Accredidation Standards

This was a great unit to end on, as it is the material that we are covering for our Group Project.  We are looking at never events, and this helped to put me in the right mindset for the project.  I was wanting to be able to learn more about never events and sentinel events, and to learn what the difference.  I also was interested to learn more about National Patient Safety Goals (NPSG) and how they play a role in patient safety.  It was good to see how big a role the NPSGs play in helping to safeguard our patients. 

The activities were very good at helping to see the importance of patient safety and how I would do things for my patients.  Many of us in the discussion chose to look at the basics of patient safety in looking at the NPSG that we would choose to begin in our unit if we were looking at the basics.  The critical thinking was another way that we provide the best care to our patients.  The HCAHPS are a way that we are viewed by our patients.  When I attempted to get the best scores, judged by myself, it was actually pretty hard to do.  I will have to look at the way that I do things and make sure that I am providing the best care possible.  It is a bit disheartening to know that the hospital only gets reimbursed for the top choices and not at least a little bit for the others.  It is nearly impossible to quell expectations, but it is a task that I look forward to undertaking.  This was a great unit that helped me to see the way that patient safety can be managed and how never events and sentinel events play a role in the way that we care for our patients and watch over them. 

Patient Safety Application

I think that I was expecting to learn more about patient safety stands and the uses of health care services.  I also wanted to learn more about the ways to reduce variation in providing health care in a safe manner, with patient safety at the helm.  I feel that I have learned quite a bit about the role that patients play in health care and continue to feel that their role gets dismissed a bit by some and it needs to be reinforced instead of crushing it.  I learned that transparency helps to reduce lawsuits instead of creating them as many still believe. 

The discussion was a really good one about the ways that we can help to protect our patients.  It brought about a real life situation and looked at ways that we would handle it.  When it comes to our patient’s safety, there should be any egos or barriers put up by us.  We should be transparent and acknowledge when we have made a mistake.  Like the Case Study that we looked at, we need to realize that not all of our patients are looking to sue or get something more than the truth from us.  We need to be careful of our licenses, but not assume that there is always someone at every turn that wants to try to take it from us.  At the core, people are mostly just scared and just want to be properly cared for. 

Reading over the information from this unit, I really took a look in the mirror to see how I am doing things in my own practice and to evaluate the care that I am providing.  I will make a conscious effort to always put my patients first and to make sure that they know that I am willing to go to bat for them and to always keep them informed.  I love learning more about safety and quality and want to strive to always provide the highest quality care to all of my patients. 

Quality Improvement Strategies IV

I think that I was expecting to learn more about quality improvement strategies and how they apply specifically to the patient and their role in improving quality.  I wanted to learn more about ways to engage the patient and ways that they help to improve quality.  Last week we learned about HCAHPS and I wanted to see how that would play a role in the quality improvement strategies of the hospital.  I learned quite a bit about the role that the patient plays in quality and have learned that their role is much bigger than I expected, but I am glad to see that the hospitals and other health care units are looking to see what the patient wants and expects instead of telling the patient what they need and should expect.

The discussion was a really good one on the types of indicators and benchmarks that could be used in a OR setting.  This was a real world problem that could exist or possibly does in certain situations.  I also really liked the Case Study and Critical thinking assignments.  They helped to see how I would react in certain situations that probably occur on a regular basis.  As more and more money is being regulated by the quality of care instead of the quantity of care, which is where the importance should lie, the quality of care will continue to improve and it is up to each employee to push the safety and quality envelope forward.

As I am a member of my hospital's "Patient Care Council" specifically in the safety and quality council, I am able to take what I am learning in these lessons to them and help to push forward on certain things that need to be changed in the hospital.  Also, I am an instructor for the new zero harm initiative that the hospital is pushing out with called "Safety First."  I really enjoy learning more about the ways that quality and safety are used in health care.

