Improvement Plan Tool Kit

Improvement Plan Tool Kit

This improvement plan tool kit will assist nurses in implementing evidence-informed practices and strategies to improve and sustain safety in medication administration in inpatient care settings. The measures provided by the improvement tool kit are supported by extensive research and have proven to reduce and prevent medication errors. The safety improvement tool kit focuses on four essential areas for sustaining safety within hospitals and medication administrations. These include general organizational safety and quality best practices, work environment safety and quality risks, individual duty towards personal and team safety improvement, and best practices for reporting and improving workplace safety issues.

Annotated Bibliography

General Organizational Safety and Quality Best Practices

Gilmartin, H. M., Hess, E., Mueller, C., Connelly, B., Plomondon, M. E., Waldo, S. W., & Battaglia, C. (2022). Learning environments, reliability enhancing work practices, employee engagement, and safety climate in va Cardiac Catheterization Laboratories. Health Services Research, 57(2), 385–391. https://doi.org/10.1111/1475-6773.13907

This article presents a study that characterizes the relationship between learning environments and work practices that enhance reliability with employee engagement, retention, and safety climate within VA (Veterans Affairs) cardiac catheterization laboratories. Learning environments include the educational approaches, cultural context, and settings of organizations that support learning while reliability-enhancing practices include hiring, training, and inclusion in an organization’s decision-making practices. Based on data drawn from various Veterans Affairs cardiac catheterization laboratories that care for high-risk Veterans, the study found that using learning environments and reliability-enhancing work practices in different healthcare settings lowered nurse burnouts and turnover intentions. The environment also improved employee satisfaction and the organization’s safety climate. This article is essential to safety and quality improvement within healthcare environments and for nurse managers, as it explains how establishing learning environments and staff quality practices improve nurse job satisfaction and reduces burnout with an impact on the safety climate.

Hu, X., & Casey, T. (2021). How and when organization identification promotes safety voice among healthcare professionals. Journal of Advanced Nursing, 77(9), 3733-3744. https://doi.org/10.1111/jan.14868

This study presents an empirical analysis of how healthcare management’s commitment to safety influences psychological safety and employees’ motivation towards safety and a moderate relationship between organizational identification and safety voice behavior. Employees identifying with an organization are more likely to be motivated toward safety practices if they perceive that their management cares about safety. This article is essential to nurse managers and leaders. It highlights how the healthcare organization’s management’s commitment to safety can tap into the employees’ relationship with the organization to motivate safety behaviors. It also highlights how management can promote organizational identification among employees.

Koeck, J., Young, N., Kontny, U., Orlikowsky, T., Bassler, D., & Eisert, A. (2021). Interventions to Reduce Medication Dispensing, Administration, and Monitoring Errors in Pediatric Professional Healthcare Settings: A Systematic Review. Frontiers in Pediatrics, 9(633064.). https://doi.org/10.3389/fped.2021.633064

This article presents a systematic review of the interventions employed to reduce medication dispensing, administration, and monitoring errors within a pediatric healthcare setting. Administrative and engineering controls are the most used interventions to mitigate and monitor medication errors. Administrative control includes educational programs and training, operating protocols, and rearranging staff and equipment. Engineering interventions include adopting electronic workflow management systems and medication administration technologies such as barcodes and computerized alerts for administration. Other interventions identified include substituting equipment, staff, or medications, indicating a potential reliance on these measures. Administrative and engineering strategies are identified as higher-level controls that help monitor and reduce errors. This article is of great importance to nurses and nurse managers. It highlights how the hierarchy of controls employed in medication error monitoring and reduction influences the efficiency and efficacy of such interventions in improving medication administration safety.

