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NURS FPX 6021 Assessment 3 : Quality Improvement Presentation Poster

Assessments 3: Quality Improvement Presentation Poster

Name

Capella University

NURS-FPX6021: Biopsychosocial Concepts for Advanced Nursing Practice 1

Professor Name

March, 2024

Abstract 

Diabetes-related kidney failure is a common complication among people with kidney diseases in the United States. Implementing effective quality improvement (QI) strategies to improve these patients’ health outcomes is essential. A kidney survey revealed that about 30% of kidney failures in the US are related to diabetes. Research has shown that poor medication adherence and unhealthy dietary choices, such as a high-sodium diet, are the primary factors contributing to kidney failure in diabetic patients. QI initiatives such as the Plan-Do-Study-Act (PDSA) cycle have been adopted to address these issues. This approach guides patients in managing their medications and self-care practices to combat kidney failure.

A poster presentation explores the application of the PDSA cycle in QI for diabetic patients with kidney failure to improve treatment outcomes. The poster highlights the challenges faced in this area, such as the need for effective training, patient support, and specialist availability. It also proposes solutions such as adopting a patient-centric approach. The poster sheds light on the collaborative efforts of interprofessional teams and the impacts of the PDSA cycle, providing a concise overview of these QI measures  (Batsis et al., 2023). These strategic interventions aim to enhance the effectiveness of treatment for diabetic patients with kidney failure.  

Quality Improvement Strategies for Enhanced Biopsychosocial Consideration

A systematic approach is needed to improve healthcare quality for conditions like renal failure. Patient-centered care is crucial, which involves creating personalized treatment plans and involving patients in decision-making. Regular patient feedback through surveys and focus groups is essential to ensure that the care remains patient-focused and evolves with patients’ needs. Adherence to evidence-based practices and protocols is a crucial aspect of QI. Regular training sessions and updated clinical protocols can standardize care, ensuring consistent patient outcomes. Implementing EHRs and data analytics can help track patient progress and identify areas that require improvement in treatment approaches (Batsis et al., 2023).

Interprofessional collaboration is crucial in managing complex conditions such as renal failure. An effective management approach often involves a team of healthcare professionals, including nephrologists, dietitians, nurses, and social workers. Improving communication and collaboration among these professionals is essential to providing comprehensive and cohesive care (Toti et al., 2022). Regular interdisciplinary team meetings and integrated care plans ensure that all patient care aspects are addressed efficiently and effectively.

Continuous Quality Improvement (CQI) models, such as the Plan-Do-Study-Act (PDSA) cycle, facilitate ongoing improvements. For example, implementing a new dietary protocol for renal failure patients can be achieved through the PDSA cycle, where every stage – planning, doing, studying, and acting – is meticulously executed and evaluated for effectiveness. Training and development of healthcare staff are also critical components of QI. Providing staff with opportunities for continuous learning, including workshops on the latest renal failure treatments and skills training for improved patient interactions, enhances the quality of care provided. Leadership development for senior nursing staff and others in key roles ensures that the QI initiatives are driven effectively (Kashani et al., 2023).

Finally, extending QI efforts beyond the healthcare facility through community outreach and education is vital. Educating the community about the prevention and management of renal failure can empower patients, potentially reducing the incidence or severity of the condition. Interprofessional collaboration is vital in managing complex conditions like renal failure. Effective management often involves a team of healthcare professionals, including nephrologists, dietitians, nurses, and social workers. Enhancing communication and collaboration among these professionals is key to providing comprehensive and cohesive care. Regular interdisciplinary team meetings and integrated care plans ensure that all patient care aspects are addressed efficiently and effectively.

The Plan-Do-Study-Act (PDSA) cycle is an iterative, four-phase approach that allows for continuous refinement of processes and interventions in healthcare settings to improve patient outcomes and address the complex needs of renal failure patients.

  • The first phase involves identifying a specific goal or problem related to renal failure management, developing a detailed plan, and setting objectives.
  • In the second phase, the plan is put into action, and careful documentation of procedures and patient engagement is crucial for evaluating the intervention’s effectiveness later.
  • In the third phase, the outcomes of the implemented plan are monitored and analyzed to determine the effectiveness of the intervention.
  • In the fourth phase, based on the insights gained from the study phase, decisions are made on whether to adopt, adapt, or abandon the changes.

Overcoming challenges such as ensuring patient participation, adapting to individual patient needs, and coordinating among multidisciplinary teams requires strong communication, patient education, and flexibility (Toti et al., 2022). By regularly engaging in PDSA cycles, healthcare providers can enhance the quality of life and outcomes for patients with renal failure.

Limitations and Challenges of the PDSA Cycle in Renal Failure Management

The PDSA cycle is a widely used model in healthcare quality improvement. However, several limitations need to be acknowledged and addressed to ensure its effectiveness. These limitations include its time-consuming nature, the need for robust data collection and analysis, resistance to change, resource constraints, scope and scalability, and its focus on short-term outcomes. By recognizing and proactively addressing these limitations, healthcare organizations can utilize the PDSA cycle more effectively, leading to improved patient care and health outcomes, especially in complex areas such as renal failure management (Toti et al., 2022).

