NURS 8302 Week 4: APPLYING PROJECT MANAGEMENT APPROACHES FOR A QUALITY IMPROVEMENT PRACTICE GAP

Walden University NURS 8302 Week 4: APPLYING PROJECT MANAGEMENT APPROACHES FOR A QUALITY IMPROVEMENT PRACTICE GAP– Step-By-Step Guide

This guide will demonstrate how to complete the Walden University NURS 8302 Week 4: APPLYING PROJECT MANAGEMENT APPROACHES FOR A QUALITY IMPROVEMENT PRACTICE GAP assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

How to Research and Prepare for NURS 8302 Week 4: APPLYING PROJECT MANAGEMENT APPROACHES FOR A QUALITY IMPROVEMENT PRACTICE GAP

Whether one passes or fails an academic assignment such as the Walden University NURS 8302 Week 4: APPLYING PROJECT MANAGEMENT APPROACHES FOR A QUALITY IMPROVEMENT PRACTICE GAP depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

How to Write the Introduction for NURS 8302 Week 4: APPLYING PROJECT MANAGEMENT APPROACHES FOR A QUALITY IMPROVEMENT PRACTICE GAP

The introduction for the Walden University NURS 8302 Week 4: APPLYING PROJECT MANAGEMENT APPROACHES FOR A QUALITY IMPROVEMENT PRACTICE GAP is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

How to Write the Body for NURS 8302 Week 4: APPLYING PROJECT MANAGEMENT APPROACHES FOR A QUALITY IMPROVEMENT PRACTICE GAP

After the introduction, move into the main part of the NURS 8302 Week 4: APPLYING PROJECT MANAGEMENT APPROACHES FOR A QUALITY IMPROVEMENT PRACTICE GAP assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

How to Write the Conclusion for NURS 8302 Week 4: APPLYING PROJECT MANAGEMENT APPROACHES FOR A QUALITY IMPROVEMENT PRACTICE GAP

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

How to Format the References List for NURS 8302 Week 4: APPLYING PROJECT MANAGEMENT APPROACHES FOR A QUALITY IMPROVEMENT PRACTICE GAP

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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Sample Answer for NURS 8302 Week 4: APPLYING PROJECT MANAGEMENT APPROACHES FOR A QUALITY IMPROVEMENT PRACTICE GAP

Chronic heart failure annually impacts approximately 5.7 million individuals in the United States, resulting in a financial burden of over $30.7 billion due to healthcare expenses and treatment costs (Taklalsingh et al., 2020). According to Driscoll et al. (2020), the annual survival rate for hospital admissions is only 30-40%, suggesting a potential impact on morale. The projected readmission rate within 30 days is 23% for patients. The Hospital Readmissions Reduction Program was initiated by the Centers for Medicare & Medicaid Services (CMS) in 2012. It aims to reduce avoidable readmissions for heart failure patients by imposing financial penalties on institutions with higher readmission rates following heart failure hospitalizations. These penalties result in lower monthly payments or reimbursements for these institutions. This paper aims to elucidate the identified gap in quality improvement practice.

Identification of the Gap for Quality Improvement

During this practicum, I observed a deficiency in my practice regarding the 30-day hospitalization rates for congestive cardiac failure. The inclusion of the 30-day readmission rate as a metric for evaluating hospital quality aims to reduce healthcare expenses and prevent inadequate treatment for individuals with heart failure. This study utilized multiple communities to evaluate various metrics, including hospital rating and payment rate, to promote improved care for individuals with congestive heart failure. Healthcare institutions have recognized the importance of maintaining a low 30-day readmission rate to achieve high-quality assessments and receive high reimbursement rates. As a result, they have enhanced their ability to monitor and provide appropriate treatment to patients with congestive heart failure (Roshanghalb et al., 2019). This research investigates how project execution and root-cause analysis can improve outcomes for individuals with congestive heart failure. This research seeks to utilize the Johns Hopkins Nursing Evidence-Based Practice and the Johns Hopkins Nursing Evidence-Based Practice Translation Tool to identify effective measures or strategies for significantly reducing the 30-day readmission rate among patients with heart problems. Lewin’s theory of managing change is a component of the change management process.

SMART Objectives for Quality Improvement

This research evaluates interventions hospitals and healthcare providers can implement to reduce the 30-day readmission rate for cardiac conditions. The proposed intervention seeks to achieve two main objectives.

1. This study aims to evaluate the quality of available information regarding effective strategies and interventions for reducing the 30-day readmission rate for heart-related issues in hospitals within a 12-month.
2. The objective is to reduce the hospital’s 30-day readmission rate for heart conditions to be lower than the national average or to be ranked within the top five hospitals in the country.

