IMPACTS OF MEDICATION ADMINISTRATION ERROR 1.docx

IMPACTS OF MEDICATION ADMINISTRATION ERROR
1
IMPACTS OF ADMINISTRATIVE ERRORS
5
Impacts of Medication Administration Error on Three to Four
years-old Leukemia Patients
Submitted by:
Prospectus
Doctor of Nursing Practice
The Prospectus Overview and Instructions
Prospectus Instructions:
1. Read the entire Prospectus Template to understand the
requirements for writing your prospectus. Each section contains
a narrative overview of what should be included in the section
and a table with the required criteria for each section. WRITE
TO THE CRITERIA, as they will be used to assess the
prospectus for the overall quality and feasibility of your
proposed research study.
2. As you draft each section, delete the narrative instructions
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requirements for that particular section. Do not delete/remove
the criterion table as this is used by you and your committee to
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3. Prior to submitting your prospectus for review by your chair
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complete a realistic self-evaluation, inserting what you believe
is your score for each listed criterion into the Learner Self-
Evaluation column. This is an exercise in self-evaluation and
critical reflection, and to ensure that you completed all sections,
addressing all required criteria for that section.
4. The scoring for the criteria ranges from a 0-3, as defined
below. Complete a realistic and thoughtful evaluation of your
work. Your chair and methodologist will also use the criterion
tables to evaluate your work.
5. Your Prospectus should be no longer than 6-10 pages when
the tables are deleted.
0
Item Not Present
1
Item is Present. Does Not Meet Expectations. Revisions are
Required: Not all components are present. Large gaps are
present in the components that leave the reader with significant
questions. All items scored at one must be addressed by learner
peer reviewer comments.
2
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3
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are present that leaves the reader with questions. No changes
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Contents
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Introduction
Health care firms have invested in nurses as front line staff that
should recognize and report any errors pertaining to medication,
although the nurse is the source of the error, a contributor of
has observed the error take place (Jones, at el 2016). They
depend on the nurse's ability to detect the problem and make
decisions to put forward the medication errors that have been
discovered. Chemotherapy is one of the dangers that young
Leukemia patients suffer when they are overexposed to the
radioactive rays. The administration of chemotherapy is the
main part of the clinical principals of oncology nursing. When
the medication is not well prescribed to the patients, who are
involved in the physical treatment rather the care that they are
being given by nurses.
Through statistical numbers, it shows about in-patients who are
suffering from the treatment suffer adverse impacts from the
administrative decisions that should be well structured by the
treating nurses. Human errors that happen among health care
workers are at the rising trend mainly because of forgetfulness,
inattention, poor motivation, carelessness, negligence, and
recklessness. These factors are due to human actions that can be
avoided by taking measures that will help resolve the problem.
Some of the errors are unrealistic since they seem to be petty
and minor to be committed with such high profile people who
have taken their studies of making things right in the treatment
of patients.
The efforts of reducing errors in health care sectors are mainly
directed towards the prevention of such occurrences than at the
management section when a mistake occurs. The management
should drive a mechanism of making sure they have a well-laid
protocol on how they should handle when they happen since

young patients are delicate of suffering a lot in making changes
in their health. Many institutions prescribe when errors happen
for Leukemia patients to be reported through the institutional
reporting system in such incidence.
Due to due to limited clinical experience, nursing students have
high chances of making mistakes in handling patients, offering
poor medication treatments. Students have been reported of a
lack of knowledge about patients' diagnosis, the purpose, and
correct method of administration of medication that patients are
supposed to be prescribed, especially to young patients who
require a lot of care while dealing with them. The
administration has the knowledge of nursing students having
weakness in handling patients in Leukemia since they are
sensitive to the type of prescription they are supposed to be
subjected to.
When a mistake has happened during the treatment of Leukemia
young patients, the administration should admit and report the
mistake in a good time to save the lives of the Leukemia
patients. There should be a proper monitoring system that
should be drawn in a cross range so that patients can have an
appropriate manner that they will have to settle their factors on
records and to have treatment of patients. Records do not
actually portray the exact situation with regard to the
occurrence of medications and errors that should be handled
inappropriate manner. The administration should take a close
range of all activities that take place with the institution so that
they can handle all errors that may happen during service
delivery to patients.
Criteria
Learner Self-Evaluation Score
(0-3)
Chair Evaluation Score

(0-3)
Reviewer Score
(0-3)
Introduction
This section briefly overviews the research focus or problem,
why this study is worth conducting, and how this study will be
completed.
The recommended length for this section is two to three
paragraphs.
1. A dissertation topic is introduced along with why the study is
needed.
2. It provides a summary of results from prior empirical
research on the topic.
3. Using results, societal needs, recommendations for further
study, or needs identified in three to five research studies
(primarily from the last three years), the learner identifies the
stated need, called a gap.
4. The section is written in a way that is well structured, has a
logical flow, uses correct paragraph structure, uses correct
sentence structure, uses correct punctuation, and uses correct
APA format.

NOTE: This Introduction section elaborates on the Topic from
the 10 Strategic Points. This Introduction section provides the
foundation for the Introduction section in Chapter 1 of the
Proposal.
Reviewer Comments:
Background of the Problem
The aim of the project is to examine crossly on impacts on
administrative errors that are made on young patients who are
suffering from Leukemia aged between three to four years. The
main consequences of medication administration errors affect a
patient’s morbidity and mortality. These errors affect families
of the patients, patients, and health institutions indirectly
through cost implications that would have been handled without
having committed the mistakes. Patients lose their lives when
they are given a wrong dose that should have been protected in
the early stages. The errors also bring about psychological
torture that will stretch to patients who are in the same
institution about the fate of their medication on the same
facility.
Notably, there are numerous issues that lead to medical errors.
Lack of clinical skills, experiences, and expertise have led to
poor diagnosis and treatment of young patients suffering from
Leukemia. Failure to maintain medical records has also reduced
the quality of patient care. Moreover, poor and inefficient
monitoring of teenagers with Leukemia results into poor
treatment hence putting the minors at a risk of succumbing to
the disease. Consequently, the families of kids suffering from
Leukemia are left with a huge emotional burden. Additionally,
the money spent on continuous treatment leaves the family
struggling financially to cater for medical costs due to errors
committed by medics. Generally, medical errors adversely

affect the quality of healthcare that young patients suffering
from Leukemia receive –hence the need to look into the issue of
keenly in order to improve the quality of medical care in all
healthcare facilities.
Criteria
(0-3)
Chair or Score
(0-3)
Reviewer Score
(0-3)
Background of the Problem
This section uses the literature to provide the reader with a
definition and statement of the research gap and problem the
study will address. This section further presents a brief
historical perspective of when the problem started and how it
has evolved over time.
The recommended length for this section is two-three
paragraphs.
1. Includes a brief discussion demonstrating how literature has
established the gap and a clear statement informing the reader
of the gap.
1
2. Discusses how the “need” or “defined gap” has evolved
historically into the current problem or opportunity to be
addressed by the proposed study (citing seminal and/or current
research).
1

3. ALIGNMENT: The problem statement for the dissertation
will be developed from and justified by the “need” or “defined
gap” that is described in this section and supported by the
empirical research literature published within the past 3-5 years.
2
APA format.
2
NOTE: This Background of the Problem section uses
information from the Literature Review in the 10 Strategic
Points. This Background of the Problem section becomes the
Background of the Study in Note; this section develops the
foundation for Chapter 1 in the Proposal. It is then expanded to
develop the comprehensive Background to the Problem section
and Identification of the GAP sections in Chapter 2 (Literature
Review) in the Proposal.
Reviewer Comments:
Problem Statement
Cases of Young children aged between three and four years
have been reported several on poor medications that are offered
by health institutions. Administrative errors during diagnosis
and treatment have resulted to poor quality of patient care.
Today, medical errors have become rampant in the health
section leading to high mortality rate. Medical errors committed
by medics lead to wrong diagnosis and treatment of young
patients suffering from Leukemia. Inefficient treatment of

patients results into a number of adverse effects to both families
and friends of patients. Wrong diagnosis and treatment will lead
to heavy financial burden as well as emotional suffering once
patients continue to suffer since they are not given the
appropriate medical assistance. Therefore, the issue of
administrative errors continues to affect our healthcare system –
leading to poor quality of healthcare.
Criteria
(0-3)
Chair or Score
(0-3)
Reviewer Score
(0-3)
Problem Statement
This section includes the problem statement, the population
affected, and how the study will contribute to solving the
problem.
The recommended length for this section is one paragraph.
1. States the specific problem proposed for research with a clear
declarative statement.
1
2. Describes the population of interest affected by the problem.
The general population refers to all individuals that could be
affected by the study problem.
1

3. Describes the unit of analysis.
For qualitative studies, this describes how the phenomenon will
be studied. This can be individuals, groups, or organizations
under study.
For quantitative studies, the unit of analysis needs to be defined
in terms of the variable structure (conceptual, operational, and
measurement).
1
4. Discusses the importance, scope, or opportunity for the
problem and the importance of addressing the problem.
1
5. The problem statement is developed based on the need or gap
defined in the Background to the Study section.
2
APA format.
1
NOTE: This section elaborates on the Problem Statement from
the 10 Strategic Points. This section becomes the foundation for
the Problem Statement section in Chapter 1 and other Chapters
where appropriate in the Proposal.

