Project Knowledge Within the Nursing Workplace Assignment

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Project Knowledge Within the Nursing Workplace Assignment

Personal Improvement Project Plan

Quality improvement is essential in the healthcare system, especially for healthcare facilities and nursing staff. That is because it helps ensure that the healthcare facilities provide the safest and quality healthcare services to the patients while ensuring that nursing staff balances their overall work for productivity and well-being (Agency for Healthcare Research and Quality, 2019-c).

Project Aim

My improvement project aims to improve how I handle and balance my work and home life and work closer to my standard 40 hours a week. Currently, I am working well over 40 hours, thus failing to meet my goal of spending quality time with my family. Therefore, the table will incorporate my workdays but exclude the weekends. The main reason for prioritizing my work and home life balance is because I have identified that my mental health status has been deteriorating ever since I accepted the nurse manager role. Prioritizing my time management will create a culture of well-being and will allow me to recharge instead of depleting my happiness. Project Knowledge Within the Nursing Workplace Assignment

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My concerns with my lack of home and work life balance, is creating a doubt in my mind that maybe I am not the right person for this nurse manager role. However, I am hopeful I will become more productive in my work and improve my relationships with my husband and children through my personal quality improvement project on time management. I will incorporate some crucial components in my project, including process analysis, measurement, changes, and project reflection and application.

Process Analysis

Quality improvement projects require engaging with effective models and procedures to identify the issues that may lead to an adverse effect. For instance, if I do not identify the main issue that influences my work-life balance, it may affect my well-being and relationship with my family. My plan will involve a root cause analysis method to identify all loopholes that may influence my quality improvement approach (Agency for Healthcare Research and Quality, 2019-d). Hence, the process I plan to take is to start with an improvement in my daily work hours each week for four weeks.

As Agency for Healthcare Research and Quality (2022) postulates, process mapping

in a project is essential since it helps one identify the process and task owners and outline the expected timelines. As a result, I will build on each step by adding another tool to try and improve my hours. For example, in week 1, I will not engage any tool to evaluate how many hours I will work to act as my improvement process control. In week 2, I will write down the estimated time and tasks needing to be covered within that week. For Week 3, I will incorporate an alarm as a prompt to control the hours I work, especially in marking the completion of my hours. Lastly, in week 4, I will add an alarm to help me complete all tasks without delay. That will involve a 15-minute alarm that will notify me 15 minutes before departure. Furthermore, I will ensure that these alarms are on repeat mode to prevent me from forgetting to set them. The process mapping was made possible by collaborating with my director.

(Figure 1) Project Knowledge Within the Nursing Workplace Assignment

Measurement

According to Wolfe, Taylor, and Subramanyam (2021), quality improvement measurement results in various improvement activities while looking at defining key processes or outcomes; the collection of relevant and substantial data; and analyzing and interpreting these data. Measurement helps evaluate current performance, set realistic goals, and monitor improvement interventions and efforts (Johnson & Sollecito, 2020). In that case, I chose to do my data collection by tallying every day’s work for the four weeks (Figure 2).

(Figure 2)

As a result, I connected with my director to develop different tools to use each week but added them to the previous tools utilized each week (Figure 3).

Personal Improvement Data Collection

Date	# Of Hours Worked	Did I make a list? (Y/N)	Set alarm to leave for the day. (Y/N)	Set reminder alarms? (Y/N)	Actual Hours Worked	Weekly OT hours over standard (40)
5/30	10.5	–	–	–
5/31	10.75	–	–	–
6/1	11	–	–	–
6/2	9.5	–	–	–
6/3	11	–	–	–
Week 1					52.75	12.75
6/6	9.25	Y	–	–
6/7	9.5	Y	–	–
6/8	11.25	N	–	–
6/9	9	Y	–	–
6/10	8.5	Y	Y	–
Week 2					47.5	7.5
6/13	10.25	Y	Y	–
6/14	8.75	Y	Y	–
6/15	9.5	Y	N	–
6/16	6.5	Y	Y	–
6/17	9	Y	Y	Y Project Knowledge Within the Nursing Workplace Assignment
Week 3					44	4
6/20	8	Y	Y	Y
6/21	8.5	Y	Y	Y
6/22	9	Y	Y	Y
6/23	10	Y	Y	Y
6/24	6.75	Y	Y	Y
Week 4					42.25	2.25

