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NURS FPX 4020 Assessment 4 Improvement Plan Tool Kit

Student Name Capella University NURS FPX 4020 Improving Quality of Care and Patient Safety Prof. Name Date Improvement Plan Tool-Kit The Acadia General Hospital has been encountering medication administration erors compromising patient safety, for which safety improvement plan has been developed in previous assessment. This improvement plan toolkit addresses medication administration errors and enlightens the healthcare workforce of AGH with a better understanding of the safety improvement plan. This will potentially persuade the healthcare workforce to implement the safety improvement plan as it is based on evidence-based scholarly articles. The resource toolkit is prepared by thorough research on medication administration errors via multiple databases such as CINAHL, Google Scholar, PubMed, JSTOR, and PubMed Central. The resource tool kit focuses on four categories related to medication administration: Introduction to medication errors, Risk factors of medication administration errors, Nurses’ role in preventing medication administration errors, and Evidence-Based practices for minimizing medication administration errors. Introduction to Medication Errors Carver, N., Hipskind, J. E., & Gupta, V. (2019). Medical error. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK430763/ This resource covers medical errors from its introduction, issues of concern, and risk factors to clinical. significance. According to this resource, medication errors can be directed to different events varying in the magnitude of patient harm. The avoidable medication adverse events cause 44,000 to 98,000 mortalities in US hospitals. The resource further describes types of medical errors, comprising wrong dose, drug, patient, route of administration, diagnostic, and system errors. These events incur heavy costs to the community that range between 37.6 to 50 billion dollars, including additional healthcare costs, loss of productivity, and disability. The resource also emphasizes the multifaceted approaches to control errors, including error reporting culture, implementation of legislative measures to enhance patient safety, and use of strategies to prevent medication errors, such as using technology and improving communication among interdisciplinary teams. This resource is helpful for nurses to understand what medication errors are, their prevalence, and their types. This will lead to reduced risk to patient safety and improved quality of care with medication administration. Furthermore, nurses can use this resource in their healthcare settings, such as Acadia General Hospital, to understand factors leading to medication errors and strategies to avoid them. This will create an organizational culture prioritizing patient safety and reducing patient harm due to medication errors. NURS FPX 4020 Assessment 4 Improvement Plan Tool Kit Elliott, R. A., Camacho, E., Jankovic, D., Sculpher, M. J., & Faria, R. (2021). Economic analysis of the prevalence and clinical and economic burden of medication error in England. BMJ Quality & Safety, 30(2). https://doi.org/10.1136/bmjqs-2019-010206  This study by Elliot and colleagues (2021) mainly focuses on the prevalence of medication errors and economic burden in England. This resource highlights that 237 medication errors occur in England annually, of which 66 million are of significant clinical value. Moreover, implications of these errors include the utilization of 181,626 bed-days and total costs incurred to NHS up to £98 462 582 per year. This resource is helpful for nurses as it enlightens them on the prevalence of medication errors outside the U.S. and the financial repercussions. Moreover, nurses can gain insights from this resource on how medication errors can cause a financial burden on the country and how these preventable adverse events can result in a better and more stable economy if the appropriate measures are adopted timely. Nurses can use this resource to understand medication errors from an economic perspective in their healthcare setting. Additionally, it can improve nurses’ work performance when they have adequate knowledge of the subsequent consequences of medication administration errors.  NURS FPX 4020 Assessment 4 Improvement Plan Tool Kit Rodziewicz, T., & Hipskind, J. (2020). Medical error prevention (pp. 1–37). http://www.saludinfantil.org/Postgrado_Pediatria/Pediatria_Integral/papers/Medical%20Error%20Prevention%20-%20StatPearls%20-%20NCBI%20Bookshelf.pdf  This resource talks about the prevention of medical errors. This resource highlights multiple adverse events, including medication-associated errors, with their causes and preventive strategies. Moreover, it discusses healthcare technologies to prevent medication errors, such as electronic health records and computerized prescriber order entry. It guides nurses in preventing medication errors due to communication errors by integrating “read back” strategies on telephone orders and enhancing multidisciplinary team collaboration. Nurses can use this resource to discover the types of errors and preventive strategies to reduce the incidence of these errors in Acadia General Hospital (AGH) and better understand the safety improvement plan where technology is required. Risk Factors of Medication Administration Errors  Walker, D., Moloney, C., SueSee, B., Sharples, R., Blackman, R., Long, D., & Hou, X.