Assessment 4

Improvement Plan Tool Kit

For this assessment, you will develop a Word document or an online resource repository of at least 12 annotated professional or scholarly resources that you consider critical for the audience of your safety improvement plan, pertaining to medication administration, to understand or implement to ensure the success of the plan.

Introduction

Communication in the health care environment consists of an information-sharing experience whether through oral or written messages (Chard & Makary, 2015). As health care organizations and nurses strive to create a culture of safety and quality care, the importance of interprofessional collaboration, the development of tool kits, and the use of wikis become more relevant and vital. In addition to the dissemination of information and evidence-based findings and the development of tool kits, continuous support for and availability of such resources are critical. Among the most popular methods to promote ongoing dialogue and information sharing are blogs, wikis, websites, and social media. Nurses know how to support people in time of need or crisis and how to support one another in the workplace; wikis in particular enable nurses to continue that support beyond the work environment. Here they can be free to share their unique perspectives, educate others, and promote health care wellness at local and global levels. (Kaminski, 2016).

You are encouraged to complete the Determining the Relevance and Usefulness of Resources activity prior to developing the repository. This activity will help you determine which resources or research will be most relevant to address a particular need. This may be useful as you consider how to explain the purpose and relevance of the resources you are assembling for your tool kit. The activity is for your own practice and self-assessment, and demonstrates course engagement.

Demonstration of Proficiency

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

· Competency 1: Analyze the elements of a successful quality improvement initiative.

· Analyze usefulness of resources for role group responsible for implementing quality and safety improvements with medication administration.

· Competency 2: Analyze factors that lead to patient safety risks.

· Analyze the value of resources to reduce patient safety risk or improve quality with medication administration.

·
Competency 3: Identify organizational interventions to promote patient safety.

· Identify necessary resources to support the implementation and sustainability of a safety improvement initiative focusing on medication administration.

· Competency 5: Apply professional, scholarly, evidence-based strategies to communicate in a manner that supports safe and effective patient care.

· Present reasons and relevant situations for resource tool kit to be used by its target audience.

· Communicate resource tool kit in a clear, logically structured, and professional manner that applies current APA style and formatting.

References

Chard, R., & Makary, M. A. (2015). Transfer-of-care communication: Nursing best practices.
 AORN Journal, 102(4), 329–342.

Kaminski, J. (2016). Why all nurses can/should be authors.
 Canadian Journal of Nursing Informatics, 11(4), 1–7.

Professional Context-Nurses are often asked to implement processes, concepts, or practices—sometimes with little preparatory communication or education. One way to encourage sustainability of quality and process improvements is to assemble an accessible, user-friendly tool kit for knowledge and process documentation. Creating a resource repository or tool kit is also an excellent way to follow up an educational or in-service session, as it can help to reinforce attendees' new knowledge as well as the understanding of its value. By practicing creating a simple online tool kit, you can develop valuable technology skills to improve your competence and efficacy. This technology is easy to use, and resources are available to guide you.

Scenario-For this assessment, consider taking one of these two approaches:

1. Build on the work done in your first three assessments and create an online tool kit or resource repository that will help the audience of your in-service understand the research behind your safety improvement plan pertaining to medication administration and put the plan into action.

2. Locate a safety improvement plan (your current organization, the Institution for Healthcare Improvement, or a publicly available safety improvement initiative) pertaining to medication administration and create an online tool kit or resource repository that will help an audience understand the research behind the safety improvement plan and how to put the plan into action.

Preparation- Google Sites is recommended for this assessment; the tools are free to use and should offer you a blend of flexibility and simplicity as you create your online tool kit. Please note that this requires a Google account; use your Gmail or GoogleDocs login, or create an account following the directions under the “Create Account” menu.

Refer to the following links to help you get started with Google Sites:

· G Suite Learning Center. (n.d.). 

Get started with Sites
. https://gsuite.google.com/learning-center/products/sites/get-started/#!/

· Google. (n.d.). 

Sites
. https://sites.google.com

· Google. (n.d.). 

Sites help
. https://support.google.com/sites/?hl=en#topic=

Instructions

Using Google Sites, assemble an online resource tool kit containing at least 12 annotated resources that you consider critical to the success of your safety improvement initiative. These resources should enable nurses and others to implement and maintain the safety improvement you have developed.

