|Essay type:||Process essays|
|Categories:||Planning Problem solving Nursing care|
In contemporary healthcare settings, it is not good practice for a patient to be under the care of just one provider. An interdisciplinary group of healthcare providers should deliver services to the patient. The reason for this is the rapid change taking place in the field of healthcare; there is a shared desire among the involved stakeholders for improved quality of services while doing this at reduced costs. This desire, in turn, has led to enhanced attention to healthcare providers’ team composition, culture, communications, and general relationships. There is an agreed-on desire to support the significance of quality relationships in the workplace. It has been identified by researchers that in healthcare settings, a positive relationship exists between a culture of teamwork and quality performance.
In nursing practice, teamwork deserves more attention. There is a significant relationship between patient outcomes and nursing teamwork. After an evaluation of my organization, it was found out that teamwork in the nursing practice was lacking; this harmed patients’ satisfaction and perceptions. The evaluation indicated that these healthcare providers work as individuals rather than as a team, and there are increased burnout issues among the nurses. These issues harmed patients’ outcomes; this was compared to the few hospitals that had strong nursing teamwork. There was a need for an intervention on the nursing teamwork to make it better; hence this proposal, “Enhancing Nursing Teamwork: A Quality Improvement Initiative.”
Why a Quality Improvement Initiative is Needed
The reforms made on healthcare have triggered a shift in the quality of healthcare. The Affordable Care Act (ACA) has developed a program that focuses on value, and incentives are provided for the outcomes of quality of healthcare. Value-based Purchasing (VBP) gives bonuses for acute care organizations that meet targets set in a variety of areas; these include outcomes, the patient experiences, etc. The reforms point to the significance of the quality of healthcare hence the reasons why a quality improvement initiative is required in nursing teamwork. A culture of teamwork in healthcare settings leads to quality performance measures. Teamwork can be described as a group made up of more than one person that works together to attain specific set goals. The initiative will ensure the quality of services, maintain professional standards, and affirm the nurse’s commitment to the organization.
Synergy within the field of healthcare has been reported by Witges and Scanlon (2015) to lead to better relationships within the settings, which in turn lead to improved general performance and better levels of productivity; these are measured by patient outcomes. The same report states that synergy lets the individuals involved maximize their skills and professionalism by working interdependently to attain the same goal. Judge (2017) notes that lower mortality rates and low vacancy rates are related to a high level of nursing teamwork. Nursing teamwork leads to professional development among the nurses, cost-effectiveness in the organization, high individual job satisfaction, improved patient perceptions, and experiences. Nursing teamwork that is not effective, on the other hand, has been associated with patient falls and high nursing turnovers, which in turn lead to losses to healthcare organizations (Kaiser, & Westers, 2018).
Kaiser and Westers (2018) notes that when nurses teams collaborate, they reduce the levels of stress in patients, which positively impacts the patient’s outcome. He also claims that teamwork reduces issues that relate to burnout in nurses. In general, Barton, Bruce, and Schreiber (2018) give the following as accomplishments of nursing teamwork; enhanced patient safety, a better clinical performance, eased patient worries on treatments and procedures, elevated efficiency and reduced healthcare costs, and reduced medical errors. All the mentioned benefits in the literature review point to the importance of teamwork; it shows why this quality improvement initiative is essential.
In the implementation of a quality improvement initiative, conceptual models are essential in guiding the project. For this initiative, the Plan, Do, Study, Act (PDSA) model was selected to act as a guide for the implementation; the model was created by The Institute of Health and Improvement. The model allows continuous modification because of its cyclic nature. The Plan stage of the model involves collecting and analyzing data on already implemented initiatives; it then determines the scope, team members, objectives, data collection, and measurement methods. The Do stage is where the plan is carried out. The Study phase is where the effectiveness of the change or outcomes are evaluated. The final stage, Act, is where the changes are refined based on results.
Steps in Implementing the Initiative
This section describes the translation of evidence. Before the implementation and evaluation of the whole organization was conducted to provide an evidence-based change feasibility implementation and to determine how ready the organization is for the changes.
First Phase, Plan
In the model described above, the first step Plan is where data is collected and analyzed. For this phase, the data sources, measurement, and variables are analyzed:
NTS: variable for level of teamwork in nursing
HCHAPS: this is patient satisfaction; it is determined using communication with nurses composite scores, which is determined by three questions asked to the nurses.
NDNQI: variable for inpatient fall rate. Measured as one unexpected patient fall to the floor per a thousand days.
Gallup Q12. It measures the satisfaction of staff.
Interviews were used to collect data from the nurses about their satisfaction.
The Second Phase, Do
It is the part where the implementation is carried out. The first step is gaining access to data elements; this will be the elements described in the last section, NTS, HCAHPS, Gallup Q12, and NDNQI. These are results based on an already established relationship that exists between levels of nursing teamwork and that of outcomes before the intervention. In this part, interviews are carried out to establish the current nursing teamwork levels and the impact it has. Data is collected from patients and staff. Apart from the collection of quantitative data, informal interviews will be carried out to get a better understanding of the perceptions of nursing teamwork. Participation in this informal interview is only voluntary. Consent is signed to keep the identity of the volunteers a secret.
The next step involves meeting with a statistician and a data analyst for recommendations before moving to the next step of performing a statistical analysis. A comparative analysis in the form of a t-test will be carried out using the sample size and data collected. Graphs, tables, pies, and other statistical tools can be used to organize the data and analyze it. Statistical and thematic analysis of the data elements is carried out and compared against the unit level aggregate to determine low and high scores of the nursing teamwork. The next step is determining the need for interventions to enhance teamwork, then lastly, constructing recommendations of tailored interventions.
Evaluation of Outcomes
The evaluation of the outcomes is done based on whether the quality improvement initiative meets its intended objectives. If the project meets its objectives, then it can be considered successful. A relationship will be analyzed between the following to evaluate the outcomes;
- Relationship between overall nursing teamwork and the staff’s job satisfaction
- Relationship between overall nursing teamwork and patient satisfaction
- The relationship between overall nursing teamwork and fall rates between different groups of patients
p-value of 0.05 will be used for the statistical analysis of the above queries separately. Chi-square analysis, together with the spearman correlation test, will be used to assess the relationships between the variables. Spearman correlation measures the relationship between two variables, for example, in this case, overall nursing teamwork and patient satisfaction.
Barton, G., Bruce, A., & Schreiber, R. (2018). Teaching nurses teamwork: Integrative review of competency-based team training in nursing education. Nurse education in practice, 32, 129-137. https://doi.org/10.1016/j.nepr.2017.11.019
Judge, K. (2017). Teamwork Can Change Everything. Journal of Infusion Nursing, 40(2), 90. 10.1097/NAN.0000000000000213
Kaiser, J. A., & Westers, J. B. (2018). Nursing teamwork in a health system: A multisite study. Journal of nursing management, 26(5), 555-562. 2018
https://doi.org/10.1111/jonm.12582Witges, K. A., & Scanlan, J. M. (2015). Does synergy exist in nursing? A concept analysis.
Nursing Forum, 50(3), 189-195. 2014
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