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NURS FPX 4020 Assessment 4 Improvement Plan Tool Kit

Student Name Capella University NURS4020 Improving Quality of Care and Patient Safety Prof. Name Date Improvement Plan Tool-Kit  This assessment presents an improvement plan toolkit for the healthcare workforce of Tampa General Hospital to reduce medication administration error rates and enhance patient safety. This toolkit gathers authentic and credible information from databases such as Google Scholar, CINAHL, PubMed, and Capella Online Library. This improvement plan toolkit aims to enable healthcare professionals of TGH to implement practical measures to deliver high-quality care treatments with most minor incidences of medication errors, particularly relevant to medication administration errors. Through adequate knowledge substantiated with evidence, the nurses and relevant healthcare professionals can implement a safety improvement plan effectively as their concepts are clear with a thorough understanding of the proposed plan. This resource toolkit comprises four major sections, including an overview of medication administration errors and nursing practices, preventing medication administration errors, training nurses on safe medication administration, and technological tools relevant to medication administration.  Overview of Medication Administration Errors and Nursing Practices Wondmieneh, A., Alemu, W., Tadele, N., & Demis, A. (2020). Medication administration errors and contributing factors among nurses: A cross-sectional study in tertiary hospitals, Addis Ababa, Ethiopia. BMC Nursing, 19(4), 1–9. https://doi.org/10.1186/s12912-020-0397-0  This resource discusses medication administration errors in hospitals in Ethiopia. Moreover, it highlights the risks and contributing factors that persist among healthcare organizations and lead to medication administration errors by nurses. The identified factors leading to the onset of these errors are lack of adequate training among nurses, unavailable guidelines on medication administration, external interruptions, insufficient work experience, and night duty shifts. This resource is helpful for nurses as they can predict the factors that lead to medication administration errors and gain further insights from this study’s past experiences and data. Moreover, they can use this resource to further educate their colleagues on the factors nurses must be careful about while administering the medications. Lastly, nurses can use the strategies provided by this resource, such as adherence to guidelines during medication administration and training nurses on the safe administration of medications. Tsegaye, D., Alem, G., Tessema, Z., & Alebachew, W. (2020). Medication administration errors and associated factors among nurses. International Journal of General Medicine, Volume 13(13), 1621–1632. https://doi.org/10.2147/ijgm.s289452  This article by Tsegaye and colleagues provides an overview of medication administration errors, including prevalence and types of medication administration errors such as errors of wrong dose, wrong time, parenteral route errors, wrong evaluation, and underdose errors. Furthermore, it highlights the work, managerial, and professional-related factors that lead to medication administration errors. NURS FPX 4020 Assessment 4 Improvement Plan Tool Kit The factors included a lack of adequate communication, sufficiently trained nurses, interruptions, and unavailability of protocols for medication administration. Nurses can take help from this resource as it guides them on all possible factors that nurses must consider to avoid errors during medication administration. They can use this resource to overcome these factors in their healthcare settings and learn from the information discussed in this article. This will help them prevent medication administration errors due to these risk factors. Hanson, A., & Haddad, L. M. (2022). Nursing rights of medication administration. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK560654/  This resource discusses medication administration from a nursing practice perspective. It provides detailed information on nurses’ role in medication administration, issues of concern, clinical significance, and interdisciplinary interventions for safe medication administration. This resource highlights the nursing rights of medication administration, which nurses must learn and implement to improve patient safety and reduce medication administration errors. Nurses can use these rights of medication administration by using technologies like barcode medication administration (BCMA) or electronic medical records (EMR) to verify medications. Therefore, this resource can play a vital role in delivering medication administration as they must adhere to the five rights of medication administration. Preventing Medication Errors Rodziewicz, T., & Hipskind, J. (2019). Medical error prevention. http://www.saludinfantil.org/Postgrado_Pediatria/Pediatria_Integral/papers/Medical%20Error%20Prevention%20-%20StatPearls%20-%20NCBI%20Bookshelf.pdf This resource describes medication errors, types of errors, and multiple preventive measures for medication errors. This resource also highlights medication administration errors and ways to prevent them. For instance, training nurses or pharmacists to double-check medications, integrating barcode administration technologies, and medical reconciliation. Nurses can use this resource to learn about medication errors and practical strategies to overcome them. Moreover, they can integrate these preventive measures into their healthcare setups. Nurse leaders can propose these strategies to hospital administration to implement them and reduce medication administration errors. This resource will reduce patient safety risks by giving clear preventive