NRS 493 Scholarly Activities
Capstone Project Change Proposal
Grand Canyon University
Th purpose of the activity is to describe the quality improvement initiative in my health care setting and I was a part of the quality improvement committees. The committee aimed to address the issue of increasing health care errors and problem associated with it to find solutions to reduce number of health care errors (Truter et al., 2017). Health care errors involve physicians, nurses, pharmacists, informatics nurses, nurse leaders, patients, and other health care professionals. The activity was conducted in the meeting room where a round table setting was opted. The committee included nurses, physicians, nurse leaders, pharmacy technicians and manger, health educators, medical record staff, case manager, chief executive officer, practice manager, and informatics nurses. Each of the member were asked to highlights issues and possible solutions for them. A brief on the issue along with meeting agenda, resources, reports, and timing and location of the meeting was sent through official email. The activity mainly targeted nurses, physicians, nurse informatics, pharmacists, and technical staff that handles prescription, dispensing, and management software to increase quality of care and reduce errors. The main benefit of the activity was it involved knowledge-sharing, shared decision-making, and interprofessional collaboration, which increased my knowledge and competencies in reducing health care errors.
Health care errors are increasing in health care especially when nurses and other health care staff work overtime, suffer burnout, face a lot patients, feel tired, and fail to collaborate effectively to pass the information effectively. In USA, 251,454 patients died due to medication errors in 2013 (Hopkins, 2016) and the rate is at 250,000 in 2020 (Anderson & Abrahamson, 2021) and can vary from 210,000 to 240,000 (Carver et al., 2021). Further, the increased error rate will increase hospital readmission, cost of care, hospital stay, dissatisfaction levels in patients, guilt in nurses, lawsuits, threat to patient security, and reduces quality of care and EBP practice levels (Assiri et al., 2018). As a result, it is a big problem, which needs to be addressed quickly as it affects nurses, physicians, pharmacists, patients, and health care organization itself. Thus, the activity aimed to address following issues
NRS 493 Scholarly Activities
- Reduce health care errors
- Increase interprofessional collaboration
- Implement effective error reporting and corrective measures
- Increase quality of care
- Reduce distractions during drug administration (Trakulsunti & Antony, 2018)
The current state of the activity topic is in its implementation state where Iowa EBP model is being used to implement and evaluate the outcomes of the solutions. As a nurse, it is important to understand the problem to effectively implement solutions as it reduces burnout, unnecessary anxiety, increase collaboration (Trakulsunti & Antony, 2018), reduce overtime due to error, reduces conflict in health care, increase knowledge, competencies, and skillset (Ringwala et al., 2019).
There are different solutions that aim to address each problem and different issues associated with it. The solutions along with reasoning are as follows:
- Implement physician order entry-based system as such system helps in effectively ordering or prescribing, dispensing, and administering medications (Vélez-Díaz-Pallarés et al., 2018).
- Error reporting system will help in reducing time delay during wrong prescription and medication administering
- Avoiding abbreviates and other short forms to reduce miscommunication (Trakulsunti & Antony, 2018).
- Tabards with different signs such as do not disturb as I am administering medication, only disturb if its emergency, and similar tabards to reduce interruptions (Palese et al., 2019)
- Using checklist and patient medication and health history forms to identify any allergic and reactive medicines, reviewing medication with current patient health, and preventing any wrong medication through checklist (Truter et al., 2017).
The activity provided opportunity for me to provide my perspectives, experiences, and evidence-based solutions in addressing medication and health care error issue. The activity identified the problem, its impact and importance, solutions to problem along with timeline and project plan, and need for better collaboration as these were primary objectives and goals. Such activities are important as they aid in communicating with industry experts, facilitates shared decision-making, discussing on key issues, finding solutions with different perspective on same problem, and developing better sense of health care community where nurses will be a part of decision-making, and policy-making, which is essential for nurses in modern nursing practice (Hajizadeh et al., 2021).
