Capstone Project Change Proposal – Improving a Fall Prevention Program in a Clinical Environment Essay

Capstone Project Change Proposal – Improving a Fall Prevention Program in a Clinical Environment Essay

Capstone Project Change Proposal – Improving a Fall Prevention Program in a Clinical Environment Essay

Assessment of Project

The leadership practicum at the University of Texas Medical Branch (UTMB) helped me develop my leadership skills by applying theories of nursing and leadership. It enhanced my research skills, which I used to improve the delivery and outcomes of health care. During the project, I identified a practice area that needed improvement, analyzed the problem, and planned to improve healthcare delivery. The proposed project for the practicum was to develop a new policy to streamline the process of infusion therapy in the outpatient department.  I presented the project proposal to my preceptor, and we negotiated the project’s objectives to align them with the organization’s mission and goals. My preceptor has been an important figure in advancing my leadership skills and has guided me throughout the project’s planning and implementation.

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Focus, Goals, and Competencies

The leadership practicum project focused on developing a new policy at UTMB to streamline the process of infusion therapy in the outpatient department. The project also focuses on improving the ordering processes of drugs in the outpatient setting. The project’s scope is on process improvement in the ambulatory infusion center at UTMB. UTMB lacks detailed protocols for the infusion of IV medications administered in the outpatient setting. The policy will guide the safe administration of IV drugs and promote patient safety and better health outcomes.  It will outline providers’ roles and responsibilities with respect to intravenous medicines management. It will also provide understandable information and guidance in preparing and administering IV drugs. Besides, the policy will provide explicit performance criteria for IV drugs preparation and administration.

The project’s goal was to improve the efficiency of administration of IV medications such as biologics and chemotherapy agents at UTMB’s ambulatory infusion center. The proposed policy will direct nurses on the procedure to take when administering IV drugs in adults and pediatrics to ensure the right drugs are infused to the right patient and are administered in the correct dosage and right route. The project seeks to improve patient safety by reducing the risk of potential adverse drug events (ADEs) caused by incorrect infusion of IV drugs (Furniss et al., 2018). Protocols need to be in place with regard to managing and administering IV drugs and fluids to ensure that the organization and health providers comply with government legislation and deliver safe, effective patient care (Furniss et al., 2018). Health providers are held responsible for their practice. Therefore, they must be well-versed with the professional and legal responsibilities regarding their competence in the storage, preparation, prescribing, labeling, infusing, recording, and monitoring of IV drugs.

The AONE competencies I hoped to accomplish over the project’s course fall under the domain of knowledge of the healthcare environment. They include fostering the establishment of an organization-wide patient safety program; application of knowledge on patient safety science; examining clinical activities to ascertain expected and unexpected patient risks (Waxman et al., 2017). The project supported the achievement of these competencies since I developed a policy that promotes patient safety. I examined the practice of IV drug administration and identified potential risks of ADEs. Besides, I applied knowledge on patient safety to develop a solution that will streamline the process in infusion therapy to improve safety in IV drug infusion.

Project Needs

The project was informed by the increasing inconsistencies in administering IV medications such as biologics and chemotherapy at UTMB. An incomplete and inadequate ordering process causes the inconsistencies. IV drugs are associated with about 56% of medication errors and 54% of potential ADEs. Lyons et al. (2018) state that 61% of the most adverse and life-threatening potential ADEs are related to the administration of IV drugs. Consequently, there was an urgent need to develop a policy to help reduce medication errors and ADEs, which compromise patient safety and hinder better patient outcomes. Furthermore, the complexities related to prescribing, preparing, and infusing IV drugs suggest greater potential patient risks than for other routes of drug administration (Lyons et al., 2018). The lack of policies and protocol to guide IV drug infusion increase the risk of harm, and safety protocols are needed to reduce these risks.

The mission of UTMB is to improve the health of the residents of Texas and globally. The organization uses diversity and quality to further education, shove the bounds of discovery, improve population health, foster stronger communities, and influence public policy for the common good (UTMB, 2021). UTMB’s mission is consistent with improving patient safety, suggesting the need to align changes and practices across the organization to increase positive outcomes and improve patient satisfaction.  I did not alter the practicum project course since it aligns with the organizational mission of promoting patient safety. Besides, the project aligns with the philosophy, which supports continued growth, evidence-based practice, patient satisfaction, and quality patient care.

Barriers

The practicum experience did not face any major barriers since I was strongly supported by the leadership at UTMB. The stakeholders involved in the project included my preceptor, who has previous supervisory experience in infusion therapy, a nurse educator, EPIC support, the pharmacy team, physicians, nursing staff, and the unit managers at UTMB. However, the implementation of the project may face potential barriers related to EPIC support in the organization’s IT system. Besides, there may be competing priorities related to timely implementation, which may hinder the effective accomplishment of the project.

Outcomes

The project’s outcome will be measured by reviewing the incidences of ADEs in patients following IV drug infusion at the ambulatory infusion center at UTMB. The project’s outcomes will be reviewed six months and 12-months after initiation of the policy. The reported ADEs after policy implementation will be compared to those before implementation (Lyons et al., 2018). ADEs at UTMB are usually reported in the Adverse Event Reporting System (AERS), an electronic database used to report ADEs in the hospital. Data on ADEs will be obtained from the UTMB, and health providers in the outpatient setting will be encouraged to report every ADE case in the AERS. A decrease in the number of ADEs will suggest that the policy was effective, while an increase or stagnation will suggest that the policy needs further improvement.

The project is sustainable since the policy will be used in the long term to guide health providers in prescribing, preparing, and infusing IV drugs. If the providers strictly adhere to the policy, the organization will sustain high patient safety levels in drug administration. Furthermore, the policy can be shared with other healthcare organizations that face a similar challenge to help streamline IV infusion practices.

