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4-Continuous Quality Improvement (CQI) is defined by the
American Society for Quality (ASQ) as “a philosophy and
attitude for analyzing capabilities and processes and improving
them repeatedly to achieve customer satisfaction”. (Huber 292)
CQI is something that is relevant to all nurses as we all need to
be responsible for continual improvement at work. As
professionals we should always have this as a top priority.
There are many challenges in the workplace, and by looking for
ways to improve, we are constantly learning and growing as a
profession, this is a large piece of evidence-based practice,
which is something we all hold as a standard in healthcare
today.
An example of how I would apply CQI in my current position
working as a nurse circulator in the operating room, is to ensure
that the time out procedure is followed every single case I
circulate. This is important as we often get complacent in rules
and regulations, as do surgeons that we are trying to keep happy
as they are customers just as much as our patients are.
I had circulated a case with another nurse during orientation in
which not all implants for a total knee replacement were in the
room. I was not notified of this until after the case started, the
patient was anesthetized, and time out had been completed
though this requirement was not stated/asked. Later the rep for
the implants then stated the implants were in route from another
location. This is unacceptable, and I am glad that I was still in
orientation at the time this occurred as it was a great learning
experience for me. I learned how to write an incident report that
day, and why the time out procedure is so important.
Resources
Huber, Diane.
Leadership and Nursing Care Management, 5th Edition
. Saunders, 10/2013. VitalBook file.
5-Health care delivery requires structure (staff, education,
equipment, prospective data collection), and process (policies,
procedure, protocols), which when integrated provide a system
(programs, organizations, cultures) leading to outcomes (patient
safety, quality, satisfaction). An effective health care system
has all of these elements – structure, process, system, and
patient outcomes in a framework of continuous quality
improvement, or CQI (Kronich et al., 2015).
The purpose of QCI is to improve health care by identifying
problems, implementing and monitoring corrective action and
evaluating its effectiveness. Hospitals use a specific process to
find areas in the health care delivery system that need
improvement. When an area has been found, staff develop and
implement strategies for improvement. General areas that are
being studied include access to care, continuity of care, the
intake process upon admission, emergency care, and adverse
patient events, including all deaths (National Commission on
Correctional Care, 2018).
In my previous position, working as a NICU RN, we initially
did not use two RN’s to verify the content in the TPN-bags for
each patient. Shortly after I started working at this facility, this
change was implemented. The purpose was to catch medical
errors from pharmacy that sadly was occurring more frequently.
This new process of reading labels with another RN while
verifying the content with the document from pharmacy, and
then hanging the TPN required more time in the nurses’ day. In
addition, all this was done toward the end of day-shift around
1730. This process resulted in stress among the RN’s and often
overtime, which was not appreciated by management.
Thankfully, a solution was found by changing the time of day
TPN was delivered to the unit. By working together and
brainstorming solutions, everyone was satisfied in the end;
quality of care was improved, and the nurses were able to finish
their duties in time.
References:
Continuous Quality Improvement. (2018).
Retrieved from
https://www.ncchc.org/spotlight-on-the-standards-24-1
Kronich, L., Kurz, M., Lin, S., Edelson, D., Berg, R., Billi,
J.,…Cabanas, J. (2015). System of Care and Continuous Quatity
Improvement.
Retrieved from
https://www.ahajournals.org/doi/abs/10.1161/cir.000000000000
0258
6-I agree with your response about having a rapid response team
because this helps identify patients at risk for cdoing before the
event when you can give care to help prevent a code. I think
rapid response teams are a must in facilities. according to
patient safety primer .gov
Rapid response teams represent an intuitively simple concept:
When a patient demonstrates signs of imminent clinical
deterioration, a team of providers is summoned to the bedside to
immediately assess and treat the patient with the goal of
preventing intensive care unit transfer, cardiac arrest, or death
(psnet.ahrq.gov). I also agree with your staement about the lean
technique that is in our text as a useful apporach to imrove
efficincy in renedering care. When we are effective
communicators and work as a team in our settings, we will
definietly be more productive and work loads can be reduced,
less stress in the workplace, etc. Team work is amazing when it
is used the way it was intended to. Evryone working together to
achieve a common goal is also important. If everyone is not on
the same page, then this is where conflict can areise. Thank you
for sharing, I enjoyed reading your post!
