NUR445 Week 4 Assignment: PICO Question
Step 1 Using the information provided through the interview, formulate a PICO-based research question regarding the identified quality improvement measure. The question must state the selected population, the intervention to be implemented, the comparison to another group that did not have the proposed measure implemented and the outcome as a result.
The question selected for research must be able to be measured with a pre- and post-intervention reputable scale (meaning a measuring tool that has been tested and proven reliable and valid). The assessment tool is important to help determine baseline status of the selected population and to determine if the intervention demonstrated an improvement or regression toward the goal or outcome. Examples of reliable and valid measuring tools that could be used for pre- and post-assessment of pain include the visual analog scale (VAS), the Wong-Baker Faces Pain Rating Scale, and the FLACC scale.
Example of a PICO-based question could be;
Question: Do post-surgical adult patients have improved pain control with use of a PCA pump
compared to intermittent nurse-administered injections of pain medication?
P: Post-surgical adult patients
I: Patient-controlled analgesia (PCA)
C: Intermittent nurse-administered injections of pain medication
O: Improved patient pain control
Step 2 Save and submit your assignment.
When you have completed your assignment, save a copy for yourself in an easily accessible place
and submit a copy to your instructor.
Cite all sources in APA format.
Interview is below:
Quality Improvement Measures
In this interview, I choose to interview one of the healthcare administer. The preferred individual for the interview is a clinical manager. A clinical manager is in charge of maintaining responsibilities for administrative aspects of the clinical facility. On the other hand, a clinical manager is responsible for the clinical operation, budgeting, and reviewing treatment plans, among other operations (Øyri et al., 2020). The above factors are why I found a clinical manager to be the best for the interview. Below is an interview conducted between a clinical manager and I. The clinician’s name is Mr. Darwin Oliver.
(Dan): Hello and welcome, Mr. Darwin. I am glad you honored my invitation.
Mr. Darwin: hello, thank you for having me.
(Dan): What are some of the Quality Improvement Measures being implemented in your organization?
Mr. Darwin: Currently, at our institution, we aim to reduce some of the existing factors that have caused adverse patient outcomes, such as medical error. For instance, due to some of the existing cases of medical errors, major re-admission cases have been reported, thus affecting patient outcomes. Some of the Improving patient outcomes in our healthcare system have been prioritized, such as the use of EHR to reduce these cases while articulating for keenness within the organization. Therefore, I can confirm that it is the primary QIM intervention on our table right now.
(Dan): Why is the QIM important to your organization? Is it beneficial?
Mr. Darwin: First and foremost, QIM helps in increasing the likelihood of the desired health outcome. For us, better patient outcome is our number one priority, and thus it is evident why QIM initiatives are essential to us. Additionally, I can confirm that it is beneficial to both patients and professionals and thus helps us push for better patient outcomes.
(Dan): According to you, what is the history of the current Quality improvement measure to the facility?
Mr. Darwin: In our institution, the history of QIM has been in place for a while now. Its initiation comes as a result of the need to improve healthcare outcomes and, at the same time, reduce medical errors that have been recurrent in the institution. Therefore, I can state that the QIM initiative has been in place to ensure better patient outcomes and minimize medical errors that have resulted in adverse outcomes for the patients.
(Dan): Alright, and what would you say about the issue of agent change in your organization? Additionally, who are the most affected by QIM, and what outcomes are sought?
Mr. Darwin: That is an excellent question. I would like to state that we have maintained the same agents in the department of outpatient services for the longest time as they have done superb jobs in making the facility a better place for patients. These agents have served the purpose of checking on the patient to ensure that they receive the right healthcare services and at the same time address some of the existing causes of medical errors to mitigate them in the future. I would also want to state that patients and nurses have been affected in the long run by the QIM initiatives whereby some of the initiatives have been forfeited, thus adversely affecting these individuals.
(Dan): How about the idea of implementing similar measures to what you have currently?
Mr. Darwin: For now, I can say no. But going forward-looking into the possibility for change would not be a bad attempt, don’t you think?
