Assignment Prompt & Instructions
– ## Discussion2PICOTQuestion.docx
– ## PDSAPROJECT.docx
**## Discussion2PICOTQuestion.docx**
Discussion 2 PICOT Question
During my clinical rotation in the step-down unit for trauma at Broward Medical Center, I have noticed that nursing ratios are high for the acuity of these patients. In a fast-paced acute care environment, finding the proper nurse-to-patient ratios is not just a logistical challenge but a matter of life and death. Staffing levels often fluctuate due to budget constraints and widespread shortages. Research shows a clear connection: when nurses care for fewer patients, outcomes improve, mortality drops, medical errors decline, and patient satisfaction rises (Phillips et al., 2021). This pressing clinical issue, identified through quality improvement efforts, emphasizes how inadequate staffing can jeopardize patient safety and satisfaction scores. Tackling this challenge head-on is critical to delivering high-quality care and building a more resilient, effective healthcare system. Also, evidence shows that appropriate nurse staffing contributes to improved patient outcomes and improved satisfaction scores that benefits both patients and nurses. Addressing this major problem would help our patients and our nurses’ well-being.
**Clinical Question**
In adult patients admitted to an acute care hospital setting, how does a lower nurse-to-patient ratio compared to a higher ratio affect patient outcomes such as mortality rates, incidence of medical errors and Hospital Acquired Pneumonia, and patient and nurse satisfaction over a period of 8 months?
**PICOT Question**
**P-Patient or Problem:** Adult patients in acute care hospital settings.
**I-Intervention:** Lower nurse-to-patient ratios.
**C-Comparison:** Higher nurse-to-patient ratios.
**O-Outcome**: Improved patient outcomes, reduced patient mortality rates, reduced incidence related to medical errors, decreased incidence of Hospital-acquired pneumonia (HAP), and increased patient and nurse satisfaction.
**T**-
**Time:** Within 8 months of implementation
References
_Nurse staffing_. ANA. (2019a, July 11). https://www.nursingworld.org/practice-policy/nurse-staffing/
Phillips, J., Malliaris, A. P., & Bakerjian, D. (n.d.). Nursing and patient safety. https://psnet.ahrq.gov/primer/nursing-and-patient-safety
**## PDSAPROJECT.docx**
**PDSA PROJECT & POWERPOINT PRESENTATION**
**PDSA Practice Improvement Plan** PDSA Practice Improvement Plan The assignment will be divided into four phases.
The PDSA project will give students the experience to initiate and coordinate planned changes in a healthcare organization. This assignment aims to engage the student in identifying a clinical problem or process, undertaking a literature review, and implementing an evidence-based intervention to improve patient, nurse/staff, or clinical outcomes and/or processes.
**_Students will use the Agency for Healthcare Research and Quality's (2020) Plan-Do-Study-Act (PDSA) Directions and Examples as a guideline for this assignment (Web link Available in Modules)_**
**Part I: Plan**
1.
**Problem Identification**
·
Problem Identification:
· Students will identify a clinical issue or process by:
· Reviewing clinical site's electronic health records.
· Nurses can leverage Electronic Health Records (EHRs) to identify clinical issues and improve system processes in several impactful ways:
2.
1.
**Data Aggregation and Analysis**: EHRs compile comprehensive patient data, allowing nurses to analyze trends and patterns. This can help identify common clinical issues, such as frequent infections or medication errors, and address them proactively
1.
**Clinical Alerts and Reminders**: EHRs can generate alerts for potential clinical issues, such as abnormal lab results or missed medications. These alerts help nurses intervene promptly, improving patient safety and care quality
1.
**Support for Diagnostic and Therapeutic Decisions**: EHRs provide decision support tools that assist nurses in making informed clinical decisions. These tools can suggest potential diagnoses or treatment options based on patient data, enhancing the accuracy and efficiency of care
1.
**Improving Communication**: EHRs facilitate better communication among healthcare team members by providing a centralized platform for patient information. This ensures that all team members are aware of the patient's status and any clinical issues, leading to more coordinated and effective care
1.
**Identifying Systemic Issues**: By analyzing data from EHRs, nurses can identify systemic issues within the healthcare facility, such as workflow inefficiencies or resource shortages. Addressing these issues can lead to improved processes and better patient outcomes
1.
**Quality Improvement Initiatives**: EHRs enable the tracking of key performance indicators and outcomes. Nurses can use this data to participate in quality improvement initiatives, aiming to enhance care standards and patient satisfaction
1.
**Documentation and Compliance**: Accurate and thorough documentation in EHRs helps ensure compliance with regulatory requirements and standards. This not only improves patient care but also protects the healthcare facility from legal and financial risks
2.
