Tag: Clinical-Nursing

Capella University NHS-FPX 4000 Assessment 3 Instructions: Applying Ethical Principles

Applying Ethical Principles

Analysis of the Case

The selected case study for this task is the ‘to vaccinate or not to vaccinate.’ Dr. Kerr is presented with a case where the parents, Mr. and Mrs. Smith, are reluctant to have their 5-day-old daughter Anna vaccinated citing that they desire to raise her in a natural way. The Smiths have cited their preference of avoiding any forms of vaccinations stating that they present risks such as autism. Dr. Kerr, obligated to offer the best advice and care to the Smiths and little Ana respectively, is conflicted about what to do as the parents are adamant about accepting vaccination (Capella University, 2020). Simply, the ethical dilemma that Dr. Kerr is faced with is whether to vaccinate the child and protect her from illnesses or heed to the wishes of the Smiths. There are three parties are involved in this dilemma; the pediatrician, the parents, and the child. Dr. Kerr is tasked with offering the best care for the patient while recognizing that parents are allowed to choose not to vaccinate their children under certain circumstances. Baby Ana is affected by the dilemma because depending on the decision that will is made, she will be protected or not protected from illnesses.

The three components of the ethical decision-making model are moral awareness, moral judgment, and ethical behavior. In the case of the pediatrician faced with the ethical dilemma of whether to vaccinate or not to vaccinate a 5-day-old child, moral awareness would involve the pediatrician being aware of the ethical implications of vaccinating or not vaccinating the child (Capella University, 2020). Moral judgment would involve the pediatrician making a judgment about what is the right thing to do in this situation, taking into account the potential benefits and risks of both vaccinating and not vaccinating the child. Ethical behavior would involve the pediatrician acting in accordance with their moral judgment, either vaccinating or not vaccinating the child as they believe is right. The particular factor that led to this dilemma is the reluctance and insistence by the Smiths that their daughter should not be vaccinated. In view of this, the pediatrician is faced with the tough decision to make on whether to vaccinate the child or not.

The Effectiveness of the Communication Approaches Present in a Case Study

The pediatrician took the time to listen and understand the Smiths’ reasons for being reluctant to vaccinate their child. Once the reasons were explained, the pediatrician provided information that may help change their minds. For example, the couple was convinced that there are more costs than benefits to vaccinating a child but the pediatrician explained to them why vaccination is important for children and the community as a whole in the long term. Throughout the discussion that the healthcare professional was interacting with the Smiths, she demonstrated professionalism in two important ways, Firstly, she took her time to listen to the opinions and justifications of the parents before outlining the reasons why vaccination was necessary Capella University NHS-FPX 4000 Assessment 3 Instructions: Applying Ethical Principles. She especially quoted medical studies and reasons to try and convince the parents to reconsider their hard stance against vaccination.

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Healthcare professionals should use clear and concise communication when interacting with patients (Ratna, 2019). This means that they should use language that is easy to understand and get straight to the point. They should avoid using jargon or technical terms that the patient may not understand. Additionally, healthcare professionals should avoid using offensive language or making threats when communicating with patients (McCartney, 2017). This could cause the patient to feel uncomfortable or intimidated, which could make them less likely to want to follow the healthcare professional’s instructions. The consequences of using effective communication approaches are that the message is more likely to be received and understood by the intended audience. Additionally, using effective communication approaches can help build trust and rapport between the sender and receiver (Anderson et al., 2019). On the other hand, the consequences of using non-effective communication approaches are that the message is more likely to be misunderstood or misinterpreted by the intended audience. Additionally, using non-effective communication approaches can damage relationships and create mistrust between the sender and receiver.

The Effectiveness of the Approach Used

In response to the ethical dilemma, Dr. Kerr took made two important actions. First, she shared important information about the risks that unvaccinated children have in the community as compared to those that are vaccinated. She also explained to the Smiths that with more people refusing vaccinations to their children, they are increasing the risk of vaccine-preventable illnesses. The approach taken by the pediatrician was to first assess the situation to see if the parents are truly refusing to have their child vaccinated or if they are concerned about the possible impacts of the vaccine (Rus & Groselj, 2021). The health professional took the time to answer their questions and explain the importance of vaccines. Furthermore, she tried to talk to the parents to see if there are any underlying reasons for their refusal but in this case, there were none save for the fact that they preferred to raise their daughter in what they termed as an ‘organic’ way. The likely cause of action that Dr. Kerr took in a bid to resolve this dilemma was to involve other health professionals or agencies to help resolve the issue. This case highlights the importance of open communication between healthcare professionals and their patients (Rus & Groselj,2021). It is crucial that healthcare professionals take the time to answer questions and address concerns that patients and their families may have. Additionally, it is important to educate patients and their families about the importance of vaccines and the risks of not being vaccinated. In some cases, it may be necessary to involve other healthcare professionals or agencies to help resolve complex issues.

Ethical Principles Application

One possible solution the healthcare professional could suggest is to provide the parents with accurate and up-to-date information about the risks and benefits of vaccination. Also, the healthcare professional could explain that the risks of not vaccinating their child are much greater than the risks of vaccinating and that there is no evidence that vaccines cause autism (Ahmed & Mahmoud, 2020). In addition, the healthcare professional could also offer to answer any questions the parents may have. This approach makes the healthcare professional more effective in building relationships across disciplines within his or her organization because it shows that the healthcare professional is willing to listen to the parent’s concerns and provide them with accurate information. What’s more, likely to foster professional collaboration because it shows that the healthcare professional is open to working with the parents to find a solution that is acceptable to both parties.

References

Ahmed, A., Ali, H. S., & Mahmoud, M. A. (2020). Prioritizing Well-being of Patients through Consideration of Ethical Principles in Healthcare Settings: Concepts and Practices. 
Systematic Reviews in Pharmacy
, 
11
(5), 643-648.

Anderson, R. J., Bloch, S., Armstrong, M., Stone, P. C., & Low, J. T. (2019). Communication between healthcare professionals and relatives of patients approaching the end-of-life: a systematic review of qualitative evidence. 
Palliative medicine
, 
33
(8), 926-941.
https://doi.org/10.1177/0269216319852007

Capella University (2020). NHS-FP4000 Exemplar Sample Ethical Case Study. Retrieved from Cases in health services management.

McCartney, J. J. (2017). The duty to vaccinate: Clarifying and broadening the basis of the obligation.
American Journal of Bioethics
, 17(4), 46–47. https://doi- org.library.capella.edu/10.1080/15265161.2017.1284939 Capella University NHS-FPX 4000 Assessment 3 Instructions: Applying Ethical Principles

Ratna, H. (2019). The importance of effective communication in healthcare practice. 
Harvard Public Health Review
, 
23
, 1-6.
https://www.jstor.org/stable/48546767

Rus, M., & Groselj, U. (2021). Ethics of vaccination in childhood—A framework based on the four principles of biomedical ethics. 
Vaccines
, 
9
(2), 113.
https://doi.org/10.3390/vaccines9020113

 

Capella University NHS-FPX 4000 Assessment 3 Instructions: Applying Ethical Principles Instructions 

Assessment 3 Instructions: Applying Ethical Principles

Develop a solution to a specific ethical dilemma faced by a health care professional by applying ethical principles. Describe the issues and a possible solution in a 3-5 page paper.

