Get your college paper done by experts

Place an order in 3 easy steps. Takes less than 5 mins.

Order Now

Patient outcomes are a direct result of quality care.

Purpose

This week’s graded discussion topic relates to the following Course Outcome (CO).

  • CO 5: Apply improvement methods, based on data from the outcomes of care processes, to design and test changes to continuously improve the quality and safety of healthcare. (PO 8)

The Assignment

Review the story at the link below before posting to the discussion:

Rau, J. (2015). Half of nation’s hospitals fail again to escape Medicare’s readmission penalties. Kaiser Health News. Retrieved from http://khn.org/news/half-of-nations-hospitals-fail-again-to-escape-medicares-readmission-penalties/ (Links to an external site.)Links to an external site.

Save your time - order a paper!

Get your paper written from scratch within the tight deadline. Our service is a reliable solution to all your troubles. Place an order on any task and we will take care of it. You won’t have to worry about the quality and deadlines

Order Paper Now

After you have finished, consider how you would respond to the following situation:

Your local hospital has received notice from CMS (Centers for Medicare and Medicaid) regarding their readmission rates.

  1. As a BSN prepared nurse, you have been asked to serve as a consultant to suggest a new Quality (Performance) Improvement process for ONE of the areas of deficiency. Write some brief steps (suggestions) for improvement as you contemplate accepting the consulting opportunity.
  2. Share practice improvements utilized from your own clinical nursing experiences that have led to enhanced patient outcomes.

Patient outcomes are a direct result of quality care. What would be your primer for one area of improvement that data has presented as an opportunity? What national benchmark are you comparing your benchmark to?

 

Example

I have been asked, as a BSN prepared nurse to evaluate and promote a quality performance improvement plan process for patient readmissions involving those patients with congestive heart failure, CHF (Rau, 2015). The first step is to review the pharmacy medication reconciliation to ensure the medications prescribed reflect the core measures for the type of CHF the patient has. Patients with systolic dysfunction with an ejection fraction less than 40%, require an angiotensin receptor blocker. Other targeted measures require some patients to take a beta blocker (American Heart Association, 2013). The diagnosis of hypertension needs to be addressed. If present, an ACEI or ARB, beta blocker, and hydralize should be on the medication list. In addition to cardiac medications,  an evaluation of diuretics such as Lasix needs to be evaluated with consideration of the dose and if a dose increase is warranted. The second step requires a recent echocardiogram within the last six months to be on the record, if there is not, then one needs to be done during the concurrent hospitalization. During the hospitalization, DVT prophylaxis needs to be given, as many patients with CHF are non-ambulatory (American Heart Association, 2013).

The reason for hospital readmission needs to be evaluated, such as an acute on chronic episode of systolic, diastolic or combined systolic and diastolic heart failure needs to be known. Has the patient been compliant with mediation, sodium intake, and daily weight?  Follow-up physician appointments with a reminder and resources available for the patient to get to and from appointments are other considerations. The last item to review is those patients requiring a CPAP at night or oxygen. Does the patient have a working machine and enough oxygen on hand? These are all items that can be tracked in order to prevent readmission in less than 30 days. Upon discharge, information on the heart failure clinic needs to be reviewed with both the patient and family member. The heart failure clinic has additional resources available such as a customized management plan for home, a calendar to record daily weight and symptoms, bathroom scale, sodium tracker, and if needed a pill organizer.

Clinical experience that can be drawn from my current nursing role as a clinical documentation specialist, CDS includes the identification of a specific diagnosis. An abundant number of patients are admitted with CHF, but further clarification is required if the physician simply documents the reason for admission is CHF. The acuity comes first. The difference between acute and chronic or acute on chronic is mediation, lab values, and patient presentation. Symptoms such as a BNP over 100, increased shortness of breath, increased edema, lung sounds with crackles, orthopnea and an increase in diuretic dosage especially if the change is from oral to intravenous requires clarification if the patients are having an acute exacerbation. Next includes the identification of the type of heart failure such as systolic or diastolic CHF. Systolic heart failure includes patients with a reduced EF, while diastolic CHF are those with a preserved EF and diastolic dysfunction. There are also patients that have both diastolic dysfunction and a reduced EF. Identification of the type of heart failure is paramount, as treatment and medication choices can differ.

"Our Prices Start at $11.99. As Our First Client, Use Coupon Code GET15 to claim 15% Discount This Month!!":

Get started

How it works

Place an order

Select the paper type, page limit, discipline, and format, and then set the deadline. Specify your paper instructions and attach the additional materials.

Track the progress

Check the finished parts of the paper and ask for amendments if necessary. Use the online chat for quick communication with the writer

Receive a paper

Release the payment when you are fully satisfied with the work. Leave feedback to share your experience with our writer.

Why our online essay writing service?

All types of paper writing help

Whether you need an essay, research paper, or dissertation, We have you covered. Our writers can create any kind of academic writing. Also, we can rewrite and edit your papers.

24/7 support

If you have questions about our service or need additional details to make a request, our friendly customer support will get your issues resolved.

On time delivery

Punctuality is our second name. Your order will be delivered strictly within the deadline. If you have an urgent order, we can do it! Our writers will need at least three hours to complete it.

Let us cover any of your writing needs!

Academic Paper Writing Service

Our best writers will gladly help you with:

Coursework / Homework

  • Homework Assignment
  • Engineering Assignment
  • Statistics Assignment
  • Biology Assignment
  • Nursing Assignment
  • Chemistry Assignment

Paperwork

  • Essay
  • Term Paper
  • Research Paper
  • Thesis / Dissertation
  • Research Proposal
  • Editing and proofreading

Others

  • Multiple Choice Questions
  • Short Answer Questions
  • Word Problems
  • Programming Assignment
  • Article Writing
  • Mathematics Calculations