**Review of Literature**
·
Review of literature:
· What level of knowledge is out there to address the clinical problem or process you identified at your clinical site?
· Currently, what evidence-based guidelines are published on the clinical problem or process?
· The literature reviewed should consist of systematic reviews, meta-analyses, peer-reviewed studies, or clinical guidelines.
· Expert opinion articles and clinical articles can be used as supportive literature for clinical issues with limited research.
· Students will also "review the literature" by going to the "MDC Resources" tab available on their Canvas' Navigation Panel, then click on the weblink titled "MDC's Research Databases (i.e., Journals)" or simply click on this weblink:
[MDC's Research Databases (i.e., Journals)](https://mdc.instructure.com/courses/131153/modules/items/12175272)
· Students will need to reference a minimum of five (5) research articles published by professional journals or organizations on their identified clinical problem or process.
· Present a summary of your literature review in a table format using the following criteria:
· 1st column: Study (i.e., author(s))
· 2nd Column: Population
· 3rd Column: Intervention
· 4th Column: Comparison
· 5th Column: Outcomes
· 6th column: Results
· 7th Column: Level of Evidence
· Please use "Level of Evidence" instead of Quality
· Use Winona State University's (WSU) Evidence Based Practice Toolkit: Levels of Evidence (Melynk & Fineout-Overholt, 2023) by clicking here:
[https://libguides.winona.edu/ebptoolkit/Levels-EvidenceLinks to an external site.](https://libguides.winona.edu/ebptoolkit/Levels-Evidence)
·
[Links to an external site.](https://libguides.winona.edu/ebptoolkit/Levels-Evidence) For each source, students will review WSU's Levels of evidence and determine which level to assign to each
source.
3.
**I plan to:** You will write a concise statement of what you plan to do in your PDSA project
4.
**I hope this produces:** Here you will put a measurement or outcome that you hope to achieve with your project
5.
**PICO(T) Question (Must be the same PICOT question approved by Course Professor in Discussion #2)**
· Please see Discussion #2 Guidelines & Grading Rubric
**The Process**
1.
**Steps to Execute:** Write the steps you're going to take in the PDSA cycle, the population you are working with, and the time limit
·
·
The population could be a patient, a problem, a population, a unit, a division, or an organization problem.
· The population has to be greater than 10
·
·
The time limit that you will do this project.
· The time is limited to the days you attend clinical
· Time limit cannot start before you started you clinical hours or end after your last day
· The PDSA project must be completed within your 48 in-person/on site clinical hours
**Part II: Do**
1. After you have your plan, you will execute it or set it in motion.
2.
**What happened when you implemented your plan? What did you observe?**
· Here you will write down data (i.e., numbers) you gathered OR observations you witnessed during the implementation of your plan.
· Present data/numbers or observations in a table.
· This may include how the patients react, how the nurses react, and what impact it had on patient outcomes, unit practices, or organizational processes.
3. After presenting your data/observations in a table, you will also answer the following questions:
·
· "Did everything go as planned?"
· If yes, provide a brief summary.
· If no, provide a brief summary.
· "Did I have to modify the plan?"
· If yes, describe what you modified and why?
· If no, state that no modifications were necessary.
**Part III: Study**
1. After implementation, you will study the results (i.e., data/numbers or observations that you gathered).
1. If you will use observations instead of numbers as your data, you will need to write very detailed notes on what you observed.
2.
**What did you learn?**
·
**Did you meet your measurement goals?**
· If yes, provide a brief summary.
· If no, provide a brief summary.
**Part IV: Act**
·
**What did you conclude from this cycle?**
· You will write what you came away with for this implementation and whether it worked.
· If it did not work, what can you do differently in your next PDSA cycle to address what went wrong?
· If it did work, is your unit ready to implement your intervention across the unit or healthcare system?
**References & Citations (i.e., Parenthetical & Narrative)**
·
· Please note that you must list all your references in a separate slide(s) at the end of your presentation.
· All references must be cited in APA 7th edition.
· All citations (i.e., parenthetical or narrative) must be cited in APA 7th edition.
· Please note that every time you use information gathered from a source or AI, you must use a parenthetical or narrative citation for each in your PowerPoint slides.
**Formatting:**
·
·
**APA 7th edition Formatting**:
· Please make sure to consult your APA 7th edition manual or one of the following APA 7th edition websites:
**Handout**
**Design a handout to give out on the day of your presentation to your preceptor and other audience members (i.e, unit leadership, other departments. and other team members at your clinical site)**
· The handout (one to two pages long) should contain a brief summary of the PDSA project including:
· Title of Project
· Problem Identified
· Plan: State PICOT question
· Do: What did you observe? (Use data to answer this question)
· Study: What did you learn? Did you meet your measurement goals?
