Strategies Used to Improve Pain Management Discussion

Strategies Used to Improve Pain Management Discussion

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Question Description
Help me study for my Nursing class. I’m stuck and don’t understand.

DISCUSSION

Shannon Carter

RE: Sources of Reputable Online Info

COLLAPSE

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The strategies used to improve pain management in the geriatric unit were successful. Good data was used from 6 days of inpatient information to formulate a plan. Hospital Consumer Assessment of Health Plans Survey (HCAHPS) is a standardized survey that measures patient’s perspectives of hospital care by collecting data and publicly reporting results so that the quality of care provided is transparent (cms.gov, 2020). A run chart was formed. There were some weak areas notated from the run chart, being a poorly attended educational meeting from the staff. However, the effective strategy showed a 25% increased in patient satisfaction scores than what it has been. The score from this unit was in the lower 70’s with 85% being very satisfied. The run chart supported the nurse’s decisions with the importance of teaching patient pain management and offering the nurses ANCC contact hours.

The performance improvement plan used was the PDSA; Plan, Do, Study, and Act. This process is used to make sure that improvements are data-driven (Yoder-Wise, 2019). However, ISE showed a poorly attended meeting for attitudes towards addictions in pain management for patients. The leadership can be confident that the QI team summarized strategies, and promoted progress @ the end of the year by having an effective Run chart to decide how well or how poorly the process was performing. The improvement tool contributed to the outcome by defining the problem and adding strategies for improvements based on data from the surveys and inpatient interviews to improve patient satisfaction scores.

Data guides the clinical team to make the needlepoint of patient care in the right direction for team members and patients (Spath, 2018). The Nurse Manager/CNO can count on the team for improvement when the Run chart is utilized to help the team decide how well or how poorly a process is performing. 100 % of the information from the survey was used to improve patient satisfaction scores. All the information was used to formulate a Run chart to illustrate how the process is running.

Reference

Spath, P.(2018). Introduction to Healthcare quality management (3rd ed.). Chicago, IL. Health Administration Press. PDSA (p. 124) Chapter5.

Yoder-Wise, P.S. (2019). Leading and Managing in Nursing (7thed.). St. Louis. MO: Mosby.

Cms.gov. 2020.HCAHPS: Patients’ Perspectives of care survey/cms. [online] Available at: https://www.cms.gov/Medicare/Quality-Initiative-Patient- Assessment Instruments/Hospital Quality Inits /Hospital HCAHPS[Accessed 27 October 2020].

Christina Oxendine

RE: Discussion – Week 3

COLLAPSE

Improving patient satisfaction scores in relation to pain management is the primary goal for the inpatient geriatric medical nursing unit and increasing scores to meet the national benchmark scores when being compared to similar units. Benchmarking is the measurable performance tool used to compare various organizations performance levels and determine if they are above or below national standards (Spath, 2018). Currently, the units satisfaction score regarding pain management is in the low 70s compared to other units scoring around 85% indicating they are very satisfied. HCAPHS is a standardized survey that measures patients perspectives of hospital care by collecting data and publicly reporting results so that the quality of care provided is transparent (cms.gov, 2020).

Strategies and interventions that were implemented to increase pain management score to meet national standards for the unit ranged from 01/2014 to 03/2016. According to the run chart results, satisfaction scores did not begin to increase until 03/2015 when EMR data on pain medication effectiveness was reviewed in QI team which resulted in meetings with staff to determine effective strategies and the implementation of a rapid cycle improvement model and a Plan-Do-Study-Act Cycle (PDSA). Once these strategies were implemented a sustainable change was noted on the nursing unit with patient satisfaction scores increasing to almost 100%. The nurse manager can expect to see the unit exceed the national benchmark for the next quarter by continuing to meet monthly with the improvement team to discuss performance measures in place and to ensure continuous improvement is occurring. According to Spath, to evaluate if changes were successful they should be implemented on a wider scale and modified if needed and repeat to gain greater insight to the problem and allow the improvement team to add or take away from success and failures so that the next process change can be beneficial (Spath, 2018).

After the rapid cycle improvement model was implemented, the run chart showed an improvement in patient satisfaction scores related to pain management and the interventions implemented resulted in a 100% satisfaction rate in 03/2016, which supports the nursing units decision to celebrate. Leadership can be confident that the trend will continue by ensuring that monthly meetings are still being held to discuss improvement methods and make changes if needed. During the meetings, a run chart can be reviewed so the team can review patient satisfaction scores and compare monthly data. A run chart is an analytical tool that is used for quality improvement and allows users to visualize the performance of processes and preserving the time order of data (Perla, Provost, & Murray, 2011).

References

Cms.gov. 2020. HCAHPS: Patients’ Perspectives Of Care Survey | CMS. [online] Available at: [Accessed 26 October 2020].

Perla, R. J., Provost, L. P., & Murray, S. K. (2011). The run chart: A simple analytical tool for learning from variation in healthcare processes. BMJ Quality & Safety, 20(1), 46. doi:http://dx.doi.org.ezp.waldenulibrary.org/10.1136/b…

Spath, P. (2018). Introduction to healthcare quality management (3rd ed.). Chicago, IL: Health Administration Press.

