Capella Safety Quality and Informatics Improve Patient Outcomes Paper


Question Description

  • Write 8-10 pages in which you identify a major patient-safety issue within your own organization and use evidence-based best practices and technology to develop a plan to improve the safety issue. Quality improvement and patient safety are central to the nursing leadership role. Show Less By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
    • Competency 2: Safety and Quality Practices – Incorporate concepts of patient safety, clinical management, and quality improvement to improve patient outcomes.
      • Describe a patient safety issue and compare currently used organizational processes for handling this issue with concepts, principles, and practices that contribute to quality improvement and patient safety.
    • Competency 3: Nursing Research and Informatics – Incorporate evidence-based practice interventions (for example, information systems and patient care technologies) as appropriate for managing the acute and chronic care of patients, promoting health across the lifespan.
      • Recommend evidence-based interventions, including technology, to address specific patient-safety issues.
    • Competency 4: Policy, Finance, and Regulations – Understand the scope and role of policy, finance, and regulatory environments in relationship to individual and population outcomes.
      • Analyze the legal and ethical consequences of not addressing patient-safety issues.
    • Competency 5: Communication – Communicate effectively with all members of the health care team, including interdepartmental and interdisciplinary collaboration for quality outcomes.
      • Write coherently to support a central idea in appropriate APA format with correct grammar, usage, and mechanics as expected of a nursing professional.
    • Competency 6: Organizational and Systems Management – Apply knowledge of organizational behavior, nursing theory, and systems (micro- and macro-) as appropriate for the scope and role of one's own practice.
      • Describe strategies to overcome specific organizational barriers to change.
    Competency Map
    Check Your ProgressUse this online tool to track your performance and progress through your course.
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    Central to the nursing leadership role, quality improvement and patient safety are analyzed from many perspectives. Types of quality improvement and patient safety programs may range from internal, organization-based quality improvement team reports to external benchmarks from The Joint Commission, the Agency for Healthcare Research and Quality (AHRQ), MAGNET, and numerous other organizations. Show Less A landmark 2001 publication by the Institute of Medicine (IOM) identified the imperative to focus on quality care and patient safety. The initiative to create cultures of patient safety and quality care remain at the forefront of the health care leadership landscape. As a future nursing leader, you must understand the components and use of effective tools for successful quality improvement programs within your practice setting. In this program, you have also examined the application of research and information technology in the nursing profession. Information systems and patient-care technologies have contributed in many ways to improved patient outcomes; however, safeguards, secure practices, and ethical standards are necessary to promote and support data security, patient confidentiality, and regulatory requirements. You have also investigated the effective use of patient-care technologies, communication systems, and information systems across the health-illness continuum.
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    Questions to Consider

    To deepen your understanding, you are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of the business community. Show Less
    • How do external organizations analyze quality improvement?
    • How can data from patient-safety initiatives be used to help other organizations?
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    Suggested Resources

    To help you prepare for this assessment, review the resources you used and the assessments you completed in BSN-FP4004, BSN-FP4006, BSN-FP4008, and BSN-FP4016.
    Capella Resources
  • Assessment Instructions


    As you prepare for this assessment, complete the following:
    1. Before you begin, examine your organization's history of safety in a specific area and how your organization addresses patient safety issues. If possible, consult with a key stakeholder in the organization (such as an administrator) to better understand specific patient-safety concerns and how the organization is working to resolve the concerns. This person should also be able to discuss some of the organizational barriers impacting the patient safety issue.
    2. Next, look at the basic concepts, principles, and practices that contribute to organizational quality improvement and patient safety. Review the literature for best practices and how technology might be used to improve the issue.
    3. Finally, be sure to consider the legal and ethical implications associated with the safety issue, as well as possible organizational barriers to change.


    As you construct this assessment, address each point as completely as possible:
    • Describe a patient-safety issue within your organization, comparing the way your organization addresses the issue with the concepts, principles, and practices that contribute to quality improvement and patient safety.
    • Analyze the legal and ethical consequences of not addressing the issue.
    • Recommend evidence-based interventions, including technology, to address the patient-safety issue.
    • Describe strategies to overcome specific organizational barriers to change, based on your knowledge of the organization.