· Act: What did you conclude from this cycle?
· Add photos, graphics, tables, etc. to your handout to enhance presentation of information
· A screenshot of the handout should be included in your PDSA PowerPoint presentation after your "References" slide.
**Discussion Questions**
· Student will create three (3) discussion questions to ask the audience at the end of presentation.
· These questions will be integrated into the PDSA PowerPoint presentation after the slide containing the screenshot of the "handout".
· One question per slide.
## image1.png
**## PDSAPROJECT.docx**
**PDSA PROJECT & POWERPOINT PRESENTATION**
**PDSA Practice Improvement Plan** PDSA Practice Improvement Plan The assignment will be divided into four phases.
The PDSA project will give students the experience to initiate and coordinate planned changes in a healthcare organization. This assignment aims to engage the student in identifying a clinical problem or process, undertaking a literature review, and implementing an evidence-based intervention to improve patient, nurse/staff, or clinical outcomes and/or processes.
**_Students will use the Agency for Healthcare Research and Quality's (2020) Plan-Do-Study-Act (PDSA) Directions and Examples as a guideline for this assignment (Web link Available in Modules)_**
**Part I: Plan**
1.
**Problem Identification**
·
Problem Identification:
· Students will identify a clinical issue or process by:
· Reviewing clinical site's electronic health records.
· Nurses can leverage Electronic Health Records (EHRs) to identify clinical issues and improve system processes in several impactful ways:
2.
1.
**Data Aggregation and Analysis**: EHRs compile comprehensive patient data, allowing nurses to analyze trends and patterns. This can help identify common clinical issues, such as frequent infections or medication errors, and address them proactively
1.
**Clinical Alerts and Reminders**: EHRs can generate alerts for potential clinical issues, such as abnormal lab results or missed medications. These alerts help nurses intervene promptly, improving patient safety and care quality
1.
**Support for Diagnostic and Therapeutic Decisions**: EHRs provide decision support tools that assist nurses in making informed clinical decisions. These tools can suggest potential diagnoses or treatment options based on patient data, enhancing the accuracy and efficiency of care
1.
**Improving Communication**: EHRs facilitate better communication among healthcare team members by providing a centralized platform for patient information. This ensures that all team members are aware of the patient's status and any clinical issues, leading to more coordinated and effective care
1.
**Identifying Systemic Issues**: By analyzing data from EHRs, nurses can identify systemic issues within the healthcare facility, such as workflow inefficiencies or resource shortages. Addressing these issues can lead to improved processes and better patient outcomes
1.
**Quality Improvement Initiatives**: EHRs enable the tracking of key performance indicators and outcomes. Nurses can use this data to participate in quality improvement initiatives, aiming to enhance care standards and patient satisfaction
1.
**Documentation and Compliance**: Accurate and thorough documentation in EHRs helps ensure compliance with regulatory requirements and standards. This not only improves patient care but also protects the healthcare facility from legal and financial risks
2.
**Review of Literature**
·
Review of literature:
· What level of knowledge is out there to address the clinical problem or process you identified at your clinical site?
· Currently, what evidence-based guidelines are published on the clinical problem or process?
· The literature reviewed should consist of systematic reviews, meta-analyses, peer-reviewed studies, or clinical guidelines.
· Expert opinion articles and clinical articles can be used as supportive literature for clinical issues with limited research.
· Students will also "review the literature" by going to the "MDC Resources" tab available on their Canvas' Navigation Panel, then click on the weblink titled "MDC's Research Databases (i.e., Journals)" or simply click on this weblink:
[MDC's Research Databases (i.e., Journals)](https://mdc.instructure.com/courses/131153/modules/items/12175272)
· Students will need to reference a minimum of five (5) research articles published by professional journals or organizations on their identified clinical problem or process.
· Present a summary of your literature review in a table format using the following criteria:
· 1st column: Study (i.e., author(s))
· 2nd Column: Population
· 3rd Column: Intervention
· 4th Column: Comparison
· 5th Column: Outcomes
· 6th column: Results
· 7th Column: Level of Evidence
· Please use "Level of Evidence" instead of Quality
· Use Winona State University's (WSU) Evidence Based Practice Toolkit: Levels of Evidence (Melynk & Fineout-Overholt, 2023) by clicking here:
[https://libguides.winona.edu/ebptoolkit/Levels-EvidenceLinks to an external site.](https://libguides.winona.edu/ebptoolkit/Levels-Evidence)
·
[Links to an external site.](https://libguides.winona.edu/ebptoolkit/Levels-Evidence) For each source, students will review WSU's Levels of evidence and determine which level to assign to each
source.