Introduction

Whether you are a nurse, a public health professional, a health care administrator, or in another role in the health care field, you must base your decisions on a set of ethical principles and values. Your decisions must be fair, equitable, and defensible. Each discipline has established a professional code of ethics to guide ethical behavior. In this assessment, you will practice working through an ethical dilemma as described in a case study. Your practice will help you develop a method for formulating ethical decisions.

Instructions

Note: The requirements outlined below correspond to the grading criteria in the scoring guide. At a minimum, be sure to address each point. In addition, you are encouraged to review the performance-level descriptions for each criterion to see how your work will be assessed.

For this assessment, develop a solution to a specific ethical dilemma faced by a health care professional. In your assessment:

Access the 
Ethical Case Studies
 media piece to review the case studies you will be using for this assessment.

Select the case most closely related to your area of interest and use it to complete the assessment.

Note: The case study may not supply all of the information you need. In such cases, you should consider a variety of possibilities and infer potential conclusions. However, please be sure to identify any assumptions or speculations you make.

Include the selected case study in your reference list, using proper APA style and format. Refer to the 
Evidence and APA
 section of the Writing Center for guidance.

Summarize the facts in a case study and use the three components of an ethical decision-making model to analyze an ethical problem or issue and the factors that contributed to it.

Identify which case study you selected and briefly summarize the facts surrounding it. Identify the problem or issue that presents an ethical dilemma or challenge and describe that dilemma or challenge.

Identify who is involved or affected by the ethical problem or issue.

Access the 
Ethical Decision-Making Model
 media piece and use the three components of the ethical decision-making model (moral awareness, moral judgment, and ethical behavior) to analyze the ethical issues.

Apply the three components outlined in the Ethical Decision-Making Model media.

Analyze the factors that contributed to the ethical problem or issue identified in the case study.

Describe the factors that contributed to the problem or issue and explain how they contributed.

Apply academic peer-reviewed journal articles relevant to an ethical problem or issue as evidence to support an analysis of the case.

In addition to the readings provided, use the Capella library to locate at least one academic peer-reviewed journal article relevant to the problem or issue that you can use to support your analysis of the situation. The 
NHS-FPX4000: Developing a Health Care Perspective Library Guide
 will help you locate appropriate references.

Cite and apply key principles from the journal article as evidence to support your critical thinking and analysis of the ethical problem or issue.

Review the 
Think Critically About Source Quality
 resource.

Assess the credibility of the information source.

Assess the relevance of the information source.

Discuss the effectiveness of the communication approaches present in a case study.

Describe how the health care professional in the case study communicated with others.

Assess instances where the professional communicated effectively or ineffectively.

Explain which communication approaches should be used and which ones should be avoided.

Describe the consequences of using effective and non-effective communication approaches.

Capella University NHS-FPX 4000 Assessment 3 Instructions: Applying Ethical Principles

Discuss the effectiveness of the approach used by a professional to deal with problems or issues involving ethical practice in a case study.

Describe the actions taken in response to the ethical dilemma or issue presented in the case study.

Summarize how well the professional managed professional responsibilities and priorities to resolve the problem or issue in the case.

Discuss the key lessons this case provides for health care professionals.

Apply ethical principles to a possible solution to an ethical problem or issue described in a case study.

Describe the proposed solution.

Discuss how the approach makes this professional more effective or less effective in building relationships across disciplines within his or her organization.

Discuss how likely it is the proposed solution will foster professional collaboration.

Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.

Apply the principles of effective composition.

Determine the proper application of the rules of grammar and mechanics.

Write using APA style for in-text citations, quotes, and references.

Determine the proper application of APA formatting requirements and scholarly writing standards.

Integrate information from outside sources into academic writing by appropriately quoting, paraphrasing, and summarizing, following APA style.

Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:

Assessment 3 Example [PDF]
.

Additional Requirements

Your assessment should also meet the following requirements:

Length: 3–5 typed, double-spaced pages, not including the title page and reference page.

Font and font size: Times New Roman, 12 point.

APA tutorial: Use the 
APA Style Paper Tutorial [DOCX]
 for guidance.

Written communication: Use correct spelling, grammar, and punctuation.

References: Integrate information from outside sources to include at least two references (the case study and an academic peer-reviewed journal article) and three in-text citations within the paper.

APA format: Follow current APA guidelines for in-text citation of outside sources in the body of your paper and also on the reference page.

Competencies Measured

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

Competency 1: Apply information literacy and library research skills to obtain scholarly information in the field of health care.

Apply academic peer-reviewed journal articles relevant to an ethical problem or issue as evidence to support an analysis of the case.

Competency 3: Apply ethical principles and academic standards to the study of health care.

Summarize the facts in a case study and use the three components of an ethical decision-making model to analyze an ethical problem or issue and the factors that contributed to it.

Discuss the effectiveness of the approach used by a professional to deal with problems or issues involving ethical practice in a case study.

Apply ethical principles to a possible solution to an ethical problem or issue described in a case study.

Competency 4: Write for a specific audience, in appropriate tone and style, in accordance with Capella’s writing standards.

Discuss the effectiveness of the communication approaches present in a case study.

Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.

Write following APA style for in-text citations, quotes, and references.

 

Capella University NHS-FPX 4000 Assessment 3 Instructions: Applying Ethical Principles Ethical Case Studies

Consider the ethical dilemma the health care professional is faced with in the selected case study. Pay particular attention to details that will help you analyze the situation using the three components of the Ethical Decision Making Model (moral awareness, moral judgment, and ethical behavior).

Note: The case study may not supply all of the information you may need for the assignment. In such cases, you should consider a variety of possibilities and infer potential conclusions. However, please be sure to identify any speculations that you make.

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Incident 2: Emergency Department Repeat Admissions — A Question of Resource Use

Incident 9: The Missing Needle Protector

Incident 10: To Vaccinate, or Not?

Jenna and Chris Smith are the proud parents of Ana, a 5–day–old baby girl born without complications at Community Hospital. Since delivery, the parents have bonded well with Ana and express their desire to raise her as naturally as possible. For the Smiths, this means breastfeeding exclusively for the first six months, making their own baby food using pureed organic foods, and not allowing Ana to be vaccinated.

The Smiths are college educated and explain they have researched vaccines and decided the potential harms caused by them far outweigh any benefits. They point to the rise in autism rates as proof of the unforeseen risk of vaccines. Their new pediatrician, Dr. Angela Kerr, listens intently to the Smiths’ description of their research, including online mommy–blogs that detail how vaccines may have caused autism in many children. The Smiths conclude by resolutely stating they’ve decided not to vaccinate Ana, despite the recommendations of the medical community Capella University NHS-FPX 4000 Assessment 3 Instructions: Applying Ethical Principles.