Reviewer Comments: Purpose of the Study
Basically, medical errors remain a major hindrance to quality
healthcare. Moreover, administrative errors continue to threaten
the success of the country’s healthcare system. Inefficient
diagnosis and treatment of young patients suffering from
Leukemia leads to high mortality rate. The significance of this
study is to use a qualitative approach in trying to understand the
root cause of administrative errors in healthcare. Several data
collection tools will be used in order to understand the factors
that lead to medical errors. The findings of the research will
help to develop strategies meant to counter the rising cases of
medical errors when attending to young patients with Leukemia.
This will help to enhance the quality of healthcare and also
reduce the rising mortality and morbidity rate.
Criteria
(0-3)
Chair or Score
(0-3)
Reviewer Score
(0-3)
PURPOSE OF THE STUDY
This section reflects what the study is about, connecting the
problem statement, methodology & research design, target
population, variables/phenomena, and geographic location.

7. It begins with one sentence that identifies the research
methodology and design, target population, variables
(quantitative) or phenomena (qualitative) to be studied, and
geographic location.
1
8. : Defines the variables and relationships of variables.
9.
: Describes the nature of the phenomena to be explored.
1
APA format.
1
NOTE: This section elaborates on the information in the
Purpose Statement from the 10 Strategic Points. This section
becomes the foundation for the Purpose of the Study section in
Chapter 1 and other Chapters where appropriate in the Proposal.
Reviewer Comments:Research Questions
The study is going to be a qualitative descriptive that will be
focusing on the effects of administrative errors on patients aged
between three and four years (Mohammadabad at el 2015). It
has created a lot of concern about how patients should handle
their conditions even if they are not presented in the health
facility. The research will also focus on how other parties, such
as relatives and the family of the patient, get impacted.
Research questions
The following research questions will help to guide this
qualitative study:

· RQ1: How does the administration handle situations on errors
over Leukemia young leukemia patients?
· H1: Administration has not mechanism of dealing with
medical errors.
· RQ2: How soon should the errors be handled by the health
facility?
· H2: Medical errors occur regularly.
· RQ3: What the major causes of administrative errors?
· H3: The root cause of medical errors is unknown.
Criteria
(0-3)
Chair Score
(0-3)
Reviewer Score
(0-3)
Research Question(s) and/or Hypotheses
· The recommendation is a minimum of two research questions,
along with related hypotheses and variables is required for a
quantitative study.
· Also recommended is a minimum of two research questions,
along with the phenomenon description is required for a
qualitative study.
· Put the Research Questions in the appropriate Table in
Appendix B based on whether the study is qualitative or

quantitative.
The recommended length for this section is a list of research
questions and associated hypotheses (quantitative)
11. States the research question(s) the study will answer and
describes the phenomenon to be studied.
12. : States the research questions the study will answer,
identifies and describes the variables, and states the hypotheses
(predictive statements) using the format appropriate for the
specific design and statistical analysis.
2
13. Alignment: The research questions are based on both the
Problem Statement and Theoretical Foundation model(s) or
theory(s). There should be no research questions that are not
clearly aligned to the Problem Statement.
2
APA format.
2
NOTE: This section elaborates on the information about
Research Questions) & Hypothesis/variables or Phenomena
from the 10 Strategic Points. This section becomes the
foundation for the Research Question(s) and/or Hypotheses
section in Chapter 1 in the Proposal.
Reviewer Comments:Advancing Scientific Knowledge and
Significance of the Study
The study will look also look at other aspects that are affecting

health facilities such as lack of types of equipment and proper
technology that should be put in place. The study relates to
other fiends of technology, social welfare, and an education
system that should be taken in an advancing manner of having a
composed aspect of having critical affairs of making patients
meet their needs.
Criteria
(0-3)
Chair Score
(0-3)
Reviewer Score
(0-3)
ADVANCING SCIENTIFIC KNOWLEDGE and
SIGNIFICANCE OF THE STUDY
This section reiterates the gap or need in the literature and
states how the study will address the gap or need and how the
research will contribute to the literature, practical implications
to the community of interest, and alignment with the program of
study.
The recommended length for this section is one to two
paragraphs, providing a brief synopsis of each criterion listed
below, which will be expanded in the proposal.
15. Clearly identifies the “gap” or “need” in the literature that
was used to define the problem statement and develop the
research questions. (citations required)
2
16. Describes how the study will address the “gap” or
“identified need” defined in the literature and contribute to

/advance the body of literature. (citations required)
2
17. Describes the potential practical applications from the
research. (citations required)
2
18. Identifies and connects the theory(ies) or model(s) that
provide the theoretical foundations or conceptual frameworks
for the study. (citations required)
2
APA format.
2
NOTE: This section builds on information about the Literature
review and Theoretical Foundations sections in the 10 Strategic
Points. This section becomes the foundation for the Theoretical
Foundations section in Chapter 2
Reviewer Comments:
Rationale for Methodology
The qualitative approach will be used in this study. Qualitative
method is the most appropriate technique that can be used to
collect data from key respondents within the healthcare sector
in order to understand the factors that contribute to medical
errors. Qualitative data collection techniques like interviews
and questionnaires can be used to get the views of key

respondents in order to understand the issue of medical errors
and its effects on quality of healthcare (Ravandi, at el 2015).
For instance, interviewing key stakeholders in the healthcare
sector will help to capture the causal factors of administrative
errors in medical care provision.
Criteria
(0-3)
Chair or Score
(0-3)
Reviewer Score
(0-3)
Rationale for Methodology
The Rationale for the Methodology section clearly justifies the
methodology the researcher plans to use for conducting the
study. It argues how the methodological choice (quantitative or
qualitative) is the best approach to answer the research
questions and address the problem statement. Finally, it
contains citations from textbooks and articles on research
methodology and/or articles on related studies to provide
evidence to support the argument for the selected methodology.
20. Identifies the specific research methodology for the study.
2
21. It justifies the methodology to be used for the study by
discussing why it is an appropriate approach for answering the
research question(s) and addressing the problem statement.

22. Justify in terms of the problem statement and the variables
for which data will be collected.
23. Justify in terms of problem statement and phenomenon.
2
24. Uses citations from seminal (authoritative) sources
(textbooks and/or empirical research literature) to justify the
selected methodology. Note:Introductory or survey research
textbooks (such as Creswell) are not considered seminal
sources.
2
APA format.
2
NOTE: This section elaborates on the Methodology and Design
in the 10 Strategic Points.This section becomes the foundation
for the Research Methodology in Chapter 1 of the Proposal and
the basis for developing Chapter 3, Research Methodology.
Reviewer Comments:Nature of the Research Design for the
Study
This research design will apply key qualitative data collection
instruments such as questionnaires and interviews in order to
collect data from the sample size. The data collected will then
analyzed in order to understand the nature of the current
healthcare system and the root cause of medical errors.
Qualitative-descriptive research is descriptive in nature and
helps in describing a natural phenomenon. This method will

help provide a clear finding of factors that have been making
the condition disastrous. Despite having control measures that
will help patients get relieved. The study area of this project is
mainly in the health facilities despite the level and ranks of the
health facility.
Criterion Score
(0-3)
Chair or Score
(0-3)
Reviewer Score
(0-3)
Nature of the Research Design for the Study
This section describes the specific research design to answer the
research questions and why this approach was selected. Here,
the learner discusses why the selected design is the best design
to address the problem statement and research questions as
compared to other designs. This section contains a description
of the research sample being studied, as well as the process that
will be used to collect the data on the sample.
The recommended length for this section is two to three
paragraphs and must address each criterion.
26. Identifies and describes the selected design for the study.
2
27. This justifies why the selected design addresses the problem
statement and research questions.

28. Justifies the selected design based on the appropriateness
of the design to address the research questions and data for each
variable.
29. Justifies the selected design based on the appropriateness
of design to address research questions and study the
phenomenon.
1
30. Briefly describes the target population and sample for the
study.
2
31. Identifies the sources and instruments that will be used to
collect data needed to answer the research questions.
1
32. Briefly describes data collection procedures to collect data
on the sample.
2
APA format.
2
NOTE: This section also elaborates on the Design portion of the
Methodology and Design section in the 10 Strategic Points. This
section provides the foundation for the Nature of the Research

Design for the Study in Chapter 1.
Reviewer Comments:Sources of Data
Data sources will include:
· Patients
· Medical practitioners
· Previous studies
· Key stakeholders in the healthcare industry.
This research will obtain data from mainly from questionnaires
that will be drafted and be sent through patients and other stuff
who willing to give us feedback (Schmiegelow at el 2016).
Additionally, there will be the use of face to face conversations
with patients to have clear feedback on how the treatment is
being done in the health facility. Similarly, we will conduct
some interviews that will help us have more data collection and
accurately on the same factors.
Criterion Score
(0-3)
Chair or Score
(0-3)
Reviewer Score
(0-3)
RESEARCH MATERIALS, INSTRUMENTATION, OR
SOURCES OF DATA
This section identifies and describes the types of data that will

be collected, as well as the specific research materials,
instruments, and sources used to collect those data (tests,
surveys, validated instruments, questionnaires, interview
protocols, databases, media, etc.).
The recommended length for this section is one to two
paragraphs. Note: this section can be set up as a bulleted list.
:
Provides a bulleted list of the instrumentation and/or materials
for data collection.
Describes the survey instruments or equipment/materials used
(experimental research) and specifies the type and level of data
collected with each instrument.
Includes citations from original publications by instrument
developers (and subsequent users as appropriate) or related
studies.
1
Describes the structure of each data collection instrument and
data sources (tests, questionnaires, interview protocols,
observations databases, media, etc.).
1
The section is written in a way that is well structured, has a
APA format.
1
NOTE: This section elaborates on the Data Collection from the

