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Please respond the these 4 discussion posts with 2 references: 1. What is the d

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Please respond the these 4 discussion posts with 2 references:
1. What is the difference between a quality improvement system and a quality improvement tool? Explain.
Quality improvement systems are used to guide the process of quality improvement in an approach to complex problem-solving. These QI models structure the course to system improvement. In contrast, QI tools are diagrams, charts, maps, checklists, and other materials and activities that take the design from abstract to a more physical structure (Hughes, 2008). QI tools are described as an instrument or approach used to support and improve quality management and improvement activities.
2. Select and compare three quality tools. What are some of the critical similarities and differences among the selected quality tools?
There are several tools used in quality improvement. These are all used to focus on systems and not individuals. The goal is to address systems errors and to change provider practices. Almost every QI tool performed some type of pretesting or pilot testing. These are the three examples I have chosen and their details:
a. Root-cause analysis is beneficial for assessing reported errors/incidents and distinguishing between active and latent errors, identifying the need for changes to policies and procedures, and serving as a foundation for suggesting system modifications, including better risk communication.
b. Six Sigma/Toyota Production System has been successfully used to reduce defects/variations, operational costs and enhance results in a range of health care settings and processes. Six Sigma was discovered to be a thorough procedure that clearly distinguished between the causes of variation and function result measures.
c. Plan-Do-Study-Act (PDSA) method is used to gradually implement initiatives and improve them as needed. PDSA is a cycle where a single new process is examined, followed by reviewing findings and responding to what was learned through problem-solving and making improvements before initiating the next PDSA cycle.
3. How will you select one of the quality improvement processes and approaches and implement one or more quality tools as described in last week’s presentation for your QI project?
The Root-cause analysis would be the best tool for my QI project. This tool can assist me in finding the reasons why staff are hesitant to take the COVID-19 vaccinations. Utilizing a survey tool, I can solicit reasons for their hesitancy and then connect them to what causes this misinformation and where it is coming from. This may even give me the path towards presenting the pros and cons of taking the COVID-19 vaccine concerning patient and staff safety.
Hughes, R. (2008). Tools and strategies for quality improvement and patient safety. Patient Safety and Quality: An Evidence-Based Handbook for Nurses.
Nash, D., Joshi, M., Ransom, E., and Ransom, S. (2020). The healthcare quality book: vision, strategy, and tools (4th Edition). Health Administration Press, Chicago.
A quality improvement system is the process of quality improvement as a whole, whereas a quality improvement tool is a small portion of the system that one utilizes to reach the goal of quality improvement. The quality improvement system can be viewed as the methodology of the quality improvement project, and the tools are used to support and frame the methodology. Depending on the methodology that was chosen, the quality improvement tools chosen may differ. Each quality improvement project is different, so the structure and tools utilized are what is going to best support the aim of the project. Different tools may be utilized in different stages of the improvement project as well.
There are a few different methodologies to name, each of their structures slightly different. Depending on the method, the tools will differ. There are seven tools that are frequently used throughout the different methods of quality improvement, all having similarities and differences. For example, there is cause and effect diagrams which can be used in brainstorming instances (ASQ, 2020). This tool, also known as a fishbone diagram, can show different effects a problem may have depending on the action taken (ASQ, 2020). Where a fishbone diagram is helpful for brainstorming and grouping ideas into categories, a control chart is used to analyze data. A control chart is a graph that is used to show the progress of the improvement over time (ASQ, 2020). Likewise, a check sheet can be used to analyze data as well, but instead of a graph, it is essentially a table that can be used to track frequency of data (ASQ, 2020).
For my quality improvement project, my aim is to develop a process for telehealth psychiatric services in our emergency department. I will not have a definitive “yes, telehealth worked” at the end of the project, but instead, a “yes this process has the potential for success in our emergency room”. For this project, I will have to look at the methods that will best fit the structure of a process development. One method, the Plan/Do/Study/Act method, will be the best fit for the structure of my quality improvement project. This method utilizes a cycle for testing and implementing change, which I feel will help me fine tune the process of implementing telehealth (PHAB, 2020). There are so many facets of this project that need to be considered, and I will need to test different processes before I find one that works. Utilizing fishbone diagrams will be helpful because they can offer different solutions and show relationships and make connections between ideas.
