To prepare
• Review the Week 4 Assignment Rubric, provided in the Course Information area.
• Review the AWE Checklist and Additional Resources for your Assignment:
o 2000/3000 AWE Level Assignment Template
o TOP Ten BSN References and Citations
• Review this week’s Writing Resources and Program Success Tools. Revisit the Writing Resources and Program Success Tools from Weeks 1 through 3 as needed. Focus on the QIs at http://www.qualityindicators.ahrq.gov/.
• Choose a QI related to a nursing topic of interest to you. Think about the ways in which following and measuring this crucial health data improve effectiveness and efficiency in your nursing practice. Consider any points that relate your selected topic to the journey ahead in your nursing career.
• Find two articles in the Walden Library to support your scholarly opinion in your paper.
Assignment
Use the Walden Writing Center guidelines titled “Writing a Paper” and “Scholarly Writing: Overview” to do the following:
• Draft a 2- to 3-page paper describing your selected QI in general, and then describe how this QI has the potential to improve the quality, safety, and outcomes of your patients and their families.
• Describe the current data available and leadership’s goal for improvement.
• Draft a solution using 2 sources from professional and scholarly literature to support your proposal.
• Use the 2000/3000 AWE Level Assignment Template in the resources for this week to complete your Assignment.
• Use in-text citations to support your paper. Use essay-level writing skills, including the use of transitional material and organizational frames.

Introduction

Nursing quality involves the improvement of the effectiveness, efficiency, accessibility, and patient safety to those in need. The most critical of nursing quality is patient safety has increased. However, nurses play a significant role in determining the nursing quality to ensure that their practice yields quality care and guarantee patient safety. The purpose of this paper is to describe the ways in which following and measuring Postoperative Respiratory failure health data will improve effectiveness and efficiency in your nursing practice. It will also explain the potential of this the QI to improve the quality, safety, and outcomes in patients and their families.

Postoperative Respiratory Failure

Postoperative Respiratory failure is a critical health data that is used by AHRQ (PSI-11) as an indicator of Patient Safety. It has a higher PSIs rate as compared to other PSIs, making it an effective health data used to measure the patient outcome across a diverse patient population. As a PSIs, Postoperative Respiratory failure determines the level of inpatient safety risks that patients are exposed to during acute care VHA hospitalizations and non-psychiatric (Rajaram, Barnard & Bilimoria, 2015). The PSI is common in veterans with psychotic disorders than those patients who have never had any case of psychotic disorders.

Some potential causes of respiratory failure among patients who have shown signs of psychosis include restriction to aces ambulatory restrictions services, inability to comply with spirometry incentive and any other toileting involving the pulmonary parts of the body. The condition may also be caused as a result of drug interactions with anesthetics taken in response to the remedy the psychotropic condition (Canet, Sabate, Mazo, et al, 2015). Also, the use of antipsychotics or benzodiazepines on an ‘as-needed’ basis in response to insomnia, agitation, or aggression may also cause Postoperative Respiratory failure. Equally, patients with higher levels of cigarette smoking are also at the risk of experiencing Postoperative Respiratory failure (Smith, Zhao & Rosen, 2012).

The Current Data Available and Leadership’s Goal for Improvement

Going by the available literature, Post-operative Respiratory failure is said to be the most common perioperative causes of death especially in adult patients who have undergone thoracic surgery. However, it is important to note that the term respiratory failure brings on board issues such as failures caused by ARDS, pneumonia, and pulmonary emboli (McLean, Diaz-Gil, Farhan, 2015). This broad view has hindered a clear understanding of what postoperative respiratory failure is so as to be well conversant with its causes and then start planning for its prevention.

Postoperative respiratory failure is attributed to the increased cost of care, longer hospital stays, and a high rate of mortality. Ranging between 30 days and five years. The patient factors that are common in patients with PRF smoking are age, past history of using COPD, as well as functional dependence (Winters, Bharmal, Wilson, et al, 2016). The procedural factors associated with PRF include vascular, prolonged and emergency procedures, thoracic, head/neck procedures, and abdominal. The effectiveness preventive measures that can be used to manage PRFs include subjecting the patients to exercises aimed at expanding the lung and discriminative application of nasogastric tubes for patients with abdominal cases (Canet & Gallart, 2014). The patients may also be subjected to a short-acting neuromuscular blockade and advised to practice preoperative smoking behavior and laparoscopic techniques.

Conclusion

In conclusion, patient safety is a key component of nursing quality which can be achieved through the use of PRFs as a PSI. Conversely, nurses must be trained and make their resources available. PRF has become a major patient safety indicators thus increasing the role nurses plays t as they interact with patients, patients’ families and their colleagues in the profession. To facilitate patient safety, nurses monitor patients to ascertain signs of clinical deterioration, near misses, and errors. They also learn the weakness inherent in the care processes to promote high-quality care.

References

Rajaram, R., Barnard, C., & Bilimoria, K. Y. (2015). Concerns about using the patient safety indicator-90 composite in pay-for-performance programs. Jama313(9), 897-898.

Canet, J., & Gallart, L. (2014). Postoperative respiratory failure: pathogenesis, prediction, and prevention. Current opinion in critical care20(1), 56-62.

Canet, J., Sabate, S., Mazo, V., Gallart, L., de Abreu, M. G., Belda, J., … & Pelosi, P. (2015). Development and validation of a score to predict postoperative respiratory failure in a multicentre European cohort: a prospective, observational study. European Journal of Anaesthesiology (EJA)32(7), 458-470.

McLean, D. J., Diaz-Gil, D., Farhan, H. N., Ladha, K. S., Kurth, T., & Eikermann, M. (2015). Dose-dependent association between intermediate-acting neuromuscular-blocking agents and postoperative respiratory complications. The Journal of the American Society of Anesthesiologists122(6), 1201-1213.

Winters, B. D., Bharmal, A., Wilson, R. F., Zhang, A., Engineer, L., Defoe, D., … & Pronovost, P. J. (2016). The validity of the Agency for Health Care Research and Quality Patient Safety Indicators and the Centers for Medicare and Medicaid Hospital-acquired Conditions. Medical care54(12), 1105-1111.

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