publishing. 

https://doi.org/10.1007/978-3-030-71123-8

Shabnampreet Kaur

Dec 2, 2022, 11:41 PM

Patient safety is one of the biggest needs of healthcare today. The IHI module PS101 explains how patient safety is jeopardized in various healthcare settings, and how medical errors lead to the loss of life or deterioration in patient condition. In order to improve patient outcomes in terms of value and quality of life patient safety should be improved. Polypharmacy is one such issue that is raising questions about patient safety (Sherman,2017). Patients receiving managed long-term care services in their homes, especially older adults fall prey to the negative impacts of polypharmacy. Not only is it leading to an increased cost of healthcare but it is giving birth to a cascade of negative impacts on patients’ daily lives such as an increased number of falls, functional and cognitive decline, and adverse reactions. So one such issue is making patient safety at risk. There are numerous other examples from hospital-based and long-term based care settings, and even primary care settings where patient safety is put at risk. The main goal of improving patient safety is to prevent the loss of life, reduce disabilities, provide value-based care to the patient, and thereby reduce the burden in terms of costs. In the article “Treat the Resident, Not the Urine: Using Patient Safety to Reduce Urinary Tract Infections and Overuse of Urine Culture in Long Term Care”(Haley & Fritz, 2019), the authors have given the example that according to the Infectious Disease Society of America (IDSA, screening, and treatment of asymptomatic bacteriuria is not recommended for elderly, institutionalized patients. Physicians in the Lebanon VAMC were requesting many urine cultures which were noted during the implementation of a Nurse Driven Protocol for Foley catheter removal. According to the guidelines by IDSA and the American Geriatric Society, the staff members were educated on the assessment of urinary tract infection among patients using signs and symptoms of the infection, rather than taking urine cultures and treating asymptomatic bacteriuria. Education to staff members was provided based on the benchmarks by the American Geriatrics Society, Agency for Healthcare Research and Quality (AHRQ), and IDSA. The minimum data Set (MDS) assessment tool was used for data analysis pre-and post-implementation of the education program. The positive cultures were reviewed based on guidelines by CDC. The results showed that the long-term care MDS quality measures for UTI were reduced from 9.29 in 2016 to 0.66 in 2018(Haley & Fritz, 2019). Also, fewer requests for urine cultures were received and these requests were reduced by 54%(Haley & Fritz, 2019). To bring a positive change behaviors should be altered.  The Behavior Change Wheel was developed to assist providers to identify appropriate behaviors while trying to encourage the adoption of a behavior (Seeparsand, 2021)r. The behavior change wheel includes a behavioral model according to which behaviors are functions of capability, opportunity, and motivation. The component capability contains the psychological or physical domain. In the above-mentioned article, the staff members were motivated which created an awareness about a certain practice. The knowledge thus generated helped in behavioral regulation with education and empowerment. The workers were able to retain the information and acquired the new skill which was demonstrated by the reduction in the rate of cultures. The opportunity contains the domains of social influence and environmental contexts such as interpersonal processes causing staff members to change their behaviors and social environment respectively. (Seeparsand, 2021) Motivation contains beliefs about capabilities, beliefs about consequences, emotions and goals., intentions, optimism, reinforcement, and social or professional roles. 

Haley, T., & Fritz, S. (2019). Treat the Resident, Not the Urine: Using Patient Safety to Reduce Urinary Tract Infections and Overuse of Urine Culture in Long Term Care.
American Journal of Infection Control,
47(6), S8.

https://doi.org/10.1016/j.ajic.2019.04.148

Seeparsand, F. (2021, December 27). The Behaviour Change Wheel: Using psychology to encourage healthier and more sustainable choices.
Dunnhumby.

The Behaviour Change Wheel: using psychology to encourage healthier and more sustainable choices

Sherman, P. (2017, June 16). Addressing the Polypharmacy Conundrum.
Uspharmacist August 4, 2020, from

https://www.uspharmacist.com/article/addressing-the-polypharmacy-conundrum