-Y. (2022). Factors influencing medication errors in the prehospital paramedic environment: A mixed method systematic review. Prehospital Emergency Care, 1–37. https://doi.org/10.1080/10903127.2022.2068089 This study by Walker and colleagues (2022) highlights various factors contributing to medication administration errors. These include organizational factors such as a culture that does not encourage patient safety, understaffing, and inadequate resources and reporting systems. Medications with poorly labeled packaging and confusing names, such as look-alike-sound-alike medication, are medication-related factors that lead to medication errors. Additionally, external interruptions and inadequate lighting are environmental factors influencing medication errors. Other factors include procedure-related factors (poor medication verification processes) and cognitive factors (cognitive overload, poor memory, and confirmation biases). This resource provides a comprehensive list of factors that nurses can use to gain adequate knowledge on contributing factors towards medication errors and must take suitable measures to prevent them. This requires interdisciplinary collaboration and resources to eliminate these factors. Nurses of AGH can utilize this resource to learn about key factors that hinder patient safety and work accordingly to reduce medication errors owing to these mediators.  Wondmieneh, A., Alemu, W., Tadele, N., & Demis, A. (2020). Medication administration errors and contributing factors among nurses: A cross sectional study in tertiary hospitals, Addis Ababa, Ethiopia. BMC Nursing, 19(4), 1–9. https://doi.org/10.1186/s12912-020-0397-0 NURS FPX 4020 Assessment 4 Improvement Plan Tool Kit This resource highlights medication administration errors and contributing factors among nurses that lead them to medication errors, reducing patient safety. The authors identified that lack of adequate training, inadequate work experience, and unavailability of proper guidelines for medication administration were major nurse-oriented factors that caused medication administration.

NURS FPX 4020 Assessment 3 Improvement Plan in Service Presentation

Student Name  University Name NURS FPX 4020 Improving Quality of Care and Patient Safety Instructor Name Date  Improvement Plan In-Service Presentation Good morning/ afternoon, everyone, and welcome to my presentation. I am —-, a registered nurse at Acadia General Hospital. Today, I will deliver a presentation on an in-service improvement plan for reducing medication administration. Before I begin, I would like you all to remain seated quietly and park your questions till the end of the session, where I will adequately satisfy your concerns and queries. Let us delve into the content and objectives of this presentation. Agenda  This presentation entails the following contents: Outcomes of In-Service Safety Improvement Plan The audience will learn their critical roles in reducing medication administration errors in AGH by completing this in-service safety improvement plan. Moreover, the audience will learn new practices or skills that they can implement in promoting safe medication administration. They will learn about the proposed safety improvement plan and how to implement it effectively. This will result in enhanced performance in safe medication management, reduced incidences of medication administration errors, and enhanced patient satisfaction. Moreover, the costs associated with medication administration errors will diminish, and resources can be better allocated, facilitating the efficiency of healthcare organization and performance. Objectives of In-Service Session on Safe Medication Administration All healthcare settings work to deliver the best quality care treatments to patients, alleviating the severity of health problems and improving their health outcomes. The escalating number of adverse events like medication administration errors hamper the organizational goal of providing effective and efficient care to patients. Therefore, all healthcare professionals must adhere to principles of safe and effective care provision grounded in coordination and collaboration, reducing the possibility of medication administration errors (World Health Organization, n.d.). This session aims to tackle the prevailing issue of medication administration errors at AGH, impacting patient safety and hospital performance. The goals and objectives of this in-service session are to foster a conducive environment for nurses to minimize medication administration errors by 1) equipping nurses with adequate knowledge on focused medication administration, 2) utilizing the effective use of healthcare information technologies that facilitate safe medication management and, 3) adherence to new policies on safe medication administration.  Safety Improvement Plan The safety improvement plan is devised to overcome the alarming issue of medication administration errors at AGH. Lately, the healthcare organization has encountered multiple medication administration errors due to several factors, such as a lack of implementing medication administration protocols, nurses’ negligent behavior and mental absenteeism, lack of healthcare technology, and lack of clear hospital policies. For this purpose, a safety improvement plan is crafted considering these dominating factors. The proposed plan includes training nurses on mindfulness, integrating barcode medication administration technology, and developing new policies on medication administration. The improvement plan is expected to enhance patient safety when nurses are well-trained in focused medication administration and are mindfully present (Ekkens & Gordon, 2021).  NURS FPX 4020 Assessment 3 Improvement Plan in Service Presentation Moreover, BCMA will enable the practical implementation of double medication verification through barcode and minimize medication errors due to wrong medication (Mulac et al., 2021). Lastly, developing new policies, such as penalties and job termination on consistent medication administration incidents, will inculcate a sense of responsibility and alertness among nurses, delivering correct medication administration (Vaismoradi et al., 2020). This safety improvement plan will potentially reduce medication administration errors and patient harm by safe medication administration.  