MSN Writing Services

NURS FPX 6021 Assessment 3 Quality Improvement Presentation Poster

Student Name Capella University NURS-FPX 6021 Biopsychosocial Concepts for Advanced Nursing Practice 1 Prof. Name Date Abstract Background: Stress and depression are commonly found mental health issues in patients undergoing long-term hemodialysis due to chronic kidney disease (CKD). These patients may suffer from an actual or perceived loss of quality of life (QoL) due to the lifelong treatment they are under care of (Ghaffari et al., 2019). Thus, requires quality improvement initiatives to promote patients’ safety and improve their QoL.  Purpose: The purpose of this poster presentation is to address the mental health issues using cognitive behavioral therapy (CBT) as a change strategy.  Limitations/challenges: There are some challenges in implementation of CBT, so stress management training is explained as an adjuvant change strategy for reducing depressive symptoms in hemodialyzed patients to improve their quality of life. Methods: Six Sigma model’s DMAIC approach is used as a quality improvement (QI) method to promote continuous improvement.  Conclusion: The Six Sigma is an effective QI method but shows some limitations which can be addressed effectively to improve quality healthcare. CBT and stress management training (SMT) have been successful in reducing stress and depression from hemodialyzed patients ultimately improving their QoL.  Quality Improvement Methods Quality improvement is a framework that is used to improve the care quality. It is based on standardized methods and processes which helps in achieving desirable outcomes and improves organizational care for patients’ benefits (Centers for Medicare & Medicaid Services, 2021). The DMAIC is a Lean Six Sigma approach that is used as a guideline to improve care quality for patients’ satisfaction (Ahmed, 2019). The process begins with defining a problem. In hospitals, dialysis dependent patients are more likely to suffer from stress and depressive symptoms which leads them to either have poor quality of life or make a perception about it (Ghaffari et al., 2019). Next step is to measure the effectiveness of existing interventions that is being done to reduce stress in hemodialyzed patients and analyze the problems in those interventions. One the problems are identified; new improvement strategies that is CBT and stress management training are implemented in the system. For continuous improvement, the control step is used to evaluate the concerns of these strategies for future integration and improvement.  Challenges of the Six Sigma Approach Several barriers hinder the implementation of Six Sigma approach for CKD patients. As this is a 5 steps process, some stakeholders consider it as a complex cycle and can be time consuming. Another commonly found barrier is lack of knowledge about the methods, implementation and process (Deniz & Çimen, 2018). To address these challenges it is essential that top level executives play their part in supporting healthcare providers by introducing the strategy in their organization, training them related to its use and accompanying them throughout the process to ensure their concerns are addressed adequately. Moreover, it is essential to develop an insight that every action is undertaken for patients’ satisfaction in terms of reducing stress and improving their quality of life. (Deniz & Çimen, 2018; Rathi et al., 2022).  Change Strategy Foundation Approximately, 1/4th of CKD patients who are on long-term dialysis treatment suffer from depressive disorders. This depression can lead to severe morbidities eventually can cause death (Nataatmadja et al., 2020). This statistic prepares a foundation for the proposed change strategy which is cognitive behavioral therapy (CBT). CBT is described as a patient-provider interaction to identify the impacts of psychological thoughts on patients’ behaviors (Nakao et al., 2021). A research states that CBT has been effective in reducing symptoms of depression and stress among hemodialyzed patients (Zegarow et al., 2020). Another study conducted on hemodialyzed patients in Turkey Kidney Foundation to see the effectiveness of CBT showed significant improvements in patients’ cognitive function, social interaction, and improved their overall quality of health (Tuna et al., 2021).  Evidence to Support QI Method Quality improvement is a continuous process and requires methods which are based on continuity hence, literature explains that six sigma model is a continuous cycle which is developed for identifying the problem, finding solutions, eveluating the results and repeating the steps to get desired outcomes (Ahmed, 2019). Furthermore, research concludes the use of six sigma as a succesful QI method for dialysis dependant patients suffering from anxiety and depression as it helped in reducing the incidence (Yang et al., 2021). Therefore it is evident that despite of the challenges, with adequate management, six sigma approach is useful for the population of this study.   Challenges of Change Strategy There are some limitations of CBT, like:  To address these challenges, it is essential that top tier management plays an important role in terms of resource allocation. However, there is another strategy as well which can be implemented in the form of support groups for these patients. This intervention is stress management training (SMT). SMT in support group is explained as patients with similar conditions sit together and discuss their stressors to work together and help each other (Ghasemi Bahraseman et al., 2021). A controlled-trial study showed that patients who received stress management training had improved perceptions about their lives and had knowledge of more coping strategies than the control group. They had low stress, more confidence, and improved problem-solving skills (Ghasemi Bahraseman et al., 2021).  Knowledge Gaps and Unknowns It is essential that the data collected at the measure stage is explicit in explaining the problem and root causes of the problem. Data gaps/missing information will impact next stages of the cycle where poor analysis would be done. Clear and detailed information will help to improve the analysis of the problem hence assist in finding effective solutions. Moreover, six sigma is a singular standard pathway and doesn’t have space for adding other methods. Thus, every information added in this cycle should cover all aspects of patients. Uncertainty of any information can break the pathway.  Some of the knowledge gaps identified during this presentation are missing information about individual causes of depression and stress. Generalized data used for this assessment couldn’t