(Dan): Yeah, as we advance, it is a good approach. According to you, what are some of the obstacles to implementing QIM?
Mr. Darwin: For instance, in my work area, different individuals have partially resisted using EHR as they are opposed to technology based on different factors. Again, when it comes to data collection and implementation of the solutions at hand, major resistances have been recorded in the acceptance of the new approach, thus affecting the overall attempts to implement QIM.
(Dan): What can you say about the stakeholder effects and the overall goals of QIM?
Mr. Darwin: Different stakeholders have different obstacles in any managerial approach. For instance, promoting better patient safety has been affected by factors such as the acceptability of EHR, among other factors, thus crippling the advances to reduce negative effects on the patients. However, it has not been a problem for us since we have inclusivity in decision-making and, thus, better implementation of QIM (Dixon et al., 2016). Additionally, QIM has goals such as standardizing the process and reducing variations while improving patient outcomes.
(Dan): Finally, give your recommendation on the issue of QIM?
Mr. Darwin: Given the benefits of QIM, in our case, I believe that we understand the nature of the harm that medical errors can cause. Therefore, we are on our way to enhance unique socio-technical probabilistic risk assessment approaches to review historical errors. Through the review of historical errors, we can minimize similar errors in the future and thus better patient outcomes.
(Dan): That’s all for today. Thank you, sir, for your time; I hope to see you in the future.
Mr. Darwin: You are welcome. Thank you for having me; it was a pleasure.
References
Dixon-Woods, M., & Martin, G. P. (2016). Does quality improvement improve quality?. Future Hospital Journal, 3(3), 191.
Øyri, S. F., Braut, G. S., Macrae, C., & Wiig, S. (2020). Hospital managers’ perspectives with implementing quality improvement measures and a new regulatory framework: a qualitative case study. BMJ open, 10(12), e042847.
Sample Paper
PICOT Research Question
The PICOT approach is derived from components of a clinical research question that includes the patient (P), intervention (I), comparison (C), outcome (O) and time (T). The PICOT research question format allows the development of a researchable and answerable question (Fandino, 2019). The PICOT represents the impact population (P) suggested interventions (I) comparison to other alternatives (C) patient outcomes (O) and the time required to facilitate change in patient care (T). It makes evaluating and finding evidence on a health issue more efficient. For this case scenario, the quality improvement measures focus on handling medical errors. Therefore, the PICOT research question is: Among patients in acute care settings, how does the use of EHR reduce medical errors compared to usual medication practice in a month.
P- Patients in an acute care setting
I- Use of EHR system
C- Normal medication practice
O- Reduced medical errors
T- One month
The healthcare organization aims at reducing some of the existing factors that have impacted the patient outcomes, such as medical errors. The use of the HER system has been prioritized in improving patient outcomes. The picot research-based question aims to help focus on the most important issue and evaluate the significance of the intervention in achieving a suitable outcome. Therefore, the picot research question will examine the quality improvement measure (EHR system), which focuses on reducing medical errors among patients in acute care settings within a month.
Global Trigger Tool
The evidence-based intervention utilized the Global Trigger Tool to measure the outcomes of medical errors and patient safety. The Global Trigger Tool was used for pre and post-assessment of the intervention through accurately identifying adverse harm and rate of medical errors. Tracking adverse events over time was a useful way of examining whether changes were improving patient safety in the care processes (Panagioti et al., 2019). The Global Trigger Tool will measure and monitor the patient safety levels within healthcare care, thus demonstrating the effectiveness of integrating the electronic patient record.
References
Fandino, W. (2019). Formulating a good research question: Pearls and pitfalls. Indian journal of anaesthesia, 63(8), 611.
Panagioti, M., Khan, K., Keers, R. N., Abuzour, A., Phipps, D., Kontopantelis, E., … & Ashcroft, D. M. (2019). Prevalence, severity, and nature of preventable patient harm across medical care settings: systematic review and meta-analysis. bmj, 366.