Need to Improve Safety Outcomes It is crucial to address the current situation of escalating medication administration error incidents at AGH due to various health and other implications. Medication administration errors require further treatments to reduce patient harm, impacting patients’ well-being due to physical, mental, and emotional stress. Patients may distrust healthcare professionals and impede required care treatments, further aggravating poor health outcomes. This may lead to severe health conditions, leading to mortalities. Moreover, the financial burden increases on patients and the organization due to extra treatments and procedures, leading to a financial crisis. Furthermore, the organization can suffer from a rapid decline in patient revenue as patients’ satisfaction is reduced, and their turnover rates will be higher, leading to economic instability of hospitals (Elliott et al., 2021). Therefore, AGH must address medication administration errors by implementing the proposed safety improvement plan.  Audience’s Role in the Implementation of Improvement Plan The role of the audience, including nurses, policymakers, and IT personnel, is necessary to implement an improvement plan successfully. Nurses are primary stakeholders involved in medication administration procedures, and their active involvement in learning and practicing nursing rights of medication administration will result in safe medication delivery. Nurse leaders must conduct training sessions on mindful and focused medication delivery. Moreover, the healthcare administration will be responsible for policy-making for nurses to create stringent policies on safe medication administration. They will develop a policy on penalties, which nurses must abide by when making medication administration errors. Additionally, if the nurses resist change in attitudes, the policymakers will craft a policy of job termination. Besides, the integration and implementation of BCMA technology require the IT personnel they guide nurses on its practical use and managing glitches, if any. This requires an interdisciplinary collaboration to ensure the proposed improvement plan is efficiently driven and brings the desired outcomes of reduced medication administration errors. Importance of Embracing Role in Plan All these stakeholders are critical to the success of the improvement plan targeted at medication administration. Nurses can sustain their jobs by embracing their role as competent care providers with adequate training and mindful medication administration, preventing themselves from job termination and heavy fines. Policymakers play a crucial role in achieving the desired goal of reducing medication administration errors with strict policy development procedures. This will enhance nurses’ adherence to improvement plans due to fear of losing jobs and aiming for acquiring bonuses by efficient performance. Moreover, healthcare organizations can work efficiently, fulfilling their aim of delivering high-quality care to patients. Lastly, IT personnel will lead a technology-driven organization, paving the way for

NURS FPX 4020 Assessment 2 Root Cause Analysis and Safety Improvement Plan

Student Name  University Name NURS FPX 4020 Improving Quality of Care and Patient Safety Instructor Name Date  Root-Cause Analysis and Safety Improvement Plan Root-cause analysis (RCA) is a systematic strategy for solving problems and issues that cause significant destruction in any organization. Healthcare organizations use this strategy to resolve various issues, including preventable adverse events such as medication administration errors. The prevailing medication administration errors called for immediate action of RCA to lessen medication administration errors. This paper will highlight the use of RCA in Acadia General Hospital (AGH), where medication administration errors critically impact patient safety. Moreover, the assessment will discuss the root causes of recent medication administration errors in AGH, apply evidence-based practice strategies, and craft a safety improvement plan. Lastly, it will highlight identified existing resources of AGH that could be leveraged to improve safety improvement plans for safe medication administration. Analysis of the Root Cause Several medication administration errors occurred at AGH, but the incident of medication administration error due to the wrong medication by Jenna instigated the RCA. Jenna was a nurse on duty in the medical ward; on her evening round, she found that one of her patients, Graham, who complained of arthritis pain, required a dose of “Celebrex.” The nurse retrieved the wrong medication, “Celexa,” instead of “Celebrex”  due to lack of attention and being mentally absent during dispensing. Additionally, the question arises if the ward environment was chaotic or if there were distractions that could have contributed to Jenna’s mistake. Moreover, she did not double-check the medication before handing it to the patient. Graham took the medication without knowing that it was the wrong medication. It is essential to probe if there was a breakdown in communication between Jenna and Graham or if the patient was adequately informed about the medication he was receiving. The nurse found the mistake when investigating the medication administration chart and immediately reported to the healthcare team to manage Graham’s condition. Fortunately, the patient did not suffer any severe side effects of the anti-depressant agent to stabilize mood. NURS FPX 4020 Assessment 2 Root Cause Analysis and Safety Improvement Plan This error could have been prevented if the nurse exhibited attentive behavior and mindful performance during medication administration. The negligent behavior toward crucial tasks like medication administration was the primary cause of this incident. Moreover, the nurse did not comply with the medication administration protocols and required further education and training on safe medication delivery. The situation calls for evaluating whether communication between the medical staff, particularly in relaying and verifying medication instructions, was effective and transparent. When nurses show inadequate attention and mindfulness attitudes, these errors occur frequently, particularly for sound-alike and look-alikes medications (Schroers et al., 2020). Furthermore, the lack of technology-based medication administration further results in medication errors. The presence of healthcare information technology can alleviate the incidences of these errors.  