Question

consider the case study below and answer the question that follows:

You have just taken over the nurse manager job on a medical surgical unit. The nurse manager that was previously in the position left abruptly two weeks ago. An alternate nurse manager from the telemetry unit next door has been filling in to help with staffing, but has provided little management and supervision to the unit. When you walk around the unit throughout your first day of work and settle into reviewing the paperwork on your desk, you notice several issues that need to be addressed:

• The day nurses are choosing the patients for the night nurses, and the night nurses are choosing patients for the day nurses. Some nurses have extremely light loads, while others have extremely heavy loads. The nurses are choosing patients for their friends without consideration for staffing, patient load, and quality care factors. When you inquire about the prior staffing assignments system, the nurses replied, “Whatever it was, it was never enforced. So we took over.”
• HCAHPS survey scores are extremely low in several categories including: “Your Care From Nurses” and “Your Experiences in this Hospital.”
• The supply closets on the unit are barren. Staff are using whatever they can find in patients’ rooms and sometimes in other units.
• Patient readmission rates are 20% higher than those of the rest of the hospital.

1. consider the case study above, how can the quality improvement THEORY IN NURSING be applied to this situation?

2. Explain the main components of the quality improvement THEORY IN NURSING and your rationale for application in this Case Study situation.

3. Discuss why the quality improvement THEORY IN NURSING is the best for this case study.

Answer 1

1. In health care, quality improvement (QI) is the framework to systematically improve the ways care is delivered to patients. Processes have characteristics that can be measured, analyzed, improved, and controlled. In the given scenario systematic actions are missing and is to be provided according to the quality improvement theory in nursing. The important features of the theory that helps here are systematic work(work as system and processes) and focus on being part of the team(all nurses are assigned equal and fair work)

2. Components of quality improvement theory:

• Adaptive leadership, culture, and governance
• Data collection
• Analytics
• Evidence and consensus based practices
• multidisciplinary QI team

Adaptive leadership is necessary as the lack of leadership resulted in random care for patients which is ineefective and unpleasant for patients. Proper collection and analysis of data by a team is required.

3. This case surely lacks systematic management of patients and collection and analysis of data, which are the key components of quality improvement theory. The nurses agreed to the fact that they picked their patients randomly as there was no system to guide them and this also made unequal distribution of work among them. As quality improvemnt ensures that all the nurses become part of the team, it also solves the issue. Hence in this scenario, quality improvement theory in nursing is best suited.