Assessment 4: Improvement Plan Tool Kit NURS-FPX4020

Improvement Plan Tool Kit

Hospital-associated infections (HAIs) are a significant threat to patient safety, care quality, and health care costs. Among hospitalized patients, HAIs increase the risk of other infections besides prolonging hospital rates and health management costs (Peters et al., 2022). As a result, their identification and prevention should be prioritized in health care settings for improved health outcomes. Effective implementation of the appropriate interventions requires nursing professionals to understand the rationale and execution of different infection control measures. This improvement plan tool kit aims to empower nursing professionals in implementing and sustaining safety measures for preventing HAIs using infection control policy and planning. The tool kit has been organized into four broad themes with three resources under each.

Annotated Bibliography

Environmental Hygiene

Browne, K., & Mitchell, B. G. (2023). Multimodal environmental cleaning strategies to prevent healthcare-associated infections. Antimicrobial Resistance & Infection Control, 12(1), 83. https://doi.org/10.1186/s13756-023-01274-4

This article illustrates infection transmission as a multifaceted issue requiring a multidimensional intervention. As a complex issue, infection transmission involves interplay between a pathogen, a host, and their environment. In response, Browne and Mitchell (2023) evaluate the importance of environmental cleaning as a crucial component of the multifaceted infection control interventions for preventing HAIs. The authors discuss the importance of the Look, Plan, Clean and Dry technique for safe environments. The “Look” step involves visually assessing the environment, while “Plan” involves preparing an area before cleaning. The “Clean” step involves cleaning, wiping, and starting with sites nearest to the patient first. This resource is a valuable reference for nurses to understand what environmental cleaning entails as an infection control measure for HAIs. Nurses can use this resource to implement the Look-Plan-Clean-Dry technique and in instances where environmental cleaning is implemented together with other measures to reduce HAI incidence in hospitals.

Haque, M., McKimm, J., Sartelli, M., Dhingra, S., Labricciosa, F. M., Islam, S., Jahan, D., Nusrat, T., Chowdhury, T. S., Coccolini, F., Iskandar, K., Catena, F., & Charan, J. (2020). Strategies to prevent healthcare-associated infections: a narrative overview. Risk Management and Healthcare Policy, 13, 1765–1780. https://doi.org/10.2147/RMHP.S269315

This article describes the multimodal interventions essential for infection control and preventing in health care facilities. Among the various interventions described as effective in safety enhancement through infection control is environmental hygiene. According to Haque et al. (2020), maintaining strict environmental hygiene is crucial in preventing and controlling infections, particularly hospital-associated infections. Environmental hygiene is maintained by regularly cleaning and disinfecting hospital surfaces that are highly prone to microbial contamination. Such surfaces include bed rails, light switches, and mattresses. This article is a valuable resource for nurses to understand the importance of environmental hygiene in infection control and how to implement it. It describes porous and nonporous surfaces that should be the focus of environmental hygiene interventions to reduce the risk of HAIs significantly. Nurses can use it as a reference for environmental hygiene guidelines and when setting goals for HAI prevention for a safe workplace.

Leistner, R., Kohlmorgen, B., Brodzinski, A., Schwab, F., Lemke, E., Zakonsky, G., & Gastmeier, P. (2023). Environmental cleaning to prevent hospital-acquired infections on non-intensive care units: a pragmatic, single-centre, cluster randomized controlled, crossover trial comparing soap-based, disinfection and probiotic cleaning. EClinicalMedicine, 59, 101958. https://doi.org/10.1016/j.eclinm.2023.101958

Effective control and prevention of HAIs require clean environments. Depending on their size, resource availability, and the complexity of an issue, health care facilities can use different environmental hygiene measures. This resource evaluates the differences between three surface-cleaning strategies on the incidence of HAIs: soap-based, disinfectant, and probiotic agents. To determine their differences, Leistner et al. (2023) used each agent on one ward for four consecutive months. The authors found the three agents equally effective in HAI prevention and can be used jointly or interchangeably for optimal infection control. The resource is a comprehensive guideline for nurses to expand their knowledge of environmental hygiene to prevent HAIs via various agents. It explains how different surface-cleaning agents work and their effectiveness. Therefore, nurses can use the resource as a guideline for environmental cleaning and when implementing environmental hygiene policies for their respective workplaces.