3.
**I plan to:** You will write a concise statement of what you plan to do in your PDSA project
4.
**I hope this produces:** Here you will put a measurement or outcome that you hope to achieve with your project
5.
**PICO(T) Question (Must be the same PICOT question approved by Course Professor in Discussion #2)**
· Please see Discussion #2 Guidelines & Grading Rubric
**The Process**
1.
**Steps to Execute:** Write the steps you're going to take in the PDSA cycle, the population you are working with, and the time limit
·
·
The population could be a patient, a problem, a population, a unit, a division, or an organization problem.
· The population has to be greater than 10
·
·
The time limit that you will do this project.
· The time is limited to the days you attend clinical
· Time limit cannot start before you started you clinical hours or end after your last day
· The PDSA project must be completed within your 48 in-person/on site clinical hours
**Part II: Do**
1. After you have your plan, you will execute it or set it in motion.
2.
**What happened when you implemented your plan? What did you observe?**
· Here you will write down data (i.e., numbers) you gathered OR observations you witnessed during the implementation of your plan.
· Present data/numbers or observations in a table.
· This may include how the patients react, how the nurses react, and what impact it had on patient outcomes, unit practices, or organizational processes.
3. After presenting your data/observations in a table, you will also answer the following questions:
·
· "Did everything go as planned?"
· If yes, provide a brief summary.
· If no, provide a brief summary.
· "Did I have to modify the plan?"
· If yes, describe what you modified and why?
· If no, state that no modifications were necessary.
**Part III: Study**
1. After implementation, you will study the results (i.e., data/numbers or observations that you gathered).
1. If you will use observations instead of numbers as your data, you will need to write very detailed notes on what you observed.
2.
**What did you learn?**
·
**Did you meet your measurement goals?**
· If yes, provide a brief summary.
· If no, provide a brief summary.
**Part IV: Act**
·
**What did you conclude from this cycle?**
· You will write what you came away with for this implementation and whether it worked.
· If it did not work, what can you do differently in your next PDSA cycle to address what went wrong?
· If it did work, is your unit ready to implement your intervention across the unit or healthcare system?
**References & Citations (i.e., Parenthetical & Narrative)**
·
· Please note that you must list all your references in a separate slide(s) at the end of your presentation.
· All references must be cited in APA 7th edition.
· All citations (i.e., parenthetical or narrative) must be cited in APA 7th edition.
· Please note that every time you use information gathered from a source or AI, you must use a parenthetical or narrative citation for each in your PowerPoint slides.
**Formatting:**
·
·
**APA 7th edition Formatting**:
· Please make sure to consult your APA 7th edition manual or one of the following APA 7th edition websites:
**Handout**
**Design a handout to give out on the day of your presentation to your preceptor and other audience members (i.e, unit leadership, other departments. and other team members at your clinical site)**
· The handout (one to two pages long) should contain a brief summary of the PDSA project including:
· Title of Project
· Problem Identified
· Plan: State PICOT question
· Do: What did you observe? (Use data to answer this question)
· Study: What did you learn? Did you meet your measurement goals?
· Act: What did you conclude from this cycle?
· Add photos, graphics, tables, etc. to your handout to enhance presentation of information
· A screenshot of the handout should be included in your PDSA PowerPoint presentation after your "References" slide.
**Discussion Questions**
· Student will create three (3) discussion questions to ask the audience at the end of presentation.
· These questions will be integrated into the PDSA PowerPoint presentation after the slide containing the screenshot of the "handout".
· One question per slide.
## image1.png
**## Discussion2PICOTQuestion.docx**
Discussion 2 PICOT Question
During my clinical rotation in the step-down unit for trauma at Broward Medical Center, I have noticed that nursing ratios are high for the acuity of these patients. In a fast-paced acute care environment, finding the proper nurse-to-patient ratios is not just a logistical challenge but a matter of life and death. Staffing levels often fluctuate due to budget constraints and widespread shortages. Research shows a clear connection: when nurses care for fewer patients, outcomes improve, mortality drops, medical errors decline, and patient satisfaction rises (Phillips et al., 2021). This pressing clinical issue, identified through quality improvement efforts, emphasizes how inadequate staffing can jeopardize patient safety and satisfaction scores. Tackling this challenge head-on is critical to delivering high-quality care and building a more resilient, effective healthcare system. Also, evidence shows that appropriate nurse staffing contributes to improved patient outcomes and improved satisfaction scores that benefits both patients and nurses. Addressing this major problem would help our patients and our nurses’ well-being.