It is recommended that you focus on the 3 or 4 most critical categories or themes with respect to your safety improvement initiative pertaining to medication administration. For example, for an initiative that concerns improving workplace safety for practitioners, you might choose broad themes such as general organizational safety and quality best practices; environmental safety and quality risks; individual strategies to improve personal and team safety; and process best practices for reporting and improving environmental safety issues.

Following the recommended scheme, you would collect 3 resources on average for each of the 4 categories focusing on safety with medication administration. Each resource listing should include the following:

· An APA-formatted citation of the resource with a working link.

· A description of the information, skills, or tools provided by the resource.

· A brief explanation of how the resource can help nurses better understand or implement the safety improvement initiative pertaining to medication administration.

· A description of how nurses can use this resource and when its use may be appropriate.

Remember that you must make your site ‘public’ so that your faculty can access it. Check out the Google Sites resources for more information.

Here is an example entry:

· Merret, A., Thomas, P., Stephens, A., Moghabghab, R., & Gruneir, M. (2011). 
A collaborative approach to fall prevention. Canadian Nurse, 107(8), 24–29.

· This article presents the Geriatric Emergency Management-Falls Intervention Team (GEM-FIT) project. It shows how a collaborative nurse lead project can be implemented and used to improve collaboration and interdisciplinary teamwork, as well as improve the delivery of health care services. This resource is likely more useful to nurses as a resource for strategies and models for assembling and participating in an interdisciplinary team than for specific fall-prevention strategies. It is suggested that this resource be reviewed prior to creating an interdisciplinary team for a collaborative project in a health care setting.

Additionally, be sure that your plan addresses the following, which corresponds to the grading criteria in the scoring guide. Please study the scoring guide carefully so you understand what is needed for a distinguished score.

· Identify necessary resources to support the implementation and continued sustainability of a safety improvement initiative pertaining to medication administration.

· Analyze the usefulness of resources to the role group responsible for implementing quality and safety improvements focusing on medication administration.

· Analyze the value of resources to reduce patient safety risk related to medication administration.

· Present reasons and relevant situations for use of resource tool kit by its target audience.

· Communicate in a clear, logically structured, and professional manner that applies current APA style and formatting.

Example Assessment: You may use the following example to give you an idea of what a Proficient or higher rating on the scoring guide would look like but keep in mind that your tool kit will focus on promoting safety with medication administration. Note that you do not have to submit your bibliography in addition to the Google Site; the example bibliography is merely for your reference.

·
Assessment 4 Example [PDF]
 Download Assessment 4 Example [PDF].

To submit your online tool kit assessment, paste the link to your Google Site in the assessment submission box.

Example Google Site: You may use the example Google Site, 
Resources for Safety and Improvement Measures in Geropsychiatric Care, to give you an idea of what a Proficient or higher rating on the scoring guide would look like for this assessment but keep in mind that your tool kit will focus on promoting safety with medication administration.

Note: If you experience technical or other challenges in completing this assessment, please contact your faculty member.

Additional Requirements

· APA formatting: References and citations are formatted according to current APA style

Scoring Guide

Use the scoring guide to understand how your assessment will be evaluated.

Improvement Plan Tool Kit Scoring Guide

CRITERIA	NON-PERFORMANCE	BASIC	PROFICIENT	DISTINGUISHED
Identify necessary resources to support the implementation and sustainability of a safety improvement initiative focusing on medication administration.

Analyze usefulness of resources for role group responsible for implementing quality and safety improvements with medication administration.

Analyze the value of resources to reduce patient safety risk or improve quality with medication administration.

Present reasons and relevant situations for resource tool kit use by its target audience.

Communicate resource tool kit in a clear, logically structured, and professional manner that applies current APA style and formatting.

  

Reply to these works with a reflection of their response.  200 words each ones

Please make sure to provide citations and references (in APA, 7th ed. format)  

1.My name is Ceria Mok Yam, I came from Venezuela 8 years ago and currently living in Miami with my husband and 2 little kids. I am a foreign medical doctor and as part of my goals to continue working in the healthcare field I became a registered nurse last year and decided to continue my path through the family nurse practitioner program. Right now, I am fully dedicated to my classes and family. My hobbies usually include a pleasant restaurant and playgrounds or kids’ friendly activities. And my long term goals include working as a PCP in a medical office once I complete my FNP.

