NURS FPX 8030 Assessment 4 Methods and Measurement

NURS FPX 8030 Assessment 4 Methods and Measurement

Methods and Methodology

Patient safety should top the list of priorities in the healthcare sector.  To maintain patient safety, an organization must take care regarding any problems that might directly endanger the patient’s safety.  The same safety measures are required when using electronic health records.  Contrary to popular belief, more patient-related safety issues are directly linked to EHR difficulties (Ash et al., 2020).  Although the EHR has prevented some patient safety problems, there are still underlying problems with the EHR systems that endanger patient safety (Bersani et al., 2020).  Patient safety issues that are directly tied to EHR problems are more frequent and occur more frequently than they should in a healthcare organization.  Issues with the EHR system data entry, interoperability, and information accessibility are a few that may affect patient safety (Bani Issa et al., 2020).  When it comes to patient safety, data collection is crucial.  All patient information must be accurate during collection and when entered into the EHR system.  Data entered incorrectly into the EHR system might result in medication errors, misdiagnoses, or many other patient safety problems (Ash et al., 2020).  This paper will present an overview of the problem and proposed intervention and suggest two instruments to evaluate the recommended intervention. 

NURS FPX 8030 Assessment 4 Methods and Measurement

Proposed Interventions

The following measures might improve patient safety while using electronic health records. A critical intervention for improving patient safety regarding the use of EHRs is the introduction of strict data input protocols. Sloppy data entry methods, such as entering incorrect information or failing to update existing records, may lead to errors in patent care (Ash et al., 2020).  Healthcare institutions should use rigorous data input procedures to reduce the possibility of errors, such as the obligatory double-checking of essential data items.  There are several possible steps in this direction, including creating data entry guidelines, instruction on paper data input techniques, and routine reviews and audits of data procedures to ensure compliance with established protocols. 

Providing EHR users with sufficient training is a key method for improving patient safety regarding EHR use.  By offering substantial and ongoing training, healthcare organizations may support the growth of knowledgeable and confident EHR users (Bani Issa et al., 2020).  Along with initial teaching on using the EHR, this should include ongoing guidance and assistance to keep users informed of system updates and effective EHR usage techniques. Regular EHR user competency evaluations may also help identify knowledge gaps that could benefit from additional training (Bersani et al., 2020).  In addition, healthcare businesses can gain from EHR usability; healthcare organizations may ensure that their EHRs are functional and user-friendly, eventually improving patient safety.  

Using Evidence-Based Practice

Evidence-Based Practice (EBP) is the process of making decisions about a patient’s care by carefully and wisely utilizing the most recent research, clinical knowledge, and patient values. The best evidence typically comes from scientific approaches, including descriptive and qualitative study, applying scientific principles, and professional judgment (Melnyk, 2018).  When there is sufficient research evidence, EBP should be informed by research evidence, clinical knowledge, and patient values (Bani Issa et al., 2020).   EBP is a method of clinical decision-making that focuses on the preferences and values of the patient and integrates the best available evidence with the doctor’s experience. The evidence-based practice aims to analyze the variations among evidence-based practices and introduce critical care to nurses. Through creative methods to help remove internal and external barriers to EBP, EBP enhances patient care outcomes (Bersani et al., 2020).    Research has shown that patient outcomes improve when practitioners use evidence-based practice (Melnyk, 2018).   It is sometimes referred to as a problem-solving approach to clinical treatment.  It involves carefully using the most current best practices, clinical knowledge, and patient values and preferences (Choudhury & Asan, 2020).  EBP has been shown to boost patient safety, enhance clinical results, reduce health-related expenditures, and remove obstacles to the broader application of recent findings, which include healthcare professionals’ clinical expertise and fluency levels.  

Instruments to Assess and Evaluate Practice Change

There are a variety of instruments that could be used to assess ad evaluate proposed practice changes.  These instruments can include questionnaires, surveys, interviews, and focus groups.  Making sure that the change we want to make happens and that you have the data to back it up is one of the most crucial phases in putting the EBP proposal into practice.  Finding a way to collect data after a proposal has been implemented is vital to demonstrating that the desired result was obtained and that the data is reliable (Choudhury and Asan, 2020).  In addition, one must be structured and consider all possible techniques for analyzing techniques for analyzing findings when there are time restrictions for a study to determine whether your EBP plan has a beneficial effect (Choudhuy & Asan, 2020).  To shorten the extraordinarily long lag between creating research findings and their adaption in clinical settings, urgent action is required to expedite EBP quickly. 