Dr. Kerr begins by stating that while vaccines have certainly sparked controversy in recent years, she strongly recommends that Ana become fully vaccinated. Dr. Kerr explains that vaccines have saved the lives of millions of children worldwide and have been largely responsible for decreases in child mortality over the past century. For example, the decreased incidence of infection with the potentially fatal Haemophilus influenzae type b, has resulted from routine immunization against that bacterium. Similarly, epidemics such as the recent outbreak of measles are usually associated with individuals who have not been vaccinated against that pathogen.

Dr. Kerr goes on to endorse the general safety of vaccines by informing Ana’s parents that safety profiles of vaccines are updated regularly through data sources such as the federal government’s Vaccine Adverse Event Reporting System (VAERS). The VAERS, a nationwide vaccine safety surveillance program sponsored by the Food and Drug Administration and the Centers for Disease Control and Prevention, is accessible to the public at 
https://vaers.hhs.gov/index
. This system allows transparency for vaccine safety by encouraging the public and healthcare providers to report adverse reactions to vaccines and enables the federal government to monitor their safety. No vaccine has been proven casual for autism spectrum disorder (ASD), or any developmental disorder. On the contrary, many studies have shown that vaccines containing thimerasol, an ingredient once thought to cause autism, do not increase the risk of ASD.

Finally, Dr. Kerr reminds the Smiths that some children in the general population have weakened immune systems because of genetic diseases or cancer treatment, for example. It may not be medically feasible to vaccinate such children. Other children are too young to receive certain immunizations. Instead, these children are protected because almost all other children (and adults) have been vaccinated and this decreases their exposure to vaccine–preventable illnesses (VPIs). This epidemiological concept is known as “herd immunity.” As more parents refuse immunization for their healthy children, however, the rate of VPIs will increase. This puts vulnerable children at significant risk of morbidity and mortality. Routine childhood immunization contributes significantly to the health of the general public, both by providing a direct benefit to those who are vaccinated and by protecting others via herd immunity. Dr. Kerr concludes by stating that after considering the risks versus the benefits of immunization, most states require vaccinations before children can attend school. Parents may decide not to vaccinate under specific circumstances, however, which vary by state.

Jenna and Chris Smith confirm their understanding of what Dr. Kerr has explained, but restate that they do not want Ana vaccinated at this time. Dr. Kerr is perplexed as to what to do Capella University NHS-FPX 4000 Assessment 3 Instructions: Applying Ethical Principles.

NHS-FPX4000 Assessment 2 Instructions: Applying Research Skills

Applying Research Skills

Medical professionals make avoidable mistakes with patients’ medications all too often. Medication errors may occur at any point from the manufacturing process through the delivery of the drug to the patient. Following the five rights of medication administration may help reduce the number of medication mistakes made by medical providers. The right medication, right patient, right dosage, right time, and route of administration are the five pillars of effective medication management (Hanson & Haddad, 2021).

There have been several improvements in drug safety during the years I have been a nurse. Medication safety is something I recall thinking about throughout my time working in a critical care facility. Back then, my department’s standard medicines came in a single delivery and were consolidated onto a single medicine cart. The erroneous drug may have been placed in the cabinet containing a patient’s medications. Before administering the drug we did not need to run it through a scanner to check that the dosage was accurate. These two risk factors increased the likelihood of adverse medication reactions. Medication administration may be difficult, but following the five rights is essential for patient safety.

Identifying Academic Peer-Reviewed Journal Articles

At the beginning of my research, I used Summon, Capella University’s online database, to locate the appropriate academic journals. “Medical errors,” “medication safety,” and “adverse drug events” safety were some of the search terms I used. Using these terms, I was able to find more resources devoted to this crucial issue. Once I had a collection of publications, I restricted my search to those published during the last three years. Finally, I limited my results to credible sources that have been vetted by experts in the field. I was able to find up-to-date academic resources on my issue because of this exhaustive search.

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Assessing Credibility and Relevance of Information Sources

The credibility of any information you find in your study depends on knowing where it came from. As a result, I limited my search to academic, peer-reviewed literature exclusively. This will result in research results that are supported by evidence. In addition, I checked to make sure the publications were appropriate for my topic. This is essential in order to discover credible resources related to medical errors. As a corollary, the sources must be objective. This aids in providing knowledge in an evidence-based fashion. It is crucial to utilize the most recent information available while determining which source to trust. Only papers from the three prior years were included in my study. Given the frequency with which medical standards are updated, this helps guarantee that I am getting the updated information possible on the subject of medical errors.

Annotated Bibliography

Arkin, L., Schuermann, A., Penoyer, D., & Loerzel, V. (2022). Exploring nurses’ attitudes, skills, and beliefs of medication safety practices. Journal of Nursing Care Quality, 37(4), 319-326. 
https://doi.org/10.1097/ncq.0000000000000635

The purpose of this study was to gauge nurses’ perspectives on current guidelines for preventing medication errors. The nurse’s attitude may have an effect on her ability to make objective clinical judgments. Much of the study presented here on nurses’ attitudes centered on the quality of the workplace and the contentment its employees felt with their jobs. The researchers estimate that 25% of all medication blunders occur when the medicine is being administered (Arkin et al., 2022). The study also focused on how nurses’ demeanor and confidence in their own abilities relate to the frequency and severity of medication mistakes. The NASUS Skills subscale was used to go into topics like root-cause analysis and error debriefing with coworkers. The researchers propose that this may be biased because individuals are reluctant to disclose when they have engaged in medical errors NHS-FPX4000 Assessment 2 Instructions: Applying Research Skills. As the authors note, it is crucial to evaluate people’s attitudes and abilities in greater depth.

Bucknall, T., Fossum, M., Hutchinson, A. M., Botti, M., Considine, J., Dunning, T., Hughes, L., Weir‐Phyland, J., Digby, R., & Manias, E. (2019). Nurses’ decision‐making, practices and perceptions of patient involvement in medication administration in an acute hospital setting. Journal of Advanced Nursing, 75(6), 1316-1327. 
https://doi.org/10.1111/jan.13963

The article highlights the fact that medication errors account for 5–10% of all medical mistakes made in health facilities. Patients’ active participation in their own drug management is a concept that the researchers investigate. The researchers argued that patient participation in the medicine delivery process is an integral aspect of any safe nursing practice. Given their position as the last link in the chain of events, nurses play a crucial role in ensuring that patients are safeguarded when medications are administered (Bucknall et al., 2019). Medication errors are more likely when staff are interrupted while they are working. According to the results of the research, medication mistakes may be reduced by using the “sterile cockpit” method. This method reduces disruptions by teaching workers and providing visual clues to let them know when a nurse is giving out medicine. The researchers suggest that this method, in conjunction with patient engagement and teaching, may help to reduce the occurrences of medication errors.

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(1). 
https://doi.org/10.1186/s12912-020-0397-0

The authors of this work analyzed the causes of medication errors and the frequency with which they were reported. Problems with nurse-physician communication, drug labeling, insufficient nursing personnel, inefficient pharmacy procedures, and sloppy transcription were found to be major contributors to medication mistakes. Nurses’ biggest hesitations in disclosing medication mistakes stem from concerns about the administrative reaction and the consequences of doing so (Wondmieneh et al., 2020). Medical error disclosure, according to the study, is just as crucial as error prevention. Constant emphasis was placed on the need for open lines of communication throughout the study. Collaborative efforts were also shown to be crucial for minimizing medication errors. The researchers suggest that raising nurses’ understanding of safety issues is crucial for enhancing their ability to collaborate and communicate.