    Additional Requirements

    • Format: Include a title page and reference page. Use APA style and formatting.
    • Length: Ensure your completed assessment is 8–10 pages in length, not including the title page and reference page.
    • References: Cite at least five current scholarly or professional resources.
    • Font: Use double-spaced, 12-point, Times New Roman font.

Tutor Answer

School: UC Berkeley


Safety, Quality, and Informatics

Scope of near miss in endoscopy procedures
a. Level of risk


How the organization deals with near misses in endoscopic unit
a. Safety checklist
b. Patient participation
c. Person-centered care
d. Reporting and tracking


Legal and ethical repercussions of not addressing the patient safety issue
a. Beneficence and nonmaleficence
b. Autonomy and right to self-determination
c. Veracity
d. Disclosure of right to knowledge


Proof-based intercessions to address the patient-safety issue
a. Technological interventions


Approaches to overcome particular organizational obstacle to change
a. Actions relating to communication
b. Actions relating to training
c. Actions relating to budget
d. Actions relating to change management
e. Actions relating to authority


Safety, Quality, and Informatics
Student’s Name
Institutional Affiliation




Safety, Quality, and Informatics
Pelzang and Hutchinson presume that the WHO recognizes patient safety as an
international issue and position it as a global aim, seeking to bring gains to ailing persons in all
countries (2018). Estimates show that millions of persons globally suffer demise, harm or
disability due to unsafe medical practices and about half of these deleterious outcomes are
preventable. The patient safety issue identified to complete this discussion is near misses. Near
misses can happen during endoscopy procedures and proof based practice is an imperative
element in guaranteeing patient safety. Errors are rampant but mainly inconsequential but a
series of minor errors can climax to a notable injurious event. Certain elements make endoscopic
techniques increasingly at risk of causing patient harm and adverse events. The capacity to
undertake many and advanced therapeutic techniques throughout the GI tract has moved the field
to more of a surgical specialty with associated complications and risks.
Scope of Adverse Near Miss in Endoscopy Procedures
Endoscopy is a prime clinical activity for gastroenterologists and is indicated in majority
of preventive, therapeutic, and diagnostic techniques in 21st century (Axon, 2016). However,
mishaps can happen during endoscopy some avertable while others unavoidable or minimized by
incorporating suitable measures. Matharoo et al. posit that these errors happen regularly resulting
in adverse events of notable deaths and morbidities (2017). An adverse event refers to an
unintended negative outcome resulting from medical care and not the illness process. These
adverse outcomes can include specimen mix-up, glutaraldehyde colitis, cholangitis, pancreatitis,
splenic rupture, bleeding, perforation, incorrect injection, cardiac arrest, incorrect procedure,
hypoglycemia, inhalation, apnea, hypotension, cross-infection, allergic reactions, and broken
tooth. Besides, growth in endoscopy has caused notable changes in service provision, for



example, teaching and background of the providers, depth of sedation given, and choice of drug.
According to Matharoo et al. (2017), people recognize adverse events in endoscopy but still
center primarily on technical operational outcomes. As a result, reported adverse outcomes tend
to be technique-specific representing the rare severe end of the span instead of more frequent
minor events. Mishaps can occur during pre-technique, intra-technique, and post-technique
stages of care.
Level of Risk
There is a broad band of patient safety issues including consent, drug errors, sedation,
intravenous access, and monitoring, histological and sampling errors, technical expertise and
apparatus, documentation and reporting errors, non-technical mastery and training, distractors
and time management, and oxygen monitoring. Severe patient safety incidents include patient
misidentification leading to wrong procedure, sedation without oxygen, sedation without oxygen
saturation monitor, unmonitored sedated patient in corridor, recovery in corridor unattended and
prolonged as waiting for porter to transfer to ward, wrong drug administration (additional
midazolam instead of pethidine), and incorrect patient details on endoscopy report. Strong links
exist between the kind of sedation (Basavana Goudra et al., 2017) as well as different patient
elements and the occurrence of an adverse outcome. Possible reasons for the association include
increased technical complexity of techniques, comorbidities of patient group, and dynamic

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Tutor went the extra mile to help me with this essay. Citations were a bit shaky but I appreciated how well he handled APA styles and how ok he was to change them even though I didnt specify. Got a B+ which is believable and acceptable.

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