Application of Evidence-Based Strategies The literature addresses numerous factors that lead to safety issues during medication administration. One study states that out of 185 nurses, 24 engaged in medication administration errors due to a lack of training on safe medication administration (Wondmieneh et al., 2020). Therefore, healthcare organizations must implement evidence-based strategies. One of these strategies includes training nurses on mindfulness during medication administration procedures. The literature substantiates this strategy, as 73.3% of medication errors are reduced by training nurses on mindfulness and attentive behaviors (Ekkens & Gordon, 2021). Another strategy includes integrating barcode medication administration (BCMA) technology to avoid medication administration errors due to wrong medication. The barcode will identify and confirm that the medication administered is correct and matches the one prescribed to the patient. This will result in enhanced patient safety and reduced incidence of medication administration (Mulac et al., 2021). Lastly, developing protocols on medication administration within hospitals can reduce medication administration errors as nurses will be held accountable in case of any violations of those protocols. Nurses will be more focused on implementing the protocols and relevant policies on medication administration due to the vulnerability of losing their jobs, heavy fines, and litigation actions (Vaismoradi et al., 2020). Safety Improvement Plan Nurse leaders and the hospital administration collaborated to develop a safety improvement plan for AGH. The plan aims to address medication administration errors. It is both realistic and grounded in evidence-based strategies. Specific actions, policies, and processes have been outlined for implementation, complete with goals and timelines. Training Nurses on Mindfulness The nurse leader will conduct mindfulness and focused medication administration training sessions for three months after developing this plan. This training will teach them the importance of attentive behaviors and mindfulness during the most crucial medication management tasks. Moreover, nurses will learn to avoid interruptions and be mentally present while administering medication to patients. Through this training, nurses will avoid making mistakes due to a lack of focus and attention. The desired outcomes and goals of this training include delivering correct medications to patients with a clear and focused mind and reducing medication errors due to nurses’ negligent behaviors (Ekkens & Gordon, 2021). Integration and Implementation of BCMA  The hospital will integrate a new technological process to reduce AGH medication errors. The barcode medication administration technology will allow nurses to match the barcode on the medication’s label with that of the patient’s prescribed barcode on the wrist. If the barcodes do not match, nurses will be alerted to the wrong medication, preventing its administration. Moreover, nurses can check which medication is required to administer to a patient related to his health condition, leading to safe medication management. The outcome of this technology will be reduced rates of medication administration errors due to wrong medication. Nurses will deliver the correct and proper medication, enhancing patient safety and reducing harm due to medication administration errors (Mulac et al., 2021). This strategy will require a timeline of six months as it requires financial, material, and human resources.  New Policies on Medication Administration The AGH will develop new policies on medication administration, such as penalties for violating the medication administration

NURS FPX 4020 Assessment 1 Enhancing Quality and Safety

Student Name  University Name NURS FPX 4020 Improving Quality of Care and Patient Safety Instructor Name Date  Enhancing Quality and Safety Healthcare professionals should provide high-quality care treatments that do not compromise patients’ health and safety. All healthcare providers must improvise medical interventions tailored to their health needs and minimize the chances of adverse events. Medication errors are preventable adverse events that can impact patient safety and quality of life. The incidence of adverse drug events, including medication errors, accounts for 1.3 million emergency department visits and 350,000 hospitalizations annually (CDC, 2019). Nurses are primary medication managers for patients as they administer them into human bodies. It is paramount for nurses to strictly adhere to safe medication administration that promises patient safety and improved health outcomes, ultimately enhancing patients’ quality of life. Factors Leading to a Specific Patient Safety Risk On a fine day, Jenna worked as a registered nurse at Acadia General Hospital in the medicine ward. Jenna was doing an evening round and looked up to the prescribed medication record of a 50-year-old patient named Graham, who was admitted to the hospital due to unmanaged arthritis pain. The patient was prescribed “Celebrex,” a non-steroidal anti-inflammatory drug. The nurse went to the dispensing area and retrieved the wrong medicine bottle labeled “Celexa,” which sounded like the prescribed “Celebrex.” The nurse gave the patient “Celexa, ” an anti-depressant agent for mood disorders. Graham took the medication, unaware that it was the wrong drug. Later, Jenna reviewed his medication administration record and noticed she had administered incorrect medicines. She immediately reported to the medication safety team, and the patient was closely monitored. Fortunately, Graham did not experience severe side effects from the drug, but this incident raised concerns about the patient’s safety.  