Lessons from the Research

I bolstered my understanding of medication errors by reading the aforementioned studies. Because of my profession as a nurse, this is one of my top priorities. The welfare of the patient is the first priority. According to what I found out, one-fourth of all errors in the healthcare system occurs while medications are being administered. When it comes to their medicine, patients put their faith in the hands of the trained specialists who handle their prescriptions at every stage, from ordering to production to packing and administration.

Medication errors should now be less common as a result of the advancements made in the healthcare industry, yet there are still issues to be resolved. Errors with medications are entirely avoidable. Patient’s well-being and the safety of their medications must be at the forefront of our minds as medical professionals.

References

Arkin, L., Schuermann, A., Penoyer, D., & Loerzel, V. (2022). Exploring nurses’ attitudes, skills, and beliefs of medication safety practices. Journal of Nursing Care Quality, 37(4), 319-326. 
https://doi.org/10.1097/ncq.0000000000000635

Bucknall, T., Fossum, M., Hutchinson, A. M., Botti, M., Considine, J., Dunning, T., Hughes, L., Weir‐Phyland, J., Digby, R., & Manias, E. (2019). Nurses’ decision‐making, practices and perceptions of patient involvement in medication administration in an acute hospital setting. Journal of Advanced Nursing, 75(6), 1316-1327. 
https://doi.org/10.1111/jan.13963

Hanson, A., & Haddad, L. M. (2021). Nursing Rights of Medication Administration. In 
StatPearls [Internet]
. StatPearls Publishing. 
https://www.ncbi.nlm.nih.gov/books/NBK560654/

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(1). 
https://doi.org/10.1186/s12912-020-0397-0

 

NHS-FPX4000 Assessment 2 Instructions: Applying Research Skills Instructions 

Assessment 2 Instructions: Applying Research Skills

Create a 2-4 page annotated bibliography and summary based on your research related to best practices addressing one of the health care problems or issues in the Assessment Topic Areas media piece faced by a health care organization that is of interest to you.

Introduction

In your professional life, you will need to find credible evidence to support your decisions and your plans of action. You will want to keep abreast of best practices to help your organization adapt to the ever-changing health care environment. Being adept at research will help you find the information you need. For this assessment, you will review the Assessment Topic Areas media piece and select one of the health care problems or issues to research, which will be a current health care problem or issue faced by a health care organization that is of interest to you.

Instructions

Note: The requirements outlined below correspond to the grading criteria in the scoring guide. At a minimum, be sure to address each point. In addition, you are encouraged to review the performance-level descriptions for each criterion to see how your work will be assessed.

For this NHS-FPX4000 Assessment 2 Instructions: Applying Research Skills assessment, research best practices related to a current health care problem. Your selected problem or issue will be utilized again in Assessment 4. To explore your chosen topic, you should use the first two steps of the Socratic Problem-Solving Approach to aid your critical thinking.

View the Assessment Topic Areas media piece and select one of the health care problems or issues in the media piece to research. Write a brief overview of the selected topic. In your overview:

Summarize the health care problem or issue.

Describe your interest in the topic.

Describe any professional experience you have with this topic.

Identify peer-reviewed articles relevant to health care issue or problem.

Conduct a search for scholarly or academic peer-reviewed literature related to the topic and describe the criteria you used to search for articles, including the names of the databases you used. You will select four current scholarly or academic peer-reviewed journal articles published during the past 3–5 years that relate to your topic.

Refer to the NHS-FPX4000: Developing a Health Care Perspective Library Guide to help you locate appropriate references.

Use keywords related to the health care problem or issue you are researching to select relevant articles.

Assess the credibility and explain relevance of the information sources you find.

Determine if the source is from an academic peer-reviewed journal.

Determine if the publication is current.

Determine if information in the academic peer-reviewed journal article is still relevant.

Analyze academic peer-reviewed journal articles using the annotated bibliography organizational format. Provide rationale for inclusion of each selected article. The purpose of an annotated bibliography is to document a list of references along with key information about each one. The detail about the reference is the annotation. Developing this annotated bibliography will create a foundation of knowledge about the selected topic. In your annotated bibliography:

Identify the purpose of the article.

Summarize the information.

Provide rationale for inclusion of each article
NHS-FPX4000 Assessment
2 Instructions: Applying Research Skills.

Include the conclusions and findings of the article.

Write your annotated bibliography in a paragraph form. The annotated bibliography should be approximately 150 words (1–3 paragraphs) in length.

List the full reference for the source in APA format (author, date, title, publisher, et cetera) and use APA format for the annotated bibliography.

Make sure the references are listed in alphabetical order, are double-spaced, and use hanging indents.

Summarize what you have learned from developing an annotated bibliography.

Summarize what you learned from your research in a separate paragraph or two at the end of the paper.

List the main points you learned from your research.

Summarize the main contributions of the sources you chose and how they enhanced your knowledge about the topic.

Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:

 

Assessment 2 Example [PDF].

Additional Requirements

Your assessment should also meet the following requirements:

Length: 2–4 typed, double-spaced pages, not including the title page and reference page.

Font and font size: Times New Roman, 12 point.

APA tutorial: Use the APA Style Paper Tutorial [DOCX] for guidance.

Written communication: Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.

Content: Provide a title page and reference page following APA style.

References: Use at least four scholarly or academic peer-reviewed journal articles.

APA format: Follow current APA guidelines for in-text citation of outside sources in the body of your paper and also on the reference page.

Competencies Measured

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

 

Competency 2: Apply scholarly information through critical thinking to solve problems in the field of health care.

Assess the credibility and relevance of information sources.

Analyze academic peer-reviewed journal articles using the annotated bibliography organizational format.

Summarize what was learned from developing an annotated bibliography.

Competency 4: Write for a specific audience, in appropriate tone and style, in accordance with Capella’s writing standards.

Apply academic peer reviewed journal articles relevant to the health care problem or issue being researched.

Produce text with minimal grammatical, usage, spelling, and mechanical errors.

Integrate into text appropriate use of scholarly sources, evidence, and citation style.

NHS-FPX4000 Assessment 2 Instructions: Applying Research Skills

NURS FPX 4020 Assessment 2 Root Cause Analysis

School of Nursing and Health Sciences, Capella University

NURS FPX4020: Improving Quality of Care and Patient Safety

Root-Cause Analysis and Safety Improvement Plan

Medical error can be termed unfortunate but a reality that continues to occur in healthcare settings and at high rates in different nations. These medication-related mistakes or errors can result in unwanted and unimaginable consequences to the patient, family, clinicians, and healthcare organization (Rahmayanti et al., 2020). Today, care quality and patient safety have become critical indicators of an all-around effective healthcare system, practices, and professionals. Compromise on safety can result in unwanted feedback and patient experience. Efforts to improve the healthcare experience and address diverse issues affecting effective care delivery have fueled research to continue being conducted on the best way to address the identified problem and improve the overall functionality of the healthcare sector and system.

