Question

A quality team identifies a problem on an intermediate care unit concerning documentation of ambulation for patients who are postoperative for open heart surgery and are on a routine schedule. Patients are ambulated sporadically, not per the surgery protocol. On closer analysis, it is noted that the ambulation schedule is adhered to during the day shift because the cardiac rehab nurse worked with each patient. However, the evening shift presents problems; there is no documentation of ambulation or sporadic documentation. The quality improvement (QI) nurse notes only 30% compliance in documented ambulation during the evening shift. The QI nurse determines that the target for this issue is 100% compliance with ambulation schedules.

A. Would it be appropriate to conduct a root cause analysis or failure mode effects analysis on this issue? Explain your response.

B.   Define the problem in this case scenario.

C.  What is the key performance indicator in this case?

D. Analyze possible factors leading to ideal ambulation and actual ambulation.

Answer 1

A)Rot cause analysis is done after an event or failure occurred where as in failure mode effect analysis is done to check the availability to avoid failure by taking steps.Here failure effect mode analysis can be used to handle this scenario because it is necessary to analyse the cause and find solution why the ambulation is not done in evening hours.

B)The problem in the scenario is time management. Effectively doing this will improve the quality of care.If the RN is busy she can supervise the patient ambulation with the trained care takers.

C). The key performance indicator is the compliance report of 30% ambulation in evening.

D)Some of the possible factors leading to ideal ambulation and actual ambulation are

• Scheduling time
• Time management
• Encouraging nurses to ambulate the patient
• Poor planning
• Health education about its necessity