10 Strategic Points.
This information is summarized high level in Chapter 1 in the
Proposal in the Nature of the Research Design for the Study
section. This section provides the foundation for Research
Materials,Instrumentation (quantitative), or Sources of Data
(qualitative) section in Chapter 3.
Reviewer Comments:Data Collection
The data collection process will be based on informed consent.
Each respondent will be at liberty to provide data and also free
to withdraw from the research process. Moreover, the
confidentially and privacy of respondents will be protected.The
data will be collected through having patients who are at least
in a stable condition in that they can have that freeway of
having the ideas of contains the study. I will consider having
one patient after another so that I will judge the information
that they are providing if it's legible for the study (Iland at el
2015). I will also use the questioners that will not involve the
addition of the names of the response in order to keep the
information private and protect patients from any harm from
their responses.
The process will be as follows:
· Interviews will be conducted in a cool and conducive
environment that is free from disturbance.
· The respondent will answer the questions without any
influence from the researcher.
· The researcher will guide the respondent throughout the
process.
· The questionnaires will be given to the respondents who will
fill them and later return the filled questionnaires to the

researcher.
Criteria
(0-3)
Chair or Score
(0-3)
Reviewer Score
(0-3)
DATA COLLECTION AND MANAGEMENT
This section details the data …
10 STRATEGIC POINTS2
Ten Strategic Points
DNP-835-0501- Patient Outcomes and Sustainable Change
10 Strategic Points Table
(Use this table to complete the 10 Strategic Points document for
your project.)
10 Strategic Points
Comments/Feedback
Broad Topic Area

Impact of Medication Administration Errors on 3-4-Year-old
Leukemia Patients
Literature Review
A. Verghese, A., Charlton, B., Kassirer, J. P., Ramsey, M., &
Ioannidis, J. P. (2015). Inadequacies of physical examination as
a cause of medical errors and adverse events: a collection of
vignettes. The American journal of medicine, 128(12), 1322-
1324.
The authors in this article examines the “Inadequacies of
physical examination as a cause of medical errors and adverse
events: a collection of vignettes” from the American journal of
medicine. It takes into consideration the fact that, the oversights
in the corporeal assessment are a medical fault which aren’t
studied via chart evaluation. Furthermore, the article states that
these oversights in the corporeal assessments may be the
primary contributors to the neglected or late diagnosis besides
unnecessary exposure to contrast as well as radiation on the
Leukemia patients. Either the authors indicate that the incorrect
treatments resulting from these delays leads to unfavorable
results like fainting on the Leukemia patient, lack of appetite on
the side of the patient, worsening the Leukemia conditions
which eventually can lead to early death of the patient.
B. Hockings, J. K., Owolabi, D. K., Broyles, J. E., & Wheelis,
S. C. (2017). Impact of medication administration error on over
3 years Leukemia patients and the stimulating factors in acute
leukemia and stem cell transplant patients. Supportive Care in
Cancer, 25(6), 1853-1858.
The authors of this article explored the “Impact of medication
administration error on over 3 years Leukemia patients and the
stimulating factors in acute leukemia and stem cell transplant
patients.” This article is from supportive care in cancer and it
was retrieved from Google Scholar. The article authors
acknowledge the fact that, the medication administration errors
lead to severe impacts on the health conditions of the patient

more especially the ones who are 3 – 4 years of Leukemia.
According to the authors, the impacts associated with the
medication administration errors may lead to worsening of the
health condition of the patient, the rate of Leukemia
advancement into higher stages may also increase with
treatment or managing of this deadly disease being more
complicated. The authors argue that using erroneous medicines,
the Leukemia advancement increases without the knowledge of
the patient which makes even the survival chances of the patient
to reduce due to stress upon realizing that there was an error in
his or her medication.
C. Douer, D. (2016). Efficacy and safety of vincristine sulfate
liposome injection in the treatment of adult acute lymphocytic
leukemia. The oncologist, 21(7), 840-847.
This research study examines the “Efficacy and safety
vincristine sulfate liposome injection in the treatment of adult
acute lymphocytic Leukemia” this article is from the oncologist.
The article has been retrieved from Google Scholar. The authors
take into consideration on the erroneous administration of
vincristine sulfate liposome injection drug which is commonly
used for treatment of Leukemia more especially at the lower
stages like this of 3 – 4 years. However, when this drug is
misused, it leads to instant death according to the author since
even when it’s correctly applied, it’s normally restricted due to
neurotoxicity concerns. The author indicates that if a patient
with large body surface area to volume ratio is overdosed with
the drug, it will lead to death or reduction of the survival rates
to almost 20% in accordance with the authors’ analysis.
D. Tavitian, S., Denis, A., Vergez, F., Berard, E., Sarry, A.,
Huynh, A., ... & Bertoli, S. (2016). Impact of obesity in
favorable‐risk AML patients receiving intensive chemotherapy.
American journal of hematology, 91(2), 193-198.
The authors of this article analyze the “Impact of obesity in
favorable risk AML patients receiving intensive chemotherapy”

an article from American journal of hematology. The article has
been retrieved from Google Scholar. According to the authors,
the obesity has got negative impacts more especially to the
Leukemia patients who are receiving intensive chemotherapy
while trying to manage it at the earlier stages. According to the
authors, the erroneous medication administration to such
Leukemia patients may lead to paralysis in the earlier stages as
well as earlier death if the erroneous medication isn’t
recognized earlier.
E. Santoleri, F., Lasala, R., Ranucci, E., La Barba, G., Di
Lorenzo, R., Vetrò, A., ... & Costantini, A. (2016). Medication
adherence to tyrosine kinase inhibitors: 2-year analysis of
medication adherence to imatinib treatment for chronic myeloid
leukemia and correlation with the depth of molecular response.
Acta haematologica, 136(1), 45-51.
This last article explores “Medication adherence to tyrosine
kinase inhibitors: 2-year analysis of medication adherence to
imatinib treatment for chronic myeloid leukemia and correlation
with the depth of molecular response.” From Acta
haematologica, the article is retrieved from Google Scholar. In
accordance with the authors of the article, adherence to tyrosine
medication can help in the treatment of Leukemia more
especially at the earlier stage of 3 – 4 years. However, the
authors stresses that the erroneous administration of these drugs
that are meant to cure the Leukemia, they can turn out to be a
poison in the body which facilitates the advancement of the
disease in the body and eventually leads to coma and
consequently death.
From the above articles, various variables were identified which
includes, the patients served between 4AM to 8AM experience
higher rates of erroneous medication which is a time dependent
variable. The second variable is on the medication ordered by
practicing nurses, with resultant observation that it is very high
more especially during weekends. This is an independent
variable. The year of the trainee also means that a dependent

variable in the last first year trainees committed many erroneous
administrations of medication compared to final years trainees.
Problem Statement
It is not known the impact of medication administration errors
on 3-4-year-old leukemia patients
Clinical/PICO Questions
What is the impact of medication administration errors in
pediatric patients?
What are the impacts of medication administration errors on 3-
4-Year-old Leukemia Patients?
Sample
· Location– Harris County, Texas. USA
· Target Population:
· Pediatric Hospitals/ Patients
· 3-4-Year-old Leukemia Patients
· Physicians
· Therapists
Sample: Will be composed of interviews with 5 pediatric
hospitals, physicians, parents and 5 Therapists in the county.
Define Variables
To effectively understand the impact of medication
administration errors on 3-4-year-old Leukemia patients, the
following variables would be used.
· The number of patients seen who erroneously administered
medication are – dependent variable
· Medication ordered by the trainees – independent variable
· The year the trainee is in medical practicing like first year or
final year – independent variable.
Methodology and Design
Qualitative Descriptive Study

Purpose Statement
The purpose of this qualitative descriptive case study is to
understand are the impacts of medication administration errors
on 3-4-Year-old Leukemia Patients in Harris County, Texas?
Data Collection Approach
· Informed & signed consent by participants
· Visits to pediatric hospital facilities
· Interview with Physicians, Parents & Therapist recorded on
tape
· Sampling Method: Purposeful Sampling
· Sources: Interviews, Surveys & Questionnaires
Data Analysis Approach
· Data will be collected and analyzed for the study.
· Descriptive statistics will be used in summarizing the data
collected.
· Coding will be used to address questions posed.
· A narrative summary will be developed.
References

Douer, D. (2016). Efficacy and safety of vincristine sulfate
liposome injection in the treatment of adult acute lymphocytic
leukemia. The oncologist, 21(7), 840-847.
Hockings, J. K., Owolabi, D. K., Broyles, J. E., & Wheelis, S.
C. (2017). Impact of medication administration error on over 3
years Leukemia patients and the stimulating factors in acute
leukemia and stem cell transplant patients. Supportive Care in
Cancer, 25(6), 1853-1858.
Santoleri, F., Lasala, R., Ranucci, E., La Barba, G., Di Lorenzo,
R., Vetrò, A., ... & Costantini, A. (2016). Medication adherence
to tyrosine kinase inhibitors: 2-year analysis of medication
adherence to imatinib treatment for chronic myeloid leukemia
and correlation with the depth of molecular response. Acta
haematologica, 136(1), 45-51.
Tavitian, S., Denis, A., Vergez, F., Berard, E., Sarry, A.,
Huynh, A., ... & Bertoli, S. (2016). Impact of obesity in
favorable‐risk AML patients receiving intensive chemotherapy.
American journal of hematology, 91(2), 193-198.
Verghese, A., Charlton, B., Kassirer, J. P., Ramsey, M., &
Ioannidis, J. P. (2015). Inadequacies of physical examination as
a cause of medical errors and adverse events: a collection of
vignettes. The American journal of medicine, 128(12), 1322-
1324.
10
WORKING WITH INFERENTIAL STATISTICS
2
WORKING WITH INFERENTIAL STATISTICS
2
Working with Inferential Statistics
DNP-830-0502: Data Analysis