**Clinical Question**
In adult patients admitted to an acute care hospital setting, how does a lower nurse-to-patient ratio compared to a higher ratio affect patient outcomes such as mortality rates, incidence of medical errors and Hospital Acquired Pneumonia, and patient and nurse satisfaction over a period of 8 months?
**PICOT Question**
**P-Patient or Problem:** Adult patients in acute care hospital settings.
**I-Intervention:** Lower nurse-to-patient ratios.
**C-Comparison:** Higher nurse-to-patient ratios.
**O-Outcome**: Improved patient outcomes, reduced patient mortality rates, reduced incidence related to medical errors, decreased incidence of Hospital-acquired pneumonia (HAP), and increased patient and nurse satisfaction.
**T**-
**Time:** Within 8 months of implementation
References
_Nurse staffing_. ANA. (2019a, July 11). https://www.nursingworld.org/practice-policy/nurse-staffing/
Phillips, J., Malliaris, A. P., & Bakerjian, D. (n.d.). Nursing and patient safety. https://psnet.ahrq.gov/primer/nursing-and-patient-safety
**## PDSAPROJECT.docx**
**PDSA PROJECT & POWERPOINT PRESENTATION**
**PDSA Practice Improvement Plan** PDSA Practice Improvement Plan The assignment will be divided into four phases.
The PDSA project will give students the experience to initiate and coordinate planned changes in a healthcare organization. This assignment aims to engage the student in identifying a clinical problem or process, undertaking a literature review, and implementing an evidence-based intervention to improve patient, nurse/staff, or clinical outcomes and/or processes.
**_Students will use the Agency for Healthcare Research and Quality's (2020) Plan-Do-Study-Act (PDSA) Directions and Examples as a guideline for this assignment (Web link Available in Modules)_**
**Part I: Plan**
1.
**Problem Identification**
·
Problem Identification:
· Students will identify a clinical issue or process by:
· Reviewing clinical site's electronic health records.
· Nurses can leverage Electronic Health Records (EHRs) to identify clinical issues and improve system processes in several impactful ways:
2.
1.
**Data Aggregation and Analysis**: EHRs compile comprehensive patient data, allowing nurses to analyze trends and patterns. This can help identify common clinical issues, such as frequent infections or medication errors, and address them proactively
1.
**Clinical Alerts and Reminders**: EHRs can generate alerts for potential clinical issues, such as abnormal lab results or missed medications. These alerts help nurses intervene promptly, improving patient safety and care quality
1.
**Support for Diagnostic and Therapeutic Decisions**: EHRs provide decision support tools that assist nurses in making informed clinical decisions. These tools can suggest potential diagnoses or treatment options based on patient data, enhancing the accuracy and efficiency of care
1.
**Improving Communication**: EHRs facilitate better communication among healthcare team members by providing a centralized platform for patient information. This ensures that all team members are aware of the patient's status and any clinical issues, leading to more coordinated and effective care
1.
**Identifying Systemic Issues**: By analyzing data from EHRs, nurses can identify systemic issues within the healthcare facility, such as workflow inefficiencies or resource shortages. Addressing these issues can lead to improved processes and better patient outcomes
1.
**Quality Improvement Initiatives**: EHRs enable the tracking of key performance indicators and outcomes. Nurses can use this data to participate in quality improvement initiatives, aiming to enhance care standards and patient satisfaction
1.
**Documentation and Compliance**: Accurate and thorough documentation in EHRs helps ensure compliance with regulatory requirements and standards. This not only improves patient care but also protects the healthcare facility from legal and financial risks
2.
**Review of Literature**
·
Review of literature:
· What level of knowledge is out there to address the clinical problem or process you identified at your clinical site?
· Currently, what evidence-based guidelines are published on the clinical problem or process?
· The literature reviewed should consist of systematic reviews, meta-analyses, peer-reviewed studies, or clinical guidelines.
· Expert opinion articles and clinical articles can be used as supportive literature for clinical issues with limited research.
· Students will also "review the literature" by going to the "MDC Resources" tab available on their Canvas' Navigation Panel, then click on the weblink titled "MDC's Research Databases (i.e., Journals)" or simply click on this weblink:
[MDC's Research Databases (i.e., Journals)](https://mdc.instructure.com/courses/131153/modules/items/12175272)
· Students will need to reference a minimum of five (5) research articles published by professional journals or organizations on their identified clinical problem or process.
