ASSIGNMENT INSTRUCTIONS: PLEASE READ EVERYTHING BEFORE STARTING THE ASSIGNMENT.
Quality improvement frameworks:
- Start talking about quality improvement in health care how PDSA framework help to accomplish this. What it is PDSA? And how is used for quality improvement? (WILL UPLOAD ARTICLES ABOUT PDSA) Then we have to apply the steps of this PDSA framework to a clinical practice that needs improvement.
- The clinical example is:
In clinical practice, where this nurse practitioner works, it was noticed that most smoking screenings were missing on diabetic patient’s health records; therefore, smoking cessation education was not performed and documented by health care providers.
-Then generate research how smoking is detrimental on diabetic patients… Like… The health risks of smoking are well known and most people know the risks they are taking. For people with diabetes, however, smoking is a serious risk factor for numerous health issues they may face.
Smokers with diabetes have higher risks for serious complications, including:
- Heart and kidney disease
- Poor blood flow in the legs and feet that can lead to infections, ulcers, and possible amputation (removal of a body part by surgery, such as toes or feet)
- Retinopathy (an eye disease that can cause blindness)
- Peripheral neuropathy (damaged nerves to the arms and legs that causes numbness, pain, weakness, and poor coordination)
https://www.cdc.gov/tobacco/campaign/tips/diseases/diabetes.html
-Smoking screening and smoking cessation education are crucial for diabetic patients, therefore quality improvement on this area is imperative.
****(THE FOLLOWING IS THE APPLICATION OF PDSA MODEL. PLEASE FOLLOW THIS AND IMPROVE GRAMMAR AND SENTENCES IN ORDER TO MAKE IT SOUND BETTER. YOU CAN ALSO IMPROVE IT AS NEEDED. ADD CONCLUSION AND REFERENCE PAGE AT THE END) *****
-The Plan-Do-Study-Act (PDSA) framework will be used to guide an improvement project in a primary care health clinic.
-What are we planning to accomplish? During the next 6 months, improve smoking cessation education for diabetic patients; thus, decreasing further complications. Initial screening by the medical assistance is imperative. More than 90% of the patients with diabetes will be screened and received the appropriate smoking cessation education, and medical assistance will be offered to quit smoking.
-How will we know that a change is an improvement? The average of all diabetic patients receiving treatment for smoking cessation, the percentage of patients with diabetes who have quitted smoking, and the percentage of diabetic patients (who received education and treatment) who hasn’t developed any diabetic complications.
-What changes can we make that will results in improvement? The medical assistance will screen every patient with diabetes for smoking. The medical providers will provide education and document about smoking risks on diabetes and will offer patient medical help for quitting.
The team will make plans to start reporting the data monthly. Data will be collected from all diabetic patients for the next 3 months, and will continue to be re-evaluated. They will begin to plan the first series of PDSA cycles to test and implement the project.
First PDSA Cycle
Plan: plan will be assigned to health care team and management. Will develop simple database in access for diabetic patients, and download list of patients with diabetes. A protocol will be established for routine smoking screening on diabetic patients. Time will be Allowed for training sessions to educate staff about the project. For one month every diabetic patient will be screened for smoking (eClinicalWorks/EHR). Physicians and nurse practitioners will develop an educational tool or hand-out specific for diabetic patients who smoke. Distribute hand-outs to diabetic patients during each visit. Medical providers will ensure smoking cessation education documentation under educational flow sheet.
Do: For 2 entire weeks, diabetic patients were screened for smoking during medical assistance vital signs collection. The patient’s response and all screening answers were entered into the EHR. The medical provider was verbally informed and educational hand-out was given by medical assistant prior to entering the patient’s room. Nurse practitioner and physicians offered education to diabetic patients on smoking and health risks and offered medical help to quit. Health care providers also documented education and responses of patient. Plan was started on patients that were interested on quitting smoking.
Study: At the end of week two, the team studied the PDSA. Chart review revealed that 15 diabetic patients were not screened for smoking use. It showed that failure to screen was mostly happening in the afternoons or when the practice was very busy.
Act: The team met and discussed about the project progress and barriers to it. The PDSA was partially successful. Health care team decided on adding a reminder note, an Alert could be placed on patient’s electronic chart. Thus, preventing screening omissions. Health care team continued revising PDSA tool, testing, adapting and implementing project with diabetic patients. This family practice would need to design multiple PDSAs all working toward the same larger goal.
- Lastly, provide a conclusion, short summary on quality improvement and the benefits of using PDSA framework… blahblah….
- Scholarly references