In the case of medication-related issues or errors, applying a root cause analysis can provide a beneficial remedy for clinicians and patients to further understand, combat, and improve on medical errors to address the problem at hand and prevent future occurrences. While sometimes it may be challenging to identify the root cause of an error, relevant players must evaluate strategies to mitigate such a problem in the future and the adverse effects that may be experienced. According to Mills (2016), the Joint Commission in the US demands hospitals and other care facilities occasionally undertake an analysis of sentinel events. The Root Cause Analysis (RCA) application provides a technique that helps care providers identify the causes of an issue. At the same time, it allows the development of a mitigation procedure for the identified problem. Using an RCA helps healthcare organizations regarding medication errors understand the error while helping mitigate the occurrence which compromises patient safety. This paper provides a detailed case analysis while adopting the Root-Cause analysis model to identify and establish a solution to the identified medication-related error based on a provided case scenario.

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Case scenario for Root Cause Analysis Application

A middle-aged man was admitted to the medical service of a teaching hospital with suspected vasculitis. When the initial diagnostic studies failed to provide a definitive diagnosis, the team decided to treat the patient empirically with high-dose steroids. When discussing the patient on morning rounds, the senior resident instructed the intern quite clearly to “give the patient one gram of steroids.” After rounds (and some quick math), the intern ordered:

“Prednisone 20 mg tabs 50 pills PO x 1 now”

After receiving the written order, the pharmacist contacted the intern to clarify the order. She suggested to the intern that the one gram of steroids probably was supposed to be given in an intravenous form. The busy and harried intern stated firmly that he wished to give the patient fifty 20-mg pills. When the pharmacist persisted in questioning the order and gently suggested the intern may want to contact his senior resident for clarification, the intern refused and replied, “You can give it with a tablespoon of Maalox.” The patient was brought fifty 20-mg pills of prednisone and became angry and frustrated as he swallowed pill after pill. He developed mild nausea and heartburn while taking the prednisone. The following day, upon review of the medication record, the senior resident found the error. The oral prednisone was stopped, and the patient was correctly given a gram of intravenous methylprednisolone (Solu-Medrol). He eventually recovered from his vasculitis and was discharged in stable condition NURS FPX 4020 Assessment 2 Root Cause Analysis.

Analysis of the Root Cause

The primary incident entailed a wrong prescription administered to a patient (a middle-aged man), miscommunication between the care providers, non-adherence to implemented protocols, and lack of counter-checking as per the protocols. The incident also entailed poor implementation of safety measures. The error or medication issue identified in the case provided can be attributed to a host of intertwined factors, and one after the other resulted in the entire case unfolding. The attending senior resident noted the prescription and administration error after of prednisone error after the patient started experiencing nausea and heartburn after taking the pills.

To commence with, the on-duty physician questioned the patient prescription, which the nurse intern had presented, and even asked the intern to consult with the senior resident, but the intern insisted on the prescription he had ordered. The process resulted in the intern giving the wrong medication and dosage, which caused heartburn and nausea to the patient. Verbal communication for medications poses a threat and is a possible cause of misinformation and medication error. On another note, there lacked a defined hospital protocol regarding how prescriptions should be communicated. Despite being an emergency, it was justified not to overlook the protocol if it was present, hence a factor aggravating the error. Equally, there was negligence in hospitals’ safety measures in the prescription preparation room where the drug chart for how prescriptions should be done and who should do it. The physician should have contacted the senior resident instead of trusting the intern with such critical medical administration. Finally, although the facility may have a well-described protocol for handling emergency and high-risk medication, the on-duty intern had poor adherence to adopting and implementing safety measures and had also poor communication skills as he should have listened to the physician and contacted the senior resident before administration of the pills. Miscommunication and lack of counter-checkers also expanded the mistake. Nevertheless, after the issue was identified the following morning, there was a swift reaction to save the patient, where the senior resident ordered a gram of intravenous methylprednisolone (Solu-Medrol), and the patient later recovered and was discharged in stable condition. Finally, regarding the provided case, miscommunication, lack of cooperation between the physician and the intern, and non-adherence to safety protocols can be identified as the primary root causes of the medication administration error.

Application of the Evidence-Based Strategies

As identified, medication-related errors have been a significant concern in the healthcare industry, with their occurrence reducing safety and care quality (Mutair et al., 2021). Nevertheless, over the years, diverse research has been undertaken establishing different measures to help lower medication-related errors. Evidence-based practices not only mean addressing the identified error but also providing a lasting solution, improved safety, and patient experience. Based on the discussed case, diverse EBP practices could be adopted to address the factors resulting from the medication error. One critical measure is formulating and using communication protocols within the emergency unit and the entire healthcare delivery team. According to Tariq et al. (2018), communication deficit is a critical factor for errors in healthcare settings. However, adopting communication protocols would be vital in verbal communication. Standardized communication protocols within a healthcare team and facility help to define the flow of information, passing, and sharing of accurate information regarding patient information and medications.

Poor implementation and non-adherence to safety and related protocols within the healthcare setting can be significant barriers to effective care delivery and patient management (Mutair et al., 2021). When the recommendations are put into practice, policy actions must be taken to inform and educate the providers on how to incorporate them into a routine; resources must be made available to facilitate the adoption of the practice, and surveillance and monitoring protocols must be put in place to improve adherence (Tariq et al., 2018). Policies on how to handle non-adherence are also crucial. For instance, the current pharmaceutical error resulted from poor communication and non-adherence to safety protocols by both the physician and the intern. Adherence to the safety protocols can be facilitated by ensuring that staff members have easy access to critical updates and protocol revisions. On top of that, sloppy protocol monitoring led to errors. The attending nurse intern willfully disregarded the physician’s advice for him to contact the senior nurse NURS FPX 4020 Assessment 2 Root Cause Analysis.

Regarding a middle-aged man with suspected vasculitis, proper adherence to quality and safety protocols would be a critical foundation to minimize medication errors, and the incident could have been prevented. While the lack of adequate knowledge by the intern regarding medication could be a factor behind the mistake, healthcare organizations must adopt teamwork and regular training for nurses and other care providers to update them on new care practices (Mutair et al., 2021). Nurses are typically involved in drug delivery as direct caregivers and care coordinators in multidisciplinary care teams. They must be warned about dangerous drugs that need to be administered with special care. Development and adoption of safety ad protocols in a daily healthcare setting provide a foundation for an integrated and effective organizational culture driven by demand for excellence, hence improved safety, coordination, and quality care.

Improvement Plan with Evidence-Based and Best-Practice Strategies

The increasing focus on patient experience, quality care, and safety has led to the constant adoption of quality improvement measures. According to Treiber & Jones (2018), quality improvement entails facilitating improvement in terms of the performance of healthcare operations and facilities and simultaneously improving the overall quality of health services. Regarding the discussed case, quality improvement would result in minimized medication errors by addressing the root causes. The practices to improve quality would target to address or improve the identified factors behind the medication error. Based on the specified case, quality improvement measures would focus on improved communication between physicians and nurses. There would be a need to adopt and implement a standard transmission, that is, written or electronically generated prescription, ensuring nurses have a reference for easy preparation and error identification.

