Read two or more of your colleagues’ postings from the Discussion question. Respond with a comment that asks for clarification, provides support for, OR contributes additional information to two or mo

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Read two or more of your colleagues’ postings from the Discussion question.

Respond with a comment that asks for clarification, provides support for, OR contributes additional information to two or more of your colleagues’ postings.

  • THE SCENARIO IS BELOW
  • ATTACHED FILE OF 3 COLLEAGUES POST THAT ARE TO BE RESPONDED TPO
  • ALSO ATTACHED IS THE INFORMATION INCLUDED IN THE SCENARIO THAT WAS USED

Applying Performance Improvement Tools

Read the following scenario:

Imagine that, for about a year, your nursing unit has been involved in an intensive campaign to improve patient satisfaction scores with pain management. You are getting good data from your patients, as the length of stay on this inpatient geriatric medical nursing unit is only about 6 days. Your hospital does 100% survey to inpatients, and the response rate is about 25%, which is higher than it has been. This notwithstanding, the percent of “patient very satisfied” (top box), with a score of 5, has been in the low 70s. The national benchmark for medical surgical units like yours is about 85% very satisfied. Of all the units in your hospital, your unit is the lowest scoring on this HCAPHS survey. But as your unit is the only geriatric medical nursing unit in the hospital, you’d always thought it was the nature of the patient population.

You have been the day shift representative to the QI team, and the scores on your unit are posted monthly. Here are the numerous strategies that have been tried on your unit and the timeframes.

For this Discussion, examine the strategies and interventions tried in your unit and consider the following questions: a) Were the strategies effective in creating a sustainable change on your nursing unit, and b) To what extent can your nurse manager and CNO count on your unit exceeding the national benchmark in the next quarter, the next year? That is, does this run chart have some predictive ability? Does the run chart support the nursing unit’s decision to celebrate? To what extent can the leadership be confident that the trend will continue?

