This article covers a sample assignment solution about Quality Improvement in an Organization.


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Identify a quality improvement opportunity in your organization or practice. In a 1,250-1,500 word paper, describe the problem or issue and propose a quality improvement initiative based on evidence-based practice. Apply \”The Road to Evidence-Based Practice\” process, illustrated in Chapter 4 of your textbook, to create your proposal.


Quality Improvement in an Organization


In the US, More than 6,800 prescription medications and countless over-the-counter drugs are available to Americans. Tariq et al. (2020) further note that a health care professional’s responsibility is further complicated in the process of offering patient care as there exist thousands of health supplements, lotions, potions, and herbs that the public uses to treat and manage their health and well-being. The continued influx of these substances within the healthcare market implies that errors can occur as the physicians prescribe or dispense drugs, whereby the high risk of interactions between these substances and the prescribed medication only serves to compound the problem. The authors mentioned above report that between 7 000 and 9 000 occur in the US solely due to medication errors. Within this essay’s context, a medication error is taken to be a failure in the treatment process that leads to or has the potential to lead to the patient’s harm.

Additionally, health, medical and nursing experts agree that MEs are adverse drug events that are 100 % preventable and include but are not limited to medications administered at the wrong time, by the wrong route, using the administration method, and where the wrong dose may be administered. In general, MEs are adverse drug events that also embrace overdose administration, medication omission, or even administration. Consequently, the purpose of the proposed quality improvement project is to increase the competency of nurses tasked with the responsibility of administering a medication that, by extension, will result in better patient outcomes. 

Medication Errors Problem Overview

Medication errors remain an ongoing problem among hospitalized and may occur at any stage of the treatment process, whether during prescribing, transcribing, prescription, auditing, preparing, dispensing administration, and monitoring (Wang et al., 2015). Near misses are errors that occurred but were captured before they could reach the patient, unlike medication administration errors, which are those errors that reach the patients and pose a threat to patient safety and effectively compromise the quality of care offered. Besides patient deaths, many patients experience an adverse reaction or other complications. Still, they do not report while the total cost of caring for patients with medication-associated errors exceeds $40 billion annually, with more than 7 million Americans affected. As such, MEs is a pertinent issue in healthcare settings, but while healthcare team members agree that this a significant problem, there is little consensus on how to remedy this growing issue. The treat of punishment from one’s healthcare facility is a leading reason why few professionals are ready to report medication errors.

Effect of Medication Errors on Quality and Patient Outcomes

Better quality care service produces better patients’ outcomes. However, medication errors are one of the significant factors affecting the quality of care and can lead to poor health outcomes. Such errors are mostly transcription errors, which lead to temporary harms, preventable medication errors, long hospital admission time, which are in some cases, life-threatening and can lead to death. Medication errors reported in today’s health organizations include not identifying contradictions, lack of recognizing drug-drug interactions, allergies, and wrong selection of therapy. These errors lead to preventable adverse drug situations that affect the patient’s safety. Subsequently, incorrect medication history may block the establishment of pre-admissions and drug therapy during the patient’s treatment. Every year bit is estimated that tens of millions of sick people suffer worldwide due to disabling accidents or fertility because of medication errors.

Current Initiatives Meant to Decrease the Medication Errors Rate within the Selected Hospital and Barriers to these initiatives like Bar Code Medication Administration Technology.

Health Information Technology (HIT) has been the current initiative meant to lower medication errors among nurses. Although technology systems used in healthcare are new from other fields, HIT implementation has been appraised in patients’ safety through services automation, such as prescribing medications, discharging patients, health record storage, and other quality outcomes. This initiative has provided hope for lowering medical errors and reducing the increasing health care cost. Equally, some researchers have campaigned for meaningful use incentive programs like BCMA implementation, and it has brought interest in government agencies. According to Schwartzberg et al. (2015), some studies have made it apparent that less or no enhancement can be done on HIT adoption. However, several other studies have used qualitative research models to show HIT benefits like BCMA. The common barriers encountered in the hospital’s effectiveness are system errors and inadequate training where intragroup and self-monitoring can be used as strategies to system the system.

