Improvement Plan Tool Kit

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The fundamental aim of this improvement plan tool kit is to help nurses implement and uphold improvement measures in pediatric unit within healthcare settings. The organization of this tool kit assumes four categories, namely; general organizational safety and quality best practices, environmental safety and quality risks, staff-led preventive strategies, and best practices for reporting and improving environmental safety issues. There are three annotated bibliographies for each category.

Annotated Bibliography

General Organizational Safety and Quality Best Practices

Lipke, B., Gilbert, G., Shimer, H., Consenstein, L., Aris, C., Ponto, L., . . . Kowal, C. (2018;2017;). Newborn safety bundle to prevent falls and promote safe sleep. MCN, the American Journal of Maternal/Child Nursing, 43(1), 32-37. doi:10.1097/NMC.0000000000000402

This article is another great resource for nurses caring for a postpartum mother but also for soon to be mothers because they can be made aware of risks that put themselves and the infants at risks for falls. This article shows the collaborative approach of creating a safety bundle to prevent injury for infants from falls and how to implement the safety bundle. The article educates nurses as well as mothers on the use of electronic sensors to reduce the occurrences of fall that may be hazardous to the lives of both the mother and the newborn. The information provided in this article encourages advanced competency in nursing students, which will help them create and adopt injury prevention mechanisms to infants thus qualitatively improving practices in serious health units such as the pediatric unit.

November, L. (2016). Are we getting the message across? women’s perceptions of public health messages in pregnancy. British Journal of Midwifery, 24(6), 396-402. doi:10.12968/bjom.2016.24.6.396

This article discusses a study that was created for Nurse Midwives about informing patients about safe sleep and safely caring for their infant. This resource is great not only for midwives but also for physicians because it brings to light the important topics that need to be discussed in the office before delivery. This study showed how many midwives actually discussed the safe sleep and safe handling of infants before delivery and how often they did. The study showed the importance of discussing these topics frequently to help prevent infant falls and drops. The information provided by this resource is particularly important for nursing students intending to practice midwifery in their future career.

Wasser, H. M., Heinig, M. J., & Tully, K. P. (2017). The importance of the baby-friendly hospital initiative. JAMA Pediatrics, 171(3), 304-305. doi:10.1001/jamapediatrics.2016.4823

This article is important because being a baby friendly hospital that encourages rooming in and not sending the infant to the nursery is a risk factor for infant drops and falls. I think this article is a good resource for all staff that is a part of the baby friendly initiative but also for any mother that will be delivering at a baby friendly hospital. It shows how baby friendly does help increase the success of breastfeeding and bonding with the infant but also discusses why this implemented initiative can be a risk for infant falls and drops. The resource expands the understanding of nursing students on the challenges that accompanies infant falls and drops and the quality measures taken to improve, or resolve the challenges.

Environmental Safety and Quality Risks

Rakhudu, M. A., Davhana-Maselesele, M., & Useh, U. (2016). Concept analysis of collaboration in implementing problem-based learning in nursing education. Curationis, doi:http://dx.doi.org.library.capella.edu/10.4102/curationis. v39i1.1586

This article talks about that when utilizing nursing education when working together as nurses and/or other healthcare professionals it increases better quality outcomes. This article demonstrates that a hospital’s perinatal unit was able to decrease harm due to adverse outcome during a patient’s stay on their unit. It demonstrated that the staff were able to work together as a team during trainings and implement four new standardized care processes that decreased harm on their unit up to 14%. I think this is an important article because it shows how utilizing higher education opens more ideas that can be collaborated together and then shows what happens if the ideas work and if they don’t. This article is a great resource for nursing staff to show how collective collaboration with education can help benefit patients’ safety when everyone has the same common goal.

LeClair-Smith, C. , Branum, B. , Bryant, L. , Cornell, B., Martinex, H. , Nash, E. & Philips, L. (2016). Peer-to-Peer Feedback. JONA: The Journal of Nursing Administration, 46(6), 321-328. doi: 10.1097/NNA. 0000000000000352

This article is about how an acute care organization was able to start a non-chastising peer feedback model. I think this article would be great for nursing staff but also any type of employment area because the best way for new ideas and improvement is to get everyone’s perspectives along with hearing the good and the bad experiences to prevent further bad experiences from happening. I think this idea would be a good resource to look at before and after a new policy is created because utilizing it before gives the guidelines on what is the correct approach when giving feedback to others so when the time comes to give the feedback it won’t be presented as argumentative.

Dearing, J. W., & Cox, J. G. (2018). Diffusion of innovations theory, principles and practice, Health Affairs, 37(2), 183-190.doi: http://dx.doi.org.library.capella.edu/10.1377/hlthaff.2017.110

This article explains the Innovation Diffusion Theory from Rogers I think it will be a good resource for nursing management or even nursing staff to start a new idea. It shows how a new idea may be perceived along with different groups of coworkers that will adapt to carrying out the new idea. Basically it shows how the snowball effect works when upper management introduces a new idea then implements to line level staff and how if there are more people on board with an idea that it will continue to pick up support. Of course there will be some push back from staff about doing it but this theory allows that hopefully only small percent. This resources are likely to be helpful for nursing management and staff as a resource as an example of how to work together to and improve issues on the unit.