measures for improving the quality of care with medication administration. Manias, E., Kusljic, S., & Wu, A. (2020). Interventions to reduce medication errors in adult medical and surgical settings: A systematic review. Therapeutic Advances in Drug Safety, 11(1), 1–29. https://doi.org/10.1177/2042098620968309  This resource highlights the interventions to reduce and prevent medication errors in medical and surgical units. This systemic review describes interventions for various errors, including prescribing, administering, and dispensing errors. Nurses can utilize this source to gain insight into medication administration errors and ways to prevent them. For instance, this resource emphasizes that computerized prescription entry (CPOE) and automated medication distribution systems reduce medication-giving errors. This resource can help nurses obtain knowledge and understanding of the combination of interventions implemented to reduce medication errors, such as the use of AMDS systems along with medication matching by trained nurses.  Vaismoradi, M., Tella, S., A. Logan, P., Khakurel, J., & Vizcaya-Moreno, F. (2020). Nurses’ adherence to patient safety principles: A systematic review. International Journal of Environmental Research and Public Health, 17(6), 1–15. https://doi.org/10.3390/ijerph17062028  NURS FPX 4020 Assessment 4 Improvement Plan Tool Kit This study discusses the nurses’ adherence to patient safety principles and emphasizes their role in providing safe and effective care treatments. This review article also highlights how nurses’ inadequate adherence to patient safety principles leads to medication administration errors. Moreover, it talks about the nurses’ adherence to principles of nursing care based on the task and work environment. For instance, nurses show better adherence to cooperative tasks such as double checking drugs during administration and availability of equipment such as BCMA
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NURS FPX 4020 Assessment 3 Improvement Plan in Service Presentation

Student Name Capella University NURS4020 Improving Quality of Care and Patient Safety Prof. Name Date Improvement Plan In-Service Presentation Hello everyone; I am ___, and today, I will discuss the safety improvement plan in this in-service presentation. First, I appreciate the participation of all these nurses who play a massive role in Tampa General Hospital by providing care treatments to patients day and night. However, we all know our hospital lags in providing adequate safety through care treatments, and we encounter numerous medication errors. To alleviate the incidence of these errors and enhance the safety of our patients, I will present a safety improvement plan to you all, encouraging you to improve your performance. I will first discuss the agenda of this presentation with you all. Agenda and Outcomes This presentation will entail the following content: By discussing these points, nurses can implement the safety improvement plan. This will enhance patient safety, reduce healthcare costs to patients and the system, improve work efficiency, and promote the hospital’s reputation. Now, let us begin discussing each point in detail. Please park your questions till the end, when we will conduct a question-answer session. Purpose and Goals of In-Service Presentation Session This in-service presentation session aims to mitigate the number of medication administration errors in our hospital lately. Medication administration errors are preventable adverse events that must be avoided in healthcare. Hospitals aim to improve patients’ conditions, and nurses must deliver quality care that satisfies patients’ health needs without aggravating their disease progressions. The goals of this presentation are as follows: NURS FPX 4020 Assessment 3 Improvement Plan in Service Presentation Safety Improvement Plan Overview of Current Problem and Proposed Plan The medication administration errors at TGH mainly occur for various reasons. The primary causes include nurses’ competencies in meeting the medication administration standards, such as double-checking the medications, following the five rights of medication administration, lack of maintenance of automated dispensing systems, and negligence towards identifying medication errors due to non-serious attitudes. Therefore, the proposed safety improvement plan is made in such a way that it addresses these causes of medication administration errors. The proposed safety improvement plan comprises training and educational programs for nurses to promote safe medication administration, revising the hospital’s SOPs for nurses, including developing policies on mindful medication administration and integrating BCMA technology and its practical use. The training session for nurses will enlighten their knowledge of accurate medication administration (Manias et al., 2021). The nurses will administer medication mindfully, applying the principles of safe medication delivery and ignoring external interruptions (Yang et al., 2022). Moreover, the BCMA technology integration can prevent medication errors due to wrong medication administration (Owens et al., 2020). Need to Improve Safety Outcomes TGH needs to improve safety outcomes for patients and reduce the incidences of medication administration errors.  