DNP 835 Topic 6 DQ 1 Discussions GCU

The DNP degree empowers nurses to create programs for improving quality outcomes. What barriers need to be alleviated to increase the APN role in health care change?

The IHI module for PS 203 conveyed vital information about the just and safe cultures of an organization. Patient safety culture is defined as the shared values, attitudes, competencies, and patterns of behavior related to patient safety within an organization (Kong et al. 2019). Adopting and maintaining a just culture in an organization is an effective way of providing the most effective safe and quality healthcare with the least error (Boussat et al., 2021; Kong et al., 2019). According to Boussat et al. (2021) involving a multidisciplinary team action encompasses the utmost responsibility for quality care involving the analysis of the causes of the problem, planning, and implementation with shared responsibilities of the team members contributing to the solutions that are later disseminated to the entire units for prevention of further occurrences in fighting medical errors. The use of a multidisciplinary team approach is in support of the argument by Yang et al. (2009) that the majority of medical errors are not due to individual negligence but rather more commonly faulty systems, processes, and conditions that lead people to make mistakes or fail to prevent mistakes that lead to errors. As a DNP, applying a leadership role for quality improvement is imperative in achieving a culture of safety in the organization. As reference by Yang et al. (2009) on the effectiveness of leadership behavior and safety performance in enhancing safety culture in high-reliability organizations like the air-traffic industries.

Enforcing safety performance assessments both at the employees’ level and the organizational level to dictate weaknesses and solutions is vital. This can be performed through safety training, safety management, accident investigation, safety equipment, safety measures, and safety organization (Yang et al., 2009). The employees’ ability and experiences which describe their knowledge and skills are evaluated while the organization’s level involves the organizational value and climate of an organization. Creating a collaborative interdisciplinary team will promote an avenue to critically evaluate and effectively communicate measures as a safety process at both the individual and the organizational level (Yang et al., 2009). As the DPI is about reducing the over-prescription of antibiotics for symptomatic bacteriuria and treating any healthcare problem begins with an assessment of the problem, enforcing safety performance which involves evaluation of the employees’ knowledge skills and performance and the organization’s climate will aid in training points. Various strategies to survey for patient safety quality can be utilized by the DNP to evaluate quality in an organization such as patient safety climate in health care organization (PSCHO), safety attitudes questionnaire (SAQ),  safety climate survey (SCS) developed by the Agency for Health Research and Quality (AHRQ) for research purposes (Yang et al., 2009). The use of these strategic methods can provide vital information that postulates correction between safety culture and teamwork climate, safety climate, perceptions of management, job satisfaction, working conditions, and stress recognition (Kong et al. 2019).

Reference

Boussat, B., Seigneurin, A., Giai, J., Kamalanavin, K., Labarère, J., & François, P. (2021). Involvement in root cause analysis and patient safety culture among hospital care providers. Journal of Patient Safety, 17(8), e1194-e1201. https://www.researchgate.net/profile/Bastien-Boussat/publication/322106358_Involvement_in_Root_Cause_Analysis_and_Patient_Safety_Culture_Among_Hospital_Care_Providers/links/5a4d074daca2729b7c8b252f/Involvement-in-Root-Cause-Analysis-and-Patient-Safety-Culture-Among-Hospital-Care-Providers.pdf

Kong, L. N., Zhu, W. F., He, S., Chen, S. Z., Yang, L., Qi, L., & Peng, X. (2019). Attitudes towards patient safety culture among postgraduate nursing students in China: A cross-sectional study. Nurse Education in Practice, 38, 1-6. https://www.sciencedirect.com/science/article/abs/pii/S1471595318307455

Yang, C. C., Wang, Y. S., Chang, S. T., Guo, S. E., & Huang, M. F. (2009). A study on the leadership behavior, safety culture, and safety performance of the healthcare industry. International Journal of Humanities and Social Sciences, 3(5), 546-553. https://citeseerx.ist.psu.edu/document?repid=rep1&type=pdf&doi=e43644ea75191d018042175f607688b50a9338e3

You have done an excellent job summarizing the key themes of the culture of safety, reviewing the problem for a solution, and then implementing the updated process; as you stated, this is a multidisciplinary responsibility that focuses on finding a solution rather than pointing fingers. This process does not condone negligence but analyzes system inadequacies that have led to medical errors.

I am unsure if you followed RaDonda Vaught’s case; this case supports this week’s topic (Barber, 2022).

The nurse mistakenly administered Vecuronium instead of Versed; this medication is a paralytic medicine, and the patient died subsequently. Vaught was the charge nurse that day and acted as a trainer (Barber, 2022). The medication dispensing software frequently allowed nurses to override the system when mechanical issues arose; this process allowed the administrator to type in the first two letters of the medication. In this case, Vaught overrode the system and typed in VE. As a result, the first drug that came up was Vecuronium; she did not notice that the medication form was a powder, not a tablet, and that the label warned of paralyzing. Vought reported the mistake, and the case made national news as nurses rallied around her, raising money for her criminal defense, arguing that prison time would decrease the probability of reporting errors.

Before the criminal case, Vaught went before the Tennessee Board of Nursing, who allowed her to keep her license; however, an anonymous tip was given, and she was indicted (Barber, 2022). It was later discovered that Vanderbilt did not report the case to the authorities, which is a requirement, and was never “penalized for its failures, nor for several of the systemic issues that many argue contributed to the tragic sequence of events.” Many believe that the culture of safety in this example failed and may result in nurses not being honest when they make a mistake with feelings such as “Just like everyone else, nurses have constitutional rights. We have a right not to self-incriminate—which is exactly what RaDonda did, because she was an honest nurse.” RaDonda supporters believe that the process of nonpunitive punishment is erroneous; and that while the individual is ruined, the hospital or medical institution is hardly affected. Does anyone have any thoughts regarding this case and the culture of safety? Does it make you think of how tired we were during COVID-19 and how God covered us? Does it make you cautious about being honest with errors?