(Figure 3)

In the first week, I planned to work typically without any adjustment since I had already identified ways to document my hours, accordingly, thus knowing when I would work more than 40 hours weekly. However, for the second week, I made lists of the work that needed to be covered daily during morning hours. The reason was to ensure that I would perfectly organize my tasks, including an attempt to plan out my schedule. My results showed some progress, but it was still unfortunate since as I was still working for over 40 hours. The main strength of writing down tasks is that I would view them clearly and estimate how long they would take. For instance, when I needed to leave by 4.30 pm, I made it a routine to pause all remaining tasks that would take more than 30 minutes and schedule it for the next day. Another important factor I noted during my improvement project’s second week is the need to have more consistent alarms and consider my start time and not just my end-of-shift times. That is because various nursing shifts may need more time, thus making it appropriate to adjust my hours accordingly. Project Knowledge Within the Nursing Workplace Assignment
In the third week, I carried forward my second week’s strategy of writing down my tasks daily with their estimated time. After an evaluation, I found it necessary to add an alarm on my phone to keep me alert on when I was supposed to leave. As a result, my time improved, but still not at 40 hours though I saw a promising improvement in my hours. Another thing that I realized was the need to set my alarm daily during the week, so I did not need to reset it. In addition, when I realized that my hours were stacking up, I would leave a bit early to gain some work sanity and improve that balance.
I transferred all strategies from the third week but enhanced them by adding more alarms in the fourth week. The first alarm was meant for the estimated time to complete my tasks. The reason for such intervention is that it would give me a more proactive approach on whether I was taking too long or focusing too much on a task that would not meet the expected success, thus enabling me to complete more tasks on time. The other alarm was a 15-minute alarm to 4.15 pm, which I intended to use to help me assess the tasks that I would handle within 15 minutes to my official leaving time, followed by the 4.30 pm final alarm.
(Figure 4)

The strategy I took to ensure that every week started well was that each Friday, I would add a tool meant for the next week’s work efficiency with the overall goal of improving my 40-hours work schedule. When I assess the four-project weeks, I can feel the improvement of my work-life balance. I have been more present with my husband and my children because I am able to have that time with them. It has enabled me to join my family for dinner, especially in the last one and a half weeks as seen on Figure 4. In addition, not only did I increase my time with my family, but also have significantly increased my joy and love for my nurse manager position.

Changes

Change is inevitable, so in the third and fourth weeks, I tried to ensure that I worked for less than 10 hours each day. Such adjustment did not only help me to interact with my family but also helped me tackle a lot of work within the limited times since I had time to relax, thus preventing instances of burnout. The only factor I struggled with during that time was ensuring task perfection to prevent revising the tasks, which sometimes takes more time than initial plans. Project Knowledge Within the Nursing Workplace Assignment

Improvement Project Reflection and Lessons

From the personal improvement project, I have learned the need to have a precise project aim before starting any project activity. Another lesson learned is that an improvement project does not happen immediately and that a gradual process is always involved, providing visible improvements.

Maintaining the Project’s Long-Term Improvement

Self-improvement projects help in making informed decisions that can impact long-term goals. Consistency is needed to sustain the improvement’s long-term goal (Stausmire & Ulrich, 2015). The changes I made are making a significant impact on my work-life balance. They are not difficult to maintain because I can use my phone for alarms, including writing my tasks each morning to improve my ability to function throughout the day and not waste time.