NRS 493 Scholarly Activities
The list of program competencies addressed in the scholarly activity were
- Domain 3: Nursing Practice (3.2: Implement patient care decisions based on evidence-based practice).
- Domain 1: Professional Role – Manage patient care within the changing environment of the health care system. MC2: Critical Thinking: Courses require students to use critical thinking skills by analyzing, synthesizing, and evaluating scientific evidence needed to improve patient outcomes and professional practice.
- Domain 5: Holistic Patient Care (5.2: Assess for the spiritual needs and provide appropriate interventions for individuals, families, and groups. MC5: Leadership: Students are required to develop skills and knowledge associated with their professional role).
- Domain 2: Theoretical Foundations of Nursing Practice – 2.1: Incorporate liberal arts and science studies into nursing knowledge.
- Domain 1: Professional Role (1.3: Exercise professional nursing leadership and management roles in the promotion of patient safety and quality care. MC1: Effective Communication: Therapeutic communication is central to baccalaureate nursing practice.
- Domain 4: Communication/Informatics (4.3: Promote interprofessional collaborative communication with health care teams to provide safe and effective care).
Anderson, J., & Abrahamson, K. (2021). Your health care may kill you: medical errors. Stud Health Technol Inform, 243(13). Retrieved 29 August 2021, from.
Assiri, G., Shebl, N., Mahmoud, M., Aloudah, N., Grant, E., Aljadhey, H., & Sheikh, A. (2018). What is the epidemiology of medication errors, error-related adverse events and risk factors for errors in adults managed in community care contexts? A systematic review of the international literature. BMJ Open, 8(5), e019101. https://doi.org/10.1136/bmjopen-2017-019101
Carver, N., Gupta, V., & Hipskind, J. (2021). Medical error. Ncbi.nlm.nih.gov. Retrieved 29 August 2021, from https://www.ncbi.nlm.nih.gov/books/NBK430763/.
Hajizadeh, A., Zamanzadeh, V., Kakemam, E., Bahreini, R., & Khodayari-Zarnaq, R. (2021). Factors influencing nurses participation in the health policy-making process: a systematic review. BMC Nursing, 20(1). https://doi.org/10.1186/s12912-021-00648-6
Hopkins. (2016). Study suggests medical errors now third leading cause of death in the U.S. Hopkinsmedicine.org. Retrieved 29 August 2021, from https://www.hopkinsmedicine.org/news/media/releases/study_suggests_medical_errors_now_third_leading_cause_of_death_in_the_us#:~:text=Then%2C%20using%20hospital%20admission%20rates,each%20year%20in%20the%20U.S.
Palese, A., Ferro, M., Pascolo, M., Dante, A., & Vecchiato, S. (2019). “I am administering medication—please do not interrupt me”: red tabards preventing interruptions as perceived by surgical patients. Journal Of Patient Safety, 15(1), 30-36. https://doi.org/10.1097/pts.0000000000000209
Ringwala, S., Sepassi, A., & Callahan, P. (2019). A framework for estimating the economic burden of medication errors within us acute care facilities. Value In Health, 22, S294. https://doi.org/10.1016/j.jval.2019.04.1405
Trakulsunti, Y., & Antony, J. (2018). Can Lean Six Sigma be used to reduce medication errors in the health-care sector?. Leadership In Health Services, 31(4), 426-433. https://doi.org/10.1108/lhs-09-2017-0055
Truter, A., Schellack, N., & Meyer, J. (2017). Identifying medication errors in the neonatal intensive care unit and paediatric wards using a medication error checklist at a tertiary academic hospital in Gauteng, South Africa. South African Journal Of Child Health, 11(1), 5. https://doi.org/10.7196/sajch.2017.v11i1.1101
Vélez-Díaz-Pallarés, M., Pérez-Menéndez-Conde, C., & Bermejo-Vicedo, T. (2018). Systematic review of computerized prescriber order entry and clinical decision support. American Journal Of Health-System Pharmacy, 75(23), 1909-1921. https://doi.org/10.2146/ajhp170870