Critical Evaluation of Supporting Evidence for Proposed Quality Improvement Methods

Recent studies have contributed valuable insights into quality improvement methods in renal failure management, highlighting certain interventions’ effectiveness and identifying knowledge gaps. A study focusing on pediatric liver transplant recipients with chronic kidney disease implemented three quality improvement interventions: documentation of blood pressure percentile and estimated glomerular filtration rate (eGFR), documentation of a kidney management plan in case of abnormalities, and initiation of amlodipine prior to hospital discharge after liver transplant. This approach significantly decreased the prevalence of reduced eGFR at various time intervals post-transplant, demonstrating the impact of systematic documentation and proactive medication management on renal function​​ (Batsis et al., 2023).

Another area of research is using electronic health records and alert systems to improve the management of acute kidney injury (AKI). Studies have shown that implementing electronic alerts for AKI in high-risk wards can lead to early detection and more timely clinical intervention. These electronic alert systems have been effective in various settings, including outpatient laboratories and hospital wards, indicating their broad applicability and potential for improving renal health outcomes​​ (Kashani et al., 2023).

These studies support the effectiveness of structured documentation, proactive medication strategies, and the use of technology in improving renal health outcomes. However, they also point to areas where more research is needed, such as the long-term impacts of these interventions, their scalability, and applicability in different patient populations. Additionally, the studies highlight the importance of interdisciplinary collaboration and patient-specific approaches in managing complex conditions like renal failure.

Identification of Knowledge Gaps and Areas of Uncertainty in Proposed Quality Improvement Methods

Recent studies on the management of renal failure, particularly in pediatric liver transplant recipients, have made significant advances. However, these studies have also uncovered knowledge gaps that require further exploration. One study highlighted the effectiveness of quality improvement interventions like systematic documentation and medication management in reducing eGFR in this group. However, it remains to be seen how applicable these interventions are to broader patient demographics, including adults and non-liver transplant patients (Batsis et al., 2023). 

Electronic health records and alert systems for early detection of acute kidney injury also show great promise. However, their long-term effects, adaptability across various healthcare settings, and usability by healthcare professionals must be investigated. Furthermore, while a quality improvement approach involving educational sessions for renal failure patients, particularly those with diabetes, has enhanced patient understanding and encouraged evidence-based practices, it is crucial to further examine its long-term effectiveness and scalability to a wider patient population. Addressing these gaps is essential to develop more comprehensive renal failure management strategies that are universally applicable and effective.

Grounding the Project in Successful Change Strategies 

The project aims to enhance renal failure management using evidence-based practice, interprofessional collaboration, and technology integration. The Plan-Do-Study-Act cycle enables iterative refinement of changes. Staff training, stakeholder involvement, cost-effective interventions, and external funding address challenges such as resistance to change and resource limitations. Clear protocols and continuous professional education tackle the complexity of renal failure management (Batsis et al., 2023). This multifaceted approach fosters a dynamic, patient-centered renal failure management system, enhancing patient outcomes and more efficient healthcare delivery.

Addressing Potential Challenges and Strategies for Resolution  

In healthcare quality improvement, anticipating and addressing challenges is crucial. Resistance to change is a notable obstacle; involving stakeholders from the beginning helps build ownership and eases transitions. Resource constraints can impede project execution and sustainability. Effective resource management, seeking additional funding, forming external partnerships, and leveraging technology are key strategies to overcome these limitations. Managing renal failure projects face challenges such as data handling, adherence to guidelines, patient engagement, scalability, and interprofessional collaboration. To address these, implement user-friendly data tools, enhance patient involvement, pilot test, embed sustainable practices, and foster regular interprofessional communication (Li et al., 2024).

Solutions 

Addressing the challenges of a healthcare improvement project, such as in renal failure management, necessitates practical and sustainable strategies. A primary hurdle is often resistance to change from healthcare staff and patients, rooted in discomfort with new practices and uncertainty about outcomes. Counteracting this requires fostering an environment of open communication and engagement, involving stakeholders in planning and decision-making to build ownership and trust. Educating on the benefits and reasons for change and sharing success stories or evidence of similar initiatives’ effectiveness can alleviate resistance. Regular feedback and open forums for discussion help ease the transition and foster receptivity  (Batsis et al., 2023). Additionally, resource limitations, including staffing, funding, and time constraints, are significant.

Overcoming this challenge involves efficient resource management and innovative approaches. Prioritizing high-impact, low-resource aspects of the project ensures effective use of limited resources. Seeking extra funding through grants or partnerships and employing technology like automated systems or telehealth can optimize staffing and efficiency. Training staff to perform multiple roles can also help manage human resource constraints (Hirano et al., 2023). Maximizing every resource’s potential is crucial in overcoming these hurdles and achieving the project’s goals.