Project Knowledge Within the Nursing Workplace

The experience gained from the project indicates that collaboration is a practical approach to providing an objective decision toward quality improvement projects. Hence, when carrying out any organization-level and unit-level changes, there will be a need to involve various stakeholders, especially those with expert knowledge about the needed change (Ricciardi & Shofer, 2019). That is evidenced through the input of my director since, without the help, it would be a bit hard for me to identify the essentiality of the root cause analysis. This section needs more discussion. Be sure to discuss how you would apply lessons learned at the individual level to quality improvement at the unit and organization levels. This section also requires 4 references – 2 from outside sources within the past 5 years and 2 from the learning resources. Project Knowledge Within the Nursing Workplace Assignment

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CONCLUSION

~ Additionally, all papers need a conclusion paragraph to wrap up the paper

References

2 OUTSIDE SOURCES THAT ARE WITHIN LAST 5 YEARS

Agency for Healthcare Research and Quality. (2022). Process mapping. https://digital.ahrq.gov/health-it-tools-and-resources/evaluation-resources/workflow-assessment-health-it-toolkit/all-workflow-tools/process-0

Agency for Healthcare Research and Quality. (2019c). Measurement of patient safety. https://psnet.ahrq.gov/primer/measurement-patient-safety

Agency for Healthcare Research and Quality. (2019d). Root cause analysis. Retrieved from https://psnet.ahrq.gov/primer/root-cause-analysis

Johnson, J. K., & Sollecito, W. A. (2020). McLaughlin & Kaluzny’s continuous quality improvement in health care (5th ed.). Burlington, MA: Jones and Bartlett.

Ricciardi, R., & Shofer, M. (2019). Nurses and patients: Natural partners to advance patient safety. Journal of Nursing Care Quality, 34(1), 1–3. https://doi.org/10.1097/NCQ.0000000000000377

Stausmire, J. M., & Ulrich, C. (2015). Making it meaningful: Finding quality improvement projects worthy of your time, effort, and expertise. Critical Care Nurse, 35(6), 57–61. https://www.aacn.org/docs/cemedia/C1563.pdf

Wolfe, H. A., Taylor, A., & Subramanyam, R. (2021). Statistics in quality improvement: Measurement and statistical process control. Pediatric Anesthesia, 31(5), 539-547.
https://doi.org/10.1111/pan.14163

Personal Improvement Project Plan: The aim of the Personal Improvement Project is to experiment with a small change that is under your personal control; collect, analyze, and interpret data; and then reflect on what you have learned from your project about the general challenge of changing something. Through this project, you will see how the quality improvement (QI) process works in general and familiarize yourself with the tools used for healthcare QI. Project Knowledge Within the Nursing Workplace Assignment

Clearly state the aim of your project. The aim of my personal improvement project is to improve my work and home life balance. I currently work more well over my 40 hours and do not have quality time with my family. My table will have the workdays that I work and not include the weekends. My goal is to improve my work/home life balance. I want to do this because I have noticed since taking my new job, that my mental health is suffering. I am starting to regret my decision in taking my new role as a Nurse Manager. I am looking to improve my work/home life balance for a happier life and improving my relationships with my husband and children.

Part 2: Process Analysis

Consider the process leading to the results that you aimed to improve. Create a process map to identify the steps in the process and identify the people (other than you) who were involved in the process.

The process I plan to take is to start with 1 idea to improve my work hours each week. I will build on each step by adding another tool to try and improve my hours. Week 1, use no tools and see how much I work. Week 2 add one tool (Write day each day the tasks that need to be completed with estimate time for completion). Week 3 in addition to tool number one, as a alarm to go prompt me that my hours are complete. Week 4, in addition to both tools from week 3, adding an additional alarm to ensure my tasks are being completed and not derailed. Also making sure that I have a 15-minute alarm prior to my departure, with the departure alarm still going. I learned to keep these alarms and have them on repeat (so I wouldn’t forget to reset them). Myself and my director were involved in creating this process.

Part 3: Measurement

Describe the data collection method used, including an explanation of what you measured and how. Be specific.

I chose to do my data collection tallying my hours worked each day for 4 weeks. I connected with my director to come up with different tools to use each week but adding them to the previous tools utilized each week. Week 1, I continued to work without any adjustment, to document my hours accordingly, so I could see what I kind of hours I was working over my 40.