Medication administration errors cause additional distress to patients physically, emotionally, and financially (Elliott et al., 2021). Patients’ recovery time extends, the chances of acquiring nosocomial infections increase, and they have to undergo additional treatments, which impacts their health. Moreover, their emotional and mental health is profoundly impacted as they experience adverse events like medication administration errors, increasing the chances of onset of post-traumatic stress disorder (PTSD) (Aubin et al., 2022). NURS FPX 4020 Assessment 3 Improvement Plan in Service Presentation The financial implications further worsen the condition as additional treatments and extended hospital stays require additional expenditures. Besides, the organization faces numerous issues, such as a declining reputation, financial implications, and decreased revenue, as patients prefer other health facilities over TGH. One study shows that healthcare costs can be reduced by $108 million in the U.S. by implementing harm-reduction strategies (Vaismoradi et al., 2020). Considering these factors, TGH must address this issue of medication administration and improve patient safety to avoid devastating repercussions in the future. Audience’s Role and Importance  Your active participation and adherence to the plan are required to implement the safety improvement plan successfully. As the nursing staff is mainly involved in medication administration, they must practice safe and correct medication administration techniques and strategies. By implementing these ways, nurses can enhance patients’ safety and reduce their vulnerability to medication administration errors. The patient’s clinical health outcomes will improve as nurses follow medication administration protocols and avoid errors. Moreover, the healthcare costs will be reduced when nurses help implement the plan and drive improvements in the safe medication management process. Their critical position in medication administration makes them valuable stakeholders who can successfully implement the safety improvement plan (Vaismoradi et al., 2020). Benefits of Active Participation of Nurses   Nurses can benefit from embracing their role in the plan in several ways. They will not have to pay heavy penalties for making medication errors. Their job satisfaction will be enhanced. Moreover, through correct medication administration, nurses will be saved from providing extensive recovery treatment, leading to reduced work burnout and an adequate work-life balance. The healthcare organization will give them additional bonuses, leadership roles, and other rewards for minimizing medication administration errors. New Process and Skills Practice The nurses will be required to gain expertise in new processes and skills to help them administer medications without making any mistakes. Some of these new processes and skills that they can adopt are as follows: Resources and Activities Before concluding this presentation, I created resources and activities to understand the new processes and skill practices. I have printed six of the latest medication administration articles and relevant health information technologies to lessen these errors. I would like you all to make six groups of 5 members each. Then, I will distribute one printed article to each group. Then, I will give you all twenty minutes to review them and share your insights and any questions here individually. This activity will further increase your knowledge of medication administration and encourage the implementation of this safety improvement initiative. We will discuss the questions thoroughly, and I will address them so that your confusion can vanish. Lastly, I would take your feedback on this improvement plan
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NURS FPX 4020 Assessment 2 Root Cause Analysis and Safety Improvement Plan

Student Name Capella University NURS4020 Improving Quality of Care and Patient Safety Prof. Name Date Root-Cause Analysis and Safety Improvement This report delves into a significant medication administration error at Tampa General Hospital (TGH), a prevalent issue that critically impacts patient safety. As a backdrop, medication errors rank as a leading cause of preventable harm in healthcare settings. Through this assessment, we will systematically explore the root causes behind such errors at TGH using Root-Cause Analysis (RCA). Subsequently, we will propose best practice strategies to mitigate these challenges, devise an evidence-based safety improvement plan, and identify organizational resources to bolster this plan’s success. Analysis of the Root Cause  Several medication administration errors occurred at Tampa General Hospital, but the incident with a 45-year-old patient, Hannah, instigated the use of RCA. Hannah underwent appendix surgery and was admitted for her post-surgery recovery. In one of the nurses’ rounds for medication administration, Hannah was administered the wrong medication by nurse Olivia. Hannah’s doctor had prescribed her morphine, ciprofloxacin, and heparin. The nurse examined her prescribed medications and went to the dispensing unit. Meanwhile, she received a phone call and started talking casually while dispensing medication from the automated dispensing system (ADS). The ADS system faced glitches and dispensed the wrong medicines. Olivia was momentarily distracted by a phone call and paid no attention to the dispensed drug. She administered a double dose of heparin instead of morphine. This resulted in massive bleeding in the patient. This problem was detected by the nurse, Olivia, as she saw her patient bleed significantly. She immediately reported to an emergency, and Hannah’s bleeding was controlled. NURS FPX 4020 Assessment 2 Root Cause Analysis and Safety Improvement Plan This adverse event affected Hannah, her family, the organization, and the nursing staff. The patient’s recovery period was extended, and she had to undergo further procedures to control her bleeding. Moreover, her healthcare expenditures increased, and family members were distressed seeing her endure pain all over again. Healthcare organizations faced problems as their healthcare costs were further ameliorated due to additional treatments. The nursing staff was struck with fear and sadness as their poor attention toward patient care led to