Explanation of the Proposed Quality Improvement Initiative

Having looked at the impact of MEs on quality and patient outcomes and discussing the merits of using barriers to the successful implementation of BCMA technology to reduce medication error rates, this section expounds on the proposed quality improvement initiative. Suffice it to say that hospital systems across the US encounter several pressing problems ranging from clinical variation, hospital-acquired infections, dwindling cash flows, and preventable medication errors. Most importantly, health systems require to consistently innovate to address these problems, although many quality improvement initiatives fail to deliver on return on investment. With the existence of different definitions of a QIP, the Health Resource and Service Administration (HRSA) describes it as any systematic and continuous actions that lead to measurable improvement in healthcare services and the health status of the targeted groups of patients.

Therefore, the proposed QIP is a PICOT Question-based initiative that will lead to increased competency of nurses who administer medications by implementing a Simulation Education Training program in a large rural- acute care hospital located in north New York State. The facility is a 72- bed acute care hospital with RNs and LPNs. All the nurses who are 30 in number are expected to participate in the project. At the same time, the PICOT question states In all nursing staff (Population- P) employed in inpatient hospitals where MES are reported, how effective is the implementation of a SET program on medication administration (Intervention-I) compared to regular education medication administration module (Comparison-C) in increasing nursing competencies on the same and therefore reducing the medication error rate (Outcome-O) within 90 days (Time-T).

Use of SET of Nursing Staff to Decrease Medication Errors

One of the uses of simulation on nursing staff is to increase nurse’s medication administration competence. According toWalters (2015), information combined with simulation raises nurses’ competence linked with medication administration, therefore reducing medication errors. Secondly, Human patient simulation is an art of technology and can help nurses get new skills. Simulation enhances knowledge retention and acquisition of nurses. From it, nurses are at a point of executing their skills with lower time and more correctly in training sessions, thereby reducing the medication errors. Simulation is seen as a crucial tool that can be used to rectify nurses in providing clinical care skills. It grants nurses short realistic incidences, and they can practice the skills as many times as possible to become more accurate. Suffice it to say that simulation training enhances administration skills and medication calculations

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Quality improvement in an organization
Quality Improvement in an Organization

Advantages of Using SET in the Facility

If implemented as required, simulation provides numerous benefits. The simulation gives rise to opportunities like enhanced communication between patients and physicians, creates teamwork, and improves organization leadership. Another simulation benefit is that simulation t education and training increase competence and confidence and improves the ability to make critical and useful clinical decisions between the learners. The next benefit of simulation is that it leads to quality patient results and lowers the education workload in delivering clinical care. The simulation also contributes to reduced professional liabilities and institution legal risk through safety increase program training. In conclusion to simulation benefits, simulation holds safety and quality priorities around an institution and assists when eliminating institution system challenges lower the rate of adverse situations and lower rates of infections (Sorensen et al. 2015).

What the SET will involve

The SET intervention will consist of four phases. Phase I will be an introduction where the participants will be described the project, the short IRB consent form description, the signing of the form, and the pre-test administration. The signing of the consent forms will pave the way for collecting necessary demographic information with a pre-test comprising a dozen or so questions. Phase 2 will be a brief presentation of necessary medication administration and standard errors, amongst other essential components. Next will be Phase 3, consisting of a simulation medication administration exercise using a 3- G simulation mannequin where none of the participating nurses has had previous simulation experience. The nurse will then reenact all the requirements of real clinical ward activities, including the medication administration documentation during the exercise. Later the Creighton Competency Evaluation Instrument will be used for assessment purposes during the simulation exercise. The evaluation items are categorized into groups of assessment, communication, clinical judgment, and patient safety. A debriefing session with each nurse will then be held. The last step, Phase 4, will be conducted 14 days later, where a post-test identical in all aspects to the pre-test will be held to establish how well the nurses retained their knowledge.

How the SET will be delivered

The project leader will cooperate with the Improved Quality Medical and Training Hospital (IQMTH). In consultation with the Hospital Director, Office of Staff Development, establish the need for education on medication errors through SET. The Hospital Director recommended the SET training at a mandatory in-service for all nursing staff. To determine baseline competency for medication administration, a pre-test will be administered where a lecture on medication administration, common medication errors, and measures to decrease them will be discussed. Two weeks after the pre-test, the project leader will return to the facility to administer the post-test to the participating nurses.