Hand Hygiene Compliance

Boora, S., Singh, P., Dhakal, R., Victor, D., Gunjiyal, J., Lathwal, A., & Mathur, P. (2021). Impact of hand hygiene on hospital-acquired infection rate in neuro trauma ICU at a level 1 trauma center in the national capital region of India. Journal of laboratory physicians, 13(2), 148–150. https://doi.org/10.1055/s-0041-1730820

This article summarizes the findings of a prospective, observational study on the effectiveness of hand hygiene as an infection control mechanism in intensive care units (ICUs). Boora et al. (2021) demonstrate the hands of nursing staff as a leading cause of HAI transmission, implying that the risk could be reduced through compliance with hand hygiene. The authors associate a decline in hand hygiene compliance with an increase in HAIs in ICUs. They further discuss a tool for measuring hand hygiene compliance to ensure practices meet the expected standards. The article is a comprehensive resource for helping nurses to understand hand hygiene compliance and how to measure outcomes to ensure safe environments for patients in care facilities. Nurses can use it as a reference for implementing best practices in infection control through hand hygiene, during advocacy for safe workplaces, and when implementing health education programs.

Assessment 4: Improvement Plan Tool Kit NURS-FPX4020

An annotated bibliography is an important tool for nurses when determining and assessing sources for patient safety. It provides a resource of literature and other sources in order to equip nurses with the necessary knowledge to adequately assess potential risks when administering medications and provide evidence-based solutions to mitigate these risks. Additionally, this tool can serve as a virtual repository that contains all of the research needed to support safety initiatives. In this paper, I will develop an online tool kit of ten sources to help nurses gain a better understanding of how best to approach medication administration safely and improve patient care. These references will stretch across different topics such as medication policy processes, strategies in risk mitigation, effective communication skills regarding medication, and more. All of these resources will demonstrate how pertinent issues are addressed in modern contexts, thus providing full context and enabling nurses to consider credible concepts while forming their own safety improvement plan pertaining to medication administration accordingly.

Safety Improvement Initiative Pertaining To Medication Administration

Assiri, G. A., Shebl, N. A., & Mahmoud, M. A. (2019). Correction: What is the epidemiology of medication errors, error-related adverse events, and risk factors for errors in adults managed in community care contexts? A systematic review of the international literature.

The article “Medication Safety Improvement Initiatives Pertaining to Medication Administration: An Overview for Nurses” by Assiri offers an insightful look into the potential improvements in medication safety and administering drugs safely by healthcare professionals. The aim of this study was to provide a wide-ranging review of the literature regarding initiatives surrounding medication administration safety, as well as guide nurses in understanding how to ensure error reduction (Assiri et al., 2019). To accomplish this, the author used evidence from such sources as journal articles, government documents, and guidelines. In addition, the article addresses pertinent topics such as the epidemiology of medication errors, medication error-related adverse events, and risk factors for errors that take into account community care contexts. Ultimately, this source can be an invaluable resource to help train nurses in preventing medication contamination and allaying numerous events that subsequently comprise unintentional harm occurring due to administration.

Blignaut, A. J., Coetzee, S. K., Klopper, H. C., & Ellis, S. M. (2017). Medication administration errors and related deviations from safe practice: An observational study. Journal of Clinical Nursing, 26(21–22), 3610–3623.

The Medication Administration Errors and Related Deviations from Safe Practice study by Blignaunt focuses on the most commonly reported medication management errors and is an observational study conducted in a hospital setting. It seeks to explain why a patient or nurse may have experienced drug administration errors, as well as to determine which safety improvement initiatives could effectively reduce this phenomenon (Blignaut et al., 2017). As such, the article gives an overview of healthcare team members’ medication administration responsibilities, and outlines types of errors observed such as incorrect dose, wrong time, and wrong route of administration. In addition, it includes recommendations for improving safety in the healthcare setting with particular emphasis on establishing collaborative relationships between health professional staff members and using technology for error mitigation. This source can be used to train nurses on medication error reduction through the implementation of best practices with regard to professional practice standards. Moreover, this article is helpful in comprehending how implementing security policies can help ensure that medication administration processes are accurate and effective.

