NURS FPX 6016 Assessment 3: Data Analysis and Quality Improvement Initiative Proposal
The training that medical professionals undergo equips them with the knowledge and abilities needed to provide medical services (Khorana et al., 2021). According to Feehan et al. (2020), medical professionals aim to improve the health condition of critically sick patients by using evidence-based procedures. Healthcare professionals should be equipped with the skills that affect them during the training process so they can diagnose, treat, disseminate healthcare information, conduct data information analysis, and suggest preventive actions. By encouraging better lifestyle choices and communicating the need to enact laws that would promote the population’s well-being, healthcare professionals can also be seen as advocates of healthy living (Agarwal et al., 2021). Depending on their understanding of patient data and other obstacles that might be preventing the attainment of better healthcare, the nurses can also recommend any action that might improve the type of healthcare services they provide. Using data analysis to propose a quality improvement program in a neonatal intensive care unit is the focus of NURS FPX 6016 Assessment 3. The idea is motivated by the understanding that nurses and other medical professionals possess the knowledge and abilities to apply the data quality improvement plan at work to adopt procedures that can improve patient outcomes.
The unit is one of the medical facilities’ departments where babies who may need surgery are watched and premature born babies with underlying disorders are housed. High-tech technology and skilled nurses and staff are common in NICUs, which aid in the care of the infants (Shlomai et al., 2021). Low-weight infants, infants with blood infections, heart problems, respiratory illnesses, and children born before 37 weeks of gestation are among the common characteristics of infants admitted to the NICU (Merewood et al., 2021). These babies need
special attention because of their frailty. As a result, neonatal nurse practitioners and other interdisciplinary professionals routinely review NICU units to assess the quality, safety, and data quality objectives.
Problem and Needs
According to earlier research, breast milk has health benefits for infants. The WHO and the American Academy of Pediatrics have also recognized the importance of breast milk for infants and the nutritional components that are absorbed, making it vital for infants’ health (Pelizzo et al., 2020). Breast milk has several benefits, including improving early cognitive development, preventing sepsis and respiratory tract infections, and increasing feeding sensitivity in premature infants. Additionally, according to the experts, breast milk can reduce the number of premature newborns who get necrotizing enterocolitis (Wang et al., 2019). Over the past ten years, most hospitals have modified the human milk feeding rate in light of the information above about the benefits of breast milk for infants. However, several human errors in newborn feeding have resulted from the preference for breast milk as the infants’ main food source. NICU has stated that, due to data analysis tools, the errors have increased in recent years.
According to the NICU’s quality management team, which has already conducted an annual assessment of the organization’s quality outcomes in 2020 and 2021, there were almost adverse misses in the administration of breast milk.
The dashboard measures were examined after certain tests of variables, such as the assessment of infants under 34 weeks, the level of Cytomegalovirus (CMV) inactivity and screening at the organization’s units, and the rates of mistakes made when giving mother’s milk in NICU units. The quality management team discovered that two of the organization’s quality indicators fell short of the hospital’s standards based on the dashboard metrics study. CMV served as the quality
indicator for the NICU units’ screening level, inactivation rate, and mistake rate when it came to mother’s milk administration. NURS FPX 6016 Assessment 3 offers a quality improvement program based on efficient breast milk scanning to reduce human error that has been reported as a result of mothers supplying milk to their infants, based on the data analysis at the NICU.
Proposed Solution
Analyzing the relationship between the two quality indicators that did not meet the hospital’s criteria and what this means for the provision of high-quality healthcare in the facility is the segment’s top priority in NURS FPX 6016 Assessment 3. Following that, the report will suggest quality improvement tactics that can lower error rates and raise hospital CWV inactivation and screening rates. In order to formulate hypotheses that impact nursing qualities and healthcare quality, the report will examine patterns of linkages between information and signals during the proposal-making process. The assessment will also help identify the root cause of the quality problems so that a plan and framework can be developed to improve the NICU units’ satisfaction results.