Introduction
Inferential statistics is the method used to draw inferences
regarding a population after analyzing a randomly selected
sample. According to (Simonsohn & Nelson, 2015) inferential
statistic allows one to use a small portion of the population to
make assumptions about the whole at large. Independent t-test
is used to test if the means of two unrelated groups are
statistically differ from each other whereas the ANOVA helps to
determine if there are any differences between the means of
more than one independent groups. The data provided can be
analyzed to investigate whether injures caused by children
differed based on type of movie, length or years of creating the
movie, and even the violence time in a movie.
Determining Statistics using a One-Tailed t-test (Question 1)
To investigate whether the children who were exposed to
movies that were created before 1980 actually caused more
injuries than those children who were exposed to movies after
1980, we perform an independent t-test. Injuries variable is
considered to be the dependent variable whereas the year of
movie release is the independent variable. The independent
variable in this case will have two groups: “children exposed to
movies created before 1980”, labelled as 1 and “children
exposed to movies created after 1980”, labelled as 2. The SPSS
(Ho, 2006) output for comparing the means is as shown below:
Table 1: Group Statistics
Group Statistics
Movie_Created
N
Mean
Std. Deviation
Std. Error Mean
Injuries
children exposed to movies created before 1980

23
.74
1.010
.211
children exposed to movies created after 1980
51
2.12
2.016
.282
Table 2
Independent Samples Test Results
Levene's Test for Equality of Variances
t-test for Equality of Means
F
Sig.
t
df
Sig. (2-tailed)
Mean Difference
Std. Error Difference
95% Confidence Interval of the Difference
Lower
Upper
Injuries

Equal variances assumed
9.439
.003
-3.100
72
.003
-1.379
.445
-2.265
-.492
Equal variances not assumed
-3.914
71.10
.000
-1.379
.352
-2.081
-.676
The study determined that the hypothesis that those children
who were exposed to movies created before the year 1980
caused more injuries than those children who were exposed to
movies after 1980 was false since they caused statistically
significantly lower injuries compared to those children who
were exposed to movies after 1980, t (72) = -3.1, p=0.003.
ANOVA (Question 2)
To investigate the group that actually caused a lot of injuries we
analyzed injuries as the dependent variable and year as the
independent variable with the following groups:
“1” = children exposed to movies created between 1937-1960
“2” = children exposed to movies created between 1961-1989

“3” = children exposed to movies created between
1990-1999
Table 3: Descriptive Statistics
Descriptive
Injuries
N
Mean
Std. Deviation
Std. Error
95% Confidence Interval for Mean
Minimum
Maximum
Lower Bound
Upper Bound
1937-1960
13
1.00
1.000
.277
.40

1.60
0
3
1961-1989
21
1.62
2.037
.444
.69
2.55
0
6
1990-1999
40
1.95
1.974
.312
1.32
2.58
0
9
Total
74
1.69
1.872
.218
1.26
2.12
0
9
As required
Table 4: ANOVA
ANOVA
Injuries

Sum of Squares
df
Mean Square
F
Sig.
Between Groups
8.999
2
4.499
1.294
.281
Within Groups
246.852
71
3.477
Total
255.851
73
Based on the results, it can be deduced that there is a
statistically significance difference between the three groups as
shown by one-way ANOVA (F (2,71) = 1.294, p =0.281). The
group that has caused more injuries is that group with children
who were exposed to movies that were created between 1990-
1999 with a mean of 1.95, followed by that group of children
who were exposed to movies that were created between 1961-
1989 with 1.62 mean and children exposed to movies created
between the years 1937-1960 cause the least injuries

characterized by a mean of 1 as shown in the Table 2 of
descriptive statistics.
Conclusion
The assumptions for the Analysis of Variance (ANOVA) and the
one tailed t- test were met prior to conducting the analysis by
ensuring that the dependent variable “injuries” was a continuous
approximately normally distributed variable while the
independent variable “year” consisted of two independent
groups: movie that were created before 1980 and those movies
that created after 1980 (Moore et al., 2015).. There was also
homogeneity of variances as demonstrated by the Levene's test
(Lowry, 2014). Additionally, there were no significant outlies in
the variables analyzed. In conclusion, the discussed statistical
analysis can be very instrumental in deducing assumptions of a
population by simple analyzing a sample. How different
variable relate can also be determined.
References
Ho, R. (2006). Handbook of univariate and multivariate data
analysis and interpretation with SPSS. Chapman and Hall/CRC.
Lowry, R. (2014). Concepts and applications of inferential
statistics.
Simonsohn, U., Simmons, J. P., & Nelson, L. D. (2015).
Specification curve: Descriptive and inferential statistics on all
reasonable specifications.
Moore, D. S., Notz, W. I., Flinger, M. A. (2015). Basic Practice
of Statistics 6th Edition.
QUALITY AND SUSTAINABILITY: PART ONE 2
2
QUALITY AND SAFETY

Quality and Safety
Introduction
Patient safety is the essential foundation of delivering high-
quality health care. It is viewed as the underlying umbrella of
patient safety. According to the Institute of Medicine (IOM),
patient safety is indistinguishable from delivering high quality
health care. The organization defined it as “the degree to which
health services for individuals and populations increase the
likelihood of desired health outcomes and are consistent with
current professional knowledge.” Prevention of harm in its
practices have mostly defined by negative outcomes of care that
include mortality and morbidity (Mitchell, 2008). This project
discusses the role of quality and/or safety in nursing science
with emphasis on quality and/or safety measures and description
of their relationship and role in present-day nursing science and
how it applies quality or safety measures in nursing science. In
addition, it provided the components required to analyze a
health care program’s outcome (GCU, 2020).
Defining Quality and Safety Measures

According to the World Health Organization (WHO), quality in
nursing refers to “the extent to which health care services
provided to individuals and patient populations improve desired
health outcomes” (Salyers et al., 2017). For this to be achieved,
nursing practice must be people-centered, equitable, efficient,
timely effective and safe. While there are numerous ways of
developing, assessing and assuring quality, the concept of
quality in nursing care is difficult to measure. In the healthcare
setting, there are promises of providing quality care by nurses
and desired by patients. Quality care has significant impact on
patient experience and satisfaction. As the nursing environment
becomes more complex, organization leaders must understand
the role of quality in healthcare.
Regarding safety, it is yet an important component of high-
quality healthcare. You cannot talk about quality healthcare
without talking about safety. Multiple studies show that many
patients are harmed in healthcare facilities, which increases
their length of hospital stay or resulting in permanent injuries.
In severe cases lack of safety in healthcare results in death.
Studies show that this harm is not intentional, but as a result of
the multifaceted and complex nursing environment with the
outcome of a patient depending on a wide range of factors.
Multiple strategies have however been developed to improve
safety in healthcare.
Quality plays an important role in nursing practice. Healthcare
organizations must provide quality healthcare services to meet
the needs of their patients and the community in general. This
not only improves the outcome of patients but also increases
nurse satisfaction resulting in improved performance. Quality
ensures that healthcare organizations provide patient centered
services that take into consideration people’s aspirations and
preferences as well as the culture of their community. It also
ensures all patients receive equitable services regardless of their
personal characteristics such as socioeconomic status,
geographical location, ethnicity, race, or gender.
Quality in nursing also ensures that patients receive healthcare

on time and without delays. Once patients are admitted in the
healthcare system, they need to receive care as soon as possible.
It also ensures efficiency in the healthcare system. This implies
that healthcare is delivered in a manner that avoids wastage and
maximizes all resources available. Quality ensures there is
safety in delivering healthcare services to patients. This
involves delivering car that harm and risk to patients including
reducing medical errors and avoiding preventable injuries.
Providing quality care is therefore a critical part of
strengthening health systems (Graban, 2018).
The roles of safety measures in nursing practice is to ensure
reduce the likelihood of mistakes and limit harm though
planning that promotes effective communication. Nurse
practitioners, support staff and patients share a common goal; to
achieve the best health outcome possible. Safety in healthcare
promotes the well-being of the general community. Nurse
practitioners and healthcare managers must understand their
role in patient safety. Administrators must train all employees
about safety in the healthcare setting and updater the regularly
on any changes in policy. All employees in healthcare setting
must adhere to the safety procedures developed by the
organization.
Contemporary Example
There are various ways in which healthcare organizations apply
quality and safety measures in the healthcare system. One way
of ensuring safety quality and safety measures is by
communicating safety among patients. Patients have historically
played a passive role in their recovery process. Patients placed
significant trust on healthcare providers and unquestioningly
followed treatment plans. However, today healthcare
organizations emphasize on educating patients to help reduce
medical errors. Once patients are admitted in the healthcare
system, they receive specific information concerning their
safety. Patients are encouraged to ask questions where they
don’t understand to help prevent common healthcare errors that
could lead to undesirable outcomes (Vincent & Staines, 2019).

