scholarly journals Improving the patient involvement in research and development on acute psychiatric wards – an audit and quality improvement project

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S110-S110
Author(s):  
Ioana Varvari ◽  
Hany El – Sayeh ◽  
Shona McIlrae ◽  
Susan Bonner

AimsThe local audit aimed at measuring awareness of research and development policies and implementation of local and national standards. Our findings generated a quality improvement project with two main objectives: first, improving patient approach and recruitment in research and second, improving trainee satisfaction within our trust.MethodA cohort of new inpatient admissions was identified over a period of 4 weeks, between October 2019 and November 2019, on the two psychiatric wards at the Briary Wing, Harrogate District Hospital. Based on local and national standards, we designed and developed a qualitative (questionnaire) and quantitative (audit tool) approach that was aimed at both staff and patients. Our steps included: assessing awareness and implementation of standards, a retrospective collection of data on the wards, and analysis of the data in Microsoft Excel.ResultOnly one ward implemented the local guidance from which we identified a sample of 14 consecutive new admissions that were currently present on the ward and were able to answer our questions. 13 of those patients were noted as ‘approached’ on our visual board from which only 3 patients remembered reading a leaflet about research options in the admission pack, however, they have not been verbally informed. There was no process in place to assure the re-approaching of initially unwell patients or to follow up on discharge for those interested. Documentation was available in only 9 of the cases and was nonspecific: ‘admission pack done’.ConclusionThe awareness and understanding of Research and Development policies are poor and they are difficult to apply in practice in a busy inpatient environment without a clear process in place. This results in patients missing the opportunity to learn and understand more about research or to participate in ongoing studies. Quality improvement work needs to be done to improve patient recruitment in research in inpatient settings. Simple flow charts and stepwise processes as exemplified by our action plan have the potential to improve service quality, as well as patient and trainee satisfaction.

2019 ◽  
pp. 105984051987743
Author(s):  
Stacey R. Hurrell ◽  
Tara L. Cliff ◽  
Cheryl L. Robertson

As numbers of culturally diverse students rise, struggles with language, cultural differences, and health care create challenges for school nurses. The focus of this quality improvement project was to utilize the National Standards for Culturally and Linguistically Appropriate Services (CLAS) as a framework to initiate cultural competency development among school nurses. Eighteen public school nurses attended programming that began with the webinar “CLAS is in Session,” an introduction to the standards as applicable to school nursing practice. Outcome measures included self-report of cultural awareness and sensitivity (CAS) and culturally competent behaviors (CCB). A greater percentage of nurses reported feeling “somewhat competent” after program completion, though CAS and CCB scores did not significantly change. Despite lack of measurable improvement in CCB, implementation of the CLAS Standards created an important starting point for CC programming.


2018 ◽  
Vol 103 (2) ◽  
pp. e1.38-e1 ◽  
Author(s):  
Calvert Heather ◽  
Makhalira Aubrey

AimA level 3 tertiary neonatal unit with a capacity of 40 cots providing intensive care, high dependency care, special care & transitional care services, had 18 gentamicin errors reported between January and June 2017, with 84% errors occurring at prescribing and 16% errors in administration. The majority of errors (67%) were due to the complexity of calculating a 36-hourly time interval between doses. A quality improvement project was undertaken with the aim of reducing the number of gentamicin errors on the unit over a 3 month period.MethodAn overview of all gentamicin errors were presented to the multidisciplinary team (MDT) with a view of gathering ideas for improvement to ensure a team based approach. An action plan was put in place in line with National Patient Safety Agency (NPSA) recommendations1 and initiated in July 2017 based on a plan-do-study-act (PDSA) model.ResultsThe PDSA cycles included:a simplified and standardised dosing interval for dosing of gentamicin after the first dose.an updated local monograph with dosing intervals and example prescription.posters displayed in prescribing areas to promote safe and focused prescribing.a feedback session to the full MDT team regarding improvements made and further feedback.ensure compliance with policy by promoting updated guideline & on going error monitoring.consideration of alternative lower risk antibiotic in low risk babies.incorporation of gentamicin prescribing exercise as part of the new doctor induction. The following interventions will be evaluated in 3 months using Datix reported errors before and after implementation. Sequential PDSA cycles will then be conducted for learning and improvement.ConclusionA team based approach, using open communication with regular feedback and review is essential in order to improve the quality of prescribing and gain engagement from medical and non-medical prescribing colleagues. Further audit will be undertaken on monthly basis to evaluate the implementation of improvement measures.


Author(s):  
Ruchir Gupta ◽  
Minh Chau Joe Tran

In this chapter the essential aspects of practice-based learning improvement are discussed. The chapter begins with a mock scenario involving an initiative to design and implement a quality improvement project to improve the number of cases starting on time. The mock scenario is followed by a task statement that describes the specific action that the student must take. In this case, the task is to explain to a colleague the general steps of how to design and implement a quality improvement project. An action plan is then presented in a stepwise manner with mock responses and a discussion of the responses. Grading points are also discussed and how to achieve maximum score is presented.


2020 ◽  
Vol 35 (13) ◽  
pp. 908-911
Author(s):  
Xinran Maria Xiang ◽  
Daniella Miller

Many parents of children do not recall anticipatory guidance on acute seizure management, which can lead to unnecessary emergency department visits. This quality improvement project evaluated if adding a video simulation of seizure first aid improved parental recall. Parents of children with seizures were randomized to standard verbal counseling or video group, which were shown a video simulation of seizure first aid. All families also received a standardized written action plan. Eighty-three patients were randomized from July to October 2018. Overall, 53% of families who received standard counseling accurately recalled seizure first aid compared with 31% in video group (χ2 = 3.24, P = .07). Among families without baseline knowledge of seizure first aid, 43% in the standard counseling group recalled accurately compared with 16% of video group (χ2 = 4.52, P = .03). These results underscore the importance of face-to-face patient education despite the popularity of video-based media. Future Plan-Do-Study-Act cycles will include piloting a hands-on seizure first aid simulation with mannequins.


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