Quality Improvement Strategies III

I think that I was expecting to learn more about quality improvement strategies and how they apply specifically to patient satisfaction within a hospital.  I wanted to learn more about how patient satisfaction is measured and what Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) are and how they affect the overall quality of a hospital.  Also, I wanted to be able to differentiate between internal and external customers.  I was able to learn more about all of these topics.  I knew some things about the HCAHPS and patient satisfaction, but I have definitely improvement my knowledge in regards to these topics.

I really liked the discussion this week about evidence based practice or EBP.  This was a very thought provoking discussion about how as a new nurse we can impact and bring about change to an organization especially when we know that it is the best practice.  I also liked the thought stimulating case study this week about quality and patient satisfaction as it relates to a real life situation with the MRI safety.

I think that I have come to a new way to view things that I do day in and day out.  By looking for ways to continuously improve with CQI, the "small" things that I do everyday will become more evident about whether or not it is something that needs to be corrected or improved upon.  This was a great topic  that I will for sure use in the future, whether or not I go into management.  

Quality Improvement Strategies II

This week, I expected to learn more about using data as a means of being able to measure quality.  I also was wanting to learn more about the variation that exists within measuring quality and the data that exists and how to differentiate between common cause variation and special cause variation.  Lastly, I was expecting to learn about the tools that are used by quality improvement teams.  

I have come to find that there are a number of ways to actually do quality improvement strategies that gets to actual improvement in quality.  There are, and will always be, pros and cons to the types of strategies that are implemented and you just have to choose the best option for the specific situation and the specific entity that is trying to implement it, whether that is a specific industry, such as healthcare, or a specific hospital within healthcare.  

The discussion was a good way to look at the types of quality improvement strategies as we look at specifically helping patients and in particular a burn patient.  I like the critical thinking that took place to be able to not only know the types of things that go into the disease process or care for a burn patient, but also the ways that quality improvement strategies can be implemented for this patient and others.  I also liked looking at the critical thinking and case study assignments.  A fall is something that each and every nurse will have to deal with at some point or another while working at the hospital.  Hopefully, it isn't often, but it is nearly impossible to get away from it completely.  The case study was a real world situation that can be applied to myself and others and look at how I would really attempt to make a change in my working environment.  

This information is very important to me as a new nurse.  I am always looking for ways to move forward within nursing and to help the company that I am working for to find things that help to advance not only my company but also the role of nursing.  I am always looking for ways to move up in a company or structure and so having this as information for better quality will greatly influence me in this end. 

This class has really helped me to open up and look at things differently within the hospital.  I am currently part of the patient care council in my facility and specifically, the council over quality and safety.  I have been able to look at the information in a different light as I look to improve the quality improvement strategies in my hospital.  I really like the way that the material was presented to be learned, but also the material itself.

Quality Applications and Benchmarking

This week, I expected to learn more about using benchmarks in health care.  Benchmarks are interesting in the way that they get utilized.  I want to learn more about the way that they get utilized effectively and the benefits and limitations of benchmarking performance.  I would also like to learn more about the sources of benchmarking and what the best source is if there is just one. 

I have come to find that there are a number of ways to actually do benchmarking, and within health care, there are even more and other types of benchmarking that gets done as well.  There are pros and cons of benchmarking that gets done and the type of benchmarking that is available and used.  Each industry and company will need to find the best type of benchmarking for their individual situation and also there are individuals that may have preferences to their own mode of thinking.  Sometimes it is best to do just internal or just external benchmarking, but you can also do a variation of using benchmarks from both for the best results.  Again, the best method is the one that fits best with your specific company. 

The discussion was a good way to look at the types of benchmarks that get used within a specific system of health care (VTE usage and the different roles among the different providers).   I also looked at the different types of balanced scorecards that are used in hospitals and evaluate the type that I like the best.  It is good to see the way that I view things and the best way that I am able to see information, so that I am able to give my opinion if called upon to do so.  I really liked the “Critical Thinking” exercise from this week and the way that we looked at a specific problem and how we could use benchmarks to solve this issue and compare it to current practices and benchmarks. 