At the present, patients take part in their recovery planning.
They have increasingly become more involved in the treatment
progress. Therefore, they receive safer treatment as educated
consumers because health advocates and care providers have
helped them to develop the ability to notice potential problems
and ask relevant questions. Even after leaving healthcare
organizations, patients are able to monitor their situation and
determine when something goes wrong. As a result, more
patients are receiving quality treatment increasing their
outcomes. Patient education has proved to be an effective
approach in reducing medical errors that have historically
dominated the healthcare systems around the world (Modi et al.,
(2019).
Contemporary nursing practice has become more patient
centered. Whenever people talk about service quality, patient
centered care is always mentioned. Initially the philosophy was
considered to undermine the efforts of evidence-based practice.
However, health advocates now consider patient centered care
as an important framework for fostering desired wellness
outcomes. It allows nurse practitioners to incorporate evidence-
based practice in providing care to patients. Patients feel more
secure and trust the process, and they are fully aware of what to
expect. This awareness makes it easy for healthcare providers to
avoid making mistakes when dealing with patients. This also
eliminated illegal activities I the healthcare systems as
information is readily available.
Quality and Components Needed to Analyze a Health Care
Program's Outcomes
There are numerous components that can be used to analyze the
outcomes of a particular healthcare program. One of these
components is effectiveness. This involves providing healthcare
services based on evidence-based guidelines and scientific
knowledge. This helps to analyze patient outcomes by
determining whether recommended hospital care is utilized for
specific medical conditions such as prevention of surgical
infection, heart attack and pneumonia care. Timeliness is

another component needed to analyze the outcomes of
healthcare programs. Patients need to receive medical care
without any delays. In this quality measure, the patient reports
on the timeliness of care and services they received in a
particular healthcare facility (Brown, Dickinson & Kelaher,
2018).
Patient centeredness is another measure that is used to analyze
the outcomes of health care programs. This component involves
taking care of patients while considering their preferences. It
can be measured through reviewing patient reports of services
offered by an organization. It can also be analyzed by
determining whether a healthcare organization provided care
instructions after a patient has been discharged from hospital. In
patient centered care, people are given instructions on how to
care themselves at home. Failure to give these instructions
shows that the healthcare facility or hospital does not offer
patient centered care (Allen et al., 2016).
Another component that can be used to analyze the outcomes of
a particular healthcare program is efficiency. This component
involves providing services and care that minimizes wastage
and maximizes the available resources. This component can be
analyzed by utilization of hospital procedures and services as
measured by the average hospital stay or hospital discharge
rate. A low rate of discharge from the hospital shows lack of
efficiency in delivering healthcare services to patients. In the
same way, a high rate of hospital discharge is an indicator of an
effective healthcare system. Either way, an efficient healthcare
program must ensure patients receive quality healthcare services
(Lamé & Dixon-Woods, 2018).
Equity is also an important component in analyzing outcomes of
healthcare programs. This involves determining whether
patients receive equitable services regardless of their personal
characteristics such as socioeconomic status, geographical
location, ethnicity, race, or gender. Hospitals can provide
equitable services by ensuring they have equal number of beds
for both genders and ensuring there is no discrimination in the

healthcare setting. Electronic medical records can be used to
determine the services provided for every patient who visited a
particular hospital. Nurse to patient ration can also provide
critical information for the analysis of outcomes of healthcare
programs.
Conclusion
Patient safety remains the cornerstone in the provision of high-
quality health care. Health care professionals, especially nurses
are extremely important to the care, control, supervision and
coordination that will help in reducing negative or adverse
outcomes. The numerous government healthcare organizations
in collaboration with healthcare professionals must continue to
work on evaluating the impact of nursing care on positive
quality indicators that include appropriate self-care and other
measures of improved health status (Mitchell, 2008).
References
Allen, D., Braithwaite, J., Sandall, J., & Waring, J. (2016).
Towards a sociology of healthcare safety and quality. Sociology
of Health & Illness, 38(2), 181-197. Retrieved from

https://onlinelibrary.wiley.com/doi/full/10.1111/1467-
9566.12390
Brown, A., Dickinson, H., & Kelaher, M. (2018). Governing the
quality and safety of healthcare: A conceptual
framework. Social Science & Medicine, 202, 99-107. Retrieved
from
https://www.sciencedirect.com/science/article/abs/pii/S0277953
618300765
Graban, M. (2018). Lean hospitals: improving quality, patient
safety, and employee engagement. Productivity Press. Retrieved
grom https://www.taylorfrancis.com/books/9781315380827
Lamé, G., & Dixon-Woods, M. (2018). Using clinical
simulation to study how to improve quality and safety in
healthcare. BMJ Simulation and Technology Enhanced
Learning. Retrieved from
https://stel.bmj.com/content/early/2018/11/08/bmjstel-2018-
000370.abstract
Mitchell, P. H. (2008). Patient Safety and Quality: An
Evidence-Based Handbook for Nurses. Retrieved from
https://www.ncbi.nlm.nih.gov/books/NBK2681/
Modi, S., Ozaydin, B., Zengul, F., & Feldman, S. S. (2019). The
emerging literature for the triad of health informatics,
healthcare quality and safety, and healthcare simulation. Health
Systems, 8(3), 215-227. Retrieved from
https://orsociety.tandfonline.com/doi/abs/10.1080/20476965.201
9.1687263
Salyers, M. P., Bonfils, K. A., Luther, L., Firmin, R. L., White,
D. A., Adams, E. L., & Rollins, A. L. (2017). The relationship
between professional burnout and quality and safety in
healthcare: a meta-analysis. Journal of general internal
medicine, 32(4), 475-482. Retrieved rrom
https://link.springer.com/article/10.1007/s11606-016-3886-9
Vincent, C., & Staines, A. (2019). Enhancing the Quality and
Safety of Swiss Healthcare. Retrieved from
https://www.bag.admin.ch/dam/bag/fr/dokumente/kuv-
leistungen/qualitaetssicherung/Enhancing%20the%20Quality%2

0and%20Safety%20of%20Swiss%20Healthcare-EN.pdf.d
I, (Bola Odusola-Stephen), verify that I have completed (10)
clock hours in association with the goals and objectives for this
assignment. I have also tracked said practice hours in the
Typhon Student Tracking System for verification purposes and
will be sure that all approvals are in place from my faculty and
practice mentor.
DNP-840
Comprehensive Assessment Part One: Competency Matrix
For each competency below, provide no more than one or two
sentences to explain how you met the competency through
selected coursework. You will expand upon these achievements
in the "Comprehensive Assessment Part Two: Outcomes and
Reflection" assignment. Note: You are not required to complete
every column for each competency. Select evidence from
coursework relevant to that particular competency to discuss.
Minimally, you should have one column complete for each

competency.
DNP Program Competencies
Programmatic Coursework: Summary of Competency
Achievement
Section One: Programmatic Assessments
Reflective Journals
Case Reports
Scholarly Activities
10 Strategic Points
DPI Project Draft Prospectus
Literature Review
Course Assignments With Practice Immersion Hours
(DNP-805 Through DNP-840 - Include Assignment Title)
1.2: Apply science-based theories and concepts to determine the
nature and significance of health and health care delivery
phenomena.
1.3: Employ science-based theories and concepts to describe
the actions and advanced strategies to enhance, alleviate, and
ameliorate health and health care delivery phenomena as
appropriate.
2.1: Employ principles of business, finance, economics, and

health policy to develop and implement effective plans for
practice-level and/or system-wide practice initiatives that will
improve the quality of health care delivery.
2.2: Demonstrate leadership, influence, and advocacy in the
development and implementation of institutional, local, state,
federal, and/or international health policy.
2.4: Provide leadership in the evaluation and resolution of
policy, ethical, and legal issues within health care systems.
3.1: Demonstrate the conceptual ability and technical skills to
develop and execute an evaluation plan involving data
extraction from practice information systems and databases.

3.2: Evaluate current consumer health information sources for
accuracy, timeliness, and appropriateness.
3.4: Design, select, use, and evaluate programs that monitor
outcomes of care, care systems, and quality improvement
including consumer use of health care information systems.
4.1: Analyze epidemiological, biostatistical, environmental,
and other appropriate scientific data related to individual,
aggregate, and population health.
4.4: Advocate for social justice, equity, and ethical policies
within all health care arenas.

5.2: Design and implement processes/strategies that evaluate
outcomes of practice, practice patterns, and systems of care for
individual, aggregate, and populations against national
benchmarks.
5.3: Design, direct, and evaluate quality improvement
methodologies to promote safe, timely, effective, efficient,
equitable, and patient-centered care.
© 2015. Grand Canyon University. All Rights Reserved.
3
QUANTITATIVE METHODS OF INQUIRY 2
2

QUANTITATIVE METHODS OF INQUIRY
Quantitative Methods of Inquiry
Quantitative Methods of Inquiry
Quantitative methods of inquiry focus on gathering and
generalizing data through group’s people or describing a
particular phenomenon. According Letourneau University
(2019), quantitative methods emphasize on objective
measurements and the statistical, mathematical, or
numerical analysis of data collected through polls,
questionnaires, and surveys, or by manipulating pre-existing
statistical data using computational techniques. This type of
study uses interrelated set of variables to emphasize on
objective measurements while trying to establish associations
between variables. According to Clankie (2012), quantitative
method is a number driven analysis in which a researcher knows
what he or she is looking for in advance. The researcher
controls the whole experiment.
Quantitative methodologies allow researchers to quantify human

actions. While not all actions can be quantified, researchers
implement experiment research, survey research, content
analysis and meta-analysis in order to simplify their work.
These are hypothetic-deductive methods that can be quantified.
According Paynton and Hahn (2014), experimental research
uses the principles of research in the physical sciences to
conduct experiments that explore human behavior. The
researcher generally includes research control group and
experimental group in order to monitor different reactions to
different variable. This type of quantitative research can be
conducted in a real world setting or lab setting.
Survey research focuses on a number of questions designed to
cover a particular topic. According Paynton and Hahn (2014),
surveys; online, mailed, handed out, or conducted in interview
format, collect and represent participant responses in numerical
form using tables, graphs, charts, or percentages. The data is
then manipulated to come up with a conclusion about the topic.
On the other hand, content analysis is a method in which
researchers use content analysis to count the number of
occurrences of their particular focus of inquiry (Paynton
&Hahn, 2014). The researcher observes the human actions,
converts these actions to numbers and manipulates these
numbers to interpret the data by coming up with patterns or
trends that can be used to make claims on the significance of
the data.
Meta-analysis involves structured study of past literatures
discussing the topic area you want to analyze. According to
Paynton and Hahn (2014), meta-analysis analyzes existing
statistics found in a collection of quantitative research to
demonstrate patterns in a particular line of research over time.
Results from these studies are used to determine if similarity
exists among the studies or come up with new information.
In the year 2014, a mean number of 604, 175 were discharged
from all the states with the median number of discharges
standing at 393002 patients and 49564a as the mode.
Statistics