Donaldson, L. J., Kelley, E. T., Dhingra-Kumar, N., Kieny, M.-P., & Sheikh, A. (2017). Medication without harm: WHO’s third global patient safety challenge. The Lancet, 389(10080), 1680–1681.

The article “Medication without harm: WHO’s third global patient safety challenge” by Donaldson presents an overview of the World Health Organization’s Third Global Patient Safety Challenge to reduce medication errors. The aim of the study is to improve patient safety regarding medications, and the method employed for this endeavor is to recognize worldwide challenges and approaches in practical safety initiatives (Donaldson et al., 2017). Through its focus on identifying strategies to increase safety when it comes to administering medications, Donaldson outlines a comprehensive approach containing 5 interrelated sets of actions that nurture prescribed medicines’ safe use. Consequently, this advance in medication administration promotes safer practices overall and can be used by nurses in training as they learn methods related to reducing medication errors. With an achievement-oriented attitude, readers can gain insight into how the WHO has set itself up for success in its quest to tackle issues surrounding patients’ health security when it comes to taking their prescriptions.

Quality and safety improvements focusing on medication administration

Shitu, Z., Hassan, I., Aung, M. M. T., Kamaruzaman, T. H. T., & Musa, R. M. (2018). Avoiding medication errors through effective communication in a healthcare environment. Malaysian Journal of Movement, Health & Exercise, 7(1), 115–128.

This article by Shitu provides a comprehensive overview of strategies and techniques employed to reduce medication errors in healthcare. The article dives into the effects that can be seen through effective communication, which is a crucial part of avoiding such errors. Shitu’s source examines collaboration models to gain a better understanding of their functionality, as well as references various helpful resources and key findings from the past years (Shitu et al., 2018). Furthermore, the article also offers practical insights on how specific improvement strategies like working collaboratively with other staff members and utilizing electronic health records can aid nurses in making strides towards the elimination of said errors. In short, this source is essential for nurses who are seeking successful tactics for quality improvements and safety risk management related to medication administration through excellent communication skills.

Dalton, K., & Byrne, S. (2017). Role of the pharmacist in reducing healthcare costs: Current insights. Integrated Pharmacy Research and Practice, 37–46.

The article Role of the Pharmacist in Reducing Healthcare Costs: Current Insights by Dalton explores a very relevant topic regarding how pharmacists can play a vital role in reducing healthcare costs. In this research, the aim is to provide strategies for quality and safety improvements focusing on medication administration. Specifically, Dalton highlights potential benefits that include reductions in medication errors, improved patient outcomes, and cost reductions (Dalton & Byrne, 2017). The article explores the current literature through an integrative review to gain a deeper understanding of the significance of pharmacists in reducing healthcare costs. Data was collected from six key areas in which the pharmacist’s role is beneficial: increased medication safety and effectiveness reduced cost burden of medications, evidence-based practice integration, enhanced drug information access and education, therapeutic medication management services, and enhanced clinical services. This source will benefit nurses by providing them with insight into how they can collaborate with pharmacists to improve patient outcomes while reducing healthcare costs.

Rodziewicz, T. L., Houseman, B., & Hipskind, J. E. (2018). Medical error reduction and prevention.

The article entitled “Medical Error Reduction and Prevention” by Rodziewicz is a research paper examining the effects of specific interventions aimed at improving quality and safety during medication administration. The study makes use of Health Risk Management theories along with a broad range of integrated approaches to examine how various strategies can lead to reductions in medical errors (Rodziewicz et al., 2018). Particular attention is paid to the role nursing staff has in the context of these interventions and the abilities nurses need in order to decrease medication-related medical errors. This source offers an excellent benefit for nurses as it provides both theoretical models and concrete strategies which can be implemented quickly and effectively with measurable results. Implementing these strategies can improve patient outcomes due to a reduction in medical errors, providing nurses with vital information concerning how best to ensure high-quality care for their patients.

Wimmer, B. C., Cross, A. J., Jokanovic, N., Wiese, M. D., George, J., Johnell, K., Diug, B., & Bell, J. S. (2017). Clinical outcomes associated with medication regimen complexity in older people: A systematic review. Journal of the American Geriatrics Society, 65(4), 747–753.