significant incidents, posing safety risks to patients’ lives. The root causes identified in this particular scenario were as follows: The RCA revealed these underlying causes, which contributed to the onset of the unfortunate adverse event. Considering these root causes, medication errors in the future can be prevented. Moreover, patient safety can be enhanced by implementing strategies that solve the above-mentioned issues. Application of Evidence-Based Practice Strategies  After conducting a thorough root-cause analysis, it is crucial to implement evidence-based strategies considering the underlying causes of medication administration errors at TGH. These evidence-based strategies can improve patient safety and reduce medication errors. Moreover, they will reduce the costs incurred by patients and healthcare organizations. One study shows that about 62.1 % of nurses make medication errors due to a lack of training on safe and effective medication administration (Wondmieneh et al., 2020). Another study finds that external interruptions during medication administration, such as bedside conversations and taking phone calls, account for 18.8 % of medication errors (Manias et al., 2021). Another study highlights how healthcare information technologies also lead to medication administration errors due to poor maintenance and flaws in designing the technology to mitigate human errors (Ambwani et al., 2019).  NURS FPX 4020 Assessment 2 Root Cause Analysis and Safety Improvement Plan The best practices include training nurses on safe medication administration, where nurses can be educated on protocols regarding medication administration. Nurse leaders can play a vital role in training young nurses on the five rights of medication administration and how this strategy can address medication safety issues. As the five rights of medication administration include the right patient, the right drug, the correct dose, the right time, and the right route of administration, nurses can prevent medication administration errors due to the wrong medicine and the wrong patient (Manias et al., 2021). Moreover, healthcare organizations can integrate a new technology of medication administration, i.e., Bar Code Medication Administration. This will enable double-checking with accuracy through barcode scanning of the label on the drug and matching it with the barcode mentioned on the patient’s bedside or wrist. This will ensure the patient is acquiring the medication prescribed to him with the help of Barcode (Owens et al., 2020). Healthcare organizations can revise policies for nursing staff to carefully provide care treatments to patients and avoid external interruptions such as bedside communications, distracting conversations, and taking unnecessary phone calls. Any violation of these policies should instigate disciplinary actions and penalties. This will enhance a culture of careful administration of drugs without external interruptions (Yang et al., 2022).  Evidence-Based Safety Improvement Plan  Considering the alarming situation of TGH, where medication administration errors impact patients’ safety, developing a safety improvement plan for safe medication administration is imperative. This improvement plan accounts for the factors contributing to patient safety risks and can potentially lessen medication administration error rates. The plan consists of establishing training and educational sessions for nurses that guide nurses on safe medication administration. Nurses will learn about medication administration techniques, protocols, and interdisciplinary collaboration to promote a safe medication administration culture (Manias et al., 2021). Moreover, the hospital will revise its standard SOPs for nurses, who must abide by the stringent policies on mindful medication administration. The guidelines will include penalties for inappropriate bedside communication during medication administration and no cellphone use during working hours (Yang et al., 2022). Lastly, the plan provides for integrating BCMA technology into safe medication administration (Owens et al., 2020).  Desired Goals of Actions Timeline of Development and Implementation of Plan The safety improvement plan will be developed in two months, requiring resource estimation and budget management. Moreover, the practical implementation will be executed within three months after development. For instance, the plan will be implemented on a small scale in one hospital department. After three months of implementation and evaluation, revision of the
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NURS FPX 4020 Assessment 1 Enhancing Quality and Safety

Student Name Capella University NURS4020 Improving Quality of Care and Patient Safety Prof. Name Date Enhancing Quality and Safety The primary purpose of the healthcare system is to provide improved quality of care that enhances patient safety and satisfaction. This paper explains the factors involved in patient safety risks due to Medication Administration Errors (MAEs) that lead to adverse events or sometimes cost a patient’s life. MAEs occur due to violating the five medication administration rights, including incorrect drug, patient, dose, frequency, and time. Further in the paper, evidence-based practices and solutions are provided to improve patient safety by reducing MA errors. Moreover, the nurse’s role and collaboration with different stakeholders are also explained, which reduces the cost and enhances the quality of care within the healthcare system.   