Work Environment Safety and Quality Risks

Arvidsson, L., Lindberg, M., Skytt, B., & Lindberg, M. (2021). Healthcare personnel’s working conditions about risk behaviors for organism transmission: A mixed‐methods study. Journal of Clinical Nursing, 31(7-8), 878-894. https://doi.org/10.1111/jocn.15940

This article provides empirical evidence on how the work environment conditions affect healthcare workers’ behaviors, the risk of hospital-acquired infections, and the safety of patients. It also identifies the factors that influence work conditions and lead to risky health worker behaviors. The working conditions of healthcare workers have a direct influence on their behaviors. The level of hospital and care facility staffing, nurse-patient ratios and workload, physical factors, and interruptions at work influenced the workers’ behaviors. The conditions determined the engagement of the health workers in preventive or risky behavior. Unfavorable work conditions influence risky behaviors and favor the development of healthcare-associated infections (HIAs). Such risky behaviors compromise the safety of patients within particular care settings. This article is essential to healthcare managers, including nurse leaders, as they can understand how the behaviors of healthcare workers, such as nurses, are influenced by working conditions and the risks associated with healthcare conditions, behaviors, HIAs, and patient safety.

Latimer, S., Hewitt, J., de Wet, C., Teasdale, T., & Gillespie, B. (2022). Medication reconciliation at hospital discharge: A qualitative exploration of acute care nurses’ perceptions of their roles and responsibilities. Journal Of Clinical Nursing. https://doi.org/10.1111/jocn.16275

This article presents an empirical study on medication reconciliation at hospital discharge and how nurses perceive their role and responsibility to patient safety in interprofessional teams during such activities. The authors note that nurses in interprofessional teams have limited access to guidelines on clinical practice during medication reconciliation. They also have a limited role during medication reconciliation, which is a factor in their inability to fully engage in activities related to patient safety during patient hospital discharge or transfer. This article is essential in improving the safety of medication administration as it highlights the need to include nurses in interprofessional teams during medication reconciliation at the hospital during discharge or patient transfer. It also highlights the role and importance of effective team communication and supportive relationships in interprofessional teams to nurses’ contribution to patient safety during medication reconciliation at hospital discharge.

Patel, V., Chesmore, A., Legner, C., & Pandey, S. (2021). Trends in Workplace Wearable Technologies and Connected‐Worker Solutions for Next‐Generation Occupational Safety, Health, and Productivity. Advanced Intelligent Systems, 4(1), 2100099. https://doi.org/10.1002/aisy.202100099

This article discusses how wearable technologies and the adoption of connected worker solutions will impact next-gen occupational safety, health, and worker productivity. Innovative technologies efficiently and effectively identify, eliminate, substitute, and control occupational hazards. Wearable and connected technologies can constantly monitor workers within their work environment and provide worker-specific solutions based on contextual information collected from the worker. The authors also discuss the architecture and modules of such technologies, intelligent operations, and their applications across various industries. They also present how predictive analytics based on contextual data collected from connected wearables can improve the monitoring and identification of occupational safety risks and support predictive maintenance and risk elimination. This article is essential in improving patient and worker safety and creating a safe working environment as it presents technologies applicable across the entire healthcare industry to improve safety.

Individual Duty towards Personal and Team Safety Improvement

Brooks Carthon, J., Hatfield, L., Plover, C., Dierkes, A., Davis, L., & Hedgeland, T. et al. (2019). Association of Nurse Engagement and Nurse Staffing on Patient Safety. Journal of Nursing Care Quality, 34(1), 40-46. https://doi.org/10.1097/ncq.0000000000000334

This article explores how the engagement of nurses within the health facility impacts patient safety. It also highlights the interrelationship between work environment factors such as staffing, nurse engagement, and assessments of patient safety related to safety within the hospital settings. Based on empirical research, evidence notes that nurse engagement in terms of levels of participation in decision-making within healthcare systems improved patient safety. The articles also relate meeting staffing needs to improve patient safety. Financial constraints limit staffing needs. The authors conclude that applying interventions that help improve nurse engagement and meet the organization’s staffing needs act as evidence-based strategies for improving patient safety. This article is resourceful in developing a safety improvement plan as it illustrates how different factors related to the organization and nurses interact to affect patient safety.