During this first week, I am going to discuss the use of the paradigms of health, by linking between health and behavior, and describing how this relationship affects social determinants of health.

As part of the paradigms of health, John Travis, a medical practitioner, developed a model of wellbeing called The Illness-Wellness Continuum, which explain the constant dynamic between different degrees of wellness and illness, starting from a neutral point in the center of the graphic, from which a patient can move to the left showing a progressively worsening level of health, or moving to the right, indicating an increase state of health, and wellbeing (Lothes & Kantor, 2021). This model tries to explain that in the healthcare field, the absent of a disease does not necessarily mean that a person is healthy, it describes how a patient with physical injuries, symptoms, and disabilities can be treated in a way to achieve the neutral point. However, the wellness paradigms explain that additional progression to the right side of the model is necessary to ensure not only physical but emotional and mental wellness.

In order to achieve a higher level of wellness, it is essential to determine the effect of medical treatments, behavior, and socioeconomic status in the patient’s health condition; acquiring a more holistic approach can help nursing professionals better understand the importance of a individualized plan of care specific to each patient.

Some of the elements that might influence the paradigms of health include the education level (Solanki, Shankar Rath, Silan, & Singh, 2020). It is known that those with higher education levels and literacy usually engage in healthy behaviors, compared with individuals with lower education preparation and less access to information about healthy habits. Socioeconomic status has a significant impact on health conducts and conditions (Solanki, Shankar Rath, Silan, & Singh, 2020). Patients with financial challenges and reduced access to resources can have difficulties fulfilling their health goals. Also, patients with chronic disease can lead to job loss, worsening his or her resources and status.

Cultural and social support, family, close relatives, and friends, as well as community members may influence in the patient’s capacity to engage in healthy behaviors, which includes physical activities preferences, cultural habits, food options, emotional states, capacity to express themselves, and others.

In conclusion, the comprehension of the paradigms of health can help nursing professional and healthcare providers in general, to assess the individual health status and address social determinants of health in order to create interventions that provide adequate resources and promote healthier conducts, which consequently improve their overall status.

2. My name is Anny Morales Souquett, I am a foreign doctor, specialist in Gynecology and Obstetrics. I arrived in the EEUU in 2018.  I live in Miami. In 2020 I started nursing school and finish in December 2022. I did the Nclex in February 2023. I currently work as a Care Coordinator, taking care of the needs of patients with Highly Complex, High Risk, and High Utilizer. In my spare time, I enjoy walking in the parks, going to the beach, and traveling with my family. My favorite movies are Start Wars and Disney movies. In 5 years, I visualize myself as a Nurse Practitioner of a Gynecological medical office, providing the best care to my patients, doing prevention, and teaching them to provide their lifestyle. I am sure that the class will help me understand this topic much better.

Understanding how societal and personal variables affect well-being requires using the paradigms of health to investigate the connection between health and behavior. Social determinants of health, which are the circumstances under which people are born, develop, live, work, and age and which affect health outcomes, are significantly impacted by this relationship. Three references who are no older than five years old provide the following overview of this relationship:

The biomedical perspective has a history of emphasizing the physical components of health and frequently views disorders as distinct entities. Modern biological research does, however, recognize the significant influence that behavior has on health consequences. According to research, lifestyle factors like food, exercise, and drug use significantly affect how chronic diseases start and advance (Danaei et al., 2019). Healthcare professionals can better meet the needs of each patient by customizing therapies and prevention measures by understanding these linkages.

The biopsychosocial paradigm takes a comprehensive approach to health, considering biological, psychological, and social variables. Health is understood to be both a result of behavior and its primary cause. Stress-related harmful behaviors, such as smoking or binge eating, can have an impact on one’s physical health (Taylor et al., 2017). A holistic approach to healthcare must consider how these aspects interact.

Social Determinants of Health: Social determinants of health are closely related to the connection between behavior and health. Individual behaviors and health outcomes are significantly influenced by social, economic, and environmental factors. For instance, socioeconomic gaps might prevent disadvantaged groups from having access to nutritious food options and secure spaces for physical activity, which can result in harmful habits and worsened health (Braveman et al., 2017). The significance of tackling social determinants to lessen health disparities is highlighted by the recognition of these relationships.

