NURS-FPX4030 Assessment 3: Quality Improvement Initiative Proposal

NURS-FPX4030: Improving Quality of Care and Patient Safety

Assessment 3: Quality Improvement Initiative Proposal

Assessment Overview

This assessment requires you to develop a comprehensive quality improvement (QI) initiative proposal based on a provided scenario. You will identify a specific quality or safety issue, analyze its root causes, and propose an evidence-based intervention. Your proposal will outline the plan for implementation and evaluation, emphasizing interprofessional collaboration and the use of healthcare technology. This assessment measures your competency in applying quality improvement principles to enhance patient outcomes and safety in a clinical setting.

Assessment Instructions

Greetings Learners,

For this assessment, you will step into the role of a nurse leader (e.g., charge nurse, unit manager) on a medical-surgical unit. Your task is to draft a formal proposal for a quality improvement initiative aimed at the hospital’s Quality and Safety Committee. Your proposal must be grounded in evidence-based practice and follow a structured QI model (e.g., PDSA – Plan-Do-Study-Act).

Review the scenario below and complete the tasks that follow. Your proposal should be 5-7 pages in length (excluding title and reference pages) and adhere to APA 7th edition formatting guidelines.

Scenario

You are the lead Registered Nurse on a busy 35-bed medical-surgical unit at Villa Health, a community hospital. Over the past six months, internal audits have revealed a 15% increase in medication administration errors. A preliminary analysis shows that the majority of these errors are related to incorrect dosage and administering medication to the wrong patient. These incidents have not yet resulted in serious patient harm, but the trend is alarming leadership. The hospital currently uses an Electronic Health Record (EHR) but has not yet implemented a barcode medication administration (BCMA) system. The nursing staff is experienced but reports high patient-to-nurse ratios and frequent interruptions during medication passes. The hospital administration is open to proposals that are data-driven, evidence-based, and demonstrate a clear potential for return on investment through improved patient safety.

Assessment Tasks

Your proposal must address the following points in a clear and structured manner:

1. Problem Identification and Root Cause Analysis:
   • Clearly define the patient safety problem (medication administration errors) and its significance to the patient population and the organization.
   • Conduct a brief root cause analysis (RCA). Use a simple framework like the “5 Whys” or a fishbone (Ishikawa) diagram concept to explore potential contributing factors (e.g., systemic issues, human factors, technology gaps).
2. Proposed Quality Improvement Initiative:
   • Propose a specific, evidence-based QI initiative to address the problem. For this scenario, your primary intervention must be the implementation of a Barcode Medication Administration (BCMA) system.
   • Justify your choice with evidence from at least two of the peer-reviewed sources you identify. Explain how BCMA directly targets the root causes identified.
3. Implementation Plan (The “Plan-Do” stages of PDSA):
   • Outline a high-level plan for implementing the BCMA system on your unit.
   • Describe the key stakeholders (e.g., staff nurses, pharmacists, IT specialists, nurse educators) and the role of the interprofessional team in planning and executing the initiative.
   • Detail the specific steps for implementation, including staff training, workflow redesign, and a proposed timeline for a pilot program on your unit (e.g., over a 90-day period).
4. Evaluation and Measurement (The “Study-Act” stages of PDSA):
   • Define at least two specific, measurable, achievable, relevant, and time-bound (SMART) goals for your initiative.
   • Explain how you will measure success. Identify the key performance indicators (KPIs) you will track (e.g., medication error rates, staff satisfaction survey scores, number of “near misses” caught by the system).
   • Describe how the data will be collected, analyzed, and used to make further decisions (the “Act” stage – i.e., adopt, adapt, or abandon the initiative for hospital-wide rollout).

References 

1. Fahmi, A., Al-Dossari, S., & Al-Dughaither, A. (2022). The impact of barcode medication administration technology on patient safety: A systematic review. Journal of Patient Safety, 18(1), e116–e122. https://doi.org/10.1097/PTS.0000000000000832
2. Strudwick, G., Reis, A., & Kalia, K. (2021). Exploring nurses’ perceptions of the usability of a barcode medication administration system: A qualitative study. Applied Nursing Research, 60, 151448. https://doi.org/10.1016/j.apnr.2021.151448
3. van der Veen, W., van den Bemt, P. M. L. A., Wouters, H., & van der Schors, T. (2020). A comprehensive, multifaceted quality-improvement program to reduce medication errors. BMJ Open Quality, 9(2), e000839. https://doi.org/10.1136/bmjoq-2019-000839