Ito, A., Sato, K., Yumoto, Y., Sasaki, M., & Ogata, Y. (2021). A concept analysis of psychological safety: Further understanding for application to health care. Nursing Open, 9(1), 467-489. https://doi.org/10.1002/nop2.1086

This article empirically clarifies psychological safety within a healthcare context and how it can improve interpersonal relationships among healthcare workers to achieve better patient care and health outcomes. The article develops a theoretical framework to assist in applying psychological safety when developing interpersonal relationships. Psychological safety in health care is related to how individual health workers within a group perceive the consequences of taking interpersonal risks. It also influences the strength of interpersonal relationships, the perception of the safety of the work environment to take interpersonal risks, and the organizational rewards culture on risk-taking. The psychological safety concept within the organization improved interpersonal risk-taking, which further influenced group and personal trust, interpersonal support, and the quality of communication. Interpersonal risk-taking resulted in notable performance and organizational, cultural, psychological, and behavioral outcomes. This article provided a theoretical framework and recommendations for further research that nurse leaders and researchers can utilize to tap into the potential benefits of psychological safety in healthcare.

Luokkamäki, S., Härkänen, M., Saano, S., & Vehviläinen‐Julkunen, K. (2020). Registered Nurses’ medication administration skills: a systematic review. Scandinavian Journal Of Caring Sciences, 35(1), 37-54. https://doi.org/10.1111/scs.12835

This article provides an empirical review and evidence of the importance of registered nurses’ medication administration skills and how they influence medication administration safety and prevent errors. The article identifies and describes the various methods that can be used to measure the registered nurse’s medication administration skills. The skills of a registered nurse in medication administration can be determined by how they order, handle, store, and discard medication for patients. The skills can also be observed during the preparation and administration of drugs. The skills of registered nurses can also be tested by focusing on their approach to medication documentation, evaluation and assessment of medication-related issues, and skills related to the calculations involving drug dosages. The ability to cooperate with other physicians and patients also defines the safety of medication administration. The authors also highlight the nurse’s approach to reporting medication information, such as errors and further details, as a skill that should be observed to ensure safe medication administration. This article is essential to nursing educators, nurse leaders, in-practice registered nurses, and student nurses. It highlights the different methods of skill testing and areas of nurse medication administration skills that influence patient safety. It also identifies the gaps in skill testing that ensure individual nurses possess the right skills for safe medication administration.

Best Practices for Reporting and Improving Work Environment Safety Issues

Darawad, M. W., Othman, E. H., & Alosta, M. R. (2019). Nurses’ satisfaction with Barcode medication‐administration technology: Results of a cross‐sectional study. Nursing & Health Sciences, 21(4), 461–469. https://doi.org/10.1111/nhs.12620

This article focuses on introducing barcode technology to assist nurses in medication administration to reduce medication errors and improve nurses’ satisfaction with barcode medication administration. The article also presents factors influencing the nurses’ satisfaction with barcode assistance in medication administration. Barcode medication administration as an intervention targeted at the medication administration process can help reduce errors and improve nurses’ satisfaction. However, the nurse’s satisfaction with barcode medication administration was related to the training on barcode use in medication administration and computer competence, nurses’ comfort with using barcode medication administration, and how they perceived the barcode medication administration improved their productivity. The authors recommend practical training to develop computer skills critical to administering barcode medication. This article is essential to nurse educators, leaders, and students as it identifies a strategy and approach that can be integrated into nurse education to improve patient safety during practice.

Kritsotakis, G., Gkorezis, P., Andreadaki, E., Theodoropoulou, M., Grigoriou, G., & Alvizou, A. et al. (2021). Nursing practice environment and employee silence about patient safety: The mediating role of professional discrimination experienced by nurses. Journal of Advanced Nursing, 78(2), 434-445. https://doi.org/10.1111/jan.14994

This article provides empirical evidence of how the professional discrimination against nurses and the exclusion of nurses from decisions within the work environment impacts patient safety. The article explores how professional discrimination experienced by nurses mediates the relationship between a nurse’s work environment and a nurse’s silence about patient safety. In some cases, nurses within their work environment are discouraged from expressing concerns over patient safety, and, on many occasions, their concerns are ignored. As they are mainly not involved in treatment decisions and care plans for patients, they may experience discrimination within such work environments. As a result, most nurses are silent on patient safety matters, impacting the care standards delivered to patients. This article is essential to patient safety. It provides insights to nurses and healthcare managers on how nurses can experience professional discrimination and how such issues can be addressed to improve patient safety and health outcomes.