PRACTICE EXPIERENCE

Christina Oxendine

RE: Group B Practice Experience Discussion – Week 3

COLLAPSE

Process improvement models are implemented into healthcare and utilized for improvement methods and to ensure continuous improvement. When focusing on readmission rates within 30 days for patients with CHF and reviewing process improvement models, the model I chose to focus on to assist in quality improvement is the FADE model. The FADE model is a performance improvement tool that was adapted as part of the PDCA cycle and consist of four phases (Spath, 2018). The four phases of the FADE model includes:

Focus-Selecting a problem and explaining it

Analyze-Gathering data to support there is a problem

Develop-Determine a solution and create a plan to utilize the solution

Execute-Implement the plan and monitor results and make changes as needed

When applying this plan to my practice experience project related to reducing readmissions of CHF patients within 30 days I was able to identify and create a quality improvement method by implementing the FADE model.

Focus- Focus on reducing the readmission rates of patients with a CHF diagnosis within 30 days and place emphasis on appropriate discharge teaching.

Analyze- Gather data with the number of patients readmitted within 30 days of discharge and review any current interventions being utilized such as patient discharge teaching and treatment being utilized as well as length of stay during admission.

Develop- Create an action plan to ensure patients are receiving the proper discharge teaching and given information related to follow up appointments and available resources. Ensuring a team approach is taken and collaboration with the patient’s primary care provider.

Execute- Execute the implementation of the plan and interventions created regarding education about diagnosis and discharge teaching and monitor the effectiveness of them when data reports are ran and make changes as needed if readmission rates are still high.

According to Spath, the FADE model is beneficial for all types of performance problems and is useful when focusing on a problem, analyzing the problem and its causes, creating and implementing solution, and monitoring the success of interventions utilized (Spath, 2018). When I discussed process improvement models with the quality team and care management at my organization, they were in agreeance that this model was beneficial for my particular focus with reducing readmission rates.

Reference

Spath, P. (2018). Introduction to healthcare quality management (3rd ed.). Chicago, IL: Health Administration Press.

Allison Wright

RE: Group B Practice Experience Discussion – Week 3

COLLAPSE

Main Post

According to Spath, once an opportunity for performance improvement is found, the team must fully understand the cause before attempting a change. Analytic tools are used by QI teams to evaluate the current process and choose interventions that result in a sustainable change (Spath, 2018). Additionally, the author highlights the need for a defined and systematic approach, or model, to guide the implementation of quality improvement tools. Process improvement plans that follow a model are shown to produce continuous favorable change. (Spath, 2018).

I have chosen to apply the FADE quality improvement model to develop my improvement plan to decrease the rate of severe hypoglycemia events in the hospital setting. A variation of the PDSA/PDCA rapid improvement cycle, FADE’s four-phase method, is an appropriate model for all kinds of performance opportunities (Spath, 2018).

When adapting the FADE model to focus on my specific practice improvement project, the results are as follows:

Focus: Define and verify the opportunity to be improved.

Severe hypoglycemia events in the hospital are preventable medication administration errors. The network’s evidence-based protocols follow nationally set guidelines with the support of The Joint Commission. Performance opportunities are within the management or misuse of these protocols, verifiable by the measured rate of episodes occurring within the hospital.

Analyze: Collect and study data performance data and identify root causes.

Gather available data surrounding all events that have occurred beginning January 2020 and do a root cause analysis. A cause and effect diagram shows the relationship between influencing factors and outcomes and could be used to determine all possible causes of deviation from policy/procedure. The Five Whys tool would allow us to explore the “what and why” of the practice problem. This tool helps the QI team get to the root of the situation by asking “why” repeatedly until the core problem is uncovered (Spath, 2018, Chapter 6).

Develop: Design action plans for improvement, implementation, communication, and monitoring.

To capture the step-by-step details and all people/departments involved, I will use a deployment flowchart to develop a solution for the identified problem and the implementation of the solution strategies (Spath, 2018, p. 155).

Execute/Evaluate: Implement the action plan and institute a process control system to measure/monitor results. Adjust the action plan if needed.

The last step in the quality improvement process is implementing the action plan and monitoring/measuring the results—evaluating the results every 60-90 days to allow for timesaving, waste reducing, and cost-efficient practice adjustments. Histograms or line charts are valuable tools used to show performance change over time. This visual tool will be helpful when reporting results, as they are easy to understand. The information gathered could then be added to a dashboard (tabular report) of Glycemic Control Measures (Spath, 2018, p. 95).

When I spoke with my mentor and leadership members regarding the process improvement model choices and next steps, we all agreed that policy change or re-writing a protocol was not likely to be needed. The opportunity appears to be within the execution of those plans already written. If the quality improvement plan is successful, it could then be shared or “spread” across all units/sites, following the same protocol. Having a process for spreading within a network saves time and money and helps alleviate patient outcome variability. (Wolak et al., 2020).

References

Spath, P. (2018). Introduction to healthcare quality management, third edition. Health Administration Press.

Wolak, E., Overman, A., Willis, B., Hedges, C., & Spivak, G. F. (2020). Maximizing the benefit of quality improvement activities. Journal of Nursing Care Quality, 35(3), 199–205. https://doi.org/10.1097/ncq.0000000000000438

You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.

ADDITIONAL INSTRUCTIONS FOR THE CLASS

Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.
Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.
One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.
I encourage you to incorporate the readings from the week (as applicable) into your responses.
Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately.
In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).
Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.
APA Format and Writing Quality

Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).
Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
I highly recommend using the APA Publication Manual, 6th edition.
Use of Direct Quotes

I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.
As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.
It is best to paraphrase content and cite your source.
LopesWrite Policy

For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.
Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.
Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?
Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.
Late Policy

The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.
If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.
I do not accept assignments that are two or more weeks late unless we have worked out an extension.
As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.
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Communication is so very important. There are multiple ways to communicate with me:
Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.