V5
N
Valid
31
Missing
3
Mean
604175.23
Median
393002.00
Mode
49564a
a. Multiple modes exist. The smallest value is shown
Fig1: Mean Median and Mode of discharges by state in 2014.
The total number of discharges in the year 2010 were
23,455,503 patients, 18,661,237 in 2012 and 13,976,012 in the
year 2015. In the year 2010, the number of discharges was
greater compared to the year 2015. These results show a
significant decrease of 9,469,491 discharges from the year 2010
to the year 2015.
Fig2: Simple Bar Graph for the year 2010, 2012 and 2015
Compared on the basis of location, North West states have the
lowest number of discharges, 2,543,090. On the other hand,
these numbers increase in North East States which have
7,742,830 numbers of discharges. Central States have 4,002,549
number of discharges, 5,724,239 in South Eastern states and
5,415,098 in the southwest states. There is no significant
difference between these discharges in most states in the year
2011.
Fig3: Discharges Comparison based on the location in the year
2011

References
Clankie, S., & Mima, T. (2012). A brief Comparison of
Qualitative and Quantitative Research Methods [Video file]
URL: https://www.youtube.com/watch?v=LYqDKEsy9gE
Letourneau University (2019). Quantitative Research and
Analysis. Research Guides. Retrieved From https://lib-
guides.letu.edu/quantresearch
Paynton, T. Scott & Hahn, K. Linda. (2014). Ouantitative
Method. Survey of Communication Study. Retrieved From
https://courses.lumenlearning.com/introductiontocommunication
/chapter/quantitative-methods/
practice mentor.

WORKING WITH DESCRIPTIVE STATISTICS 2
2
WORKING WITH DESCRIPTIVE STATISTICS
Working with Descriptive Statistics
Working with Descriptive Statistics
The descriptive test to be done in this assignment will be based
on the statistics gender to give the frequency account, mean,
standard deviation, minimum and maximum. In addition to this,
the bar graph containing the gender and the sugar axis will be
created.
The data to be used for the assignment is that of the group of
patients that were diagnosed with diabetes. During the

diagnosis, the blood sugar of each individual was recorded as
shown below.
Men
74
71
75
248
388
505
42
21
Female
62
68
61
71
68
80
390
148
Frequency Count is the measure of the number of times that the
event occurs (Narkhede, 2018). From the data provided, the
frequency count is 8 for both males and females.
Mean is referred to as the average of the data provided. It is
used to derive the central tendency. The mean of our data is
182.50 for males and 118.50 for females.
Standard deviation is the measure of how the data spread. Its
major use is the comparison of the data which is characterized
by the same mean but the different range (Donges 2018). The
standard deviation of our data is 184.438 for males and 113.339
for females.
The minimum is the greatest element of the sample. Our
minimum is 21 in men and 61 in the female.
Maximum is the largest element of the sample. The maximum is
505 in men and 390 in the female.

From table 2, the frequency distribution of the male variable is
1. This shows that each value of the variable only appeared
once.
Unlike table 1, table 3 which has the frequency of the female
blood sugar has a frequency of 1 in all the values except 68
which has the frequency of 2.
Appendix
Table 1 the means and the standard deviation
Report
male
female
Mean
182.50
118.50
N
8
8
Std. Deviation
184.438
113.339
Graphing and Descriptive Stats in SPSS

References
Donges, N. (2018). Intro to Descriptive Statistics. Retrieved
from: https://towardsdatascience.com/intro-to-descriptive-
statistics-252e9c464ac9
Narkhede, S. (2018). Understanding Descriptive Statistics.
Retrieved from: https://towardsdatascience.com/understanding-
descriptive-statistics-c9c2b0641291?gi=8b370314b330
practice mentor.
QUALITY AND SUSTAINABILITY-PART TWO 2
2
QUALITY AND SAFETY PART 2
Quality and Safety Part 2

Introduction
Patient safety is the essential foundation of delivering high-
quality health care. It is viewed as the underlying umbrella of
patient safety. According to the Institute of Medicine (IOM),
patient safety is indistinguishable from delivering high quality
health care. The organization defined it as “the degree to which
health services for individuals and populations increase the
likelihood of desired health outcomes and are consistent with
current professional knowledge.” Prevention of harm in its
practices have mostly defined by negative outcomes of care that
include mortality and morbidity (Mitchell, 2008). This project
discusses the role of quality and/or safety in nursing science
with emphasis on quality and/or safety measures and description
of their relationship and role in present-day nursing science and
how it applies quality or safety measures in nursing science. In
addition, it provided the components required to analyze a
health care program’s outcome (GCU, 2020).
Defining Quality and Safety Measures
According to the World Health Organization (WHO), quality in
nursing refers to “the extent to which health care services
provided to individuals and patient populations improve desired
health outcomes” (Salyers et al., 2017). For this to be achieved,
nursing practice must be people-centered, equitable, efficient,
timely effective and safe. While there are numerous ways of
developing, assessing and assuring quality, the concept of
quality in nursing care is difficult to measure. In the healthcare
setting, there are promises of providing quality care by nurses

and desired by patients. Quality care has significant impact on
patient experience and satisfaction. As the nursing environment
becomes more complex, organization leaders must understand
the role of quality in healthcare.
Regarding safety, it is yet an important component of high-
quality healthcare. You cannot talk about quality healthcare
without talking about safety. Multiple studies show that many
patients are harmed in healthcare facilities, which increases
their length of hospital stay or resulting in permanent injuries.
In severe cases lack of safety in healthcare results in death.
Studies show that this harm is not intentional, but as a result of
the multifaceted and complex nursing environment with the
outcome of a patient depending on a wide range of factors.
Multiple strategies have however been developed to improve
safety in healthcare.
Quality plays an important role in nursing practice. Healthcare
organizations must provide quality healthcare services to meet
the needs of their patients and the community in general. This
not only improves the outcome of patients but also increases
nurse satisfaction resulting in improved performance. Quality
ensures that healthcare organizations provide patient centered
services that take into consideration people’s aspirations and
preferences as well as the culture of their community. It also
ensures all patients receive equitable services regardless of their
personal characteristics such as socioeconomic status,
geographical location, ethnicity, race, or gender.
Quality in nursing also ensures that patients receive healthcare
on time and without delays. Once patients are admitted in the
healthcare system, they need to receive care as soon as possible.
It also ensures efficiency in the healthcare system. This implies
that healthcare is delivered in a manner that avoids wastage and
maximizes all resources available. Quality ensures there is
safety in delivering healthcare services to patients. This
involves delivering car that harm and risk to patients including
reducing medical errors and avoiding preventable injuries.
Providing quality care is therefore a critical part of

strengthening health systems (Graban, 2018).
The roles of safety measures in nursing practice is to ensure
reduce the likelihood of mistakes and limit harm though
planning that promotes effective communication. Nurse
practitioners, support staff and patients share a common goal; to
achieve the best health outcome possible. Safety in healthcare
promotes the well-being of the general community. Nurse
practitioners and healthcare managers must understand their
role in patient safety. Administrators must train all employees
about safety in the healthcare setting and updater the regularly
on any changes in policy. All employees in healthcare setting
must adhere to the safety procedures developed by the
organization.
Contemporary Example
There are various ways in which healthcare organizations apply
quality and safety measures in the healthcare system. One way
of ensuring safety quality and safety measures is by
communicating safety among patients. Patients have historically
played a passive role in their recovery process. Patients placed
significant trust on healthcare providers and unquestioningly
followed treatment plans. However, today healthcare
organizations emphasize on educating patients to help reduce
medical errors. Once patients are admitted in the healthcare
system, they receive specific information concerning their
safety. Patients are encouraged to ask questions where they
don’t understand to help prevent common healthcare errors that
could lead to undesirable outcomes (Vincent & Staines, 2019).
At the present, patients take part in their recovery planning.
They have increasingly become more involved in the treatment
progress. Therefore, they receive safer treatment as educated
consumers because health advocates and care providers have
helped them to develop the ability to notice potential problems
and ask relevant questions. Even after leaving healthcare
organizations, patients are able to monitor their situation and
determine when something goes wrong. As a result, more
patients are receiving quality treatment increasing their

outcomes. Patient education has proved to be an effective
approach in reducing medical errors that have historically
dominated the healthcare systems around the world (Modi et al.,
(2019).
Contemporary nursing practice has become more patient
centered. Whenever people talk about service quality, patient
centered care is always mentioned. Initially the philosophy was
considered to undermine the efforts of evidence-based practice.
However, health advocates now consider patient centered care
as an important framework for fostering desired wellness
outcomes. It allows nurse practitioners to incorporate evidence-
based practice in providing care to patients. Patients feel more
secure and trust the process, and they are fully aware of what to
expect. This awareness makes it easy for healthcare providers to
avoid making mistakes when dealing with patients. This also
eliminated illegal activities I the healthcare systems as
information is readily available.
Quality and Components Needed to Analyze a Health Care
Program's Outcomes
There are numerous components that can be used to analyze the
outcomes of a particular healthcare program. One of these
components is effectiveness. This involves providing healthcare
services based on evidence-based guidelines and scientific
knowledge. This helps to analyze patient outcomes by
determining whether recommended hospital care is utilized for
specific medical conditions such as prevention of surgical
infection, heart attack and pneumonia care. Timeliness is
another component needed to analyze the outcomes of
healthcare programs. Patients need to receive medical care
without any delays. In this quality measure, the patient reports
on the timeliness of care and services they received in a
particular healthcare facility (Brown, Dickinson & Kelaher,
2018).
Patient centeredness is another measure that is used to analyze
the outcomes of health care programs. This component involves
taking care of patients while considering their preferences. It