Zheng, W., Lichtner, V., Van Dort, B., & Baysari, M. (2021). The impact of introducing automated dispensing cabinets, barcode medication administration, and closed-loop electronic medication management systems on work processes and safety of controlled medications in hospitals: A systematic review. Research in Social and Administrative Pharmacy, 17(5), 832-841. https://doi.org/10.1016/j.sapharm.2020.08.001

This article presents a systematic review with a focus on the impact of Automated Dispensing Cabinets (ADCs), Barcode Medication Administration (BCMA), and closed-loop Electronic Medication Management Systems (EMMS) on clinical workflow, medication safety, and drug diversion in controlled medications within an inpatient hospital setting. The review notes that ADCs have little significance in the prevention of errors. The implementation of BCMA reduced medication errors. However, the use of BCMA and its accuracy in medication administration was based on barcoding accuracy. This article is important to nurses, nurse leaders, and healthcare managers. It highlights the benefits and risks of implementing various technologies in hospitals focused on medication administration. The article also provides evidence on how such technologies can assist with the timely and correct supply, use, and monitoring of medications, improving medication administration safety.

References

Arvidsson, L., Lindberg, M., Skytt, B., & Lindberg, M. (2021). Healthcare personnel’s working conditions about risk behaviors for organism transmission: A mixed‐methods study. Journal Of Clinical Nursing, 31(7-8), 878-894. https://doi.org/10.1111/jocn.15940

Brooks Carthon, J., Hatfield, L., Plover, C., Dierkes, A., Davis, L., & Hedgeland, T. et al. (2019). Association of Nurse Engagement and Nurse Staffing on Patient Safety. Journal Of Nursing Care Quality, 34(1), 40-46. https://doi.org/10.1097/ncq.0000000000000334

Darawad, M. W., Othman, E. H., & Alosta, M. R. (2019). Nurses’ satisfaction with Barcode medication‐administration technology: Results of a cross‐sectional study. Nursing & Health Sciences, 21(4), 461–469. https://doi.org/10.1111/nhs.12620

Gilmartin, H. M., Hess, E., Mueller, C., Connelly, B., Plomondon, M. E., Waldo, S. W., & Battaglia, C. (2022). Learning environments, reliability enhancing work practices, employee engagement, and safety climate in va Cardiac Catheterization Laboratories. Health Services Research, 57(2), 385–391. https://doi.org/10.1111/1475-6773.13907

Hu, X., & Casey, T. (2021). How and when organization identification promotes safety voice among healthcare professionals. Journal Of Advanced Nursing, 77(9), 3733-3744. https://doi.org/10.1111/jan.14868

Ito, A., Sato, K., Yumoto, Y., Sasaki, M., & Ogata, Y. (2021). A concept analysis of psychological safety: Further understanding for application to health care. Nursing Open, 9(1), 467-489. https://doi.org/10.1002/nop2.1086

Koeck, J., Young, N., Kontny, U., Orlikowsky, T., Bassler, D., & Eisert, A. (2021). Interventions to Reduce Medication Dispensing, Administration, and Monitoring Errors in Pediatric Professional Healthcare Settings: A Systematic Review. Frontiers In Pediatrics, 9(633064.). https://doi.org/10.3389/fped.2021.633064

Kritsotakis, G., Gkorezis, P., Andreadaki, E., Theodoropoulou, M., Grigoriou, G., & Alvizou, A. et al. (2021). Nursing practice environment and employee silence about patient safety: The mediating role of professional discrimination experienced by nurses. Journal Of Advanced Nursing, 78(2), 434-445. https://doi.org/10.1111/jan.14994

