NURS FPX 6016 Assessment 2 Quality Improvement Initiative Evaluation

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Quality Improvement Initiative Evaluation

Student name

Capella University

NURS-FPX 6016

Professor’s Name

Submission Date

Quality Improvement Initiative Evaluation

An adverse event involving one of the patients at Lakeside Regional Medical Center triggered the QI initiative since the patient received an overdose of insulin due to the improper programming of the infusion pump. It also revealed the lack of proper alarm response procedures, the fact that no proper communication channels were in place with the staff and absence of the escalation procedures. To prevent medication errors in the future, the intervention was aimed at the following objectives: the improvement of the alarm system, cooperation among nurses, physicians, pharmacists, and the explanation of reporting functions (Mutair et al., 2021). This report aims to evaluate the growing patient safety and the quality improvement of the facility by facilitating the advancement of the quality improvement (QI) process, identify the gaps in the knowledge available, and giving recommendations as to how the QI process can be improved to improve the outcomes of the patients.

Analysis of Quality Improvement Initiative

In the context of Lakeside Regional Medical Center, the QI need was identified by an adverse event of a patient who received an insulin overdose due to being programmed with the incorrect infusion rate by the nursing staff. This took place due to the fact that the insulin infusion pump raised an alarm, but the nurse did not call the doctor or pharmacist on call because of other cases and the stress of other activities. The communication between the nurses, pharmacists, and physicians might have been observed to be unsatisfactory, along with the management of alarm issues. Thus, QI was created to improve the skills in managing device alarms, communication, and explanations of reporting processes to eliminate additional medication errors associated with insulin infusion therapy (Herchline et al., 2022). Even during the process of implementing QI, certain problems that were witnessed involved some hastiness on the part of the nursing staff, who said that the new protocols would increase their workload.

The problem of alarm fatigue, which is common in healthcare facilities, was not adequately covered, and numerous nurses were desensitized to the frequent alarms, expecting to respond to the alarm in time (Lewandowska et al., 2020). Follow-up training was also not effective in the initiative, thus contributing to a lack of consistency in following the new procedures, especially in high-pressure shifts. Moreover, the lack of full communication between the nursing staff and physicians and pharmacists, as well as the proper integration of the technology employed to manage the alarms with the electronic health record (EHR) system, were not resolved (Franco et al., 2025). Such unresolved problems impaired the maximum functioning of the QI initiative to enhance patient safety and care delivery.

Knowledge Gaps and Areas of Uncertainty

Limited information is available on the real results of the QI project, i.e., the decrease in the insulin overdoses and the improvement in patient safety in general. The implication of technology in alarm management is also ambiguous and may also lead to fatigue with alarms, especially when combined with other systems such as EHR (Mustafa et al., 2023). More data is required on how interprofessional teamwork, specifically between nurses, physicians, and pharmacists, is developed to guarantee responsive and efficient reactions in case of alarm incidents. Sealing these loopholes would give crucial information about the effects of the initiative and improvement points.

Success of Current Quality Improvement Initiative

The healthcare organization must follow The Joint Commission National Patient Safety Goals of NPSG.03.04.01 regarding safe medication and NPSG.06.01.01 regarding safe patient alarms to assess the effectiveness of the ongoing QI initiative, as well as generic medication, coordination, leadership, and improvement standards (Backhouse & Ogunlayi, 2020). These standards will help healthcare facilities in introducing practices that would improve the safety of the patients beyond reducing medication mistakes. As a result, two important modifications should be provided to facilitate the reduction of insulin overdose incidences and the immediate reaction to alarms. To avoid risky mistakes that may happen to the patient, TJC/CMS standards concerning high alert meds, proper handling of alarm systems, and proper interprofessional collaboration are aimed at safeguarding the patient. Such standards involve the application of research-founded policies and processes, taking and analysing performance data, and continuous performance enhancement of the various care standards and guidelines of healthcare organizations to achieve compliance and accreditations. The most important indicators of successful treatment are the rates of insulin infusion regarding their precision and reaction to the alarm, and communication between the nurses, physicians, and pharmacists (Avari et al., 2022). A decrease in the scores on these parameters can and must be sought upon reviewing the degree of the problem over time in the case of a steady rate of fatigue and medication errors.

Quality indicators may have possible implications for the healthcare facility. The center also raises the levels of patient care safety, reduces the number of adverse events, and ensures the patients receive improved outcomes on the issues of treatment based on the national guidelines. The healthcare facility will have the following benefits when the QI initiative is in the implementation phase: patient safety, a reduced rate of medication abuse, and the overall health workforce and satisfaction rates of the patients are expected to increase. Moreover, rational and efficient management and the strict compliance with these quality indicators help to ensure that the facility meets the state, national, and accreditation requirements, with the likelihood of improving various accreditation levels and a positive image of providing quality care (Langendam et al., 2020). This can lead to the appropriate use of resources, motivation of the staff, and overall effectiveness of the operations conducted by the institution.