Read two or more of your colleagues’ postings from the Discussion question. Respond with a comment that asks for clarification, provides support for, OR contributes additional information to two or mo
POST A In the scenario listed above there were strategies and interventions that were done successfully and some that needed improvement. A year is actually a short amount of time when it comes to determining patient satisfaction scores and trying to improve them because of the behind the scenes work that needs to be done to increase patient satisfaction. Along with that, each patient has their own idea of areas that need improvement and things that are unsatisfactory in their eyes. The whole goal of surveys is to collect data, both quantitative and qualitative because it allows the data to be then analyzed and interventions to be implemented (Spath, 2018). There are many ways that patient satisfaction surveys can be conducted, but it is important that they are conducted appropriately for the population at hand, such as in this case the geriatrics might not fully understand how to do a survey on survey monkey, but rather paper and pen. Each patient also needs to be screened for if they need assistance in filling out the survey, which could increase the amount of people who respond to it and the time it takes to receive the response. In the scenario above, the staff conducted multiple strategies and interventions throughout the years of 2014 to 2016. I think one area that could be improved is the area of staff training. Training was conducted in January of 2014 but then nothing since, there was annual lectures on pain management but there was not any test or training for staff to implement the knowledge gained from that lecture. It is important that the staff understand the importance of patient satisfaction surveys because they play a significant role on the outcome of the surveys. I say this because more often than not, the first encounter is what people tend to remember when they are filling out surveys, if a staff member was rude or didn’t get them their pain medication on time, that could significantly impact the results of the survey. In my opinion, one area that was done well was the constant involvement in the QI team. This impacts the results because of the data collection and analysis that can be scored and presented to staff to show what is working, what isn’t, and what areas need to be improved. One thing that was mentioned in our reading for this week was the impact of execution graphs. These graphs allow the implemented strategies and interventions to be analyzed to determine if they are actually helping increase the outcome (Perla, Provost, and Murray, 2011). Pain management is always difficult because pain is completely subjective. I feel as though managing a patient’s pain with medications that are prescribed is only a piece of it, the other being the implementation of non-pharmacological remedies if allowed. It is important that non-pharmacological methods are used as well because of how they help decrease the patient’s anxiety around the pain, which in turn helps the pain. Some remedies that have been shown to assist are, imagery, distraction, hypnosis, relaxation, comfort therapy measures such as heating or icing, massage, exercise, positioning, and music (Stanford Health Care, 2020). It is important that we look at the patient as a whole and that we aren’t just managing the symptoms but trying to make them comfortable physically and mentally as well. POST B Based on the scenario, quite a bit was done successfully.  An active improvement project was formulated to improve patient satisfaction scores related to pain management.  We’re getting good data from 25% of patients.  The percentage of “patients very satisfied” is in the low 70’s.  The national benchmark is 85%.  Through the use of education and training, the percentage from the low 70’s to the national benchmark of 85% is obtainable.  Strategies related to training on the importance of patient satisfaction monitoring and lectures on pain and pain management, were successful in both an educational and motivational manner.  This laid the baseline groundwork for any knowledge deficit lingering.   Using a comprehensive pain assessment tool later reviewed, put the educational aspect into practice.  Feedback results were posted on the unit.  Using the rapid cycle improvement model was key during the QI meeting to strategize.  It’s a model that demonstrates repeated improvements on the unit’s practice to increase performance. Another review on pain medication effectiveness, combined with pain lectures, and medication management including polypharmacy with the elderly laid another baseline for success.  EMR data on pain medication effectiveness demonstrated improvement for one month.  All this data compiled in run charts assisted the unit in seeing their progress in action.  Quality improvement tools assisted by generating ideas of educational lectures and training.  It helped by maintaining focused direction.  According to Spath (2018), these quality improvement tools aid in measuring and monitoring performance.     POST C In this week’s scenario, the top box scores for the unit are lower than the national benchmark surgical units by over 10% and the lowest unit in the hospital.  This information leads me to believe there is work to be done in the satisfaction scores with pain management.  While examining strategies and interventions that were done in the unit and comparing it with the run chart, it looks like some of the interventions are creating an improvement on the unit.  In the time frame, education is provided almost monthly on the unit, and there are several different strategies used to create better patient scores.  The run chart allows us to learn a great deal about the performance of our process with minimal mathematical complexity (Perla, Povost, and Murray, 2011).  According to the run chart, numbers started in the low 70% range for satisfaction at the beginning of the monitoring.  After education, numbers increased considerably and by the end of the monitoring on the run chart to just below 100%.  I think there is an excellent chance that the unit will exceed the national benchmark in the next quarter, and if work continues with these scores, the following year should look great.  I think there is a bit of predictability in the run chart as it is running somewhat linear for the scores that have been looked at so far.  It may drop for a month or so but should continue on the linear pattern that it has been.  I think that the nurses should celebrate the wins that they have accomplished with the increase in scoring.  However, if the nurses aren’t careful and continue to keep the issue on the forefront, they may see the number fall again.  The work will need to be a constant reminder to staff to put pain on the forefront.  I think the trend will continue, and leadership can have some confidence in the continued success if all continues. There isn’t some dramatic variable such as a staffing shortage or something that would make the numbers skew differently.  Based on the scenario, there were many successes by the unit.  I think that the education provided was provided in many different ways and at times got creative of what education was provided.  However, I also believe there is room for improvement.  I think the specific staff education and providing the same teaching on more than one day would be beneficial for those who may not make it to the training.  Quality improvement tools generate ideas, set priorities, maintain direction, determine problem causes, and clarify processes.  I think that some of these tools were used, but it would also be beneficial to use these tools to keep future numbers increasing.
Read two or more of your colleagues’ postings from the Discussion question. Respond with a comment that asks for clarification, provides support for, OR contributes additional information to two or mo
Strategies and Interventions 1/14/2014 Training on the importance of patient satisfaction monitoring 4/1/2014 Lecture on pain and pain management 6/12/2014 Use of comprehensive pain assessment tool reviewed in an ISE 8/2/2014 Journal club on R5N reviewed an article on pain management 10/10/2014 EMR data on pain assessment reviewed in QI team 1/15/2015 Data on pain management satisfaction posted on unit 3/1/2015 EMR data on pain medication effectiveness reviewed in QI team 5/15/2015 QI team meets with staff to strategize; determined to use IHI rapid cycle improvement model with iterative PDSA 6/30/2015 Annual pain lecture: emphasis on the elderly use of NSAIDS, pain manag ement, & polypharmacy 7/15/2015 EMR data on pain medication effective ness documentation shows improvement for one month 8/30/2015 ISE on the importance of patient teaching on pain management 9/1/2015 ISE on attitudes toward addiction in the elderly (poorly attended by staff) 9/30/2015 Data on comprehensive pain assess, d oc of pain meds and patient satisfaction, compiled in run charts for the unit 10/15/2015 ISE on attitudes offered with ANCC contact hours; 100% attendance on unit 12/28/2015 QI team summarizes strategies, progress at year end with unit nursing staff 1/22/2016 Data on compreh ensive pain assessment, doc pain meds effective shows improvement on these 3/1/2016 Nursing unit claims victory on improved patient satisfaction with pain management
Read two or more of your colleagues’ postings from the Discussion question. Respond with a comment that asks for clarification, provides support for, OR contributes additional information to two or mo
Strategies and Interventions 1/14/2014 Training on the importance of patient satisfaction monitoring 4/1/2014 Lecture on pain and pain management 6/12/2014 Use of comprehensive pain assessment tool reviewed in an ISE 8/2/2014 Journal club on R5N reviewed an article on pain management 10/10/2014 EMR data on pain assessment reviewed in QI team 1/15/2015 Data on pain management satisfaction posted on unit 3/1/2015 EMR data on pain medication effectiveness reviewed in QI team 5/15/2015 QI team meets with staff to strategize; determined to use IHI rapid cycle improvement model with iterative PDSA 6/30/2015 Annual pain lecture: emphasis on the elderly use of NSAIDS, pain manag ement, & polypharmacy 7/15/2015 EMR data on pain medication effective ness documentation shows improvement for one month 8/30/2015 ISE on the importance of patient teaching on pain management 9/1/2015 ISE on attitudes toward addiction in the elderly (poorly attended by staff) 9/30/2015 Data on comprehensive pain assess, d oc of pain meds and patient satisfaction, compiled in run charts for the unit 10/15/2015 ISE on attitudes offered with ANCC contact hours; 100% attendance on unit 12/28/2015 QI team summarizes strategies, progress at year end with unit nursing staff 1/22/2016 Data on compreh ensive pain assessment, doc pain meds effective shows improvement on these 3/1/2016 Nursing unit claims victory on improved patient satisfaction with pain management

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