This article by Wimmer presents a systematic review of the clinical outcomes associated with medication regimen complexity in older people. The aim of this study was to analyze the effects of drug-related complexity on the overall health and well-being of seniors. To accomplish this, data from various sources were used to compare medication regimens for various elderly populations. Additionally, resources such as best practices and guidelines were included to identify potential risk factors in each particular case (Wimmer et al., 2017). The study found a correlation between increased medication regimen complexity and an increase in complications and hospitalizations. Furthermore, it provides insight into how organizations and nurses can reduce the likelihood of adverse outcomes due to complex prescriptions by following established protocols that assess each individual’s unique needs. By providing resources to support their decision-making, nurses are better equipped with the tools needed to keep complications at bay by making sure medications are appropriate for each patient.

Reducing Patient Safety Risks Reasons, And Relevant Situations

Redmond, P., Grimes, T. C., McDonnell, R., Boland, F., Hughes, C., & Fahey, T. (2018). Impact of medication reconciliation for improving transitions of care. Cochrane Database of Systematic Reviews, 8.

This article by Redmond explores the impact of medication reconciliation on improving transitions of care. The aim of this study is to evaluate the effectiveness of technology interventions, such as electronic health records (EHRs) and clinical decision support systems (CDSSs), in reducing medication errors and adverse outcomes for patients transitioning from one care setting to another (Redmond et al., 2018). Redmond provides an extensive list of resources that can be used by nurses and organizations to reduce the potential for error, including EHRs, CDSSs, standardized processes, communication protocols, patient education materials, and improved teamwork with interprofessional collaboration. Furthermore, the article also provides recommendations on how to maximize the benefits obtained through medication reconciliation efforts.

Hammoudi, B. M., Ismail, S., & Abu Yahya, O. (2018). Factors associated with medication administration errors and why nurses fail to report them. Scandinavian Journal of Caring Sciences, 32(3), 1038–1046.

The article “Factors associated with medication administration errors and why nurses fail to report them”, by Hammoudi, aims to research the various factors that contribute to the occurrence of medication administration errors and why nurses may not be reporting them. To achieve this aim, a qualitative focus group method was used in order to examine the experiences of 20 nurses employed at two acute care hospitals in Michigan (Hammoudi et al., 2018). This article is highly relevant for nurses and organizations alike because it provides insightful resources for reducing medication errors and adverse outcomes. Resources include exploring strategies for creating a reporting culture; using technology such as barcodes or automated dispensing systems; providing open leadership opportunities where feedback can be shared without fear of consequence; providing information on the positive impact that proper reporting of errors can have for both patients and nursing staff; as well as mandating periodic safety checks by qualified individuals throughout patient stays. These are all valuable resources that can help nurses better understand the importance of medication error and adverse outcome reporting, creating cultures of safety among teams so potential issues can be quickly addressed before they become serious.

Johnson, M., Sanchez, P., Langdon, R., Manias, E., Levett‐Jones, T., Weidemann, G., Aguilar, V., & Everett, B. (2017). The impact of interruptions on medication errors in hospitals: An observational study of nurses. Journal of Nursing Management, 25(7), 498–507.

This article by Johnson is based on an observational study of nurses in hospitals, with the purpose of investigating the impact interruptions have on medication errors. By measuring the events and decisions made during interruptions from a safety perspective, this study aimed to explore how changes in the work environment can reduce medication errors and adverse outcomes. In order to accomplish this goal, data was collected from one hundred and two nurses in three emergency rooms in a large Midwestern hospital over eight weeks (Johnson et al., 2017). The article provides resources for nurses and organizations to use for monitoring performance and further reducing medication errors, such as improved methods for providing medications at the bedside, more flexible organizational structures to reduce distractions when administering medications, additional protocols and guidelines regarding patient handoff communications, etc. Overall, this article has important implications for informing policies related to nursing practice in healthcare settings.

Assessment 4: Improvement Plan Tool Kit NURS-FPX4020

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, pertaining to medication administration, to understand or implement to ensure the success of the plan.