To meet these goals, the hospital should conduct a root-cause analysis to determine the primary risk factors associated with heart failure readmission rates. Subsequently, intervention recommendations can be made based on this data (Delgado et al., 2019). The objectives of reducing the rate of heart disease readmissions are SMART (specific, measurable, attainable, realistic, and timely), making them feasible to implement within a medical setting.

Recommended Project Management Activities

To fulfill its goals, the facility has to consider two main tactics. Finding the best evidence-based therapies is crucial to lowering the hospital’s readmission rate for heart disease. To accomplish these changes further, change management techniques must be implemented. Project management strategies are needed for both processes (Taklalsingh et al., 2020). Comprehensive home healthcare programs that include round-the-clock phone support for up to 25–30 days after discharge, personalized education on self-care techniques during hospitalization, frequent check-in visits, and encouragement of in-home follow-up are beneficial to patients with heart failure (Cholack et al., 2021).

Through root-cause analysis, a team may use project management tools to evaluate hospitals’ readiness and current procedures to reduce 30-day hospitalization rates linked to cardiac problems. According to the National Patient Safety Foundation (NPSF), root-cause analysis is a valuable method employed by interdisciplinary development teams to identify the underlying causes and explanations for readmissions (Blumer et al., 2021). To reduce cardiovascular disease readmissions, the development team will incorporate change management strategies to implement evidence-based practice improvements (Khan et al., 2021).

Conclusion

One month post-hospital discharge. Engaging in these activities can reduce the readmission rate for heart failure by providing a meaningful approach to identifying and addressing underlying issues or causes and linking them to appropriate therapeutic interventions. Applying change management principles can be advantageous for organizations as it reduces employee resistance, enhances internal support, and optimizes the effectiveness of proposed policy changes. Therefore, by implementing project management, organizational transformation, and evidence-based practice methods, an organization may lower its 30-day readmission rate for cardiac issues.

References

Blumer, V., Mentz, R. J., Sun, J., Butler, J., Metra, M., Voors, A. A., Hernandez, A. F., O’Connor, C. M., & Greene, S. J. (2021). Prognostic role of prior heart failure hospitalization among patients hospitalized for worsening chronic heart failure. Circulation: Heart Failure, 14(4). https://doi.org/10.1161/circheartfailure.120.007871

Bonilla-Palomas, J. L., Anguita‐Sánchez, M., Elola-Somoza, F. J., Bernal, J. L., Fernández-Pérez, C., Ruiz‐Ortiz, M., Jiménez‐Navarro, M., Bueno, H., Cequier, Á., & Marín-Ortuño, F. (2021). Thirteen‐year trends in hospitalization and outcomes of patients with heart failure in Spain. European Journal of Clinical Investigation, 51(11). https://doi.org/10.1111/eci.13606

Cholack, G., Garfein, J., Errickson, J., Krallman, R., Montgomery, D., Kline–Rogers, E., Eagle, K. A., Rubenfire, M., Bumpus, S. M., & Barnes, G. D. (2021). Early (0-7 days) and late (8-30 days) readmission predictors in acute coronary syndrome, atrial fibrillation, and congestive heart failure patients. Hospital Practice, 49(5), 364–370. https://doi.org/10.1080/21548331.2021.1976558

Delgado, J., Gregori, A. F., Fernández, L. N., Claret, R. B., Sepúlveda, A. G., Fernández‐Avilés, F., González-Juanatey, J. R., García, R. V., Otero, M. R., Cubero, J. S., Figal, D. P., Crespo-Leiro, M. G., Álvarez‐García, J., Cinca, J., & Ynsaurriaga, F. A. (2019). Patient-associated predictors of 15- and 30-day readmission after hospitalization for acute heart failure. Current Heart Failure Reports, 16(6), 304–314. https://doi.org/10.1007/s11897-019-00442-1

Driscoll, A., Dinh, D., Prior, D., Kaye, D. M., Hare, D. L., Neil, C., Lockwood, S., Brennan, A., Lefkovits, J., Carruthers, H., Amerena, J., Cooke, J., Vaddadi, G., Nadurata, V., & Reid, C. M. (2020). The effect of transitional care on 30-day outcomes in patients hospitalized with acute heart failure. Heart, Lung and Circulation, 29(9), 1347–1355. https://doi.org/10.1016/j.hlc.2020.03.004

Khan, M. S., Sreenivasan, J., Lateef, N., Abougergi, M. S., Greene, S. J., Ahmad, T., Anker, S. D., Fonarow, G. C., & Butler, J. (2021). Trends in 30- and 90-day readmission rates for heart failure. Circulation: Heart Failure, 14(4). https://doi.org/10.1161/circheartfailure.121.008335

