Practicum Project Focus Goals and Objectives
In the Community Living Center or CLC, there have been consistent low scores for the Quality Measure (QM) for pressure ulcers. Specifically, there is a problem with pressure injuries to the heel areas. Lack of education of front line nursing assistants and poor handoff process is the focus of my project. My goal is to improve the pressure ulcer prevention program in the CLC. To do this, my objectives will be to provide the front line staff with the necessary educational offerings on pressure ulcer prevention and to work on the handoff process between shifts and team members. Improving team dynamics will also be essential to my project.
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I will be using focus group, observation and interview methodology to collect and gather the information needed to analyze the problem on the CLC units. Focus groups, interviews and observation of handoffs will allow me to gain insight to what kind of handoff is currently being done and I will be able to analyze if the process is consistent on all three shifts. In the pre-test meetings with the NA’s, I will be able to use the focus group to gain their insight on what needs to be changed so they feel they have the necessary information in order to do their job effectively. Qualitative information will be obtained that will be reviewed for evidence of a trend pattern. It will be important for me to understand what the staff thinks is the reason they don’t get the proper handoff and why they don’t constantly have the pressure interventions in place. I will use the suggestions from the groups, interviews and my own observations to educate the NAs and revise the handoff process to a consistent and standardized one across all three shifts on all units in the CLC.
In order to evaluate if the face-to-face training sessions with the front line nursing assistants (NAs) was effective, the nursing assistants will first be given a pre-test to measure the assessment of learning needs. This feedback directly from the NA’s can allow me to understand if any changes need to be made in the future planned training. An open question on the pre-test will ask for feedback and ask for suggestions/concerns on this issue. Formative assessments can be used by the instructor and the students to guide improvements in the ongoing teaching and learning context (Carnegie Mellon, n.d.). Formative assessments are commonly used in educational settings and can enhance teaching effectiveness (Pellegrino, 2010). Developed in the UK, formative assessments can produce a clear picture of the child’s strengths and future needs (Black, 2010).
Summative assessments will be then used to evaluate the NA’s assessment of their learning following the pressure ulcer training. This will be done through a post-test to evaluate the effectiveness of the instructional program. Individual feedback will be given to each NA to show them how they have improved after getting the training. Feedback provides the student with clarity and self-esteem that can validate the worth of the training (Duers & Brown, 2009).
In order to evaluate the improvement of the handoff process, audits of care plan interventions will be completed to check to see if there is improvement once the handoff process has been revised. The goal is that the handoff process is standardized and all information regarding high risk residents has been handed-off to the front line staff, ensuring the correct prevention interventions are in place.
For the evaluation of my overall project goal of improving the QM scores for pressure ulcers in the CLC, I plan to use a summative evaluation based upon the benchmarks of other CLCs. The measure of success can be evaluated by a summative assessment of comparing scores from one quarter to another as well as by comparing and using benchmarks (Carnegie Mellon, n.d.). This can be done through the SAIL data which ranks your scores against each CLC in the VA. Strategic Analytics for Improvement and Learning (SAIL) is a system for summarizing performance within Veterans Health Administration (VHA) CLC’s (U.S. Department of Veterans Affairs, 2017). An improvement in the SAIL score of pressure ulcers in the next quarter would validate the success of my project.
Black, P. (2010). Formative assessment. In P. Peterson, E. Baker, & B. McGraw (Eds), International encyclopedia of education (3rd ed, pp. 359-364). St. Louis, MO: Elsevier. Retrieved from Walden Library Databases.
Carnegie Mellon. (n.d.). The whys and hows of assessment. Retrieved from : http://www.cmu.edu/teaching/assessment/howto/basics/formative-summative.html
Duers, L.E., & Brown, N. (2009). An exploration of student nurses’ experiences of formative assessment. Nurse Education Today, 29(6), 654-659. Retrieved from Walden Library Databases.
Pellegrino, J.W. (2010). Technology and formative assessments. In P. Peterson, E. Baker, & B. McGraw (Eds), International encyclopedia of education (3rd ed, pp. 42-47). St. Louis, MO: Elsevier. Retrieved from Walden Library Databases.
U.S. Department of Veterans Affairs. (2017). Quality of Care. Retrieved from https://www.va.gov/QUALITYOFCARE/measure-up/Strategic_Analytics_for_Improvement_and_Learning_SAIL.asp