can be measured through reviewing patient reports of services
offered by an organization. It can also be analyzed by
determining whether a healthcare organization provided care
instructions after a patient has been discharged from hospital. In
patient centered care, people are given instructions on how to
care themselves at home. Failure to give these instructions
shows that the healthcare facility or hospital does not offer
patient centered care (Allen et al., 2016).
Another component that can be used to analyze the outcomes of
a particular healthcare program is efficiency. This component
involves providing services and care that minimizes wastage
and maximizes the available resources. This component can be
analyzed by utilization of hospital procedures and services as
measured by the average hospital stay or hospital discharge
rate. A low rate of discharge from the hospital shows lack of
efficiency in delivering healthcare services to patients. In the
same way, a high rate of hospital discharge is an indicator of an
effective healthcare system. Either way, an efficient healthcare
program must ensure patients receive quality healthcare services
(Lamé & Dixon-Woods, 2018).
Equity is also an important component in analyzing outcomes of
healthcare programs. This involves determining whether
patients receive equitable services regardless of their personal
characteristics such as socioeconomic status, geographical
location, ethnicity, race, or gender. Hospitals can provide
equitable services by ensuring they have equal number of beds
for both genders and ensuring there is no discrimination in the
healthcare setting. Electronic medical records can be used to
determine the services provided for every patient who visited a
particular hospital. Nurse to patient ration can also provide
critical information for the analysis of outcomes of healthcare
programs.
Conclusion
Patient safety remains the cornerstone in the provision of high-
quality health care. Health care professionals, especially nurses
are extremely important to the care, control, supervision and

coordination that will help in reducing negative or adverse
outcomes. The numerous government healthcare organizations
in collaboration with healthcare professionals must continue to
work on evaluating the impact of nursing care on positive
quality indicators that include appropriate self-care and other
measures of improved health status (Mitchell, 2008).
Analysis and Application
Description of the Healthcare Entity
Healthcare institutions exist in many varied forms depending on
their origin, core values, goals, mission, and vision (Rajfur &
Hys, 2018). Hospitals are part of the different types of
healthcare institutions. A hospital is an institution established
to offer health care services to society. As such, hospitals are
equipped with advanced tools to be used by trained health
practitioners who provided service delivery to the surrounding
communities. The healthcare entity to be considered in this
analysis is a mission hospital called AIM Healthcare Center.
AIM healthcare center was started over ten years ago by a group
of Christian missionaries. The cost of accessing healthcare
services is very high thus poor people can barely access the best
quality care. The founders identified a need to have a hospital
facility that will provide healthcare services to the less
privileged people in society. Furthermore, most of the poor
people do not have healthcare insurance coverage and thus are
unable to access quality healthcare services.
AIM healthcare center specializes in pediatric healthcare care
services as well as treating teenagers aged 18 years and below.
The founders of the mission hospital identified that young
children and teenagers from less privileged communities do not
have access to reliable healthcare services. Most of the patients
served by the AIM healthcare center are from the African-
American and Hispanic communities. Most of the financial
resources utilized to run the facility come from donations made
by individuals and various independent NGOs. The Methodist
church is also a major contributor to the Hospital's operations.
Several insurance companies also support AIM's initiatives to

provide affordable healthcare services by offering healthcare
covers at subsidized prices, exclusively to the less privileged
communities.
The entity under consideration has a workforce that comprises
120 medical doctors, 300 nurse practitioners, and 200 support
staff. Some employees at the hospital are members of the AIM
missionaries’ group who have specialized in medical studies.
AIM healthcare center is accredited by the Liaison Committee
on Graduate Medical Education as an affiliate of the
Association of Children's Hospitals. The institution is now
ranked among the best mission hospitals that offer outstanding
healthcare services to children and teenagers. Such recognition
has attracted more partners and philanthropists who support the
hospital to offer a better quality of healthcare to its patients. It
is essential to focus on providing healthcare services to the
younger generations because they are still undergoing growth
and development. Conditions that fail to be treated or managed
from early ages can be fatal in future years (Ruggles, et.al.,
2019).
Entity Success and Failure due to Quality Outcomes
The success of the AIM healthcare center over the years can be
attributed to the high level of commitment to its patient's safety.
Quality outcomes and patient safety measures are meant to
promote the effectiveness of healthcare services offered. Patient
Safety policy refers to all strategies put in place to prevent any
harm to the patients served at the facility. Quality healthcare
policy refers to the strategies put in place to ensure that all
patients receive the best healthcare services (Brown et.al.,
2018). AIM healthcare center promotes patients' safety and the
quality of healthcare services by upholding several operational
principles. The healthcare entity ensures that the patients are
offered the right medication, the right dosage, and through the
right procedures. The institution has adopted modern
technology, including nursing informatics systems, that
promotes the entire process of healthcare service delivery.
Prescriptions are not made without multiple verification. The

use of technology to conduct activities such as diagnostic
analysis and prescription has minimized errors.
Another safety measure that has promoted the success of the
AIM healthcare center is putting more emphasis on risk
mitigation strategies. The hospital has established a department
that deals with risk identification and mitigation. Risks that
arise in healthcare organizations harm the quality of services as
well as on the safety of patients. As such, it is very important to
identify and trace the root cause of various errors within a
hospital environment to promote the safety of the patients
(Mossialos, et.al., 2017). Risk mitigation policies and corrective
measures must be applied to prevent and resolve errors in
hospitals. The existence of a risk management department at the
AIM healthcare center is a critical success factor.
Despite the almost excellent services offered at the AIM
healthcare center, the hospital also faces some challenges that
may lead to failure if they are not addressed in time. Hospital-
acquired infections (HIA) have been a problem at the hospital
for several years. Policies that were implemented to address this
issue have had little if no effect; the infection rates have
increased over the years. The hospital incurs a lot of
unnecessary costs to treat hospital-acquired infections since the
cost is entirely transferred to the hospital. The high number of
patients frequenting the hospital is overwhelming for the
staffers, thus, the patient handling is poor at times. There was a
discovery that the catheters used in the wards and ICU are the
major cause of HAI at the hospital. If this problem remains
unaddressed, the hospital may be heading to failure.
Safety Area that Nursing Science Can Impact
Nursing science can have a significant impact on hospital-
acquired infections that are a threat to patient's safety. HAIs
pose a significant challenge to the hospital and should be
addressed immediately. Some variables that should be
considered while applying nursing science include the use of
antibiotics, hygiene measures, the hospital environment, as well
as the use of sterilized equipment.

Maintaining high levels of hygiene is very important especially
when addressing HAIs. Most of HAIs are contracted by patients
due to poor handling of equipment by nurse practitioners
(Percival, et.al., 2015). Hospitals are required to provide
amenities that promote the cleanliness of their staff members.
This includes the provision of hand sanitizers and other
disinfectants used in cleaning the hands before and after
conducting any activity. Patients should also be provided with
similar facilities to ensure they do not increase contamination.
Maintaining a clean environment at the hospital is yet another
way of reducing contamination and infection levels (Vincent &
Staines, 2019). The working environment should always be kept
clean and tidy. The standard guidelines for handling hospital
equipment and sterilization procedures must be observed.
Devices such as intravenous needles and syringes as well as
catheters must be disposed of properly to promote patient safety
and enhance the quality of care given. Finally, the last variable
that must be considered is antibiotics. Antibiotics can either
promote the quality of care or negatively affect the patients
depending on how they are administered. As such, it is
necessary to focus on progressive management of health
conditions to ensure that antibiotics yield the desired results.
Potential Obstacles
Nurses are not entirely to blame for the high rates of hospital-
acquired infections in various hospitals. Patients also play a
role in the contraction of HAIs due to carelessness and
ignorance (Percival, et.al., 2015). In most cases, a language
barrier affects communication between nurses and patients. For
instance, most of the patients treated at the AIM healthcare
center are Hispanics who barely understand or speak English.
This makes it very difficult for nurses to give instructions to the
patients who often do contrary to what is expected. Cultural
diversity can also hinder the implementation of quality and
safety measures.
High patient turnover rates can also affect the policy
implementation process at the AIM healthcare center. The

healthcare practitioners often have to work long hours hence the
quality of services offered declines due to exhaustion and
stress. It is not ethical to turn patients away just because a shift
is over. Nurses and doctors at AIM hospital are committed to
serving all patients and this may at times be at the expense of
their well-being. As a result, the quality of services offered is
affected.
Financial constraints also limit the policy implementation
process in the healthcare sector (Cheng, et.al., 2018). More
financial resources are required to implement any policy and
process changes. AIM healthcare sector operates based on
support from well-wishers and subsidized rates charged on
patients. The finances generated by the company are barely
enough to sustain operations. As such, the facility faces a
challenge of balancing between quality-service delivery and
allocating resources for process change implementation.
Collaborative Agents
Various stakeholders in the healthcare sector must work
together to ensure that safety and quality policies are
implemented successfully. In this case, the facility can
collaborate with first aid organizations such as Red Cross
society to transfer minor cases away from the hospital. This will
reduce the workload for nurses and lower operational costs. The
hospital can also partner with various medical training
institutions to initiate internship programs for nursing students.
Nursing students can offer support to nurse practitioners at the
hospital thus reducing their workload by handling minor tasks
(Allen, et.al., 2016). Healthcare departments established can
also be engaged to ensure the hospital receives some support for
the government. Finally, collaborating with the healthcare
managers at the hospital can promote the policy implementation
process to promote safety and quality.