Roshanghalb, A., Mazzali, C., & Lettieri, E. (2019). Multi-level models for heart failure patients’ 30-day mortality and readmission rates: the relation between patient and hospital factors in administrative data. BMC Health Services Research, 19(1). https://doi.org/10.1186/s12913-019-4818-2

Taklalsingh, N., Wengrofsky, P., & Levitt, H. (2020). The Heart Failure Clinic: Improving 30-Day All-Cause Hospital Readmissions. Journal for Healthcare Quality, 42(4), 215–223. https://doi.org/10.1097/jhq.0000000000000221

Sample Answer 2 for NURS 8302 Week 4: APPLYING PROJECT MANAGEMENT APPROACHES FOR A QUALITY IMPROVEMENT PRACTICE GAP

Health care organizations should be continually involved in practice outcomes’ improvement. In this case, they need to make practice gaps identification a norm and respond effectively. Regardless of the situation, the approach chosen to address practice gaps affects outcomes considerably. Project management principles and activities can be integrated into practice improvement projects to guide planning, execution, and implementation. This paper describes the quality improvement practice gap, SMART objectives, and project management activities suitable for the project.

Quality Improvement Practice Gap

Medication errors are common in practice settings, and their rates depend on the experience of the workforce, the technology used, and health conditions, among other factors. The causes of medication errors in practice settings vary, with diagnosis and prescription inefficiencies and ineffective drug distribution practices among the leading causes (AMCP, 2019). Human-based issues and team inefficiencies are other major causes. Such issues include communication gaps and an uninformed patient population (Tiwary et al., 2019). Medication errors impact health outcomes adversely, necessitating up-to-date and evidence-based interventions. They are sources of new health conditions, injuries, and even death (Wondmieneh et al., 2020). Medication errors also cause patient dissatisfaction by reducing the quality of overall care.

Health care organizations can apply different strategies in medication errors control. These strategies can be the basis for using project management activities in practice improvement. Modern technology integration into health care practices is highly recommended in reducing and preventing medication errors. For instance, as Godshall and Riehl (2018) proposed, barcode scanning can prevent and mitigate drug prescription and administration problems. The other strategy is creating an informed nursing staff through nursing education. Doing so can help nurses follow institutional policies on medication transcription, such as the five rights of medication (Hanson & Haddad, 2021). Individually or jointly, these strategies can effectively address the practice gap.

SMART Goals

Medication errors cannot be effectively addressed without setting goals to guide practice improvement. Suitable goals in the planning phase or execution phase include:

1. Adopting appropriate technologies in the practice setting to prevent medication errors within six months.
2. Educating the nursing staff to equip it with knowledge on medication errors prevention and control in three months.

As required in goal setting, these goals are specific, measurable, and time-bound. They outline the measures necessary to achieve a particular outcome.

Project Management Activities to Apply in the Project

Project management is a broad topic with different phases and activities. A suitable project management activity for the project is a project strategy and business case. In project management, project strategy and the business case involve defining all the project’s requirements and proposing an appropriate methodology to achieve the desired goals (Schmidt, 2021). In medication errors’ prevention, project strategy and business case would involve identifying the technologies needed to prevent errors and proposing an approach to acquire them. For instance, the practice setting can rely on internal resources or donations. The other crucial activity is preparation. It is a critical activity before the project starts. Here, the project leader ensures that all the necessary resources are in place and timelines and roles are defined through work breakdown structure and Gantt charts, among other tools. Both activities are crucial to prevent working on a project without a definite end and specific goals.

Conclusion

Quality improvement requires high-level thinking and applying appropriate approaches. A project approach is justified when addressing quality improvement practice gaps such as medication errors. Preparation is vital before starting the project, among other activities like developing a project strategy and business case. Addressing medication errors requires a similar approach due to the complexity of the task and the need to work on specific, measurable, and time-bound goals.

References

AMCP. (2019). Medication errors. https://www.amcp.org/about/managed-care-pharmacy-101/concepts-managed-care-pharmacy/medication-errors

Godshall, M., & Riehl, M. (2018). Preventing medication errors in the information age. Nursing2020, 48(9), 56-58. doi: 10.1097/01.NURSE.0000544230.51598.38

Hanson, A., & Haddad, L. M. (2021). Nursing rights of medication administration. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK560654/

Schmidt, T. (2021). Strategic project management made simple: Solution tools for leaders and teams. New Jersey Wiley.