Enhancing Quality Improvement through Interprofessional Teamwork

Interprofessional teamwork is crucial for improving the efficiency and effectiveness of quality improvement projects in healthcare, especially in complex areas such as renal failure management. This collaborative model incorporates diverse healthcare professionals, each contributing specialized knowledge and skills. The fundamental assumption of this approach is that diverse perspectives and expertise foster a more comprehensive understanding of patient needs, resulting in more comprehensive care. For example, an interprofessional team for renal failure management may include a nephrologist, nurse, dietitian, and social worker, each offering unique insights into patient care (Hamidi & Auguste, 2023). The nephrologist provides medical expertise, the nurse gives insights into daily care and patient compliance, the dietitian advises on dietary needs, and the social worker addresses social and psychological challenges. This multi-faceted approach ensures a well-rounded treatment plan that enhances problem-solving capabilities through collaborative brainstorming, leading to more effective patient care strategies.

Efficiency is another significant benefit of interprofessional teamwork in healthcare. Team members coordinate care, reducing redundancy and streamlining the process. Shared decision-making and communication within the team can speed up treatment planning and implementation, improving the patient experience. Regular meetings and shared electronic health records enable quick and informed decision-making, keeping everyone informed. However, this approach assumes a culture of mutual respect and open communication. 

The potential of interprofessional teamwork may only be fully realized with these. Challenges like professional silos and communication barriers can impede teamwork. Addressing these requires efforts to foster a collaborative culture, team-building, communication training, and clear protocols for team interactions. Effective and efficient interprofessional teamwork can significantly improve healthcare quality improvement projects, offering more comprehensive and coordinated care thus improving patient outcomes (Ghimire et al., 2022). It is rooted in mutual respect, open communication, and a commitment to shared decision-making, and it depends on the active participation of all team members.

Overall project benefits 

The Renal Failure Management Project enhances patient outcomes through evidence-based practices and patient-centered approaches. It offers holistic care that includes psychological and social aspects, reducing wait times and costs while improving healthcare efficiency. The project adapts to the evolving needs and challenges in renal failure management, ensuring lasting positive impacts.

NURS FPX 6021 Assessment 3 Quality Improvement Presentation Poster References :

Batsis, I., Elisofon, S., Ferguson, M., Jonas, M., Kimball, B., Lee, C., Mitchell, P., & Fawaz, R. (2023). A quality improvement intervention to decrease the decline in renal function in pediatric liver transplant recipients. Pediatric Transplantation, 27(4), e14506. https://doi.org/10.1111/petr.14506

Ghimire, A., Sultana, N., Ye, F., Hamonic, L. N., Grill, A. K., Singer, A., Akbari, A., Braam, B., Collister, D., Jindal, K., Courtney, M., Shah, N., Ronksley, P. E., Shurraw, S., Brimble, K. S., Klarenbach, S., Chou, S., Shojai, S., Deved, V., Wong, A., Bello, A. K. (2022). Impact of quality improvement initiatives to improve CKD referral patterns: a systematic review protocol. BMJ Open, 12(4), e055456. https://doi.org/10.1136/bmjopen-2021-055456

Hamidi, S., & Auguste, B. L. (2023). Continuous quality improvement in peritoneal dialysis: Your questions answered. Peritoneal dialysis international : Journal of the International Society for Peritoneal Dialysis, 43(4), 292–300. https://doi.org/10.1177/08968608231156924

Hirano, K., Kobayashi, D., Shimbo, T., & Komatsu, Y. (2023). Impact of a continuous quality improvement program on contrast-induced nephropathy in outpatients with chronic kidney disease: an interrupted time-series study. Nephrology, dialysis, transplantation : official publication of the european dialysis and transplant association – European Renal Association, 38(5), 1249–1259. https://doi.org/10.1093/ndt/gfac268

Kashani, K.B., Awdishu, L., Bagshaw, S.M. (2023). Digital health and acute kidney injury: consensus report of the 27th acute disease quality initiative workgroup. Nat Rev Nephrol 19, 807–818. https://doi.org/10.1038/s41581-023-00744-7

Li, H., Liu, X. L., Huang, S. F., & Wen, Y. J. (2024). Impacts of continuous quality improvement on wound pain in the puncture site of arteriovenous fistula in haemodialysis patient. International Wound Journal, 21(3), e14697. https://doi.org/10.1111/iwj.14697

Toti, L., Manzia, T. M., Blasi, F., Lenci, I., Baiocchi, L., Toschi, N., & Tisone, G. (2022). Renal function, adherence and quality of life improvement after conversion from immediate to prolonged-release tacrolimus in liver transplantation: Prospective ten-year follow-up study. Transplant international : Official journal of the European Society for Organ Transplantation, 35, 10384. https://doi.org/10.3389/ti.2022.10384

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