Latimer, S., Hewitt, J., de Wet, C., Teasdale, T., & Gillespie, B. (2022). Medication reconciliation at hospital discharge: A qualitative exploration of acute care nurses’ perceptions of their roles and responsibilities. Journal Of Clinical Nursing. https://doi.org/10.1111/jocn.16275

Luokkamäki, S., Härkänen, M., Saano, S., & Vehviläinen‐Julkunen, K. (2020). Registered Nurses’ medication administration skills: a systematic review. Scandinavian Journal Of Caring Sciences, 35(1), 37-54. https://doi.org/10.1111/scs.12835

Patel, V., Chesmore, A., Legner, C., & Pandey, S. (2021). Trends in Workplace Wearable Technologies and Connected‐Worker Solutions for Next‐Generation Occupational Safety, Health, and Productivity. Advanced Intelligent Systems, 4(1), 2100099. https://doi.org/10.1002/aisy.202100099

Zheng, W., Lichtner, V., Van Dort, B., & Baysari, M. (2021). The impact of introducing automated dispensing cabinets, barcode medication administration, and closed-loop electronic medication management systems on work processes and safety of controlled medications in hospitals: A systematic review. Research In Social And Administrative Pharmacy, 17(5), 832-841. https://doi.org/10.1016/j.sapharm.2020.08.001

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Hello. This is the final paper for this course. You must use the concept from the first 3 assessments, order numbers 45209, 45210, and 45264. Please read carefully and follow all instructions for total points. Also, I believe you will have to make all Google links visible for the instructor to have access to. All the instructions are below. I will attach the rubric and assessment example format.

For this assessment, you will develop a Word document or an online resource repository of at least 12 annotated professional or scholarly resources that you consider critical for the audience of your safety improvement plan about medication administration to understand or implement to ensure the plan’s success.

Communication in the healthcare environment consists of an information-sharing experience through oral or written messages (Chard & Makary, 2015). As healthcare organizations and nurses strive to create a culture of safety and quality care, the importance of interprofessional collaboration, the development of tool kits, and the use of wikis become more relevant and vital. In addition to disseminating information and evidence-based findings and developing tool kits, continuous support for and availability of such resources is critical. Among the most popular methods to promote ongoing dialogue and information sharing are blogs, wikis, websites, and social media. Nurses know how to support people in times of need or crisis and how to support one another in the workplace; wikis, in particular, enable nurses to continue that support beyond the work environment. Here, they can be free to share their unique perspectives, educate others, and promote healthcare wellness at local and global levels (Kaminski, 2016).

Before developing the repository, you must complete the Determining the Relevance and Usefulness of Resources activity. This activity will help you determine which resources or research will be most relevant to address a particular need. This may be useful as you consider how to explain the purpose and relevance of the resources you are assembling for your tool kit. The activity is for your practice and self-assessment, demonstrating course engagement.

Demonstration of Proficiency

By completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

Competency 1: Analyze the elements of a successful quality improvement initiative.
Analyze the usefulness of resources for the role group responsible for implementing quality and safety improvements with medication administration.
Competency 2: Analyze factors that lead to patient safety risks.
Analyze the value of resources to reduce patient safety risks or improve quality with medication administration.
Competency 3: Identify organizational interventions to promote patient safety.
Identify necessary resources to support the implementation and sustainability of a safety improvement initiative focusing on medication administration.
Competency 5: Apply professional, scholarly, evidence-based strategies to communicate in a manner that supports safe and effective patient care.
Present reasons and relevant situations for a resource tool kit to be used by its target audience.
Communicate resource tool kit in a clear, logically structured, professional manner that applies current APA style and formatting.
References
Chard, R., & Makary, M. A. (2015). Transfer-of-care communication: Nursing best practices. AORN Journal, 102(4), 329–342.

Kaminski, J. (2016). Why all nurses can/should be authors. Canadian Journal of Nursing Informatics, 11(4), 1–7.