ASQ. (2020). Learn about quality. The 7 basic quality tools for process improvement. American Society for Quality.
PHAB. (2020). Quality improvement Methodologies: Determining the Best Approach for Incorporating QI into your Agency’s Practice. Public Health Accreditation Board.
3. What is the effect on AIC by educating low-income adults with type 2 diabetes on blood sugar monitoring four times a day after a meal in compared to not monitoring blood sugar? P – low-income adults with type 2 diabetes I – educating on blood sugar monitoring four times a day after eating C Compared to uneducated low-income adults O- AIC result
The sample size for my quantitative research will be 20 participants, low-income adults. All of my patients will need to be adults and type 2 diabetic and Aic More than 6.0. The time frame would be monitoring them for 1 month.
The pros to quantitative research would be that it would be less biased as the population is random. The research behind a quantitative method involves questions, experiments, and surveys that can solve the problem (Gaille, 2019). You cannot follow up on any answers in quantitative research; that would be one of the cons, the other would be that you cannot determine if responses are genuine, as you are not sitting with them face to face when they are doing blood sugars. The pros associated with using a quantitative study are that the data collection occurs rapidly with quantitative research. There is always a risk that the research collected using the quantitative method may not apply to the general population. One of the other Cons could be the high cost(Gaille, 2019).
My research question would be:
What is the effect on AIC by educating low-income adults with type 2 diabetes on blood sugar monitoring four times a day after a meal compared to not monitoring blood sugar?
4. I will be using a descriiptive design approach to better understand Lateral Violence (LV) and its prevalence in nursing. According to Polit & Peck (2017) “descriiptive research is to observe, describe, and document aspects of a situation as it naturally occurs”(p.206). Therefore, the purpose of descriiptive research is to identify characteristics, frequencies and trends of a phenomenon. Descriiptive research asks what is happening, how it’s happening, when and where it happens? Descriiptive research also uses qualitative and/or quantitative research. Lateral violence is described as” nurses overly or covertly directing their dissatisfaction inward toward those less powerful than themselves, and each other”( Sheriden-Leos, 2008). Consequently, it can be described as nurses bullying one another. Examples include non-verbal innuendos, eyes rolling, withholding information, sabotage, and backstabbing. Why is LV so prevalent in nursing? LV has been “internationally reported for greater than two decades and results in new nurse turnover and serious negative outcomes” (Embree et al, 2013). As a result, nurses are leaving bedside nursing and developing depression and anxiety due to a toxic workplace. To study this phenomenon, I would go to a hospital and interview and survey nurses. I would survey nurses from a variety of specialties, including operating room, medical surgical units, intensive care units, and progressive care units. I would interview new grads, veterans, and apprentice nurses. I would ask questions such as have you experienced LV? Who did you experience LV from? How long did the LV last? Did you report the behavior? What was happening when the behavior occurs? Where does this behavior occur? I would give the nurses a survey to fill out, this survey would question the amount of lateral violence in the workplace. I would also observe interactions between staff. I think the pros of descriiptive research it can accurately describe a situation. Descriiptive research can also collect a large quantity of data and show patterns. I would be able to interview and survey many nurses and see patterns in the information they are telling me. For instance, LV maybe more prone on units with higher acuities and patient higher patient ratios. The disadvantage to descriiptive design is I won’t be able to repeat the test I observed on the unit. Descriiptive test also would not show me the why’s? Why is LV happening?
Research Question: How does Lateral Violence affect patient care?
Embree, J, Bruner, D, White, A. (2013). Raising the level of awareness of nurse-to-nurse lateral violence in a critical access hospital. Nursing Research and Practice, vol. 2013(7).
Sheridan-Leos, N. (2008). Understanding Lateral Violence in Nursing. Clinical Journal of Oncology Nursing, 12(3), 399-403.



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