How Existing Literature Supports the Use of SET in Reducing MEs

According to Miller et al. (2016), the use of education strategies to reduce medication errors, specifically those committed by student nurses, reduces them and, therefore, promotes a culture of patient safety. Besides simulation, self-study interventions for teaching safe medication administration have proved effective. On the other hand, experts acknowledge that humans working in complex, dynamic, and stressful states are prone to errors. As profusion, therefore, Higham & Baxendale (2017) opine that nurses are well-versed in developing and utilizing improved technologies and techniques that significantly promote high quality and safe care for patients through SET. Other studies have also demonstrated that clinician behavior modification, for example, thorough increased medication administration competencies, results in improved patient outcomes (Seaton et al., 2019.

Steps involved in the Implementation of the Proposed QIP

For the IQMC to register quality improvement and reduce the medication error rates, the selected project site will need to understand its system of delivery and the key processes where both the processes also known as inputs and the activities carried out, or the processes will be addressed simultaneously to ensure quality improvement evidenced by a decrease in medication error rates. The first step of the implementation will entail establishing an organizational foundation for the proposed SET initiative. After readiness assessment and preparation for change, the project leader and other change agents will identify the desired improvements and how these will be measured before organizing the nursing staff to accomplish the work. Then change management process will be determined together with coming up with strategies that will keep the momentum of the SET going. The last steps will be establishing how the SET performance will be tracked over time and finally celebrate its success if effectively implemented.

Pre- and Post-Intervention Approach to Evaluate the Nurses

Since the purpose of the proposed SET program is to increase nurses who administer medications, the evaluation plan will involve a pre-test as baseline data to establish the current nurses’ competency as far as the administration of medication is concerned. A post-test will be administered two weeks later to the participating nurses to evaluate the increased competencies where it is expected that increased competition will be evidenced by a reduction of medication error rates over three months.


In conclusion, the proposed QIP will offer evidence that the provision of information, and simulation education training results in improved competencies, which ultimately leads to improved patient outcomes. The fall in medication error rates after implementing the SET program will mean the SET intervention is effective.


Higham, H., & Baxendale, B. (2017). To err is human: use of simulation to enhance training and patient safety in anesthesia. BJA: British Journal of Anaesthesia119(suppl_1), i106-i114.

Miller, K., Haddad, L., & Phillips, K. D. (2016). Educational strategies for reducing medication errors committed by student nurses: a literature review. International Journal of Health Sciences Education3(1), 2.

Seaton, P., Levett-Jones, T., Cant, R., Cooper, S., Kelly, M. A., McKenna, L., & Bogossian, F. (2019). Exploring the extent to which simulation-based education addresses contemporary patient safety priorities: A scoping review. Collegian26(1), 194-203.

Tariq, R. A., Vashisht, R., & Scherbak, Y. (2020). Medication errors. StatPearls [Internet].

Vawser, T. (2015). Simulation and patient safety: the benefits to your organisation.

Wang, H. F., Jin, J. F., Feng, X. Q., Huang, X., Zhu, L. L., Zhao, X. Y., & Zhou, Q. (2015). Quality improvements in decreasing medication administration errors made by nursing staff in an academic medical center hospital: a trend analysis during the journey to Joint Commission International accreditation and in the post-accreditation era. Therapeutics and clinical risk management11, 393.

World Health Organization. (2016). Medication errors. World Health Organization.


Identify a quality improvement opportunity in your organization or practice. In a 1,250-1,500 word paper, describe the problem or issue and propose a quality improvement initiative based on evidence-based practice. Apply \”The Road to Evidence-Based Practice\” process, illustrated in Chapter 4 of your textbook, to create your proposal.

Include the following:

  1. Provide an overview of the problem and the setting in which the problem or issue occurs.
  2. Explain why a quality improvement initiative is needed in this area and the expected outcome.
  3. Discuss how the results of previous research demonstrate support for the quality improvement initiative and its projected outcomes. Include a minimum of three peer-reviewed sources published within the last 5 years, not included in the course materials or textbook, that establish evidence in support of the quality improvement proposed.
  4. Discuss steps necessary to implement the quality improvement initiative. Provide evidence and rationale to support your answer.
  5. Explain how the quality improvement initiative will be evaluated to determine whether there was improvement.
  6. Support your explanation by identifying the variables, hypothesis test, and statistical test that you would need to prove that the quality improvement initiative succeeded.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines

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