Additionally, to improve the organization protocols for drug administration, there will be a need to develop new policies. Treiber & Jones (2018) identified that the presence and availability of information in healthcare settings increase care providers’ ability to accord effective care as planned, reducing errors caused by forgetting or mix-up. Additionally, the healthcare facility. Increased visualization creates an easy source of reference for nurses. While the actions will be focused on addressing any future medication error occurrence, the scenario provides a learning experience for the organization. The quality improvement practices would also serve as patient outcome improvement practices, achieve efficiency in care delivery, and reduce the cost of care due to medical errors.

Existing Organizational Resources

A multidisciplinary care team of doctors, nurses, and nurse informaticists is one of the organizational tools that will aid in improving the plan’s execution and results. In addition, the computers in the facility library will be crucial for supplying information to the caregivers on the current protocol. Financial resources will aid in the funding of research investigations that will help in the development of instructional programs on recently developed medicines NURS FPX 4020 Assessment 2 Root Cause Analysis. The currently available surveillance tools will ensure that the new protocols are followed.

In conclusion, medication-related errors are a major concern in healthcare sectors. With diverse adverse effects, organizations must develop effective evidence-based practices to avert the crisis resulting from medication-related errors. But identifying the issue’s root causes is the first step in solving it. This aids in creating a focused strategy to address the problem.

 

 

References

Mills, E. (2016). The WakeWings journey: Creating a patient safety program. AORN Journal, 103(6), 636“639.

Mutair, A. A., Alhumaid, S., Shamsan, A., Zaidi, A. R. Z., Mohaini, M. A., Al Mutairi, A., Rabaan, A. A., Awad, M., & Al-Omari, A. (2021). The effective strategies to avoid medication errors and improve reporting systems.
Medicines
,
8
(9), 46.
https://doi.org/10.3390/medicines8090046

Rahmayanti, E. I., Kadar, K. S., & Saleh, A. (2020). Readiness, barriers and potential strength of nursing in implementing evidence-based practice. International Journal of Caring Sciences, 13(2), 1203-1211.

Tariq, R. A., Vashisht, R., Sinha, A., & Scherbak, Y. (2018). Medication dispensing errors and prevention. 
https://europepmc.org/article/NBK/nbk519065

Treiber, L. A., & Jones, J. H. (2018). After the medication error: Recent nursing graduates’ reflections on the adequacy of education. 
Journal of Nursing Education
, 
57
(5), 275-280.
https://doi.org/10.3928/01484834-20180420-04

 

 

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

For this assessment, you can use a supplied template to conduct a root-cause analysis. The completed assessment will be a scholarly paper focusing on a quality or safety issue pertaining to medication administration in a health care setting of your choice as well as a safety improvement plan.

As patient safety concerns continue to be addressed in the health care settings, nurses can play an active role in implementing safety improvement measures and plans. Often root-cause analyses are conducted and safety improvement plans are created to address sentinel or adverse events such as medication errors, patient falls, wrong-site surgery events, and hospital-acquired infections. Performing a root-cause analysis offers a systematic approach for identifying causes of problems, including process and system-check failures. Once the causes of failures have been determined, a safety improvement plan can be developed to prevent recurrences. The baccalaureate nurse’s role as a leader is to create safety improvement plans as well as disseminate vital information to staff nurses and other health care professionals to protect patients and improve outcomes.

As you prepare for this assessment, it would be an excellent choice to complete the Quality and Safety Improvement Plan Knowledge Base activity and to review the various assessment resources, all of which will help you build your knowledge of key concepts and terms related to quality and safety improvement. The terms and concepts will be helpful as you prepare your Root-Cause Analysis and Safety Improvement Plan. Activities are not graded and demonstrate 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.

Apply evidence-based and best-practice strategies to address a safety issue or sentinel event pertaining to medication administration. ;

Create a viable, evidence-based safety improvement plan for safe medication administration. NURS FPX 4020 Assessment 2 Root Cause Analysis

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

Analyze the root cause of a patient safety issue or a specific sentinel event pertaining to medication administration in an organization.

Competency 3: Identify organizational interventions to promote patient safety.

Identify existing organizational resources that could be leveraged to improve a safety improvement plan for safe medication administration.

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

Communicate in writing that is clear, logical, and professional, with correct grammar and spelling, using current APA style.

Professional Context

Nursing practice is governed by health care policies and procedures as well as state and national regulations developed to prevent problems. It is critical for nurses to participate in gathering and analyzing data to determine causes of patient safety issues, in solving problems, and in implementing quality improvements.

Scenario

For this assessment, you may choose from the following options as the subject of a root-cause analysis and safety improvement plan:

The specific safety concern identified in your previous assessment pertaining to medication administration safety concerns.

The readings, case studies, or a personal experience in which a sentinel event occurred surrounding an issue or concern with medication administration.

Instructions

The purpose of this assessment is to demonstrate your understanding of and ability to analyze a root cause of a specific safety concern in a health care setting. You will create a plan to improve the safety of patients related to the concern of medication administration safety based on the results of your analysis, using the literature and professional best practices as well as the existing resources at your chosen health care setting to provide a rationale for your plan.

Use the 
Root-Cause Analysis and Improvement Plan [DOCX]
 template to help you to stay organized and concise. This will guide you step-by-step through the root cause analysis process.

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.

Analyze the root cause of a patient safety issue or a specific sentinel event pertaining to medication administration in an organization.

Apply evidence-based and best-practice strategies to address the safety issue or sentinel event pertaining to medication administration.

Create a feasible, evidence-based safety improvement plan for safe medication administration.

Identify organizational resources that could be leveraged to improve your plan for safe medication administration.

Communicate in writing that is clear, logical, and professional, with correct grammar and spelling, using current APA style.

Example Assessment: You may use the following 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 Assessment 2 will focus on safe medication administration.

Assessment 2 Example [PDF]
.

Additional Requirements

Length of submission: Use the provided Root-Cause Analysis and Improvement Plan template to create a 4–6 page root cause analysis and safety improvement plan pertaining to medication administration.

Number of references: Cite a minimum of 3 sources of scholarly or professional evidence that support your findings and considerations. Resources should be no more than 5 years old.

APA formatting: Format references and citations according to current APA style.

NURS FPX 4020 Assessment 2 Root Cause Analysis

 

NURS FPX 4020 Assessment 2 Root Cause Analysis One Dose, Fifty Pills (AHRQ) 
Case Study from 
AHRQ WebM&M

https://www.ihi.org/education/IHIOpenSchool/resources/Pages/Activities/AHRQCaseStudyOneDoseFiftyPills.aspx

 

Learning Objectives:
 At the end of this activity, you will be able to:

Identify the risks involved with improper supervision in a health care setting.

Discuss the importance of “speaking up” within a health care setting.