This information is very important to me as a newer grad in nursing.  I am always looking for ways to move forward within nursing and to help the company that I am working for to find things that help to advance not only my company but also the role of nursing.  I am always looking for ways to move up in a company or structure and so having this as information for better quality will greatly influence me in this end. 

I am a bit of a nerd in a lot of aspects.  I love looking at information and data and thinking about the best way to present it and to showcase it.  I also like spreadsheets and coming up with ways to better improve not only myself, but also the company for which I am working.  I really like the way that the material was presented to be learned, but also the material itself.

Roles of Health Professionals

This week I was expecting to learn more about the interdisciplinary team and the way that I, as the RN, fits into the team.  I also wanted to learn more about the roles of other health professionals within the interdisciplinary team and the characteristics of effective interdisciplinary teams.  Lastly, I was expecting to learn more about the benefits on patient outcomes as a result of collaborating within interdisciplinary teams.

I feel that I gained a new appreciation for all of the different members of the interdisciplinary team, and how we all work together for the betterment of our patients and their families.  The critical thinking assignment, case study, and discussion all helped to look at different aspects of the team and how they are intertwined.  I feel that I have a better understanding of what an interdisciplinary team is and what my role is within the team. 

As I said above, the activities this week were very beneficial, especially to get the thoughts from my team members in the discussion.  This was a good discussion about a family and their overall struggle with juvenile diabetes.  It was really good to hear other opinions on the topic and the way that they would go about dealing with the situation.

As I have switched from nights to days, the need to work more within an interdisciplinary team is significantly increased.  There are many more members of the team that I never knew existed or how they played a role in the team until now.  I will use this information to work more cohesively with them I as work for the best care for each and every patient. 

This was a very interesting and rewarding unit.  The information gained this week will be vital for me as I continue to grow as a young nurse and develop into a great caregiver for my patients.  

Legal and Ethical Issues

I was expecting to learn more about legal and ethical issues within quality improvement and how that affects the actual improvement of qualities.  I also wanted to learn more about the ways that these legal and ethical issues will affect the things that I am able to do as a RN.  Healthcare is such a scrutinized field, especially when it comes to privacy, so there are plenty of ethical and legal ramifications that revolve around healthcare. 

I was able to learn plenty from this unit.  There is so much to learn in relation to quality improvement and the legal and ethical realms that surround QI.  It was such a good unit to look at and seeing the different viewpoints in the discussion about a topic of fibromyalgia and suicide.  The activities were all very thought provoking and allowed me to look within myself about how I would handle certain situations.  This is such a good thing to do as a RN.  It is important to know how I would handle certain aspects of nursing prior to actually having to be in that type of situation.  

I will be able to use this information going forward to be a better nurse.  Like I stated above, as a nurse, it is important to look at the ways in which I would deal with certain situations, so that I can be level headed about it and also to know my limitations.  I need to be able to say that I can or cannot handle a certain situation, if it comes to that.  I worked for an attorney for a number of years, and it is fun to see the way that nursing and legal things cross.  Being on the right side of the law is always the best place to be.  

Quality Improvement Strategies

I think that I was expecting to learn more about the ways to improve upon a process to ensure the highest quality, regardless of the situation.  I wanted to learn more about the processes that RNs can do at the bedside to be able to have continuous quality improvement (CQI).  I was able to learn these things.  I really liked the videos from this week and found them very insightful and beneficial to the learning of these topics.  The burnt toast analogy was amazing.  It is very true that so many times we create processes to cover up the burnt toast instead of just changing out the toaster.

The team discussion this week was very open and a good source of information about the process that goes into creating improvement.  I liked that we were able to go back and forth and still come up with a group decision on the best way to handle the scenario that was placed before us.  The topic was thought provoking and beneficial to help tie into this week's lesson.  

I think that I have come to a new way to view things that I do day in and day out.  By looking for ways to continuously improve with CQI, the "small" things that I do everyday will become more evident about whether or not it is something that needs to be corrected or improved upon.  This was a great topic  that I will for sure use in the future, whether or not I go into management.  