Project Success

The project was not implemented due to delays in EPIC since the system has to be modified to integrate the IV infusion protocol.  Nevertheless, the problem of the inconsistencies caused by an incomplete and inadequate ordering process has been brought to light by the health providers and the leadership team at UTMB. The leadership team has the same opinion that the organization needs a process for ordering medications. They also agree that a protocol is needed to guide clinicians and nurses in prescribing, preparing, and administering IV drugs. The project will be successful after its implementation and will help meet the organization’s mission of providing high-quality care, which promotes patient safety.

Conclusion

            The leadership practicum project focused on developing a new policy to streamline the process of infusion therapy in the outpatient department. It also focused on improving the ordering processes of drugs in the outpatient setting. The goal was to improve the efficiency of administration of IV medications and improve patient safety by reducing the incidence of ADEs. The project was identified due to the increasing inconsistencies in the administration of IV drugs caused by an incomplete and inadequate ordering process. The project’s outcomes will be measured by comparing the number of reported ADEs before and after the implementation of the project.

References

Furniss, D., Lyons, I., Franklin, B. D., Mayer, A., Chumbley, G., Wei, L., Cox, A. L., Vos, J., Galal-Edeen, G., & Blandford, A. (2018). Procedural and documentation variations in intravenous infusion administration: a mixed-methods study of policy and practice across 16 hospital trusts in England. BMC health services research, 18(1), 270. https://doi.org/10.1186/s12913-018-3025-x

Lyons, I., Furniss, D., Blandford, A., Chumbley, G., Iacovides, I., Wei, L., … & Franklin, B. D. (2018). Errors and discrepancies in the administration of intravenous infusions: a mixed methods multihospital observational study. BMJ quality & safety, 27(11), 892-901. http://dx.doi.org/10.1136/bmjqs-2017-007476

UTMB. (2021). About us- Vision, mission & values. Welcome to UTMB Health, The University of Texas Medical Branch. https://www.utmb.edu/som/home/about-us-vision-mission-values

Waxman, K. T., Roussel, L., Herrin-Griffith, D., & D’Alfonso, J. (2017). The AONE nurse executive competencies: 12 years later. Nurse Leader, 15(2), 120-126.

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Throughout your practicum experience, you have been designing and implementing a project. You will now assess that experience. Prior to beginning this paper, discuss the topics below with your preceptor. Include their feedback as well as your own. In a 1,250-1,500 word document, discuss the following topics:

1. What was the focus of your leadership project, the goals you set for yourself, and the AONE competencies you hoped to achieve? (A description of focus of the project, including goals and AONE competencies, is complete and includes supporting details). The setting for my practicum project will take place at the University of Texas Medical Branch. Proposed Practicum Project (include what course objective/program-specific competency this will meet): Following the American Organization for Nursing Competencies, this student will develop a new policy for the practicum site by streamlining the process in infusion therapy. The problem is that the institution lacks specific protocols for the infusion of medications provided in the outpatient setting. This will promote patient safety while working with policy. The scope of my project will be process improvement in the ambulatory infusion center of the University of Texas Medical Branch. The organizational goals and mission where I will be performing my practicum are consistent with continued growth, evidenced based practice, patient satisfaction, and quality patient care. I did not alter my practicum as it aligns with the organizational mission and goals. The aim of the project is to promote patient safety.
2. How did you discover the need for this project, and how did it fit into the organization’s philosophy and mission? (A description of how the need for the project was determined and alignment to the philosophy and mission of the organization is extremely thorough and includes substantial supporting details) It has been brought to my attention that there are inconsistencies regarding the administration of intravenous medications such as biologics and chemotherapy within the institution. The problem is caused by an incomplete and inadequate ordering process. The organizational mission is consistent with improving patient safety, suggesting the need to align changes and practices across the organization to increase positive outcomes and improve patient satisfaction. We identified the primary stakeholders involved in the project and discussed the observations and thoughts based upon the lessons learned in topics five and six. The stakeholders involved in the project will be my preceptor, who has previous supervisory experience in infusion therapy, the nurse educator, EPIC support, pharmacy, nursing staff, physicians, and the unit managers.
3. Did you encounter any real or potential barriers during your practicum experience related to your project? (A description of potential or real barriers faced during the practicum project experience is extremely thorough and includes substantial supporting details) The project is supported by leadership. Barriers relate to EPIC support and competing priorities related to timely implementation. The project will be implemented.

1. Discuss how the outcomes of your project will be measured? (A description of how the outcomes of the project will be measured and if it is sustainable is extremely thorough and includes substantial supporting details) Is your project one that is sustainable or is it designed to be a single occurrence? Need outcome measures. I believe it will be sustainable.
2. Evaluate the success of your project. If you were not able to implement your project, discuss why. What are the next steps for the project? An evaluation of the success of the project or causes of its lack of success is complete and includes supporting details. I believe it was successful. Although the implementation of the complete project will be delayed in EPIC, awareness of the problem has been brought to light. Leadership agrees that there should be a process in place for ordering medications.

Use a minimum of two peer-reviewed resources (published within the last 5 years) as evidence to support your views.

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

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Assessment of Project – Rubric

Expand All Assessment Of Project –

Focus, Goals, and Competencies

26.25 points

Project Needs

26.25 points

Barriers

26.25 points

Outcomes

26.25 points

Project Success

17.5 points

Thesis Development and Purpose

12.25 points

Argument Logic and Construction

14 points

Mechanics of Writing (includes spelling, punctuation, grammar, language use)

8.75 points

Paper Format (Use of appropriate style for the major and assignment)

8.75 points

Documentation of Sources

8.75 points

Total 175 points