· Present a summary of your literature review in a table format using the following criteria:
· 1st column: Study (i.e., author(s))
· 2nd Column: Population
· 3rd Column: Intervention
· 4th Column: Comparison
· 5th Column: Outcomes
· 6th column: Results
· 7th Column: Level of Evidence
· Please use "Level of Evidence" instead of Quality
· Use Winona State University's (WSU) Evidence Based Practice Toolkit: Levels of Evidence (Melynk & Fineout-Overholt, 2023) by clicking here:
[https://libguides.winona.edu/ebptoolkit/Levels-EvidenceLinks to an external site.](https://libguides.winona.edu/ebptoolkit/Levels-Evidence)
·
[Links to an external site.](https://libguides.winona.edu/ebptoolkit/Levels-Evidence) For each source, students will review WSU's Levels of evidence and determine which level to assign to each
source.
3.
**I plan to:** You will write a concise statement of what you plan to do in your PDSA project
4.
**I hope this produces:** Here you will put a measurement or outcome that you hope to achieve with your project
5.
**PICO(T) Question (Must be the same PICOT question approved by Course Professor in Discussion #2)**
· Please see Discussion #2 Guidelines & Grading Rubric
**The Process**
1.
**Steps to Execute:** Write the steps you're going to take in the PDSA cycle, the population you are working with, and the time limit
·
·
The population could be a patient, a problem, a population, a unit, a division, or an organization problem.
· The population has to be greater than 10
·
·
The time limit that you will do this project.
· The time is limited to the days you attend clinical
· Time limit cannot start before you started you clinical hours or end after your last day
· The PDSA project must be completed within your 48 in-person/on site clinical hours
**Part II: Do**
1. After you have your plan, you will execute it or set it in motion.
2.
**What happened when you implemented your plan? What did you observe?**
· Here you will write down data (i.e., numbers) you gathered OR observations you witnessed during the implementation of your plan.
· Present data/numbers or observations in a table.
· This may include how the patients react, how the nurses react, and what impact it had on patient outcomes, unit practices, or organizational processes.
3. After presenting your data/observations in a table, you will also answer the following questions:
·
· "Did everything go as planned?"
· If yes, provide a brief summary.
· If no, provide a brief summary.
· "Did I have to modify the plan?"
· If yes, describe what you modified and why?
· If no, state that no modifications were necessary.
**Part III: Study**
1. After implementation, you will study the results (i.e., data/numbers or observations that you gathered).
1. If you will use observations instead of numbers as your data, you will need to write very detailed notes on what you observed.
2.
**What did you learn?**
·
**Did you meet your measurement goals?**
· If yes, provide a brief summary.
· If no, provide a brief summary.
**Part IV: Act**
·
**What did you conclude from this cycle?**
· You will write what you came away with for this implementation and whether it worked.
· If it did not work, what can you do differently in your next PDSA cycle to address what went wrong?
· If it did work, is your unit ready to implement your intervention across the unit or healthcare system?
**References & Citations (i.e., Parenthetical & Narrative)**
·
· Please note that you must list all your references in a separate slide(s) at the end of your presentation.
· All references must be cited in APA 7th edition.
· All citations (i.e., parenthetical or narrative) must be cited in APA 7th edition.
· Please note that every time you use information gathered from a source or AI, you must use a parenthetical or narrative citation for each in your PowerPoint slides.
**Formatting:**
·
·
**APA 7th edition Formatting**:
· Please make sure to consult your APA 7th edition manual or one of the following APA 7th edition websites:
**Handout**
**Design a handout to give out on the day of your presentation to your preceptor and other audience members (i.e, unit leadership, other departments. and other team members at your clinical site)**
· The handout (one to two pages long) should contain a brief summary of the PDSA project including:
· Title of Project
· Problem Identified
· Plan: State PICOT question
· Do: What did you observe? (Use data to answer this question)
· Study: What did you learn? Did you meet your measurement goals?
· Act: What did you conclude from this cycle?
· Add photos, graphics, tables, etc. to your handout to enhance presentation of information
· A screenshot of the handout should be included in your PDSA PowerPoint presentation after your "References" slide.
**Discussion Questions**
· Student will create three (3) discussion questions to ask the audience at the end of presentation.
· These questions will be integrated into the PDSA PowerPoint presentation after the slide containing the screenshot of the "handout".
· One question per slide.
## image1.png
**## Discussion2PICOTQuestion.docx**
Discussion 2 PICOT Question
During my clinical rotation in the step-down unit for trauma at Broward Medical Center, I have noticed that nursing ratios are high for the acuity of these patients. In a fast-paced acute care environment, finding the proper nurse-to-patient ratios is not just a logistical challenge but a matter of life and death. Staffing levels often fluctuate due to budget constraints and widespread shortages. Research shows a clear connection: when nurses care for fewer patients, outcomes improve, mortality drops, medical errors decline, and patient satisfaction rises (Phillips et al., 2021). This pressing clinical issue, identified through quality improvement efforts, emphasizes how inadequate staffing can jeopardize patient safety and satisfaction scores. Tackling this challenge head-on is critical to delivering high-quality care and building a more resilient, effective healthcare system. Also, evidence shows that appropriate nurse staffing contributes to improved patient outcomes and improved satisfaction scores that benefits both patients and nurses. Addressing this major problem would help our patients and our nurses’ well-being.