It is crucial to comprehend how behavior and health interact within the framework of these paradigms to create public health strategies and policies that are efficient. Policymakers and healthcare practitioners can create treatments that target both individual behaviors and the larger societal contexts that drive such behaviors by considering the complex web of variables that affect health outcomes.

RUBRIC FOR GRADING

 Subjective Documentation in Provider Note Template: Subjective narrative documentation in Provider Note Template is detailed and organized and includes: Chief Complaint (CC), HPI, Current Medications, Allergies, Past Medical History, Family History, Social History and Review of Systems (ROS)ROS: covers all body systems that may help you formulate a list of differential diagnoses. You should list each system as follows: General: Head: EENT: etc. You should list these in bullet format and document the systems in order from head to toe. =  Documentation is detailed and organized with all pertinent information noted in professional language….Documentation includes all pertinent documentation to include Chief Complaint (CC), HPI, Current Medications, Allergies, Past Medical History, Family History, Social History and Review of Systems (ROS). 

 Objective Documentation in Provider Notes – this is to be completed using the documentation template that is provided. Document in a systematic order starting from head-to-toe, include what you see, hear, and feel when doing your physical exam using medical terminology/jargon. Document all normal and abnormal exam findings. Do not use “WNL” or “normal”. You only need to examine the systems that are pertinent to the CC, HPI, and History. Diagnostic result – Include any pertinent labs, x-rays, or diagnostic test that would be appropriate to support the differential diagnoses mentioned. Differential Diagnoses (list a minimum of 3 differential diagnoses). Your primary or presumptive diagnosis should be at the top of the list (#1). =  Documentation detailed and organized with all abnormal and pertinent normal assessment information described in professional language….Each system assessed is clearly documented with measurable details of the exam. 

 Esophageal Reflux Case Studies A 45-year-old woman complained of heartburn and frequent regurgitation of “sour” material into her mouth. Often while sleeping, she would be awakened by a severe cough. The results of her physical examination were negative. Studies Results Routine laboratory studies Negative Barium swallow (BS), p. 941 Hiatal hernia Esophageal function studies (EFS), p. 624 Lower esophageal sphincter (LES) pressure 4 mm Hg (normal: 10–20 mm Hg) Acid reflux Positive in all positions (normal: negative) Acid clearing Cleared to pH 5 after 20 swallows (normal: <10 swallows) Swallowing waves Normal amplitude and normal progression Bernstein test Positive for pain (normal: negative) Esophagogastroduodenoscopy (EGD), p. 547 Reddened, hyperemic, esophageal mucosa Gastric scan, p. 743 Reflux of gastric contents to the lungs Swallowing function, p. 1014 No aspiration during swallowing Diagnostic Analysis The barium swallow indicated a hiatal hernia. Although many patients with a hiatal hernia have no reflux, this patient’s symptoms of reflux necessitated esophageal function studies. She was found to have a hypotensive LES pressure along with severe acid reflux into her esophagus. The abnormal acid clearing and the positive Bernstein test result indicated esophagitis caused by severe reflux. The esophagitis was directly visualized during esophagoscopy. Her coughing and shortness of breath at night were caused by aspiration of gastric contents while sleeping. This was demonstrated by the gastric nuclear scan. When awake, she did not aspirate, as evident during the swallowing function study. The patient was prescribed esomeprazole (Nexium). She was told to avoid the use of tobacco and caffeine. Her diet was limited to small, frequent, bland feedings. She was instructed to sleep with the head of her bed elevated at night. Because she had only minimal relief of her symptoms after 6 weeks of medical management, she underwent a laparoscopic surgical antireflux procedure. She had no further symptoms. Critical Thinking Questions 1. Why would the patient be instructed to avoid tobacco and caffeine? 2. Why did the physician recommend 6 weeks of medical management? Case Studies Copyright © 2018 by Elsevier Inc. All rights reserved. 2 3. How do antacid medication work in patients with gastroesophageal reflux? 4. What would you approach the situation, if your patient decided not to take the medication and asked you for an alternative medicine approach?