Professional Context

Nurses are often asked to implement processes, concepts, or practices—sometimes with little preparatory communication or education. One way to encourage the sustainability of quality and process improvements is to assemble an accessible, user-friendly tool kit for knowledge and process documentation. Creating a resource repository or tool kit is also an excellent way to follow up an educational or in-service session, as it can help reinforce attendees’ new knowledge and the understanding of its value. By practicing creating a simple online tool kit, you can develop valuable technology skills to improve your competence and efficacy. This technology is easy to use, and resources are available to guide you.

Scenario

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

Build on the work done in your first three assessments and create an online tool kit or resource repository that will help the audience of your in-service understand the research behind your safety improvement plan about medication administration and put the plan into action.
Locate a safety improvement plan (your current organization, the Institution for Healthcare Improvement, or a publicly available safety improvement initiative) about medication administration and create an online tool kit or resource repository that will help an audience understand the research behind the safety improvement plan and how to put the plan into action.
Preparation

Google Sites is recommended for this assessment; the tools are free to use and should offer flexibility and simplicity as you create your online tool kit. Please note that this requires a Google account; use your Gmail or Google Docs login or create an account following the directions under the “Create Account” menu.

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

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

Using Google Sites, assemble an online resource tool kit containing at least 12 annotated resources that you consider critical to the success of your safety improvement initiative. These resources should enable nurses and others to implement and maintain the safety improvement you have developed.

It is recommended that you focus on the 3 or 4 most critical categories or themes concerning your safety improvement initiative regarding medication administration. For example, for an initiative that concerns improving workplace safety for practitioners, you might choose broad themes such as general organizational safety and quality best practices, environmental safety and quality risks, individual strategies to improve personal and team safety, and process best practices for reporting and improving environmental safety issues.

Following the recommended scheme, you would collect 3 resources on average for each of the 4 categories, focusing on safety with medication administration. Each resource listing should include the following:

An APA-formatted citation of the resource with a working link.
A description of the resource’s information, skills, or tools.
A brief explanation of how the resource can help nurses better understand or implement the safety improvement initiative about medication administration.
A description of how nurses can use this resource and when its use may be appropriate.
Remember to make your site ‘public’ so your faculty can access it. Check out the Google Sites resources for more information.

Here is an example entry:

Merret, A., Thomas, P., Stephens, A., Moghabghab, R., & Gruneir, M. (2011). A collaborative approach to fall prevention. Canadian Nurse, 107(8), 24–29.
This article presents the Geriatric Emergency Management-Falls Intervention Team (GEM-FIT) project. It shows how a collaborative nurse-led project can be implemented and used to improve collaboration, int,erdisciplinary teamwork, and the delivery of health care services. This resource is likely more helpful to nurses as a resource for strategies and models for assembling and participating in an interdisciplinary team than for specific fall-prevention strategies. It is suggested that this resource be reviewed before creating a multidisciplinary team for a collaborative project in a healthcare setting.
Additionally, be sure that your plan addresses the following, corresponding to the grading criteria in the scoring guide. Please study the scoring guide carefully to understand what is needed for a distinguished score.

Identify necessary resources to support the implementation and continued sustainability of a safety improvement initiative about medication administration.
Analyze the usefulness of resources to the role group responsible for implementing quality and safety improvements focusing on medication administration.
Analyze the value of resources to reduce patient safety risks related to medication administration.
Present reasons and relevant situations for using the resource tool kit by its target audience.
Communicate in a clear, logically structured, and professional manner that applies current APA style and formatting.
Example Assessment: You may use the following example to give you an idea of what a Proficient or higher rating on the scoring guide would look like. However, keep in mind that your tool kit will focus on promoting safety with medication administration. You do not have to submit your bibliography besides the Google Site; the example bibliography is merely for your reference.

Assessment 4 Example [PDF].
To submit your online tool kit assessment, paste the link to your Google Site in the assessment submission box.

Example Google Site: You may use the example Google Site, Resources for Safety and Improvement Measures in Geropsychiatric Care, to give you an idea of what a Proficient or higher rating on the scoring guide would look like for this assessment, but keep in mind that your tool kit will focus on promoting safety with medication administration.

Note: Please get in touch with your faculty member if you experience technical or other challenges in completing this assessment.

Additional Requirements

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