The first proposed instrument is a focus group. The focus group will be designed to conduct mixed-methods research on the effects of the intervention.   Focus groups are recognized as a qualitative research methodology where the chosen groups can share their opinions on a particular phenomenon.  This method is essential since it gauges the traits and qualities of the consumer’s response to specific methods or services (Singh & Sitting, 2020).  When compared to other methods like surveys or interviews, focus groups provide quick solutions that may be used right away to address issues relating to a given phenomenon or specific good or service.   Focus groups are helpful because it is simpler to gauge a consumer’s response to a brand, product, or service package and price (Buitron de la Vega et al., 2019).  This makes it possible to make rapid improvements.  Hence, two focus groups will be designed to measure the effectiveness of proposed interventions: a small group of nurses to conduct interviews and a larger group of patients to complete questionnaires.  Previously many studies like Quinn et al. (2019), Buitron de la Vega et al. (2019), and Krick et al. (2019) have documented the use of focus groups to evaluate the change process.

The outcome data will be gathered using qualitative and quantitative data-gathering techniques.  So, the mixed data collecting approach would be adopted.  The basic presumption for integrating the two approaches is that doing so results in more accurate data than gathering qualitative and quantitative data separately (Waseh & Dicker, 2019).  A more complex problem is also helped by the employment of combining qualitative and quantitative methodologies (Buitron de la Vega et al., 2019).   In addition to being more thorough, the mixed technique also boosts researchers’ confidence in their findings.  Data gathered through methods is more trustworthy than data collected through either process.  Additionally, mixed-method research might involve evaluation to ensure that each method’s advantages balance each other’s data weaknesses. 

Both qualitative and quantitative methods have advantages and disadvantages; the mixed method approach is considered appropriate for gathering outcome data.  Data from a small sample of participants will be gathered through interviews, while data gathered from a more significant number f participants will be collected through questionnaires (Kick et al., 2019).  Interviews are a qualitative research method that enables the gathering of detailed data.  Evaluators can contact the participants using this form of data gathering.  It will be beneficial to get first-hand accounts and opinions from the participants.  Interviews will also be able to gather nonverbal information from respondents.  The method’s primary goal is to collect the information that can be utilized to explain why the project’s outcomes were what they were (Wasech & Dicker, 2019).  On the other hand, surveys will assist in gathering quantitative information that will be used to estimate the size of the result.  They will make it possible to get information from many participants (Quinn et al., 2019).  Additionally, they are economical.  A mixed-method approach will make understanding the discrepancies between qualitative and quantitative data easier.  Furthermore, the mixed method approach will convey greater methodological adaptability.

PROMIS will be used to collect data from patients regarding their satisfaction with the EHR, The National Institute of Health (NIH) launched the Patient-Reported Outcome Measurement Information System networks as part of the NIH Roadmap Initiative in response to the growing significance of patient-reported outcomes (Wagner et al., 2014) aims to give physicians and researchers access to quick, accurate, reliable, and responsive assessments of the adult-child-reported health and wellbeing.  The PROMIS depression scale was developed using item response theory to boost accuracy and decrease the amount of labor required of respondents.  Wagner et al. (2014) have documented the use of PROMIS in the same context.

Evidence-based measurements will be made of actual results.  This means that the evidence will be used to inform the intervention and to evaluate the results considering the evidence.  As a result, the effects will be critically assessed.  The outcomes’ reliability, validity, and adaptability will be evaluated.  By comparing the outcomes to the criterion test, the validity of the findings will be assessed. If the results are consistent with the evidence, they will be considered valid. The reliability metric will evaluate the result’s congruence with the evidence.  The project’s results should match the intended effects (Waseh & Dicker, 2019).  The results must be transferable to clinical settings.  The project’s adaptability will be used to assess how well it can be adjusted to various circumstances and contexts.  Alternative techniques will need to be developed if the findings are not favorable.  The initial step will be to ascertain what went wrong (Waseh & Dicker, 2019).  Data collection on implementation errors will aid in preventing such mistakes in the future.  More evidence-gathering will be done in the next step.  Additionally, evidence will need to be gathered to justify the intervention for the target group.  