**Clinical Question**
In adult patients admitted to an acute care hospital setting, how does a lower nurse-to-patient ratio compared to a higher ratio affect patient outcomes such as mortality rates, incidence of medical errors and Hospital Acquired Pneumonia, and patient and nurse satisfaction over a period of 8 months?
**PICOT Question**
**P-Patient or Problem:** Adult patients in acute care hospital settings.
**I-Intervention:** Lower nurse-to-patient ratios.
**C-Comparison:** Higher nurse-to-patient ratios.
**O-Outcome**: Improved patient outcomes, reduced patient mortality rates, reduced incidence related to medical errors, decreased incidence of Hospital-acquired pneumonia (HAP), and increased patient and nurse satisfaction.
**T**-
**Time:** Within 8 months of implementation
References
_Nurse staffing_. ANA. (2019a, July 11). https://www.nursingworld.org/practice-policy/nurse-staffing/
Phillips, J., Malliaris, A. P., & Bakerjian, D. (n.d.). Nursing and patient safety. https://psnet.ahrq.gov/primer/nursing-and-patient-safety
**## PDSAPROJECT.docx**
**PDSA PROJECT & POWERPOINT PRESENTATION**
**PDSA Practice Improvement Plan** PDSA Practice Improvement Plan The assignment will be divided into four phases.
The PDSA project will give students the experience to initiate and coordinate planned changes in a healthcare organization. This assignment aims to engage the student in identifying a clinical problem or process, undertaking a literature review, and implementing an evidence-based intervention to improve patient, nurse/staff, or clinical outcomes and/or processes.
**_Students will use the Agency for Healthcare Research and Quality's (2020) Plan-Do-Study-Act (PDSA) Directions and Examples as a guideline for this assignment (Web link Available in Modules)_**
**Part I: Plan**
1.
**Problem Identification**
·
Problem Identification:
· Students will identify a clinical issue or process by:
· Reviewing clinical site's electronic health records.
· Nurses can leverage Electronic Health Records (EHRs) to identify clinical issues and improve system processes in several impactful ways:
2.
1.
**Data Aggregation and Analysis**: EHRs compile comprehensive patient data, allowing nurses to analyze trends and patterns. This can help identify common clinical issues, such as frequent infections or medication errors, and address them proactively
1.
**Clinical Alerts and Reminders**: EHRs can generate alerts for potential clinical issues, such as abnormal lab results or missed medications. These alerts help nurses intervene promptly, improving patient safety and care quality
1.
**Support for Diagnostic and Therapeutic Decisions**: EHRs provide decision support tools that assist nurses in making informed clinical decisions. These tools can suggest potential diagnoses or treatment options based on patient data, enhancing the accuracy and efficiency of care
1.
**Improving Communication**: EHRs facilitate better communication among healthcare team members by providing a centralized platform for patient information. This ensures that all team members are aware of the patient's status and any clinical issues, leading to more coordinated and effective care
1.
**Identifying Systemic Issues**: By analyzing data from EHRs, nurses can identify systemic issues within the healthcare facility, such as workflow inefficiencies or resource shortages. Addressing these issues can lead to improved processes and better patient outcomes
1.
**Quality Improvement Initiatives**: EHRs enable the tracking of key performance indicators and outcomes. Nurses can use this data to participate in quality improvement initiatives, aiming to enhance care standards and patient satisfaction
1.
**Documentation and Compliance**: Accurate and thorough documentation in EHRs helps ensure compliance with regulatory requirements and standards. This not only improves patient care but also protects the healthcare facility from legal and financial risks
2.
**Review of Literature**
·
Review of literature:
· What level of knowledge is out there to address the clinical problem or process you identified at your clinical site?
· Currently, what evidence-based guidelines are published on the clinical problem or process?
· The literature reviewed should consist of systematic reviews, meta-analyses, peer-reviewed studies, or clinical guidelines.
· Expert opinion articles and clinical articles can be used as supportive literature for clinical issues with limited research.
