Evidence-Based Quality Improvement For Older Adults The purpose of this paper is to communicate issues surrounding Quality Assurance and Performance Improvement (QAPI) within the elderly community. Age related challenges, review of literature, barriers, physical and emotional challenges, and future impact are topics for discussion. Can data support putting QAPI into practice? Shall executing the items make a difference? Now, determine how each section applies to your workplace. Age Related Challenges As people age, they develop dental problems, which lead to nutritional issues. Cognitive function decline affects memory, decision making, conversing, and problem solving. In addition, falls occur with mental status disturbances. Sleep …show more content…
I reviewed various articles in regards to these aspects. The first article was about improving diabetes care in nursing homes. To summarize this study, it was discovered that information was needed about sliding scales, non-insulin agents, and signs and symptoms (Boyle, O’Neil, Berry, Stowell, & Miller, 2013). Secondly, in Maryland, a program was initiated called Promote Understanding, Leadership, and Learning (PULL). Purposefully designed to distribute cultural change strategies in nursing homes. The program emphasizes the importance of leadership involvement with coaching staff. (Eliopoulos, 2013). The third article addressed feedback, and monitoring. It introduced Interventions to Reduce Acute Care Transfers (INTERACT). Tools were utilized, such as Situation-Background-Assessment-Recommendation (SBAR), and progress notes (Meehan et al., …show more content…
They may experience confusion, anxiety, or depression. Cognitive issues impact learning abilities. Physically, ambulating, swallowing, or completing hygiene are problems. Fall prevention, skin checks, and aspiration precautions are utilized. Although, quality improvement programs are utilized, the individual may not understand the safety protocols. Barriers and Solutions to Quality Improvement Programs A few barriers include: family involvement, self-care, and responsibility. Adult children help by assisting residents with walking, or toileting. This poses a fall risk. In addition, residents’ physical or cognitive abilities are diminished. Memory difficulties make teaching a barrier. Solutions to the above problems: early education, social service referral, and case manager involvement with the family. Future Impact on Care of the Quality of care of the elderly After researching the elderly, I feel, the quality of medical care received will be enhanced. Understanding the aging process, benefit both staff and patient. Comparing collected data, and accessing evidence based material ensure best practices, Communication with staff, patient, and families enhance medical attention. Education creates confidence in everyone. Overtime, QAPI programs will raise the bar on elderly
Team B chose to cover Emeritus at Harbour of Pointe Shores, a senior community located in Ocean Shores, Washington. The team was interested in learning more about an assisted living and rehabilitation facility. It is also an opportunity to uncover the differences from an assisted living community and a skilled nursing facility. Emeritus at Harbour of Pointe Shores provides retirement and assisted living, respite services, and on-site rehabilitation. Similar to other long-term care facilities, the facility and staff are required to follow specific guidelines and regulations to maintain licensing and accreditation. However, these
Starla, I agree with your statement that the older adult is a part of the vulnerable population. I also agree that more resources need to be available to them with education and that this could aid in the reduction of hospital readmissions. One of the articles I summarized, Risk Assessment and Intervention for Older Adults (Culo, 2011), also said the older person may have ‘red flags’ such as repeat emergency room visits or admissions, putting off medical problems, and not taking prescriptions as directed. Frequent assessments for risks and home visits could curb their health care costs. There should also be more involvement from family if available.
This prospective, pre-post quality improvement (QI) project was conducted at the University of Pittsburg Medial Center, Presbyterian Hospital, a tertiary academic medical center in Medical Intensive care unit (MICU). A multidisciplinary team consisted of physicians, pharmacists, and nurses, assessed in detail twenty-seven possible non-pharmacologic interventions that display positive impact on delirium. The remaining nine non-pharmacological interventions were combined into a protocol entitled “Give your patient M.O.R.E.” This acronym can be defined as music, opening of blinds, reorientation and cognitive stimulation, and eye/ear protocols. The purpose was to determine if the implementation of the evidence-based non-pharmacological protocol
Quality improvement data is followed in all health care setting. The use of Cerner EHRs allows data to be obtained from patient charts to analyze core measures. According to the joint commission influenza and pneumococcal vaccinations measures should be addressed in all hospital in-patients (The Joint Commission, 2015). Data can be retrieved on those patient who were diagnosed with pneumonia to determine if they received the vaccinations for pneumonia and influenza. As well as tracking the time frame between diagnosis and treatment, and additionally the patient outcome. This is captured through the documentation of the clinical staff. The information can be analyzed to determine the quality improvement changes that need to be implemented to improve patient outcomes.