NURS FPX 8030 Assessment 4 Methods and Measurement

Process Mapping is the second tool identified for the organization’s evaluation of the effective use of the EHR project.  Utilization of this visual tool can provide a clear vision of the workflow process. (Antonacci et al., 2021).   Process mapping can help to improve documentation, new hire training, and process improvement at the organizational level. (Antonacci, 2021). Process mapping, also called a flow chart, process flow chart, or workflow diagram can concisely contribute to the communication of EHR documentation. (Antonacci et al., 2021).  Mapping out the process of recommended steps to document in the EHR can ensure stakeholders have a better understanding of the workflow process and illustrate insufficiencies and areas for improvement. Process mapping templates can be used to illustrate the list of steps required to complete the appropriate steps in completing a task.  

Antonacci et al. (2021) studied how healthcare organizations could use Process Mapping in their Quality Improvement programs.  The systematic review of empirical literature was conducted according to PRISMA standards. The researchers found that PM has been used in multiple settings with approaches to quality improvement. (Antonacci et al., 2021).  Although recommended at every phase of the quality improvement process, it was found to be most beneficial in the implementation and outcome measurement phase. (Antonacci et al., 2021).  Additionally, PM can support QI projects by engaging stakeholders and facilitating why and how the change is recommended. (Antonacci et al., 2021).  The benefits of PM in the scope of QI are: QI teams can gain a realistic understanding of the current practice, helps to inform the team of the scope of design development and evaluation intervention, can identify actual constraints and opportunities to assess the problem area and develop improvement solutions, facilitate knowledge exchange. (Antonacci et al., 2021).  Using PM help to improve the strategic principle identified by the healthcare QI team, helping to shift the plan to evidence for use. (Antonacci et al., 2021).  

This approach for PM focuses on the importance of developing a visual map to ascertain the completion of the necessary steps involved in the organization’s recommended actions in the QI plan.  (Antonacci et al., 2021).  PM utilization helps identify inefficiencies and gaps in the process flow, helps to simplify ideas – breaking down complex concepts into smaller steps increases comprehension and understanding of the process, allows for a plan for contingencies, and has a clear delegation of responsibilities. (Antonacci et al., 2021).   PM has been found to increase communication in a user-friendly visual format, helping to improve employee performance.  Process mapping is an effective tool for documenting and improving processes. Using the process map as a tool can help to achieve clear communication and improve efficiency for EHR users, thus improving patient outcomes. Small, newer organizations striving to attain excellence and a foothold in the organization’s chosen area of focus can provide the groundwork and basis for implementing and assessing the functionality of the EHR used by the organization. While in use, periodic review of the PM template will identify gaps in the process, contribute to necessary updates in the process map, and identify if the current EHR fulfills the healthcare organization’s needs.   

In conclusion, although the healthcare industry recognizes that patient safety is a component of quality, safety is also essential to a well-run and capable healthcare system.  While quality is concerned with the overall scheme of care delivery’s impact on outcomes and strategic goals, patient safety tries to prevent unfavorable consequences.  According to the literature, over the past ten years, there has been a focus on using technology to enhance and improve the efficiency and quality of the clinical process (Singh & Sitting, 2020).  Improving clinical outcomes, increasing transparency, and improving patient engagement and care are just a few of the benefits that can be expected from implementing EHRs.  The EHR has also taken center stage in creating new ideas and knowledge in healthcare technology.  Healthcare institutions use various electronic healthcare record components more frequently to improve patient outcomes, care quality, and operations efficiency (Tubaishat, 2017).  Mixed methods research and Process Mapping are two instruments that can be used to measure the effectiveness of proposed interventions in a clinical setting.  

Using instruments to assess and evaluate proposed process change for a QI project serves several purposes in the project’s design.  Tools such as Process Mapping can help to serve as an internal benchmark that contributes to the continual and collaborative effort at measuring and comparing the results of key work processes, such as EHR documentation. Other tools such as surveys, questionnaires, interviews, and focus groups can help to compile the data used for the project. Both tools are effective in the use of QI projects.  QI projects need to obtain results that are transferable to clinical settings. QI projects are implemented with the ultimate goal of impacting a process and improving outcomes.  

NURS FPX 8030 Assessment 4 Methods and Measurement


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