SHSU033 Leading Excellence in Practice - University of Stirling

PART 1: Quality Improvement Proposal

PART 2: Wrap-around Reflection and supporting evidence

A Quality Improvement Proposal

Assessment - Introduction

The Quality Improvement Proposal(QIP) allows you to meet the module learning outcomesLO1, LO2 and LO3:

1. Consolidate subject knowledge of leadership theory underpinning professional practise.
2. Evaluate theories, professional and political drivers that support excellence in health care delivery.
3. Critically appraise merits and limitations of quality improvement (QI) methods in a healthcare context.

You are required to develop a Quality Improvement Proposal(QIP) to demonstrate how you would plan and test changes to make improvements in practice.

In your QIP you will:

1. Identify a small-scale area for improvement
2. Propose a potential change you could test to address theproblem
3. Define a measurement plan to determine the effectiveness/impact of your proposed change
4. UsePlan Do Study Act (PDSA) cyclesto discuss your proposed improvement and how you might develop your change and to be implemented in a practice environment in the future.

• You will complete your Quality Improvement Proposal (QIP) on the required template (Appendix B, page 15).
• One assignment appendix is required with your proposal submission. This should be the QI Tool used to (e.g., Fish bone (Ishikawa), mind map or driver diagram).
• You must include a minimum of 15 references in the QIP and a reference list at the end.
• Appendices and reference list are not included in the word count.

Potential QI Proposal Topics

Think about a placement you have been on where you have been aware of a challenge or problem that needed to be addressed. Here are some topic areas from previous students to inspire your thinking. You can choose from the list below or alternatively; you may choose a topic of your own.
Patient Centred Care and Quality Improvement:
• Reducing falls and injuries
• Increasing/monitoring dementia awareness
• Increasing/monitoring mental health awareness
• Reducing the risk of pressure ulcers
• Reducing urinary catheter-related infections
• Preventing healthcare associated infections
• Enhancing end of life care
• Streamlining outpatient clinics
• Educating patients & families about treatments/self-management
Patient Safety and Quality Improvement:
• Reducing medication errors
• Improving handovers
• Administering intravenous fluids
• Informing clinical decision making
• Reducing falls in care homes

Working Conditions and the Work Environment for Health Professionals
• Managing fatigue, burnout and stress
• Reducing high staff turnover
• Improving teamworking

QIP structure

This is a summary of what you are required to do. The template (Appendix B) will guide you through the required structure and must be used to write your QIP.

1. Identify an area forimprovement- keep it small and focused.

Remember -
a. The proposed area for improvement must be specific to nursing practice and have a direct effect on the quality of patient care or the workforce. This might be something you have observed as a problem in practice, read about in research literature or an area you have an interest in.
b. You must be able to justify the need to address the problembased on academic evidence with appropriate references(not opinion).Remember the literature should help define the problem and identify possible solutions.

2. Explain what the change or intervention being proposed would be.

a. Demonstrate how you would use one QI tool to select a small change in practice (e.g., driver diagram, fish bone)

2. Describe the measurement plan to determine the effectiveness/impact of your change.

How would you know if the suggested change has made any difference?
a. Summarise how you will measure the effectiveness or impact; you may use a table for this to show:
1 x baseline measure
1x outcome measure
2 x process measures
1 x balancing measure
b. To do this, you will need to do some reading to make sure you understand what these terms mean.

4. Explain how to perform at least one PDSA cycle necessary to test your change in the practice environment.

5. Identify implementation strategies to support your proposed change in practice and discuss ways to share learning.

Assignment

Reflection and Supporting Evidence

Introduction
This Wrap-around reflection means that you are bring together your experiences and development throughout the duration of your nursing programme at Stirlingto date (including the required mandatory training elements). This means it is not just about focusing on one specific element, but about bringing together your wider learning in placements over the past two and a half years.

As part of this reflection, you should
a. critically reflect on your personal performanceand learning over the duration of your programme to improve your practice and
b. critically consider your role in supporting and/or, supervising others whilst in your role as a student nurse.

Make sure you reflection on both these aspects within the wrap-around reflection, making links between both your personal performance and learning along with your role in supporting and/or supervising others. Your reflections must also link to the 4 pillars of The Code (NMC 2018): Prioritise People; Practise Effectively; Preserve Safety & Promote Professionalism and Trust.

Part 2 - wrap-around reflection,allows you to meet the module learning outcomesLO5 and LO6:

5. Assess the responsibilities of the newly qualified nurse in supporting, supervising, and assessing students in the practice learning environment.

6. Critically appraise the process of reflection to support ongoing personal and professional development

Use a reflective model to critically reflect on your personal performance and learning as a student nurse to improve your practice AND your experience of supporting and/or supervising others in practice. You will also submit evidence of required training across the past 3 years of your studies (as an appendix). During PLE6 you were given reflective hours to organise this content (2.5hours per week).

The wrap-around reflection could include a focus on the following:
• Recognising your individual achievements during your nursing studies
• How you have advanced your practice and nursing knowledge and skills
• Reviewing your development in both theory and practice, and the relations between them
• A consideration of your role in supporting, supervising, and/or assessing other learners in practice (whilst on placement)
• Identifying your own professional development goals, directions, or priorities moving forward

- It is expected that you will draw on relevant references to support points that you make within your reflection. As an estimate you should aim to include between 8-12 references.

Using a model of reflection

• You must use a recognised model of reflection and you must state in your title which model you have used.
• You can use your own recognised nursing reflective model or choose one from the four examples of reflective models below.
• Make sure you reference the reflective model you choose.
• You are required to use the headings specific to your chosen model.
• This reflection can be written in either 1st or 3rd person but needs to be consistent.

Potential Proposal Topics

Think about a placement you have been on where you he challenge or problem that needed to be addressed. Here previous students to inspire your thinking. You can choose alternatively; you may choose a topic of your own.

Patient Centred Care and Quality Improvement:
• Reducing falls and injuries
• Increasing/monitoring dementia awareness
• Increasing/monitoring mental health awareness
• Reducing the risk of pressure ulcers
• Reducing urinary catheter-related infections
• Preventing healthcare associated infections
• Enhancing end of life care
• Streamlining outpatient clinics
• Educating patients & families about treatments,

Patient Safety and Quality Improvement:
• Reducing medication errors
• Improving handovers
• Administering intravenous fluids
• Informing clinical decision making
• Reducing falls in care homes

Working Conditions and the Work Environment for Health
• Managing fatigue, burnout and stress
• Reducing high staff turnover
• Improving teamworking

Note: Need to do part 1 only

Attachment:- Leading Excellence in Practice.rar