University of South Alabama Quality Improvement Discussion

I want to look into choosing a topic that helps prevent negative outcomes for women that have risk factors for pre-eclampsia that need frequent follow up but are unable to come to frequent visits to doctors office and do not have money for frequent visits to ER. Currently women either do not have proper follow up or are unable to make it to appointments and end up with poor outcomes after needing an ER visit. Idea for change would be to in cooperate tele health visits with patients to monitor blood pressure, overall health, and concerns frequently with client to facilitate open communication with their providers decreasing the amount of negative outcomes seen.

Step 1 Introduction:
Open up a Word Document and write directly into the word document. Remember you need to save on
your computer and another reliable drive or computer. You don’t want to lose your work, so save often
and to 2 different places….ALWAYS! Write an introduction to the discussion. A good, solid introduction
will grab the reader’s attention by stating interesting facts, statistics or points about your topic. Then
you should conclude this introductory paragraph by including one, concise thesis or purpose statement.
The thesis tells the reader why you are writing the discussion. The entire paragraph should be about 3-5
sentences. Keep in mind that paragraphs should include a topic sentence, 2-3 support sentences (min.)
and a concluding statement (thesis sentence). Review APA manual 7th edition section 3.4 for details.
Step 2 Concepts:
Use a proper heading with this section, then begin your 2nd paragraph. You can look at APA p. 47-49 for
the proper level of headings. In this section you need to differentiate among research, evidence-based
practice (EBP) and quality improvement (QI). When you differentiate between these concepts, they
should explain why they are similar (if applicable) or different and should include more than just
definitions. In fact, you should be paraphrasing what you review in the textbooks about these concepts
and describe how they are applied in nursing. This section is not long so no more than 1-2 paragraphs is
needed. Textbooks are a great resource here.
Step 3 Database Search:
You are ready to do a preliminary search of a topic to familiarize yourself with different databases. This
topic search does NOT have to be the same as the POI you choose for the remainder of the course. The
point of this exercise is for you to see how searching the same topic in different databases yields
different results AND how MeSH terms, filters, etc. can be applied to narrow your searches. Therefore to
execute a true comparison, the same search terms and limiters should be used for both databases.
(Suggestion only: if you are not sure what to search, then take a look at this document and see if you
can determine a phenomenon of interest that would interest you for the semester. What is a
Phenomenon of Interest.pdf
Download What is a Phenomenon of Interest.pdf
Record your findings in the format (table) below. Use this information to help you format the
table: Write your paper and copy and paste it in the discussion. If the table format is not correct, you
may fix it in the discussion, but you may have to copy and paste the table separately by Go to the toolbar
look for the three dots… you will see an option to add a table. Insert the table and make sure the content
is there. If you are still having issues. Click on the three dots and chose the fourth option, the piece of
paper and you have an upload option. You need to end up with a reasonable number of articles. Think
about it this way: if I searched pediatric asthma as a general topic and ended up with 1500 articles, there
is no way that is considered reasonable, but if I ended up after using filters, such as: years of publication
dates, ages of the patient, in hospital, I might end up with 87 articles which would be more reasonable
to sift through. I would apply these same strategies to the database and see what happens. Remember
you are posting the results of these terms, hits, MeSH, and results in the designated table. Set up a table
in your discussion like this to help you stay organized; it is fine for this section to be in a table and not in
a paragraph format.
Example of Database for Discussion
Filters, MeSH
terms, Boolean
Search Terms (USE THE
before filters, etc.USE THE
compare the differences) operators,
compare the
Example: CINAHL
Meta-analysis 121
Step 4 Implementation Considerations:
Before ever making changes into practice you must always consider whether or not the facility will
permit such changes. When considering this question, you must evaluate the following variables:
stakeholders, culture, if it is financially reasonable, is technology already in existence, etc. If you do not
consider how these factors impact your practice and just start making changes, you might end up with a
project that never gets lifted off the ground. Consider the following in regards to either your specific unit
or organization OR just in general on what would be needed or how it would be impacted by a project:
(1 page)
-culture of the unit, facility or organization (think about how progressive your unit and culture is, how do
you assess for culture?)
-Leadership/Stakeholders/Change Champions (who are these individuals, how are decisions made, who
has authority, what is the role of others in the unit, consider the Organizational Chart)
-Communication channels (how do ideas and policy changes get communicated, is communication open,
closed, etc.)
-Resources: financial, technology, human, etc. (is the facility still using pen/paper charting, electronic
records, etc. who makes up the staff, is there money to buy technology?)
-Evaluation and Feedback mechanisms (when changes have occurred in the past, how do you know if
they are successful, do they post openly on social media, in the organization, is information hidden, only
done by certain people, and how would you obtain feedback, what would you need to evaluate for
Step 5 EBP & QI Models:
Next, start a new paragraph and compare and contrast a Quality Improvement (QI) model to an EBP
models. The overall goal is to decide which is a better fit as you compare each of them. It may even be
helpful to look at 2 of each to see similarities and differences among them. Remember when you
compare and contrast you are looking for similarities and differences and explaining those to the reader.
Simply outlining the models is not enough here. Consider: methods of the model, how your topic,
patients, facility, team would fit into the model when viewing the steps, etc. Once you have done a
thorough comparison of the models you should be able to determine which would be a better fit. For
some of you that might be specific to your topic you might want to focus on or the facility itself or based
on the search using the databases in step 4. There are many models for you to choose from, below are
some links to just a few, but you may choose your own EBP model that you find in texts or other
resources. Below is an example of some models: (permission to use these models for teaching purposes
has been obtained). Be sure you specifically state the models evaluated. You can either click directly on
the link or choose to download. (1-2 paragraphs)
EBP models
Johns Hopkins Evidence Based Practice Model
Star Model of Knowledge Transformation
Iowa Model
Download Johns Hopkins Evidence Based Practice
Download Star Model of Knowledge Transformation
Download Iowa Model
QI models
Plan, Do, Study, Act Model (Links to an external site.)
(Links to an external site.)FADE Model (Links to an external site.)
Step. 6 Conclusion:
Include a heading and write your conclusion paragraph. A good conclusion:-never introduces new info.summarizes what was learned/discussed and does not simply state what you did or re-state only the
purpose statement-citations are not expected in this section
Step 7: Turnitin:
Submit your initial post ONLY to Turnitin. You do not have to submit this report anywhere; faculty will
review the reports directly in Turnitin. You do NOT have to submit the cross or peer posts to Turnitin.
Rather than focus on the percentage of similarity, review what was highlighted and change anything
that can and should be changed. There is some wording that can’t be changed, i.e. quality of life,
American Academy of Pediatrics, Institute of Medicine Aims, so don’t worry about those. Focus on
changing the areas of similarity that you can change and re-submit the paper.
Initial Post References:
minimum of 2 peer reviewed, current (within 5 years) references in the initial post; approximately 750
Copy and paste your discussion directly into the discussion area. Attachments should not be included in
the discussion area. Try to make sure that there is at least 1 space in between all paragraphs and
individual references. You do not need to double space this document. You are permitted to use first
person for these informal discussions.

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