After the interview with my nurse manager, I came up with the PICO question which states: “Does the computerized physician order entry (CPOE) system reduce the number of medication errors compared to the common paper system being used today?” This question is important and I selected it because the population that the Belvoir Community hospital serves includes army officers of all ages both active and retired including their spouses and children. This group includes two sub groups of highly vulnerable persons which include the very young and the very old, who have a high-risk effect for medication errors because the potential adverse drug event is three times greater than an adult hospitalized patient (Levine et al., 2001). CPOE is not a panacea, but it does represent an effective tool for bringing real-time, evidence-based decision support to physicians. Nurses are the last defense level of protection against medication errors, and are solely responsible for the dispensing, administering, and monitoring of medications. In healthcare, computers can be used to help facilitate clear and accurate communication between health care professionals. When using a CPOE system it allows physicians to type in prescriptions right into the device or computer which significantly lessens any mistakes that can occur when
Answering the call light (also called call bell a handheld like that is attached to the patient room wall, above the headboard of the bed) in a timely manner by the nursing staff in hospital setting is necessary to prevent falls that can harm, prolonged stays, and unnecessarily increase the cost of healthcare. However, researches concerning call light uses as it relates to patient safety, patient-care management and patient satisfaction are limited (Meade et al. 2006). Patients and their families emphasize that nurses should monitor patients constantly and provide assistance and answer a call light in a timely manner (Yoder, 2011). Note that the falls may be caused by several factors such as
NHS quality improvement programs main purpose is to collect and review data entered in order to recognize the opportunities to improve business operations in healthcare. To bring changes in quality, it is necessary to respond to patient’s ideas and implement them for the better results. The key issues that are to be considered for quality-improvement NHS program, as it moves forward are the needs for the patients, necessity of the funds for quality improvements, needs of the service providers and expectations of the community. Outcomes for people and also change expertise. And to improve business operations in healthcare and also recognize opportunities.
The disorders that affect old age include delirium and dementia. "Delirium is an acute cognitive disorder involving disruptions in attention, and changes to cognitive capacity such as memory loss, disorientation, or language problems. Dementia is a progressive cognitive disorder usually seen
As a hospital, quality care should be a priority for patients that are going to be treated for a sickness, or any type of procedure that is going to take place. A lot of times a patient gets an infection while they were at the hospital, on top of being treated for what they original came in for. Health facilities should be environments of healing, which they are, but they also have tons of various types of germs and infections, which grasp onto individuals that have weak immune systems/are sick. Some infections that are at hospitals are Tuberculosis, VRE, VAP, C-Diff, UTI, and MRSA. Preventive measures to stop the spread of the infections is lacking tremendously in the work and aim to provide safety for all patient’s health. The work
EBIs to reduce disruptive behavior and increase academic achievement can include trainings and implementation support at the school, class-wide, and individual student-level, and are often either academic or behavioral in nature. Overall, implementation of both universal (i.e. class-wide) and targeted (i.e. student-level) interventions have demonstrated positive impacts on decreasing disruptive behaviors and increasing student academic achievement (Flower, McKenna, Bunuan, Muething, & Vega, 2014; Vannest, Davis, Davis, Mason, & Burke, 2010).Ross, Romer, and Horner (2012) also found that teachers in schools implementing Positive Behavioral Interventions and Supports with high fidelity
A topic I learned more of this semester in regards to the older population was dementia. Some loss in memory function is an inevitable consequence of aging, and as one ages, it takes more time to process information and retrieve memories. However, "Dementia is a general term that refers to progressive, degenerative brain dysfunction, including deterioration in memory, concentration, language skills, visuospatial skills, and reasoning, that interferes with a person's daily functioning" (Mauk, 2014, p. 377). This loss of mental skills affects the ability to function over time, causing problems with memory and how one thinks, impacting these individual's overall quality of life.
As people grow older, they develop dental problems which lead to nutritional intake issues. Cognitive function declines affecting memory, decision making, conversing, and problem solving. In addition, falls can occur with mental status disturbances. Lack of social interaction, depression, and anxiety also crop up in the elderly. Sleep patterns are altered by restless legs, snoring, and disrupted breathing sequences. At times, pain can be constant from arthritis, osteoarthritis, or other medical issues (Tabloski, 2014).
Despite the growing burden of diabetes and the lack of diabetes care providers, barriers and resistance for utilization of Advanced Practice Registered Nurses (ARPRNs) to provide diabetes care continues to exist. According to the Centers for Disease Control and Prevention (CDC) (2017), an estimated 30.3 million people have diabetes, with greater than 90% having Type Two Diabetes. In Saline County, Kansas, 12 % of the population has been diagnosed with diabetes (Robert Wood Johnson Foundation, 2016). A previous gap analysis identified the lack of outpatient diabetes education and management services in Saline County, Kansas. Follow-up SWOT (strength, weakness, opportunities and threats) identified barriers and potential solutions that must
As age increases, we can expect some loss of heart, lung, joint, and sexual functioning. Some loss of brain cells and mental efficiency is a normal part of
As an older individual there are many physical changes that occurs during this stage of life. Older individuals live independently and maintain close relationships with family and friends. Most individual’s personalities remain relatively stable throughout their lives. Depression is less prevalent than depression in younger adults. Becoming older can cause hearing impairment. 37 percent of women and 48 percent of men over the age of 75 have impaired hearing. Also there is a decline in vision. It will start to become difficult to read small print, seeing in sim light, or even finding objects. Some aging adults may even need