31 Jan Explore how other institutions integrat

MSN6016 Quality Improvement of Interprofessional Care

Assessment 1

Adverse Event or Near Miss Analysis

Preparation

Prepare a comprehensive analysis on an adverse event or near-miss from your professional nursing experience that you or a peer experienced. Integrate research and data on the event and use as a basis to propose a Quality Improvement (QI) initiative in your current organization.

Note: Remember, you can submit all, or a portion of, your draft to Smarthinking for feedback, before you submit the final version of your analysis for this assessment. However, be mindful of the turnaround time for receiving feedback, if you plan on using this free service.

The numbered points below correspond to grading criteria in the scoring guide. The bullets below each grading criterion further delineate tasks to fulfill the assessment requirements. Be sure that your Adverse Event or Near-miss Analysis addresses all of the content below. You may also want to read the scoring guide to better understand the performance levels that relate to each grading criterion.

Analyze the missed steps or protocol deviations related to an adverse event or near miss.

Describe how the event resulted from a patient’s medical management rather than from the underlying condition.

Identify and evaluate the missed steps or protocol deviations that led to the event.

Discuss the extent to which the incident was preventable.

Research the impact of the same type of adverse event or near miss in other facilities.

Analyze the implications of the adverse event or near miss for all stakeholders.

Evaluate both short-term and long-term effects on the stakeholders (patient, family, interprofessional team, facility, community). Analyze how it was managed and who was involved.

Analyze the responsibilities and actions of the interprofessional team. Explain what measures should have been taken and identify the responsible parties or roles.

Describe any change to process or protocol implemented after the incident.

Evaluate quality improvement technologies related to the event that are required to reduce risk and increase patient safety.

Analyze the quality improvement technologies that were put in place to increase patient safety and prevent a repeat of similar events.

Determine whether the technologies are being utilized appropriately.

Explore how other institutions integrated solutions to prevent these types of events.

Incorporate relevant metrics of the adverse event or near miss incident to support need for improvement.

Identify the salient data that is associated with the adverse event or near miss that is generated from the facility’s dashboard. (By dashboard, we mean the data that is generated from the information technology platform that provides integrated operational, financial, clinical, and patient saf