A Peer Response must be substantive by bringing information to the discussion or

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A Peer Response must be substantive by bringing information to the discussion or further enhance the discussion. Each Peer Response must have a minimum of ONE reference with citations (the best is a peer-reviewed article). Each response should be least 5 sentences in length. Statements like “I agree” or “great post” does not count for the words or sentences.
Discussion question/Participation #1
The shift to value-based care has once again brought more changes to the healthcare field giving nurse managers and leaders another challenge. They have discovered that healthcare needs to be more that constrained to the building. So being a proactive leader and making sure nurses are practicing to the full scope of their license and teaching these patients what to watch for, who to follow up with, and providing resources (Threw, 2018). Also having a nurse manager of leader that meet with and can explain to administration that their protocols will not work as they were meant for a color by number situation which our patients never are that easy (Threw, 2018). And then empower your nurses, you may find you have a goldmine at your fingertips when you empower and given them some ownership (Threw, 2018). By bring in the people who know the work and perform the work and involving them in the beginning, you have more ownership (Wood, 2012). Nurses are always advocating for the patient and safer practices and are often an untapped resource with brilliant ideas. By empowering the nurses, and the nurses being the majority of the healthcare.
Discussion question/Participation #2
In recent years, the health care system has been challenging in many ways for nurse leaders, managers as healthcare organizations seek innovative ways to change financing and delivery mechanisms secondary to high health care costs and increased competition which led to significant changes in the form of reengineering (Guo,2004). Being nurse leaders and managers have a wide range of responsibilities. Nurse managers and leaders have an important role in reengineering the healthcare system; by being proactive as they are making tough changes with declining reimbursement and the financial penalties that come with it, while continuing to care for very sick patients. The value-based approach to care remains very challenging for nurse leaders, managers and organization, despite many obstacles, there are tremendous opportunities for nurse leaders to reshape care by creating new ways to best utilize nurses in this new update care system. Nurse leaders should be taking a proactive approach and creating solutions that will move nursing and healthcare into the future (Thew, 2018). Nurse leaders and managers have to make sure patient care is provided with well qualified and competent staff.
Discussion question/Participation #3
Modern healthcare has evolved into a complex and dynamic system providing healthcare to
diverse patient population making reengineering a critical core competency and requisite skill for
health care organizations. It helps to reprioritize, provide cost-effective care, and increase service
value for patients/clients. Nurses are “professionals with the capacity and responsibility to
influence current and future healthcare delivery systems”(Helbig, 2018). Nurse leaders and
managers play a huge role in reshaping the healthcare that is provided by the staff through their
leadership skills. A nurse leader/manager plays a pivotal role in the re-engineering of health care
by acting as an agent of change in “developing strategies for quality improvement and contribute
positive changes to the profession of nursing to improve patient outcomes” (Helbig, 2018). Also,
nurse leaders and managers as part of the contributions to healthcare reengineering acts as an
advocate for the patients by providing information that empowers patients and enhances
informed decision making as well as ensuring a safe working hospital environment with good
support system for staffs. Another contribution of nurse leader and manager to healthcare
reengineering is accountability. When healthcare professional are held accountable for their
actions, they can learn from mistakes and continuously improve service delivery. Accountability
in healthcare improves patient trust, reduces the misuse of resources, and engage patients in their
care process, leading to improved satisfaction with the health care system, and converts the
patient from a passive recipient to an active partner on the health care team” (Milani and Lavie,
2014). Effective and appropriate accountability protect patients from employee’s error and
misconduct. This contributes immensely to reengineering thereby enhancing patients’ safety, care
and recovery.
Discussion question/Participation #4
Continuous Quality Improvement (CQI) is a process used in healthcare to assess involving physicians and other people in the implementation and planning of continuous improvement to achieve quality health outcomes (Brennan et al., 2017). Hence, CQI is applied to improve customer service, reduce cost and regulatory compliance, and reduce variability. The purpose of these programs is to improve healthcare and identify problems and solutions. Having a universal goal also means that there are many ways to study CQI.
Healthcare systems face many challenges, and healthcare systems must constantly innovate to meet these challenges. CQI is on track, but other improvement projects have failed (Brennan et al., 2017). Coordinating changes, especially in the system’s functioning, to improve clinical quality is a challenge for the healthcare system. Growing financial problems threaten the future of healthcare institutions. Organizations could benefit from prioritizing one project at a time.
In my current position, the CQI team is using pharmacists to help reduce treatment costs. Before deciding to increase pharmacist involvement in patient care, the healthcare system wanted to ensure that pharmacists’ impact on patient outcomes was long-term and lasting. To this end, specialized services in the health system and analysts analyzed to confirm that the program was working. The analysis confirmed the positive effects of drug therapy on patient outcomes by pharmacists, and the program also reduced medical costs (Price et al., 2017). CQI can be used to analyze pharmaceutical therapy.
Discussion question/Participation #5
“Quality improvement (QI) is a systematic, formal approach to the analysis of practice performance and efforts to improve performance” (American Academy of Family Physicians, n.d., para. 1)” (Helbig, 2018). The Pediatric Hospital Medicine Core Competencies (2010) expands on this by stating that Continuous Quality Improvement (CQI) in Health Care is a structured organizational process that involves physicians and other personnel in planning and implementing ongoing proactive improvements in processes of care to provide quality health care outcomes.
I use Quality Improvement daily in my role as a sepsis coordinator. I look for workflow changes or process improvements that can be made in the delivery of sepsis patient care that could have a direct impact on patient mortality/outcomes. One initiative I am working with the ED leaders at all 3 of our hospitals on is reducing time to first antibiotic due to the knowledge that for every hour that an initial antibiotic is delayed for a septic shock patient, the chance for mortality increases by 7%-8% (Johnson and Crumlett, 2021).
I also integrate Quality Improvement in my work as a bedside nurse by implementing the CAUTI and CLABSI bundles that our organization has rolled out to reduce the infection rates within these patients.
Discussion question/Participation #6
Continuous quality improvement (CQI) is the ongoing effort of an organization, including groups and individuals within the organization, working to improve services or product to meet the needs of the consumer (Grand Canyon University [GCU], 2018). CQI is used in to develop clinical practice and is based on the idea that there is always room for improvement. Identified issues are usually brought to a committee where the problem is assessed and improvements are planned and implemented (GCU, 2018). CQI leads to increased workflow capabilities, capacities, and enthusiasm to deliver the best practices. It also improves organizational efficiencies by recognizing, analyzing, and improving quality issues (McCalman et al., 2018).
An example of how I would apply CQI in my past position as a floor nurse is implementing CLABSI and CAUTI prevention bundles within my care of patients who have a central line or urinary catheter. In a study by Davies et al. (2018), it was found that CAUTI prevention bundle implementation reduced CAUTIs by 33% in a sample of 6, 236 patients. The Joint Commission states that CVC are the most frequent cause of health care-associated bloodstream infections and that implementation of CLABSI prevention bundles can help reduce rates and costs for healthcare facilities (The Joint Commission, n.d.).

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