Identifying quality issues through dashboard metrics’ analysis
The following table is a dashboard presentation of metrics of quality and safety of the NICU unit of the target hospital.
| Year | Babies born less than 34 weeks | Error rate in the administration of mother’s milk | CMV level of screening and inactivation |
| NICU 2020 | 20 | 30-percent | 80-percent |
| NICU 2021 | 25 | 40-percent | 76-percent |
According to the data, there were more infants admitted to the NICU in 2021 than there were in 2020. Additionally, there was a 10% increase in the mistake rate in 2021 when giving breast milk. The other revelation is the decrease in the degree of CMV inactivation and screening in 2021, in contrast with the quantities in 2020. The hospital administration is concerned about the decline in patient care quality in 2021, as indicated by the data in the above table. According to the data, some anecdotes give the hospital a bad reputation for providing high-quality prenatal and postnatal care for babies. The opposite story is that the nurses and other medical practitioners at the hospital have been careless in respect to the proper administration of milk to babies. Another possibility is that the margin of error in the table may lead to the feeding of other mothers’ nursing milk to neonates, increasing the risk of HIV transmission in the NICU. Additionally, a low level of milk screening before the milk is given to the babies could contribute to the administration of tainted milk, which could have negative effects on the patient. According to the NICU department analysis above, the healthcare facility is dealing with a quality issue in the care of infants.
The possibility that the organization will experience legal issues in the event that parents file lawsuits against the hospital is one of the outcomes of the examination of the dashboard metrics mentioned above (Lumbreras-Marquez et al., 2021). The other consequence is that health professionals who are sent to the unit or found to have handled the infants indiscriminately may face disciplinary action and have their nursing practice license revoked. The infants may also be affected, especially if they get infections as a result of improper milk screening and errors in delivering mothers’ breast milk to the right newborns (Klotz et al., 2018). When babies get
infections, they can stay in the NICU for longer, which would increase the parents’ bill for medical care.
In addition to the aforementioned table, further leadership concerns were identified by the hospital’s NICU department’s quality evaluation report. To illustrate this point, the results of the conversation between the nurses on the unit and the nurses’ managers showed that the transactional leadership style used at the unit might contribute to the errors noted in the data analysis report. Subordinates should follow their superiors’ directions to avoid punishment or rewards since transactional leadership uses these strategies as a motivating factor (Shlomai et al., 2021). Since most of the lower-level employees are inexperienced and dependent on their superiors for guidance, the NICU branch exemplifies the transactional leadership style. Therefore, the lack of guidance on how to handle the issues that arise in the NICU department will inevitably result in mistakes being made by the lower-level staff, which will contribute to the subpar performance shown in the above table.
Quality Improvement Initiative Proposal
The concept that is highlighted in NURS FPX 6016 Assessment 3 is based on the primary issue that caused the NICU department’s quality standards to drop. The facility was unable to provide the infants with higher-quality healthcare because of the transactional style of leadership. In light of this, it is suggested that the NICU department’s transactional leadership be replaced with transformational leadership. The transformational leadership model is more proactive than the transactional leadership model, and its leaders are flexible and open to new ideas (Wang et al., 2019). If the healthcare institution wishes to see a difference in the quality of care provided to their infants, the NICU department’s culture must be changed.
The ability to motivate subordinates and empower staff to accomplish organizational goals and objectives by addressing higher ideals and moral values is a feature of the transformational type of leadership style (Merewood et al., 2021). The healthcare facility’s fortunes will improve with the use of transformational leadership, and nurses will be committed to giving the infants higher-quality treatment.
According to NURS FPX 6016 Assessment 3, the transformational leadership style should be used using the plan-do-study-act paradigm. This strategy is being used by institutions and organizations to expedite the transition, which is an essential need in the NICU section. The following strategies will need to be used by the institution in order to execute the PDSA.
- Plan: To validate the above-mentioned conclusion on the leadership style used in the NICU department, an interdisciplinary team of various stakeholders will be formed and will utilize a questionnaire survey. Nurses and other medical staff who work in the department will be asked to complete the survey. After analyzing the results, the team will recommend that, in order to improve the two quality indicators in the above table, the leadership behavior modification should be changed to transformational leadership.