Staff prevention approach

Sherwood, G., Barnsteiner, J. H., ProQuest Ebooks, Teton Data Systems (Firm), & STAT!Ref (Online service). (2017). Quality and safety in nursing: A competency approach to improving outcomes (Second;2; ed.). Hoboken, New Jersey: Wiley Blackwel

This book has a wide range of topics touching on quality and safety in field of nursing. The most resourceful part of this book the section discussing transforming education to transform practice. The section is particularly a good resource not only for nursing practitioners within healthcare facilities, but also nursing educators in schools. Educating nurses on why reporting safety events early is essential will help normalize the situation and prevent the negative attitude against reporting a mistake. It shows that collaboration as a team can improve the safety of their patients. The collaborative approach especially with new nurses helps the staff to feel more comfortable in reporting events, which again is the best way to learn, from prior mistakes.

Mgolozeli, S. E., Shilubane, H. N., & Khoza, L. B. (2019). Nurses’ attitudes towards the implementation of the mother-baby friendly initiative in selected primary healthcare facilities at makhuduthamaga municipality, limpopo province. Curationis, 42(1), e1. doi:10.4102/curationis.v42i1.1929

This article discusses how nursing staff feels about the baby friendly initiative. I think this resource is good for nurse management to get an understanding on how their staff may feel in regards to being a baby friendly hospital. It demonstrates as a good resource for nursing to show that they can be a huge influencer when it comes to starting their own policy and help preventing safety events on their own unit. There has been information that being baby friendly puts patients at higher risk for falls and drops of infants so there is staff push-back in regards to implementing everything. This is a good tool to discuss with staff the benefits of baby friendly hospitals and create a dialogue on how to improve baby friendly initiatives within their hospital settings that will keep the infants safe from falls and drops.

Hill, A., Waldron, N., Francis-Coad, J., Haines, T., Etherton-Beer, C., Flicker, L., . . . McPhail, S. M. (2016). ‘It promoted a positive culture around falls prevention’: Staff response to a patient education programme—a qualitative evaluation. BMJ Open, 6(12), e013414. doi:10.1136/bmjopen-2016-013414

This article demonstrated that when all staff are involved with training and education on preventing falls there is an increase in teamwork collaboration when it comes to patient safety. This article is geared more towards nursing educators and nursing managers since it demonstrates that education regarding falls is important. It also explains that having nursing staff as the key role in preventing falls encouraged them to have a more positive experience when presenting new ideas. The information provided in this article encourages advanced competency in nursing students, which will help them create and adopt injury prevention mechanisms to infants thus qualitatively improving practices in serious health units such as the pediatric unit.

Best Practices for Reporting and Improving Environmental Safety Issues

Frenzel, Jeanne E,PharmD., PhD., Skoy, E. T., PharmD., & Eukel, H. N., PharmD. (2018). Use of simulations to improve pharmacy students’ knowledge, skills, and attitudes about medication errors and patient safety. American Journal of Pharmaceutical Education, 82(8), 924-931. Retrieved from http://library.capella.edu/login?qurl=https%3A%2Fsearch.proquest.com%2Fdocview%2F2135970286%3Faccountid%3D27965

Even though this article isn’t in regards to strictly just nurses I think it is a great resource for any type of job when safety can be improved. Pharmacy students had used root cause analysis (RCA) to recognized what the issues were leading up to the errors, working together as a team to problem solve how to prevent them and then being able to feel confident taking the knowledge regarding medication errors and applying it when they graduate. This study found that after the simulations, the students had increased their ability to identify the problems and create solutions in their specific work environment. This article is relevant with medication errors because it demonstrates that different departments play a role in preventing medication errors. Even though this is a great teamwork example it demonstrated in the article the new way they go about reporting medication errors and improved the safety of medication administration.

Mansouri, S. F., Mohammadi, T. K., Adib, M., Lili, E. K., & Soodmand, M. (2019). Barriers to nurses reporting errors and adverse events. British Journal of Nursing, 28(11), 690-695. doi:10.12968/bjon.2019.28.11.690

This article explains a study that was conducted to find out why nurses tend to not report adverse events. It recognized that fear of consequences after reporting the error, management barriers and procedural barriers were the reason as to why the errors were reported. This article is a great resource for nursing to demonstrate that yes errors occur and why it’s important to report them. This study showed how the process of reporting could be improved to prevent staff not reporting events. When events are not reported there is no way to improve them. This article could be a good resource for nursing because it gives examples of why it is important to document everything in the electronic record along with when it happens.

Singh, I., & Okeke, J. (2016). Reducing inpatient falls in a 100% single room elderly care environment: Evaluation of the impact of a systematic nurse training programme on falls risk assessment (FRA). BMJ Quality Improvement Reports, 5(1), u210921.w4741. doi:10.1136/bmjquality.u210921.w4741

This article demonstrates a root cause analyst of why there was an increase of falls on their unit and what improvements could be made to prevent this increase of falls. It’s a good article for any type of nursing unit not just medical since it focus on the elderly population. They realized the unit had more falls occurring, the only way that information was made was by going over the reports from staff regarding falls and seeing what risk factors were playing a role in the falls. There were instances where safety events had occurred but since it wasn’t documented or details were not completely documented they had a difficult time trying to make improvements on policies. With staff collaboration they were able to reduce the fall occurrence by 25%.

References