Reference
Retrieved from
https://psnet.ahrq.gov/primers/primer/4/rapid-response-systems

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4-Continuous Quality Improvement (CQI) is defined by the America

  • 1. 4-Continuous Quality Improvement (CQI) is defined by the American Society for Quality (ASQ) as “a philosophy and attitude for analyzing capabilities and processes and improving them repeatedly to achieve customer satisfaction”. (Huber 292) CQI is something that is relevant to all nurses as we all need to be responsible for continual improvement at work. As professionals we should always have this as a top priority. There are many challenges in the workplace, and by looking for ways to improve, we are constantly learning and growing as a profession, this is a large piece of evidence-based practice, which is something we all hold as a standard in healthcare today. An example of how I would apply CQI in my current position working as a nurse circulator in the operating room, is to ensure that the time out procedure is followed every single case I circulate. This is important as we often get complacent in rules and regulations, as do surgeons that we are trying to keep happy as they are customers just as much as our patients are. I had circulated a case with another nurse during orientation in which not all implants for a total knee replacement were in the room. I was not notified of this until after the case started, the patient was anesthetized, and time out had been completed though this requirement was not stated/asked. Later the rep for the implants then stated the implants were in route from another location. This is unacceptable, and I am glad that I was still in orientation at the time this occurred as it was a great learning experience for me. I learned how to write an incident report that day, and why the time out procedure is so important. Resources
  • 2. Huber, Diane. Leadership and Nursing Care Management, 5th Edition . Saunders, 10/2013. VitalBook file. 5-Health care delivery requires structure (staff, education, equipment, prospective data collection), and process (policies, procedure, protocols), which when integrated provide a system (programs, organizations, cultures) leading to outcomes (patient safety, quality, satisfaction). An effective health care system has all of these elements – structure, process, system, and patient outcomes in a framework of continuous quality improvement, or CQI (Kronich et al., 2015). The purpose of QCI is to improve health care by identifying problems, implementing and monitoring corrective action and evaluating its effectiveness. Hospitals use a specific process to find areas in the health care delivery system that need improvement. When an area has been found, staff develop and implement strategies for improvement. General areas that are being studied include access to care, continuity of care, the intake process upon admission, emergency care, and adverse patient events, including all deaths (National Commission on Correctional Care, 2018). In my previous position, working as a NICU RN, we initially did not use two RN’s to verify the content in the TPN-bags for each patient. Shortly after I started working at this facility, this change was implemented. The purpose was to catch medical errors from pharmacy that sadly was occurring more frequently. This new process of reading labels with another RN while verifying the content with the document from pharmacy, and then hanging the TPN required more time in the nurses’ day. In addition, all this was done toward the end of day-shift around 1730. This process resulted in stress among the RN’s and often
  • 3. overtime, which was not appreciated by management. Thankfully, a solution was found by changing the time of day TPN was delivered to the unit. By working together and brainstorming solutions, everyone was satisfied in the end; quality of care was improved, and the nurses were able to finish their duties in time. References: Continuous Quality Improvement. (2018). Retrieved from https://www.ncchc.org/spotlight-on-the-standards-24-1 Kronich, L., Kurz, M., Lin, S., Edelson, D., Berg, R., Billi, J.,…Cabanas, J. (2015). System of Care and Continuous Quatity Improvement. Retrieved from https://www.ahajournals.org/doi/abs/10.1161/cir.000000000000 0258 6-I agree with your response about having a rapid response team because this helps identify patients at risk for cdoing before the event when you can give care to help prevent a code. I think rapid response teams are a must in facilities. according to patient safety primer .gov Rapid response teams represent an intuitively simple concept: When a patient demonstrates signs of imminent clinical deterioration, a team of providers is summoned to the bedside to immediately assess and treat the patient with the goal of preventing intensive care unit transfer, cardiac arrest, or death (psnet.ahrq.gov). I also agree with your staement about the lean
  • 4. technique that is in our text as a useful apporach to imrove efficincy in renedering care. When we are effective communicators and work as a team in our settings, we will definietly be more productive and work loads can be reduced, less stress in the workplace, etc. Team work is amazing when it is used the way it was intended to. Evryone working together to achieve a common goal is also important. If everyone is not on the same page, then this is where conflict can areise. Thank you for sharing, I enjoyed reading your post! Reference Retrieved from https://psnet.ahrq.gov/primers/primer/4/rapid-response-systems