- Do: The creation of a strategic plan that may contribute in the achievement of the targeted NICU quality targets was emphasized within the framework of this element. Training the department’s nurses and equipping them with the information and abilities they need to carry out their responsibilities would be one such framework.
- Study: The goal of this section is to track data from the Do section and see how it differs and leads to the NICU department achieving its goals.
- Act: This component’s goal is to reevaluate the goals outlined in the first step in to determine how well transformational leadership meets the institution’s quality standards. After that, the
management will analyze the data in the quality indicators to see if there has been a rise or reduction. Depending on the facts at hand, the department may decide to implement new goals and strategies, and PDSA may be used to carry them out.
One of the problems with using the PDSA model is that, as this example shows, using only a few quality indicators would result in a skewed perception of the department’s issue (Lumbreras-Marquez et al., 2021).
To better understand the elements that may be influencing quality achievements in the department, NURS FPX 6016 Assessment 3 suggests introducing additional quality indicators, such as patient happiness, nurse satisfaction, and mortality rate. According to theories like the foundation theory, inefficiencies in one department may indicate the existence of an organizational issue that has a detrimental effect on other departments (Shlomai et al., 2021). As a result, management should look into whether other departments in the facility are experiencing the same quality issues as the NICU department.
Support for Quality Improvement through Integration of Interprofessional
Perspective
The idea that the inefficiencies of one set of healthcare professionals affect the quality outcomes of other healthcare professionals is one of the assumptions made regarding quality improvement in a healthcare facility. According to Wang et al. (2019), if the nurses working in the NICU section exhibit a lack of professionalism in their service delivery, the doctors working alongside them will be unable to produce their work efficiently since they are receiving information from the incompetent nurses. At such a point, other professionals in the same field should help the quality aspects management of one set of specialists. Furthermore, the medical institution’s administration must enhance resource delivery to enable all professional teams
operating there to provide the desired outcomes (Merewood et al., 2021). Other strategies must be offered to improve interdisciplinary relationships within the department to achieve cohesiveness and harmony in the provision of healthcare services. In this case, nurses must be given the freedom to implement the changes they need to start improving the quality levels within the NICU department.
Leadership is the latent element, in accordance with the assumptions outlined above and highlighted in NURS FPX 6016 Assessment 3. The suggested transformational leadership style will help the NICU department shift, particularly among the nurses, even though it might affect the nurses’ interactions with other department professionals. In light of this, the department’s interdisciplinary approach to change implementation can increase the possibility that the suggested fixes would achieve their goals (Jawdeh et al., 2020). Additionally, since the newborns will spend less days at the institution, the improved communication and contact between the various experts in the NICU section may benefit the babies.
Effective communication strategies to promote quality improvement
To achieve high-quality outcomes, it is crucial for leaders to keep their subordinates informed about the strategies they are using. The implementation of the change process may be impacted by a lack of an effective communication strategy, which implies that subordinates do not understand what the leadership wants (Agarwal et al., 2021). As the discussion above illustrates, one of the reasons for the NICU department’s quality failure was the nursing leadership’s incapacity to let their staff carry out their responsibilities without constantly needing orders from the seniors. The subordinates lacked knowledge about how to properly screen the milk, label the mother’s milk, and give the milk to the babies. The department’s error rate increased as a result of this. The NICU department’s nursing leadership’s communication strategy
failures shouldn’t continue when the suggested tactics to improve the department’s performance are put into practice.
Correspondence systems that allow for clear communication between the department’s nurses, nurse leadership, and other medical experts who work nearby are the best course of action for the hospital. The combined efforts of various healthcare professionals working in the NICU department can be enhanced by the use of verbal communication activities, electronic communication platforms, and correspondence techniques (Jawdeh et al., 2020). The other option is to use a shared information system that allows a doctor to see what a nurse has done with a patient and determine the next step to be made in the same platform or document regarding the patient’s care (Lumbreras-Marquez et al., 2021). It has long been standard procedure to keep a patient’s file and document the course of therapy so that other medical professionals can evaluate it and report back to the patient. Regarding newborns, the plan should cover a variety of issues, including the duration of the screening and other developmental markers that physicians require in order to make judgments about the child.