The 2^nd week I began to make a list of tasks each morning to organize my day and attempt to plan out my schedule. I was still working past my 40 hours, but I could see some progress. By noting some of the tasks and estimating how long they would take. This way, if it was 4pm and I am supposed to leave by 430pm, I would leave tasks that I estimated would take longer than 30-45 minutes for the next day. I recognized the need to have more consistent alarms, the need to take into account my start time and not just my end of shift times. There are some shifts that as a nurse, you can get sucked into a situation at the bedside, and my hours needed to give and take a little.

The 3^rd week, I continued to note my tasks for my day and the estimated times, but I added an alarm on my phone for the time I was supposed to leave. My time improved, but still not at 40 hours. But I can say that my hours were improving. I realized that I needed to set my alarm to go off daily during the week, so that I did not need to reset it. I also moved around some of my agenda items for my days and went into work later, so that I could stay later on some evenings and not be exhausting myself and my hours. I noticed that my hours were stacking up and so when I was able to leave “early” in a shift, I did. To try and save some of my sanity and improve that balance.

The 4^th week, I continued to do everything from the third week, but I added more alarms to my day. I set an alarm for the estimated time of my tasks. This gave me a heads up on if I was taking too long or placing too much focus on a task that was “dead in the water”. This allowed me to complete more tasks in a timely manner. I also set a 15-minute alarm for 415pm, as my que to make sure that I was finishing up my tasks with only 15 minutes left of my day. Then my final alarm went off at 430. Project Knowledge Within the Nursing Workplace Assignment

Each Friday I would add a tool for my next work week. To see if this would improve my ability to leave work closer to my 40 hours.

Through the 4 weeks, I was able to improve my work life balance, and was arriving home with the ability to join my family for dinner in the last 1.5 weeks. I was able to increase my time with my husband and children and increase my joy of my career.

Present the data in a table, graph, diagram, run chart, or XmR chart.

This section is complete, and is not part of the 4-5 page written paper.

Data Collection Plan

Date	# Of Hours Worked	Did I make a list? (Y/N)	Set alarm to leave for the day. (Y/N)	Set multiple reminder alarms? (Y/N)
5/30	10.5	–	–	–
5/31	10.75	–	–	–
6/1	11	–	–	–
6/2	9.5	–	–	–
6/3	11	–	–	–
6/6	9.25	Y	–	–
6/7	9.5	Y	Project Knowledge Within the Nursing Workplace Assignment	–
6/8	11.25	N	–	–
6/9	9	Y	–	–
6/10	8.5	Y	Y	–
6/13	10.25	Y	Y	–
6/14	8.75	Y	Y	–
6/15	9.5	Y	N	–
6/16	6.5	Y	Y	–
6/17	9	Y	Y	Y
6/20	8	Y	Y	Y
6/21	8.5	Y	Y	Y
6/22	9	Y	Y	Y
6/23	10	Y	Y	Y
6/24	6.75	Y	Y	Y

Part 4: Changes

Explain the changes you made based on the data. What worked? What didn’t work?

Part 5: Reflection and Application

Reflect on your personal improvement project and what you learned.
Explain how you will maintain ongoing improvement in this area long-term. The changes I made are making a significant impact on my work life balance. They aren’t difficult to maintain because I am able to use my phone for alarms, Writing my tasks each morning improve my ability to function throughout the day and not waste time.
Explain how you could use knowledge from this experience to facilitate both a unit-level and an organization-level change in a nursing workplace. Be specific and provide examples.

Must use at least 4 of the below references:

REFERENCES to use in Project:

Johnson, J. K., & Sollecito, W. A. (2020). McLaughlin & Kaluzny’s continuous quality improvement in health care (5th ed.). Burlington, MA: Jones and Bartlett.