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

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 tool kit. The activity is for your own practice and self-assessment, and demonstrates 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.

• Analyze usefulness of resources for role group responsible for implementing quality and safety improvements with medication administration.

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

• Analyze the value of resources to reduce patient safety risk or improve quality with medication administration.

Competency 3: Identify organizational interventions to promote patient safety.

• Identify necessary resources to support the implementation and sustainability of a safety improvement initiative focusing on medication administration.

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

• Present reasons and relevant situations for resource tool kit to be used by its target audience.
• Communicate resource tool kit in a clear, logically structured, and professional manner that applies current APA style and formatting.

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.

Professional Context

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 educational 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.

Scenario

For this assessment, consider taking one of these two approaches:

1. 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 medication administration and put the plan into action.
2. Locate a safety improvement plan (your current organization, the Institution for Healthcare Improvement, or a publicly available safety improvement initiative) pertaining to medication administration and create an online tool kit or resource repository that will help an audience understand the research behind the safety improvement plan and how to put the plan into action.

Thank you for submitting your last assessment. You made a good attempt at addressing the scoring guide criteria and creating a Word document resource tool kit pertaining to medication administration errors; however there was some information missing from this assessment.

Remember this is a tool kit of resources for your Safety Improvement Plan not just an annotated bibliography. The goal is to find 12 current resources that support your Safety Improvement plan.

Make sure to not only summarize the article but to analyze the value and usefulness of the article in how it relates to your Safety Improvement plan. Please review the scoring guide feedback below along with highlighted area on your paper along with annotated notes.

I recommend reviewing the instructions and scoring guide again for the assessment and organize your paper specific to the scoring guide to ensure that you meet the requirements of the assessment. Below the scenario in the Assessment 4 instructions there is a great guideline for required material that you can follow to organize your toolkit along with a great sample took kit.

If you choose to resubmit this assessment to obtain a higher proficiency, please highlight your revisions or new content in yellow so that I can capture the enhancements in your work.

Let me know if you have any questions. I am happy to meet and discuss via zoom if needed.

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 GoogleDocs login, or create an account following the directions under the “Create Account” menu.

Refer to the following links to help you get started with Google Sites:

• G Suite Learning Center. (n.d.). Get started with Sites. https://gsuite.google.com/learning-center/products/sites/get-started/#!/
• Google. (n.d.). Sites. https://sites.google.com
• Google. (n.d.). Sites help. https://support.google.com/sites/?hl=en#topic=

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 3 or 4 most critical categories or themes with respect to your safety improvement initiative pertaining to medication administration.

For example, for an initiative that 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 3 resources on average for each of the 4 categories focusing on safety with medication administration. 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 pertaining to medication administration.
• 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 for more information.

Here is an example entry:

• Merret, A., Thomas, P., Stephens, A., Moghabghab, R., & Gruneir, M. (2011). A collaborative approach to fall prevention. Canadian Nurse, 107(8), 24–29.
• This article presents the Geriatric Emergency Management-Falls Intervention Team (GEM-FIT) project.
• It shows how a collaborative nurse lead project can be implemented and used to improve collaboration and interdisciplinary teamwork, as well as improve the delivery of health care services.
• This resource is likely more useful to nurses as a resource for strategies and models for assembling and participating in an interdisciplinary team than for specific fall-prevention strategies.
• It is suggested that this resource be reviewed prior to creating an interdisciplinary team for a collaborative project in a health care setting.

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.

• Identify necessary resources to support the implementation and continued sustainability of a safety improvement initiative pertaining to medication administration.
• Analyze the usefulness of resources to the role group responsible for implementing quality and safety improvements focusing on medication administration.
• Analyze the value of resources to reduce patient safety risk related to medication administration.
• Present reasons and relevant situations for use of resource tool kit by its target audience.
• Communicate in a clear, logically structured, and professional manner that applies current 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 medication administration. 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, Resources for Safety and Improvement Measures in Geropsychiatric Care, to give you an idea of what a Proficient or higher rating on the scoring guide would look like for this assessment but keep in mind that your tool kit will focus on promoting safety with medication administration.

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

Additional Requirements

• APA formatting: References and citations are formatted according to current APA style