Conclusion
One way to determine whether an organization’s quality criteria can be satisfied is to examine its internal quality indicators. Greater levels of CMV screening and inactivation rates, achievement of greater rates of breastfeeding infants, and accurate milk labeling to prevent errors were the goals of the analysis of quality indicators in the hospital’s NICU department. The assessment revealed a drop in the quality parameters for mother milk administration, CMV screening, and inactivation levels. Ineffective leadership was demonstrated by the outcomes of a meeting between the nurses’ administration and the nurses themselves. The department should implement a transformational leadership approach, according to the research, which would
revolutionize the division, enable nurses to accomplish their goals, and strengthen ties among the different healthcare professionals who work there. To improve coordination between the nurses and other medical personnel, improved communication techniques would also be required. By eliminating some of the inefficiencies and mistakes that contributed to the decline in quality, the proposal will assist the healthcare facility in improving its NICU department quality measurements.
References
Agarwal, S., Patodia, J., Mittal, J., Singh, Y., Agnihotri, V., & Sharma, V. (2021). Antibiotic stewardship in a tertiary care NICU of northern India: A quality improvement initiative. BMJ open quality, 10(Suppl 1), e001470.
Feehan, K., Kehinde, F., Sachs, K., Mossabeb, R., Berhane, Z., Pachter, L. M., … & Turchi, R. M. (2020). Development of a multidisciplinary medical home program for NICU graduates. Maternal and Child Health Journal, 24(1), 11-21.
Jawdeh, E. G. A., Huang, C., Mazdeyasna, S., Chen, L., Chen, L., Bada, H. S., & Yu, G. (2020). Noncontact optical imaging of brain hemodynamics in preterm infants: A preliminary study. Physics in Medicine & Biology, 65(24), 245009.
Khorana, M., Wongsin, P., Torbunsupachai, R., & Kanjanapattanakul, W. (2021). Effect of domperidone on breast milk production in mothers of sick neonates: A randomized, double-blinded, placebo-controlled trial. Breastfeeding Medicine, 16(3), 245-250.
Klotz, D., Jansen, S., Gebauer, C., & Fuchs, H. (2018). Handling of breast milk by neonatal units: Large differences in current practices and beliefs. Frontiers in pediatrics, 235.
Lumbreras-Marquez, M. I., Campos-Zamora, M., Ramirez-De Avila, A. L., Soto-Galindo, J. C., Olivas-Chavez, J. C., Tecayehuatl-Delgado, G., … & Farber, M. K. (2021). Training for the surgical management of postpartum hemorrhage: A multicenter survey of resident physicians. The Journal of Maternal-Fetal & Neonatal Medicine, 34(21), 3503-3509.
Merewood, A., Davanzo, R., Haas-Kogan, M., Vertecchi, G., Gizzi, C., Mosca, F., … & Moretti, C. (2021). Breastfeeding supportive practices in European hospitals during the COVID- 19 pandemic. The Journal of Maternal-Fetal & Neonatal Medicine, 1-7.
Pelizzo, G., Bagolan, P., Morini, F., Aceti, M., Alberti, D., Andermarcher, M., … & Lima, M. (2020). Bedside surgery in the newborn infants: Survey of the Italian society of pediatric surgery. Italian journal of pediatrics, 46(1), 1-8.
Shlomai, N. O., Kasirer, Y., Strauss, T., Smolkin, T., Marom, R., Shinwell, E. S., … & Eventov- Friedman, S. (2021). Neonatal SARS-CoV-2 infections in breastfeeding mothers. Pediatrics, 147(5).
Wang, Y., Briere, C. E., Xu, W., & Cong, X. (2019). Factors affecting breastfeeding outcomes at six months in preterm infants. Journal of human lactation, 35(1), 80-89.