Explain how poor communication among health care providers can lead to negative experiences for patients.

Description: 
Told to give a patient one gram of steroids, an intern mistakenly orders fifty 20-mg pills. Although a pharmacist questions the order, the intern insists that the medication be given as ordered.

The Case

 

A middle-aged man was admitted to the medical service of a teaching hospital with suspected vasculitis. When the initial diagnostic studies failed to provide a definitive diagnosis, the team decided to treat the patient empirically with high-dose steroids.

 

When discussing the patient on morning rounds, the senior resident instructed the intern quite clearly to “give the patient one gram of steroids.” After rounds (and some quick math), the intern ordered:

 

“Prednisone 20 mg tabs 50 pills PO x 1 now”

 

After receiving the written order, the pharmacist contacted the intern to clarify the order. She suggested to the intern that the one gram of steroids probably was supposed to be given in an intravenous form. The busy and harried intern stated firmly that he wished to give the patient fifty 20-mg pills. When the pharmacist persisted in questioning the order and gently suggested the intern may want to contact his senior resident for clarification, the intern refused and replied, “You can give it with a tablespoon of Maalox.”

 

The patient was brought fifty 20-mg pills of prednisone and became angry and frustrated as he swallowed pill after pill. He developed mild nausea and heartburn while taking the prednisone.

 

The following day, upon review of the medication record, the senior resident found the error. The oral prednisone was stopped, and the patient was correctly given a gram of intravenous methylprednisolone (Solu-Medrol). He eventually recovered from his vasculitis and was discharged in a stable condition.

The Commentary

Lawrence Smith, MD,  Chief Academic Officer, Senior Vice-President for Academic Affairs, North Shore-Long Island Jewish Health System

 

This case could easily be characterized as simply a humorous event associated with residency training. One can envision this story being retold with much laughter in the hospital cafeteria because of the seeming lack of common sense it demonstrates (and, of course, because the patient experienced minimal harm). However, it also may be a cautionary glimpse into the tenuous balance between residency training and patient safety.

 

Inherent in care in a teaching hospital is the fact that interns and residents, often the immediate caregivers to patients, are less experienced, less expert, less efficient, and perhaps more prone to medical errors. Despite this seeming risk, comparative studies actually report better quality of care for most conditions at teaching hospitals, albeit at higher cost.(1-3) The etiology of the advantage is unclear but may be secondary to better access to specialized services, better adherence to evidence-based medicine, or improved physician availability.

 

Notwithstanding these potential virtues, this case demonstrates that residents often have gaps in knowledge and experience that may place patients at risk. Such gaps can be overcome with both supervision and clinical maturation (after all, that is what residency is for). Since the latter accrues only over time, supervision is critical, particularly during early training. Against that background, this troubling case exposes how the unique culture of residency education, as well as the long-standing tradition of resident autonomy, are often at odds with patient safety.

 

Let’s look closer at the culture that allows an intern, clearly unsure of the specifics of a therapeutic intervention for an uncommon disease, to forge ahead despite his lack of knowledge and a warning from another trained professional that his decision might be in error. Highly relevant to this case is the “hidden curriculum” in medical education.(4) This term refers to the set of influences functioning at the level of organizational structure and culture, including, for example, implicit rules that permit trainees to survive the institution. These rules often take the form of customs and rituals, and they are usually taken for granted by virtually everyone. Within residencies, the hidden curriculum is one of intense loyalty to team, coupled with enormous respect for hierarchy and for specific roles within that team. Further, needing and requesting help from colleagues is often seen as failure. It is unclear whether the intern in this case feared humiliation if he requested help. However, it would not be surprising if such a fear was responsible, at least in part, for his failure to seek assistance even after it was recommended. Unfortunately, pride and shame can take precedence over patient safety.

 

Many residency programs also have a culture of devaluing input from non-physician professionals. Whereas experienced physicians might well have heeded the warning of the pharmacist or taken the advice of experienced nurses, young physicians in training, probably due to their own insecurity and their intense dependence on the resident team as the center of their professional life, may find it extremely difficult to take advice from non-physicians. In addition, housestaff in teaching hospitals are often paged or called by non-physician professionals, especially from the nursing staff, about non-urgent issues—those related to minor deviations from “hospital usual practice,” discharging a “legal obligation” to report minor patient issues to a physician, or focused on reducing “unnecessary” nurse/aide/phlebotomist workload during the day. It may be difficult for house officers to separate trivial queries from serious ones, and they may struggle with the “cry wolf” phenomenon. In our program, having a senior nurse and chief resident occasionally monitor “calls” has improved the quality of nurse-resident communication.

 

Let us now turn to the issue of autonomy. How can an intern believe that he shouldn’t call his senior resident or attending when a pharmacist, whose primary role in the hospital is to reduce medication errors, questions the medication order? Autonomy and physician (not just housestaff) independence have long histories in western medicine.(5,6) Physicians have consistently prized autonomy in clinical decision-making NURS FPX 4020 Assessment 2 Root Cause Analysis. There is no question that autonomy within those areas that require clinical experience and judgment (often referred to as “the art of medicine”) should be valued in our medical system. This would include the sorting of patient data, interpretation and weighting of the data, framing the clinical issues in the context of the individual patient, and making decisions in the face of uncertainty. However, if physicians are not following evidence-based medicine or, moreover, are harming patients as they exercise their independence, the autonomy should be curtailed in the name of safety and quality.

 

In resident education, supervision and monitoring of the quality of care can be accomplished by two primary mechanisms: system-based oversight and direct attending supervision. Specific system-based interventions that have been effective include computerized physician order entry (7), clinical decision-support systems (8), and having clinical pharmacists round with teams in the ICU.(9) Implementation of system-based oversight must be balanced with the need to promote education and a sense of autonomy for the housestaff. That is, computerized orders and decision support must be user-friendly and not simply viewed as a “hassle” by busy residents, nor be so prescriptive that residents never learn to think on their feet. Moreover, any system-based oversight must be educational; for example, when an intern is directed not to give warfarin with Dilantin, he or she should have easy access to a link that outlines the drug interaction.

 

Beyond system-based interventions, what is the right amount of attending supervision of residents? In considering this question, it is important to recognize that it is essential that physicians in training feel absolutely responsible for their patients. That element of emotional learning (10) is critical to physician development. If attending physicians are “micromanaging,” or if system-based changes severely limit resident decision making, new physicians may not learn to accept ultimate responsibility for patient care or function quickly and decisively in the midst of clinical uncertainty.

 

To meet these goals, the skilled supervisor provides what I call “close supervision from afar.” The attending should know everything that happens to the patient and collect enough of the primary data to be sure of its accuracy yet remain in the background unless absolutely necessary. That way, the learners feel complete personal responsibility for their patients. The degree of close supervision must be based on an assessment of the skills, knowledge, and clinical maturity of the specific learners and cannot be generalized to one-size-fits-all. It is critical that the attending not correct differences in style or legitimate alternative approaches to a patient but, rather, reserve corrective interventions to true clinical errors. Differences in approach should be discussed with trainees as colleagues, not mandated from the “top.”