Foreword (pp. xiii–xvii)
Chapter 1, “The Global Evolution of Continuous Quality Improvement: From Japanese Manufacturing to Global Health” (pp. xviii–30)

Agency for Healthcare Research and Quality. (2018). Six domains of health care quality. Retrieved from https://www.ahrq.gov/talkingquality/measures/six-domains.html

Neuhauser, D., Myhre, S., & Alemi, F. (2004). Personal continuous improvement workbook (7th ed.). McLean, VA: Academy for Healthcare Improvement. Project Knowledge Within the Nursing Workplace Assignment

Institute for Healthcare Improvement. (n.d.a). How to improve. Retrieved from http://www.ihi.org/resources/Pages/HowtoImprove/default.aspx

Johnson, J. K., & Sollecito, W. A. (2020). McLaughlin & Kaluzny’s continuous quality improvement in health care (5th ed.). Burlington, MA: Jones and Bartlett.

Chapter 4, “Understanding Variation, Tools, and Data Sources for CQI in Health Care” (pp. 106–141)
Chapter 5, “Lean and Six Sigma Management: Building a Foundation for Optimal Patient Care Using Patient Flow Phy” (pp. 142–173)

Silver, S. A., Harel, Z., McQuillan, R., Weizman, A. V., Thomas, A., Chertow, G. M., … Chan, C. T. (2016). How to begin a quality improvement project. Clinical Journal of the American Society of Nephrology, 11(5), 893–900. doi:10.2215/CJN.11491015

American Society for Quality. (n.d.). Quality tools A to Z. Retrieved from https://asq.org/quality-resources/quality-tools

Agency for Healthcare Research and Quality. (n.d.). Process mapping. Retrieved from https://digital.ahrq.gov/health-it-tools-and-resources/evaluation-resources/workflow-assessment-health-it-toolkit/all-workflow-tools/process-0

Antonacci, G., Reed, J. E., Lennox, L., & Barlow, J. (2018). The use of process mapping in healthcare quality improvement projects. Health Services Management Research, 31(2), 74-84. doi:10.1177/0951484818770411

Johnson, J. K., & Sollecito, W. A. (2020). McLaughlin & Kaluzny’s continuous quality improvement in health care (5th ed.). Burlington, MA: Jones and Bartlett.

Chapter 9, “Assessing Risk and Preventing Harm in the Clinical Microsystem” (pp. 234–251)

Agency for Healthcare Research and Quality. (2019c). Measurement of patient safety. Retrieved from https://psnet.ahrq.gov/primer/measurement-patient-safety

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Agency for Healthcare Research and Quality. (2019a). Checklists. Retrieved from https://psnet.ahrq.gov/primer/checklists?q=/primers/primer/14

Agency for Healthcare Research and Quality. (2019b). Detection of safety hazards. Retrieved from https://psnet.ahrq.gov/primer/detection-safety-hazards

Agency for Healthcare Research and Quality. (2019d). Root cause analysis. Retrieved from https://psnet.ahrq.gov/primer/root-cause-analysis

Patient Safety Movement. (n.d.). Patient story: Lewis Blackman. Retrieved from https://patientsafetymovement.org/advocacy/patients-and-families/patient-stories/lewis-blackman/

Johnson, J., Haskell, H., & Barach, P. (2009). Lewis’ story—It’s hard to kill a healthy 15-year-old. Retrieved from http://www.healthwatchusa.org/conference2013/PDF-Downloads/Haskell-Lewis_Blackman_Story.pdf

Institute for Healthcare Improvement. (n.d.b). Noah’s story: Are you listening? Retrieved from http://www.ihi.org/education/IHIOpenSchool/resources/Pages/Activities/NoahsStoryAreYouListening.aspx

Ricciardi, R., & Shofer, M. (2019). Nurses and patients: Natural partners to advance patient safety. Journal of Nursing Care Quality, 34(1), 1–3. doi:10.1097/NCQ.0000000000000377

Agency for Healthcare Research and Quality. (2019e). Systems approach. Retrieved from https://psnet.ahrq.gov/primer/systems-approach

Johnson, J. K., & Sollecito, W. A. (2020). McLaughlin & Kaluzny’s continuous quality improvement in health care (5th ed.). Burlington, MA: Jones and Bartlett.

Chapter 3, “Integrating Implementation Science Approaches Into Continuous Quality Improvement” (pp. 50–105)