Factors Leading to Specific Patient Safety Risks  The patient, Jiliana, is a 60-year-old woman with anaphylactic symptoms who came to the emergency room in the community hospital. The patient’s medical history revealed hypertension and obesity. Upon the examination, the doctor prescribed a handwritten prescription which mentioned to “administer Epinephrine 1mg” only. The duty nurse without further probing into the correct route, administered her Epinephrine to aid with allergic symptoms through an intravenous route, which immediately caused an intense, crushing pain that made her lose consciousness. The resuscitation team in the hospital was called. Through supplemental oxygen and other resuscitation methods, the patient was reverted. However, this incident was a life-threatening situation for the patient. Hence, a comprehensive case investigation was performed. The case investigation revealed several factors involved in this incident that led to the mild but reversible condition. One of the factors is the negligence of healthcare professionals while prescribing and administering medications. While the physician neglected to consider the patient’s hypertensive history before ordering a drug and did not mention the route in the prescription, the nurse neglected to double-check with the doctor and the pharmacist before administering the drug. NURS FPX 4020 Assessment 1 Enhancing Quality and Safety Another factor is the communication gap among the healthcare professionals as there was a lack of collaboration among the physician, pharmacist, and nurses which led to the adverse drug event, eventually causing complications for the patients. According to the literature, most MAEs occur due to negligent behaviour and lack of communication among healthcare professionals. This negligence and communication gap leads to several preventable adverse events which are harmful to patient safety (Tariq & Scherbak, 2023). Health literacy is another important factor. Like in the given scenario the doctor did not check the patient’s medical history as she has hypertension, and prescribed medication that could be harmful to the patient. Health literacy of healthcare providers related to medication and risk factors associated with medication administration is an essential component of preventing patients’ safety (Mueller et al., 2019). Lastly, the lack of technological involvement in the medication management process led to a significant issue in Jiliana’s case. If the hospital had the Electronic Health Records (EHR) and Electronic Medication Administration Records (EMAR) system, there would be minimal chances of medication errors as a shared portal would have improved communication and alerted every healthcare professional for potential errors. Evidence-Based and Best Practice Solutions  Incidences like the one described above may bring various challenges related to patient safety which can be addressed using several evidence-based and best practices.  Standardized Guidelines: The Joint Commission International Accreditation (JCIA) body has helped healthcare organizations and healthcare professionals to create a safer evidence-based practice and environment for patients and healthcare providers to enhance patient safety by providing standardized patient safety goals (patient identification and medication management). These goals are related to medication administration as, which will help in preventing errors if followed adequately in the healthcare settings (ElLithy et al., 2023).  Effective Communication: The communication between healthcare professionals, such as physicians, pharmacists, and nurses, helps to improve patient safety in the healthcare setting. Effective Communication of the healthcare providers is enhanced when the experienced professional provide training and session to the novice nurse about medication administration. Effective communication during novice nurse training reduces the hospital’s cost to hire experienced or registered nurses for patient safety. Moreover, double-checking of prescriptions will also save the cost of medication patient and hospital. This will enable the nurses to give the right medication to the right patient with a correct route (Rodziewicz et al., 2023).  Technological Integration: Technical integration such as Barcode Medication Administration (BCMA) and Electronic Health Records (EHR) improve patient safety and is practical to adopt. BCMA helps to fulfil the five rights of medication administration, which enhances hospital efficacy and prevents MAEs. It enables the pharmacist to avoid mistakes in look-alike-sound-alike medication. BCMA reduces the rates of MAEs, ultimately reducing the cost of the patient’s stay at the hospital. Moreover, it also saves the patient’s cost of transportation due to the correct administration of the medicine (Shermock et al., 2023). Nurse Role in Care Coordination and Cost Reduction  Nurses are the frontline force that helps the healthcare system provide quality care and improve patient safety. MAEs are the leading cause of hospitalization and disability worldwide, which include multiple factors; one of them is mainly due to novice nurses and their negligence. The training of the nurses in medication administration helps them to understand the five rights of medication administration, which include the correct dose, route, patient, timing, and frequency. Training young nurses with registered nurses will improve patient safety as they discuss the patient cases during training. NURS FPX 4020 Assessment 1 Enhancing Quality and Safety Moreover, this training session enables them to communicate and collaborate with healthcare professionals such as pharmacists to get information about the new and LASA drugs (Luokkamäki et al., 2020). Care coordination involves a multidisciplinary team, which helps the patient receive an improved quality of care and enhances patient safety. The nurses will collaborate with the physician and pharmacist in a team to provide care at the right time to the right patient. The incidence reporting system within the healthcare setting will help the
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