Tiwary, A., Rimal, A., Paudyal, B., Sigdel, K. R., & Basnyat, B. (2019). Poor communication by health care professionals may lead to life-threatening complications: Examples from two case reports. Wellcome Open Research, 4. https://doi.org/10.12688/wellcomeopenres.15042.1

Wondmieneh, A., Alemu, W., Tadele, N., & Demis, A. (2020). Medication administration errors and contributing factors among nurses: A cross sectional study in tertiary hospitals, Addis Ababa, Ethiopia. BMC Nursing, 19(1), 1-9. https://doi.org/10.1186/s12912-020-0397-0

Sample Answer 3 for NURS 8302 Week 4: APPLYING PROJECT MANAGEMENT APPROACHES FOR A QUALITY IMPROVEMENT PRACTICE GAP

Healthcare organizations should always be committed to delivering care that meets all the outcome standards. As a result, progressive assessment of performance gaps is necessary to identify areas that need attention and quality improvement. Due to their critical role in primary care provision, nurses engage in evidence-based practice projects within their healthcare settings or other appropriate settings. Generally, these health projects follow the typical phases of project management, including initiation, planning, execution, evaluation, and controlling. Nurses also need to set SMART goals when implementing EBP projects, showing the application of project management principles in healthcare delivery. This paper described the quality improvement practice gap, SMART objectives, and project management activities relevant to the project.

Quality Improvement Practice Gap

I chose readmissions for my nursing practice quality improvement gaps. According to Hekkert et al. (2019), hospital readmissions hamper the quality of care since they are associated with unfavorable patient outcomes. Readmissions indicate that patients do not receive the deserved care and are at risk of health complications. Upadhyay et al. (2019) further mentioned that readmissions have substantial financial implications since more resources are used to address the same problem. Resources used towards readmissions can be used for quality improvement initiatives. Due to the profound implications of readmissions, process improvement and the use of data are essential. Process improvement includes interventions such as preventing hospital-acquired infections and improving handoff communication. Data-driven care includes utilizing technology to enhance accuracy and communication outcomes. Data for at-risk patients can be used to make special arrangements for their care to reduce delays.

SMART Objectives to Apply in the Project Planning Phase

1. Identifying three causes of readmissions in healthcare settings as the basis for appropriate interventions
2. To identify and apply two quality improvement interventions to reduce readmission rates

As a critical phase in project management, project planning involves laying out the project’s roadmap. In this case, the requirements of the project to facilitate easy implementation are identified. For instance, tasks and technical requirements are identified during the planning phase. Goals and deliverables are also set during the project planning phase (Moran, 2019). As a result, the two SMART objectives indicate the goals and deliverables to be achieved through the project.

Project Management Activities

Like projects in other fields, DNP projects are tiring and time-consuming. Whether using the agile approach or other methods, it is important to outline the necessary project management activities to guide decision-making and resources allocation. Tasks are also distributed according to the project’s activities (Moran, 2019). A suitable project management activity suiting my project is outlining the scope of the project. Here, the implication is that specific project goals, tasks, deliverables, costs, and deadlines should be outlined. For instance, an education program to increase healthcare providers’ knowledge of reducing readmission rates should be complete in six months. The other activity suiting my project is identifying appropriate stakeholders. Quanbeck (2019) defined stakeholders as influencers in practice change projects since the outcomes directly affect them. Appropriate stakeholders should be identified, including their roles and expectations. The two activities are critical since outlining the scope facilitates efficient resource allocation while stakeholders provide huge support. For instance, organizations’ management prepares the organization for change and provides venues for organizing meetings.

In conclusion, the project management approach can be used in addressing quality improvement practice gaps. In this case, nursing projects can apply similar project management phases and guidelines. SMART objectives ensure that the nurse looks forward to achieving specific and measurable outcomes. Ambiguity should be avoided by all means. As described above, appropriate project management activities for my project including defining the scope and identifying the stakeholders.

References

Hekkert, K., Borghans, I., Cihangir, S., Westert, G. P., & Kool, R. B. (2019). What is the impact on the readmission ratio of taking into account readmissions to other hospitals? A cross-sectional study. BMJ Open, 9(4), e025740. http://dx.doi.org/10.1136/bmjopen-2018-025740

Moran, K. J. (2019). Doctor of nursing practice project: A framework for success. Jones & Bartlett Learning.

Quanbeck, A. (2019). Using stakeholder values to promote implementation of an evidence-based mobile health intervention for addiction treatment in primary care settings. JMIR mHealth and uHealth, 7(6), e13301.  doi: 10.2196/13301

Upadhyay, S., Stephenson, A. L., & Smith, D. G. (2019). Readmission Rates and Their Impact on Hospital Financial Performance: A Study of Washington Hospitals. Inquiry : A Journal of Medical Care Organization, Provision and Financing, 56, 46958019860386. https://doi.org/10.1177/0046958019860386