References

Barber. (2022). A nurse’s homicide conviction is a blow to hospital safety. Fortune. https://fortune.com/2022/06/17/hospital-safety-nurse-shortage-radonda-vaught/

Plagiarism, LopesWrite & Most Common Formatting Errors

Plagiarism, LopesWrite & Most Common Formatting Errors

I am posting this as these are some of the most common assignment errors and concerns for plagiarism that have occurred throughout the past years of teaching at THE UNIVERSITY.

Currently THE UNIVERSITY uses the 7th edition of the APA Publication Manual. THE UNIVERSITY has APA resources in the Student Success Center as well as resources in the THE UNIVERSITY Library.  The APA Publication Manual and the THE UNIVERSITY resources are the only supported references by the University. Purdue OWL is not a supported resource by the University. Please ensure you are submitting according to APA style when the assignment directions call for them.   A title page is required for submissions which require APA style formatting.   You may choose to follow APA guidelines for professional papers which includes a running head in anticipation for completion of your scholarly project (see formatting of title pages in Chapter 2 of the APA Manual). An Author Note is not required on the title page. Reference lists need to be double checked for accuracy prior to submission (as I will be checking links).

The following includes some of the most common mistakes:

Format: Going significantly over or under the assignment word count. Points are reduced for either going over or under this requirement, there may also be a separate section on the rubric based on the assignment for word count. Not following correct indentation of the paragraphs or headings. Writing in the first person rather than 3rd person when opinion is not required for the rubric or student has not performed the research being presented in the assignment.

Spelling: points are reduced for distracting mistakes

Supporting details: not including citations to support information/writing of a section. If the rubric states area needs supporting details, students are not including citations to support the details of their writing.

APA/References: This is the area most of point reductions occur:

Currently THE UNIVERSITY uses the 7th edition of the APA Publication Manual. THE UNIVERSITY has APA resources in the Student Success Center as well as resources in the THE UNIVERSITY Library. The APA Publication Manual and the THE UNIVERSITY resources are the only supported references by the University, Purdue OWL is not a supported resource by the University. Please ensure you are submitting according to APA style when the assignment directions call for them.

1. Running Head: if you follow professional paper guidelines, ensure this is according to APA style. There are specifics regarding capitalization as well as number of characters allowed. (Section 2.8 & 2.18, APA, 2020).

2. Title/Cover page: Ensure the required elements are present, these requirements have changed since the 6th edition. In placing a professor’s/faculty member’s name on the title page, ensure you have provided the accurate information (e.g., Dr. or Professor), (Section 2.3, APA, 2020). An Author Note is not required on the title page.

3. Body of the text: this is the area most struggle on.

• A sample of a professional paper can be found starting on page 50 (APA, 2020)
• General writing rules of the English Language are to have at minimum 3 sentences in a paragraph. This writing rule will be used for grading of rubrics.
• APA writing is typically in the third person; me, myself, I, we and/or us, is all first person and should be used only where personal opinion is required per rubric.
• Abbreviation guidelines can be found in sections 6.24-6.31 (APA, 2020)
• Formatting of in-text citations (Sections 8.10-8.22, APA, 2020).
• Principles of paraphrasing (Section 8.23 & 8.24, APA, 2020).
• Students appear to be concerned about missing a citation. It is not APA format to cite the same author multiple times in a paragraph unless one of two things. 1. there is a new citation between or 2. if there is generalized information and then a direct quote – A sample of writing can be found in the Manual (Section 8.16, APA, 2020).
• Direct quotes need a page number, paragraph number, or section of original work. Principles of quotations can be found in the Manual (Sections 8.25-8.29, APA, 2020).
• Font, spacing and indentation are not consistent (Sections 2.19, 2.21 & 2.24 APA, 2020).
• It is not needed to restate the journal article titles or journal title in the body of the text as the citation will lead the reader to this information.
• Each and every piece of intellectual knowledge, which is not your own personal research, needs to be cited. If it is your personal observation, wording must be in the third person such as “this researcher has observed….” or something along that nature. If you are using someone’s intellectual property word for word without correct APA formatting, this is considered plagiarism – whether or not you have used a citation in the paragraph.   The Manual discusses plagiarism and self-plagiarism (Sections 8.2 & 8.3, APA, 2020).

4. Reference page most common concerns.

• Chapter 9 in the Manual is regarding the Reference List and Chapter 10 in the Manual is regarding Reference Examples (APA, 2020).
• Reference page is not on a new page, flush to top.
• Order of required elements is not correct.
• Not all required elements are found in the reference.
• Authors and year are not formatted according to APA.
• Capitalization in journal article titles are not according to APA.
• Formatting and capitalization of journal titles are not according to APA.
• Order of the references is not according to APA.
• Wikipedia references and the like are not considered scholarly work and will not be accepted as appropriate reference.
• All references in course are required to have a date and be within the past 5 years unless it is a primary sources such as the original theory written. The Manual discussed primary vs secondary sources (Section 8.6, APA, 2020).

I strongly encourage obtaining a copy of the APA manual, it will help you in your graduate studies going forward with appropriate references as per the Manual.