Underlying Assumptions

The evidence-based assumptions regarding the evaluation of the QI initiative are that the healthcare staff members follow the introduced alarm management guidelines and that proper cooperation dominates among the nurses, physicians, and pharmacists. It also assumes the equipment applied in the monitoring of the insulin infusion rates and alarms has an accurate and reliable way of measuring performance. The second important aspect is that the prosperity of the initiative always assumes that the entire staff is safety-conscious and all people are obliged to consider medical errors (Errida & Lotfi, 2021).

Interprofessional Perspectives

In QI work, the project heads of various professions need to huddle to achieve the desired changes, as coordinated activity amicably provides a superior vantage in advocating patient safety. The personnel, such as nurses, physicians, and pharmacists, are obliged to identify the available potential risks and actively engage in developing protocols that take into account those alarming signs on time, such as insulin infusion pump failure (McLaney et al., 2022). The nurses will be the first to recognize or be able to notice issues concerning alarms, and unless the physicians and pharmacists are involved, nursing mistakes like the prescription of an incorrect dosage of a medication can just pass without being noticed. This may be the case when team members have settled on their roles at the time, then the process of eliminating medication error-prone events and saving the life of the patient will be effective.

An argument exists concerning the other healthcare professionals who also make efforts to improve the competency of the QI initiative through their varying feedback. As an illustration, some nurses can contribute to the improvement of drug strategies and ensure that the settings of the infusion pump are proper. The ability of physicians to access the information about their patients and assess them in connection to the initiative leads to a more integrated approach, nurses can then monitor the state of their patients, and make adjustments to the protocols of the initiative, should it be needed (Taberna, 2020). Such collaboration not only enhances the delivery of quality-of-service, but also emphasizes the role of the collaboration in the delivery of care services to patients and the attainment of the objectives of enhancement of different dimensions of the health sector in accordance with the National and accreditation standards.

Knowledge Gaps and Areas of Uncertainty

These are the existing gaps in knowledge that should be filled to clarify the efficiency of the QI initiative. One of the ambiguous areas is associated with adhering to the alarm management procedures and the adequate preparation of the staff to equip them with the required circumstances to deal with an alarm situation. There is also no information regarding the channel of communication between nurses, physicians, and pharmacists to determine if there are gaps. The formulation of these points would have defined them under areas that need upgrading of protocols, training, and communication.

Additional Indicators and Protocols

It would be beneficial to complement other suggested indicators with alarm management and the response of staff to the quality initiative, as it is still ongoing. They can be characterized as the time span of responding to the alarms, the frequency of the adverse events because of alarms, and the percentage of alarms that should be addressed according to the expectation, by reporting to the physician or the pharmacy (Brusco et al., 2020). Tracking, such as the determination of whether proper alarms are well managed, would also give the following indicators. Therefore, the audit of patient safety that will address the parameters like the response time to alarms, activities that are performed by the personnel regularly, can handle those issues, and stimulate proactive practice improvement.

Besides these indicators, the enhancement of the already established guidelines through refreshing the training of staff, and follow-up with the creation of work-related guidelines on alarm handling can be deemed as a key to success. It may involve theoretical and practical simulations in the installation of alarms, rehearsing of high-risk scenarios, and some training on how to work as a team and communicate with representatives of other branches (Pruitt et al., 2023). The combination of these activities, assessment, and feedback would improve the efficient performance of the teams, and the quality initiative would be more appropriate to the existing and further stages.

Pros and Cons of Recommendations

Each of the presented recommendations to supplement the quality initiative is helpful in its own manner, such as the inclusion of the alarm response times and adverse event rates to add the dimensions of quantity measurement. Therefore, the safety awareness and coordination among the staff and the reduction of human error are achieved with the help of safety audit and enhanced staff training, including simulation (Samardzic et al., 2020). Nevertheless, these measures may be excessive to staffing and other resources, in terms of time to audit, and staff training, which adds to staff burnout. The personnel might also be opposed to new demands, particularly where they will be found to be cumbersome to enforce, as well as appropriate communication and potential assistance needed to facilitate the improvement of the application of the said protocols, without interfering with the remaining operations of the day.

Conclusion

Although Lakeside Regional Medical Center has come a long way in terms of testing and managing critical alarm response and communication, certain areas that require attention are the staff’s adherence to the standards and synergy among other systems. The barriers, such as fatigue that arises as a result of the alarms, will also be managed through staff training and encouraging multi-disciplinary work. Although actualizing these suggestions might prove to be resource-intensive, it is essential in the subsequent implementation of change and safety increment. On the whole, thus, the adequately supported and flexible QI initiative, besides augmenting the benefits to patients, contributes to the organization of care, which adheres to the national standards and improves the healthcare safety and effectiveness.