References
Allen, D., Braithwaite, J., Sandall, J., & Waring, J. (2016).
Towards a sociology of healthcare safety and quality. Sociology
of Health & Illness, 38(2), 181-197. Retrieved from
https://onlinelibrary.wiley.com/doi/full/10.1111/1467-
9566.12390
Brown, A., Dickinson, H., & Kelaher, M. (2018). Governing the
quality and safety of healthcare: A conceptual
framework. Social Science & Medicine, 202, 99-107. Retrieved
from
https://www.sciencedirect.com/science/article/abs/pii/S0277953
618300765
Cheng, S., Jin, H., Yang, B., & Blank, R. H. (2018). Health
expenditure growth under single-payer systems: Comparing
South Korea and Taiwan. Value in Health Regional Issues, 15,
149-154. DOI: 10.1016/j.vhri.2018.03.002 URL: https://www-
sciencedirect-
com.lopes.idm.oclc.org/science/article/pii/S221210991830030X
?via%3Dihub
Mossialos, E., Djordjevic, A., Osborn, R., & Sarnak, D. (Eds.).
(2017). International profiles of health care systems, 2017:
Australia, Canada, China, Denmark, England, France, Germany,

India, Israel, Italy, Japan, the Netherlands, New Zealand,
Norway, Singapore, Sweden, Switzerland, Taiwan, and the
United States. New York, NY: Commonwealth Fund.
URL: https://www.commonwealthfund.org/publications/fund-
reports/2017/may/international-profiles-health-care-systems
Percival, S. L., Suleman, L., Vuotto, C., & Donelli, G. (2015).
Healthcare-associated infections, medical devices, and biofilms:
risk, tolerance, and control. Journal of medical microbiology,
64(4), 323-334. https://doi.org/10.1099/jmm.0.000032
Rajfur, P., & Hys, K. (2018). Management of the healthcare
system in Germany and France. Medical Science Pulse, 12(4),
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Ruggles, B. M., Xiong, A., & Kyle, B. (2019). Healthcare
coverage in the US and Japan: A comparison. Nursing, 49(4),
56-60. DOI: 10.1097/01.NURSE.0000553277. 03472.d8
URL:https://lopes.idm.oclc.org/login?url=http://ovidsp.ovid.co
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QUALITY AND SAFETY OF SWISS HEALTHCARE.
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leistungen/qualitaetssicherung/Enhancing%20the%20Quality%2
0and%20Safety%20of%20Swiss%20Healthcare-EN.pdf.d

practice mentor.
CASE REPORT: APPLICATION OF QUALITY AND SAFETY
CONCEPTS 2
2
IMPROVING THE OUTCOMES OF MENTAL HEALTH
SCREENING
Improving the Outcomes of Mental Health Screening
Improving the Outcomes of Mental Health Screening
Introduction

There is an overwhelming evidence revealing that a
considerable number of patients are suffering from mental
health disorders without the self-awareness of their condition.
Delayed screening and treatment of mental health disorders
either leads to delayed recovery, permanent symptoms, or
sometimes death. In the last decade, these impairments proved
to occur because of the shortage of screening programs in which
the treatment is delayed, and symptoms worsen. When a
significant number of health professionals (doctors,
pharmacists, nurses, dietitians, or radiologists) are included in
the treatment of a client with mental or behavioral issues, it
becomes a challenge to ascertain recovery unless the entire care
system is intended to support a complete and timely information
by all healthcare providers (VanderKooi, Conrad, & Spoelstra,
2018). The treatment of mental disorders is a concern in many
healthcare organizations, whether financed by the government
or privately commissioned. This project looks at the AHRQ and
the IOM report ("To Err Is Human" and "Crossing the Quality
Chasm") to develop a case report using quality and safety
concepts of improving the outcomes of mental health screening.
It describes and provides an understanding of mental health
problems and proposes intervention measures as well as
solutions to remedy gaps, inefficiencies, or other issues from a
theoretical approach.
Prescribing medication without the right assessment of the
patient’s condition or administering numerous drugs without
evaluating the possible adverse effects on the patient can cause
harm to the patient. Apart from that, patients are also subjected
to the risk of technology misuse, delayed treatment, and poor
communication between multiple departments of health care.
Safety in medical care is a vast subject integrating technology
such as informatics, CT scanning, radiography, ultrasound, x-
ray, and dialysis equipment. Significant indicators of patient
safety do not point to financial resources but involve the
competency of the clinician to facilitate safety practices
(Brownson et al., 2017). The safety of patients can be enhanced

if nurses engage patients and caregivers in the treatment plan,
communicating effectively, monitoring procedures, and learning
from previous errors (Will, Johnson, & Lamb, 2019). Reporting
and analyzing errors are beneficial in identifying major causal
factors. When the causal factors are understood, healthcare
providers can think about changes and help the medical team in
initiating effective measures to prevent the occurrence of errors.
This essay reports how nurses facilitate the quality of mental
healthcare through quality screening strategies and
collaborative interventions.
Problem Statement
According to the National Alliance on Mental Illness (NAMI,
2019), more than 21% of youths aged between 13-20 years are
struggling with mental disorders. If these conditions go
untreated, the symptoms may worsen, resulting in adverse
health implications and increase the cost of treating the
condition. The mental health of adolescents in the teenage
group determines the outcome of education and career for the
affected people. This maturation age go with both the
physiological and psychological transformations that make the
empathy of life a challenge. Following this observation, an
empirical assessment of medical facilities revealed various gaps
in delivering mental screening. There is a need to develop an
effective system of care collaboration and psychological
screening amongst healthcare providers and supportive
institutions.
Literature Review
The nursing practice stands out as one of the most versatile
careers in healthcare. Amaral, Geierstanger, Soleimanpour, and
Brindis (2011), created the scientific workforce concept for
nursing. The system encouraged team training and teamwork in
the execution of different treatment practices. Until today, the
concept has been effective even after modern nursing advanced
with the incorporation of technology and evidence-based
practices. Geared by adaptive capacity and versatility of the
nursing profession, career pathways have evolved, resulting in

the advanced scope of responsibilities and practice for health
professionals. In the context of mental health screening,
research was conducted by Bauldry and Szaflarski (2017) to
find evidence in improved mental health outcomes for teenagers
using the SBHCs. The SBHC is a standardized method of
screening and a collaborative model of patient care that
incorporates SBHC health professionals, administrators, and
guidance counselors. The databases examined include Pubmed,
PsycINFO, Nursing and Allied Health Literature (CINAHL),
Educational Resources Information Center (ERIC) using the
referral system, interprofessional, and mental health.
Udod and Wagner (2018) investigated the utilization and impact
of the Youth Pediatric Symptom Checklist (PSC-Y) screening
technique on the mental health of students and the immediate
medical appointment to the SBHC. Using the data collected
from 383 students in a single high school, researchers examined
the impact of implementing a screening tool. Among the
students who completed the screening, 14% scored above the
cutoff score. These results were useful in identifying students
who had previously participated in mental screening, those with
insurance coverage, and those with children. Besides, 12% of
the students showed an interest in mental health screening
because of their behavioral and emotional challenges. Overall,
the findings supported the previous results psychological
screening with the PSC-Y tool in which there was a 48%
decrease in mental related absenteeism and a 23% decrease in
lateness for students who were referred for mental screening.
Citing the OCA report of 2014, Barratt, and Thomas (2019)
attempted to demonstrate the effectiveness of applying universal
screening in a city case presentation in which he applied an
action research approach. The screening program applying the
Behavior Assessment System, Behavior and Emotion Screening
System (BASC-2) was instigated in three city schools in an
entire academic year and a subsequent follow-up in the next
year. The universal screening tool used for the platform
measures internalizing issues like behavioral issues, emotional

disturbance, adaptive skills, and learning problems. One
identified the benefit of the screening process, as noted by the
school administration, was the capacity to design counseling
schedules with consideration of pupils' needs, which supports
concrete data. In the first year of the program implementation,
partakers in grades9, 6, and 3 (N=315) accomplished the
program with 10% (N=31) being sorted for farther intervention.
Among the 31 students, 82% had reported disciplinary issues
with the administration. The remaining 20% had no reported
disciplinary issues nor school-based screening programs. The
findings suggest that the universal screening process helps in
uncovering students with behavioral and emotional
disturbances. Through effortful communication between the
school, community stakeholders, family, and comprehensive
screening facilitators, there was an increased awareness of the
psychological needs of students, increase collaboration with
mental health clinicians, greater awareness among caregivers,
and crisis-level intervention.
Impact of SBHC on Mental Health
With low-socioeconomic status individuals being the most
vulnerable for mental disorders and rising cost of treatment,
Van der Biezen, Wensing, Poghosyan, van der Burgt, and
Laurant (2017) investigated the impact of the application of
SBHC on healthcare systems and Health-related Quality of Life
(HRQOL) scores. The survey exploited a longitudinal quasi-
empirical repeated process that assessed the highlighted
indicators in four city schools that deliberated the SBHC
program and the other two schools that did not. The data were
classified in terms of cost perspective and outcome perspective,
and the dependent variables included the total Medicaid
insurance reimbursement, the HRQOL reported, the total cost of
medical care, and the number of students in the mental
screening programs. Results of the study demonstrated that the
students’ percentage who participated in the mental health
treatment in urban increased by 5.7% and by5.9% in rural areas
after SBHC programs were deployed. In the schools that did not

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