FISH BONE

Fishbone and PDSA Quality Improvement

MY ISSUE IS PATIENTS COMING FROM PACU WITH FOLEY CATHETER WITH NO ORDERS

Assignment

Purpose

The purpose of this assignment is to apply root cause analysis (RCA) and continuous quality improvement (CQI) to a practice issue using leadership skills and evidence-based practice.

Course Outcomes

This assignment enables the student to meet the following course outcomes:

• CO 1: Apply leadership concepts, skills, and decision making in the provision of quality nursing care. (PO 2)
• CO 2: Apply the nursing process to quality improvement of patient-centered care outcomes. (POs 4, 7)
• CO 3: Explain the use of evidence-based practice by leaders and managers. (POs 2, 8)
• CO 4: Describe interprofessional communication and collaboration strategies. (POs 2, 3)
• CO 5: Summarize legal, ethical, and professional competencies utilized by nursing leadership. (PO 6)

Due Date

Students must complete the Week 6 Fishbone and Plan, Do, Study, Act (PDSA) Quality Improvement assignment and submit it to the Dropbox by Sunday at 11:59 p.m. MT.

Late Assignment Policy

Students are expected to submit assignments by the time they are due. Assignments submitted after the due date and time will receive a deduction, as noted in the rubric below.

Total Points Possible

This assignment is worth 190 points.

Preparing the Assignment

Follow these guidelines when completing each component of the assignment. Contact your course faculty if you have questions.

Directions

Complete this assignment following the steps below.

1. Download the
5. . Use of the template is required. A 10% deduction will be applied if the template is not used. See the rubric. Type your responses on the template in place of the [Type Here] text. Do not submit handwritten notes. Save the template and include your name in the file name.
6. Select a quality improvement (QI) problem that requires quality improvement. This should be the same problem you described in the Wednesday Check-In. It may be a real problem you are currently encountering in practice or clinical rotations, a concern, or a problem from scholarly sources you are familiar with. You are encouraged to choose something relative to your practice. Form a problem statement with that information. An example:
7. Admitted clients boarding in the Emergency Department are experiencing delays in care.
8. Children and adults are not receiving recommended vaccines.
9. Gather 1-2 scholarly sources that document this problem in healthcare and provide evidence supporting the need for quality improvement.
10. Complete the sections in the template outlining the problem, the rationale for the selection of the problem, and the sources documenting the need for a solution. Each section should include detail in 2-3 sentences. Cite sources where specified.
11. Use the fishbone diagram in the template to complete a root cause analysis of the problem.
12. Briefly describe the problem
13. Under each category (People, Environment, Method/Process, and Equipment/Supplies), list at least two contributing factors to the problem. The contributing factors may fall under more than one category. See the example in the lesson.
14. Mark each contributing factor as a realistic or unrealistic target for improvement efforts using the visual designations on the template. For example, staffing, while a contributing factor to many problems, is not a realistic target for improvement efforts.
15. If you prefer, you can use green or red highlight on the text of the contributing factors instead of using the visual symbols on the template.
16. Complete the PDSA Quality Improvement Project outline using the spaces provided on the template (replacing the [Type Here] instructions with your text). Write this section acting as if you have completed the QI project.
17. Select one contributing factor from the fishbone diagram. This should be one of the realistic targets for improvement efforts identified on the fishbone diagram.
18. List 2-4 interprofessional stakeholders involved in the project (delete any unused [Type Here] text).
19. Write one SMART goal for the PDSA Quality Improvement Project. Include all elements of the SMART goal in one sentence.
20. Under the Plan phase, write a plan for the quality improvement project to meet the SMART goal. How will you meet your SMART goal? Describe your plan in 2-3 sentences.
21. Under the Do phase, imagine you have completed the project. Briefly describe how the Plan was hypothetically implemented. What were the results? Include hypothetical data. Describe your implementation in 2-3 sentences using past tense.
22. Under the Study phase, imagine that you have successfully completed the project and have positive data that demonstrates successful implementation and goal attainment. Describe your evaluation using 2-3 sentences using past tense.
23. Under the Act phase, imagine that you have completed the project. Briefly describe how to maintain the improvement or revise and repeat the PDSA process based on whether or not the goal was met. Describe your process in 2-3 sentences using past tense. See the example in the lesson.
24. Click the Submit button at the top of this page to upload your completed assignment.
25. Correctly cite and reference ideas and information that come from scholarly sources. Sources should be no more than five years old unless they are historical references. Hanging indent is not required.
26. Follow grammar, spelling, word usage, and punctuation rules consistent with formal, scientific writing.
27. Abide by Chamberlain Universitys academic integrity policy.

Include the following sections (detailed criteria listed below and in the grading rubric).

Description of the Problem

1. State problem to examine in Root Cause Analysis (RCA).
2. State rationale for problem selection.
3. Include a brief description from a scholarly source(s) supporting the need for quality improvement (QI) in at least 2-3 sentences.
4. Include in-text citations.
5. Answer all questions/criteria with appropriate explanation and detail.

Fishbone Diagram

1. Identify the problem in the designated area.
2. Identify appropriate contributing factors for each category.
3. Include a brief description from scholarly source(s) supporting the need for quality improvement (QI) in at least 2-3 sentences.
4. Identify each contributing factor as realistic or unrealistic targets for QI efforts.

Correlation with Contributing Factor

1. Select one realistic contributing factor from the fishbone diagram.
2. List 2-4 interprofessional stakeholders involved in the project.
3. Write one SMART goal for the PDSA Quality Improvement Project.
4. Answer all questions/criteria with appropriate explanation and detail.

PDSA (Plan, Do, Study, Act)

1. Under the Plan phase, write a plan (in 2-3 sentences) for the quality improvement project to meet the SMART goal.
2. Under the Do phase, briefly describe (in 2-3 sentences using past tense) how the Plan was hypothetically implemented and what data was collected.
3. Under the Study phase, briefly evaluate (in 2-3 sentences using past tense) the data. Identify whether the goal was met or not met.
4. Under the Act phase, briefly describe (in 2-3 sentences using past tense) how to maintain the improvement or revise and repeat the PDSA process based on whether or not the goal was met.
5. Answer all questions/criteria with appropriate explanation and detail.

Submit the completed Week 6 Fishbone and PDSA Quality Improvement assignment template to the