Numerous factors lead to patient safety risks, including negligent behavior toward medication administration, non-adherence to medication administration protocols, lack of technology-based medication administration use, and lack of training on medication administration. Nurses may exhibit negligent behavior toward medication administration due to heavy workloads and fatigue. This leads to non-careful medication administration, particularly for “look-alike-sound-alike” medications (Schroers et al., 2020). NURS FPX 4020 Assessment 1 Enhancing Quality and Safety Moreover, non-adherence to medication administration standards and protocols, such as double-checking before administration and missing the “Five Rights of Medication Administration,” such as the right patient, right drug, correct dose, right time, and right route of administration, also pose safety risks to patients (Hanson & Haddad, 2022). Hospitals often lack technologies that facilitate safe medication administration, such as “barcode medication administration,” which can prevent medication administration due to wrong drug administration. Implementing BCMA can lower override rates to less than two percent in large healthcare settings (Boehme et al., 2022). Additionally, training inadequacies among nurses on safe medication administration are significant factors that lead to patient safety risks. One study showed that among work-related characteristics towards medication errors, about 185 nursing staff were not trained on safe medication, and 24 nurses administered the wrong drugs (Wondmieneh et al., 2020).  Evidence-Based Practices to Improve Patient Safety in Medication Administration Healthcare professionals play a crucial role in improving patient safety in medication administration and reducing costs to patients and organizations by implementing the best available evidence-based solutions. One such evidence-based practice is developing and integrating medication administration protocols within the organization. When the organization develops policies on medication administration and strictly integrates them for all nursing staff, there will be fewer chances of medication errors. Patients will receive the correct medication, leading to fewer incidents of harm. Moreover, the costs incurred by patients will be reduced as the patient will not undergo additional treatments due to medication errors. Likewise, hospitals can be saved from heavy expenditures and requirements of further resources for treating medication errors (Vaismoradi et al., 2020). Another strategy is training mindful thinking for medication administration, where nurses must be mindful of their nursing practices, particularly during medication administration. This will reduce the onset of medication errors due to wrong drug administration due to lack of focused care. The study showed that mindfulness training in medication administration reduced medication errors by 73.3 %. This enhances patient safety as patients evade medication errors due to administering the wrong drugs.  NURS FPX 4020 Assessment 1 Enhancing Quality and Safety Moreover, by focused medication administration, hospitals will prevent operations due to medication errors and save financial resources, which can be allocated efficiently to other required areas (Ekkens & Gordon, 2021).  Another strategy includes integrating BCMA technology, which can promote safe medication administration using the barcode mentioned on the medication label and the patient’s wrist. This will enable accurate and correct administration of drugs, preventing chances of wrong medication delivery. This technology will improve patient safety and reduce long-term costs incurred by the organization due to frequent medication errors occurring without technology (Zheng et al., 2020).  Lastly, establishing training and educational programs on safe medication administration can improve patient safety, reducing medication errors. These training programs will teach nurses ways to reduce medication errors, such as double-checking medications, following protocols and guidelines for safe medication administration, and techniques for medication delivery through correct administration routes (Koyama et al., 2019).  This will reduce financial implications on hospitals when preventive strategies are employed to diminish medication errors. As a result, hospital readmission rates, length of hospital stays, and hospital-acquired infections will be reduced. All these events that require massive income to manage patients’ health will be saved, and costs will be reduced for both organizations and patients.  Nurses’ Role in Coordinating Care  Nurses play a crucial role in achieving care coordination in hospitals. Nurse-led coordinated care can enhance patient safety in medication administration and reduce costs. Nurse leaders can organize training sessions and educational awareness programs for junior and fellow nurses where information on safe medication administration can be disseminated. Moreover, nurses can foster a culture of an interdisciplinary approach to the safe administration of drugs, from prescribing to delivering the drug. Nurses can utilize BCMA and other relevant technologies to reduce costs associated with medication