Reflecting on Week 2

Before beginning this unit, I expected to learn more about what quality means and how quality is measured and viewed within the health care system.  The term quality is thrown around these days like it means something, but based on the information that we learned about this week, it really doesn't scratch the surface of what the term actually means.  Nurses are looked at as trusted professionals.  If we can't provide the best quality care to our patients and continually improve upon the current level of "quality" that exists, then we don't deserve the trust that is placed upon us.  Unfortunately, I learned  that we are not doing our job as a health care system to provide the quality care that our patients deserve.  Quality of care is something that needs to always be addressed and improved upon.  

I enjoyed the activities from this week.  The M&M activity was a good visual example of quality and the way that it works.  I also liked that each team member was able to do the same experiment and the results that were found from it.  It is always helpful to discuss with team members in order to gain insights from the different team members.  The critical thinking activities were especially thought provoking this week.  I don't think that I have ever thought about some of the topics that we were supposed to give thought to this week.  I enjoy the internal thought provoking topics from the week.  

Going forward, the information that I learned this week as well as the information that I have gained thus far in my practice as a nurse will be invaluable.  I hope to be able to get into management and into some committees and I know that this information will be important as I will be able to work with the committees and hospital executives to implement new CQI plans for the betterment of the nurses, patients, and everyone that is a part of the process.  CQI is something that needs to be used everywhere to make sure the best of the best is the only thing that patients ever come in contact with.  

Questions to Contemplate

Contemplate the following questions:

·         What do you consider elements of quality care when receiving healthcare services?

·         What do you consider elements of quality care as a professional nurse?

·         Are the two similar or different?

Unfortunately, at least for this exercise, I have not really been a patient in a hospital, so I will depend mostly on when I have visited family members in the hospital and the care that I have received from visits to a care provider's office.  One aspect of care that I consider as quality when receiving healthcare services is care that is timely.  Timely, to me does not necessarily mean quick.  I think that timely just means that I have been given realistic time frames for things to be done and that those time frames have been upheld.  Another aspect that I find import is informative care.  I like to be in "the know" about all the details of what is currently happening and what the plan is going forward.  Many times, there this is a "business as usual" mentality for most health care providers and I don't know if they just assume everyone knows what is going on or if they just don't think about it, but most while it may be a normal day for the provider, this is most likely a very not normal day for the patient.  Lastly, professionalism is another thing that I consider as an element of quality care.   

As a professional nurse, I consider a number of things as elements of quality care.  I would say that as a professional nurse, I need to have professionalism.  My mannerisms need to show that I take my job and care for the patients as my only priority, no matter what else might be going on in my life.  Another aspect that I find important as a professional nurse is to be caring.  Quality care cannot be done without "care."  I go out of my way to try to serve each and every patient that I come across.  Even though the patients aren't always pleasant, I try to go above and beyond with each and every patient.  One of the last things that I try to do as a professional nurse is to use evidence based practice in everything that I do with my patients.  In providing quality care, I need to have the most up to date and accurate way to provide care that currently exists in whatever it is that I'm doing as a nurse.  

I would say that these two are very much interrelated and intersect completely at multiple points.  I would say that they are only slightly different.  The differences are probably very minute.  I believe that they are significantly similar and that they actually are essentially the same thing with different titles.  Being timely and informative is another way to care.  Evidence based practice is also another way that I show that I care and that I want the best for each and every patient.  All in all, the things that a patient wants is basically the things that a true professional nurse wants for the patient.  

Quality and Patient Safety

My name is Paul Shuman.  I am a nursing student at Utah Valley University currently working on my BSN.  I am creating this reflective journal to help in my progress in the Quality and Patient Safety course (NURS 4550) to be able to look back on this course for some valuable insight that I may have forgotten.  Being able to provide safe and quality care to my patients will be such a vital tool in my nursing career.  Patients deserve the best from me each and every time that I step onto the floor of the hospital and I intend to make that happen.