 

Under the real-world pressures of increasingly stringent billing and compliance regulations and the moral imperative for patient safety, the days of “resident-run” services with minimal oversight are coming to a close. Teaching hospitals should actively strive to strike a balance between preserving the housestaff autonomy needed for educational development and the need for patient safety. How can this be accomplished? First, attempts should be made to change the hidden curriculum of resident education, striving to create an environment where young physicians are comfortable asking for help and willing to recognize and respond to the expertise of all members of the care team. Toward this end, some specific cultural training, such as that found in crew resource management programs, might be valuable. Second, system-based interventions can preserve patient safety and educate housestaff while hopefully preserving a sense of physician autonomy. In a different culture and system, the error in this case may have been avoided—the intern would have respected the pharmacist’s expertise or called for help when there was a question about the order. Or maybe the computer would have balked at the order for fifty 20-mg pills and redirected the intern NURS FPX 4020 Assessment 2 Root Cause Analysis.

 

The answer to this seeming conflict of autonomy versus patient safety is in creating a culture where everyone looks critically at clinical outcomes, focuses on best patient care, and actively addresses the priorities of clinical autonomy, clinical judgments, and evidence-based medicine. We need an environment in which young physicians are comfortable asking for help, are willing to recognize and respond to the expertise of all members of the care team, and see patient safety systems as supporting their goals of providing better patient care—not as hassles in an already over-loaded workday. Ultimately, the goal must be to create a culture that allows physicians to comfortably ask for help when they are beyond their area of competence while preserving the intense personal sense of commitment and responsibility for the quality of care of their patients.

 

 

Take-Home Points

Striking the appropriate balance between autonomy and supervision represents one of the greatest challenges of physician education.

Many training programs have a “hidden curriculum” that overvalues autonomy and loyalty to the team and underappreciates the input of non-physician professionals.

The effective supervising physician provides “close supervision from afar.”

As we improve both human and systems-based supervision (ie, through computerized order entry), it will be vital to retain trainees’ personal sense of responsibility for their patients NURS FPX 4020 Assessment 2 Root Cause Analysis

NURS-FPX4035 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 to understand or implement to ensure the success of the plan.

Introduction

Communication in the healthcare environment consists of an information-sharing experience whether through oral or written messages (Chard & Makary, 2015). As healthcare 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 healthcare wellness at local and global levels (Kaminski, 2016).

ORDER A HUMAN-WRITTEN PAPER HERE

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 NURS-FPX4035 Assessment 4 Improvement Plan Tool Kit. The activity is for your own practice and self-assessment, and demonstrates course engagement.

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.

 

Overview

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 education 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.

For this assessment, 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 a specific patient safety issue and 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 Google Docs login, or create an account following the directions under the “Create Account” menu. Visit 
Wiki Resources
 for help.

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 three or four most critical categories or themes with respect to your safety improvement initiative. For example, if your initiative 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 at least three resources on average for each of the four categories. ;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.

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 in the Wiki Resources above for more information.

Here is an example entry:

Ko, S., Hsieh, M., & Huang, R. (2023). Human error analysis and modeling of medication-related adverse events in Taiwan using the human factors analysis and classification system regression. 
Healthcare, 11
(14), 2063. https://doi.org/10.3390/healthcare11142063

Nurses have a crucial responsibility in preventing medication errors. They should follow the “five rights of medication” to reduce the risk of such errors. These include the “right patient,” “right medication,” “right time,” “right dose,” and “right documentation.” By understanding these rights, nurses can manage medication administration effectively and ensure patient safety NURS-FPX4035 Assessment 4 Improvement Plan Tool Kit.

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

Identify necessary resources to support the implementation and sustainability of a safety improvement initiative.

Analyze the usefulness of resources to the role group responsible for implementing quality and safety improvements.

Analyze the value of resources to reduce patient safety risk.

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

Communicate resource tool kit in a Word document or Google Sites in a clear, logically structured, and professional manner that partially follows 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 the quality issue you selected in Assessment 1
. 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]
.

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 found in 
Assessment 4: Improved Heparin Infusion Safety
 to give you an idea of what a Proficient or higher rating on the rubric would look like for this assessment but 
keep in mind that your tool kit will focus on promoting safety with the quality issue you selected in Assessment 1
.

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

Additional Requirements

Number of resources: 
Your tool kit must include at least 12 professional or academically relevant resources that support the continued learning and implementation of knowledge and processes related to a safety improvement initiative. See the 
BSN Nursing Program Library Guide
 as needed.

APA format: 
Use proper APA formatting for in-text citations and each annotated resource. See the 
APA Module
.

Competencies Measured

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

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

Analyze the usefulness of resources to the role group responsible for implementing quality and safety improvements.

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

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

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

Competency 3: Identify organizational interventions to promote patient safety.

Identify necessary resources to support the implementation and continued sustainability of a safety improvement initiative pertaining to a specific patient safety issue.

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

Communicate resource tool kit in a Word document or Google Sites in a clear, logically structured, and professional manner that partially follows APA style and formatting NURS-FPX4035 Assessment 4 Improvement Plan Tool Kit

Determining the Relevance and Usefulness of Resources

For the following questions, read each brief scenario and write short answer responses addressing what information or sources of evidence would be most relevant and helpful.

Question
1
of
3

You are looking for strategies to educate a client who is prescribed dialysis three times a week regarding the importance of keeping their appointments. What resource(s) would likely provide relevant and useful information to help create a teaching strategy for the client and why?

Enter your response

 

Feedback

There is no one correct answer. One potential answer is: The Quality and Safety Education for Nurses (QSEN) Institute could be a good place to start. The QSEN website has an entire section devoted to teaching strategies, which are evidence-based. QSEN itself is a leading organization for supporting health care professionals to be able to contribute to continuous improvement in quality and safety within their practice and organizations.

Question
2
of
3

You are assisting in a research study. One of the study leads has asked you to calculate the risk-benefit ratio to verify that the study posed no harmful effects to the clients surveyed. What resource(s) would likely provide useful information on calculating the risk-benefit ratio and why? Additionally, where might you look if you needed to understand the principle of beneficence and why?

Enter your response

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There is no one correct answer. Potential answers include: For calculating the risk-benefit ration, the Health and Human Services Office of Research Integrity. This government website has guidelines, standards, regulations, and educational materials related to designing and carrying out ethical research, especially with regards to human subjects.

For better understanding the concept of beneficence, a generalized resource like the Sage Research Methods encyclopedia would be appropriate. This would provide a scholarly definition and example of beneficence. If a more detailed understanding was still needed, further resources could be explored, but this would be a good baseline to start from.

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You are working with a client to help them reestablish positive adaptation to their environment. What
resource(s) would likely provide
relevant and useful information to help you work with this client and why?

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There is no one correct answer. One potential answer is: Taking a theory-based approach could be appropriate in this situating. King’s Theory of Nursing is an example of an appropriate theory. Since King’s Theory is focused on goal attainment, it would be appropriate to apply to this situation where there is a goal for the patient. Determining the Relevance and Usefulness of Resources