· Students will also "review the literature" by going to the "MDC Resources" tab available on their Canvas' Navigation Panel, then click on the weblink titled "MDC's Research Databases (i.e., Journals)" or simply click on this weblink:
[MDC's Research Databases (i.e., Journals)](https://mdc.instructure.com/courses/131153/modules/items/12175272)
· Students will need to reference a minimum of five (5) research articles published by professional journals or organizations on their identified clinical problem or process.
· Present a summary of your literature review in a table format using the following criteria:
· 1st column: Study (i.e., author(s))
· 2nd Column: Population
· 3rd Column: Intervention
· 4th Column: Comparison
· 5th Column: Outcomes
· 6th column: Results
· 7th Column: Level of Evidence
· Please use "Level of Evidence" instead of Quality
· Use Winona State University's (WSU) Evidence Based Practice Toolkit: Levels of Evidence (Melynk & Fineout-Overholt, 2023) by clicking here:
[https://libguides.winona.edu/ebptoolkit/Levels-EvidenceLinks to an external site.](https://libguides.winona.edu/ebptoolkit/Levels-Evidence)
·
[Links to an external site.](https://libguides.winona.edu/ebptoolkit/Levels-Evidence) For each source, students will review WSU's Levels of evidence and determine which level to assign to each
source.
3.
**I plan to:** You will write a concise statement of what you plan to do in your PDSA project
4.
**I hope this produces:** Here you will put a measurement or outcome that you hope to achieve with your project
5.
**PICO(T) Question (Must be the same PICOT question approved by Course Professor in Discussion #2)**
· Please see Discussion #2 Guidelines & Grading Rubric
**The Process**
1.
**Steps to Execute:** Write the steps you're going to take in the PDSA cycle, the population you are working with, and the time limit
·
·
The population could be a patient, a problem, a population, a unit, a division, or an organization problem.
· The population has to be greater than 10
·
·
The time limit that you will do this project.
· The time is limited to the days you attend clinical
· Time limit cannot start before you started you clinical hours or end after your last day
· The PDSA project must be completed within your 48 in-person/on site clinical hours
**Part II: Do**
1. After you have your plan, you will execute it or set it in motion.
2.
**What happened when you implemented your plan? What did you observe?**
· Here you will write down data (i.e., numbers) you gathered OR observations you witnessed during the implementation of your plan.
· Present data/numbers or observations in a table.
· This may include how the patients react, how the nurses react, and what impact it had on patient outcomes, unit practices, or organizational processes.
3. After presenting your data/observations in a table, you will also answer the following questions:
·
· "Did everything go as planned?"
· If yes, provide a brief summary.
· If no, provide a brief summary.
· "Did I have to modify the plan?"
· If yes, describe what you modified and why?
· If no, state that no modifications were necessary.
**Part III: Study**
1. After implementation, you will study the results (i.e., data/numbers or observations that you gathered).
1. If you will use observations instead of numbers as your data, you will need to write very detailed notes on what you observed.
2.
**What did you learn?**
·
**Did you meet your measurement goals?**
· If yes, provide a brief summary.
· If no, provide a brief summary.
**Part IV: Act**
·
**What did you conclude from this cycle?**
· You will write what you came away with for this implementation and whether it worked.
· If it did not work, what can you do differently in your next PDSA cycle to address what went wrong?
· If it did work, is your unit ready to implement your intervention across the unit or healthcare system?
**References & Citations (i.e., Parenthetical & Narrative)**
·
· Please note that you must list all your references in a separate slide(s) at the end of your presentation.
· All references must be cited in APA 7th edition.
· All citations (i.e., parenthetical or narrative) must be cited in APA 7th edition.
· Please note that every time you use information gathered from a source or AI, you must use a parenthetical or narrative citation for each in your PowerPoint slides.
**Formatting:**
·
·
**APA 7th edition Formatting**:
· Please make sure to consult your APA 7th edition manual or one of the following APA 7th edition websites:
**Handout**
**Design a handout to give out on the day of your presentation to your preceptor and other audience members (i.e, unit leadership, other departments. and other team members at your clinical site)**
· The handout (one to two pages long) should contain a brief summary of the PDSA project including:
· Title of Project
· Problem Identified
· Plan: State PICOT question
· Do: What did you observe? (Use data to answer this question)
· Study: What did you learn? Did you meet your measurement goals?
· Act: What did you conclude from this cycle?
· Add photos, graphics, tables, etc. to your handout to enhance presentation of information
· A screenshot of the handout should be included in your PDSA PowerPoint presentation after your "References" slide.
**Discussion Questions**
· Student will create three (3) discussion questions to ask the audience at the end of presentation.
· These questions will be integrated into the PDSA PowerPoint presentation after the slide containing the screenshot of the "handout".
· One question per slide.
## image1.png
– 1
– 2