Quality improvement in record keeping using a tool fluid balance chart

NB
For the topic your intention is connected to record keeping( using Fluid balance chart FBC as an example). You now need to identify what you will actually do in order to improve the way FBCs are used. Remember to keep your change within the 'circle of control', specifically something a staff nurse can set up, keep it as a very small change indeed and local to a single clinical area. Please focus on the following
Part 2, 3,4,5 and part 6. please try and add as much citations and references as you can.
PART 2: Introduction
500 words
PART 3: Search strategy (for part 4)
100 words
PART 4: Critical analysis of the background and drivers for the quality improvement proposal 2,000 words
PART 5: The Proposal and summary of key evidence
1,000 words
PART 6: A critical analysis of leadership and change management approaches applied to the planned implementation of the quality improvement proposal, considering barriers and enablers 2,000 words
PART 7: Feedback, SNOB and action plan 400 words
PART 8: Reflection on individual learning
1,000 words
PART 9: References

Appendix for supporting evidence (if required)

 
PART 1: Self-assessment checklist
NOTES (delete on your final document for submission)
You should complete the following self-assessment checklist to ensure that you have meet the criteria of the portfolio and assessment. If there is any area that you have not included in your portfolio use this as an opportunity to revise and include this. This will also help identify areas that you may require further support or were you need to further develop your work.
Self-Assessment Checklist
Criteria
Have I included this in my portfolio?
Score on the following scale:
3: Included
2: Included but could be enhanced
1: Not included
Introduction
Introduces topic / problem and area of practice?

Overview of quality improvement idea?

Linked and supported by evidence and policy?

Introduces portfolio and guides reader to what is to follow?
Search strategy
Have you completed each part to demonstrate how you searched for evidence?
Could someone else replicate the search based on this information?
Critical analysis of the background and drivers for the quality improvement proposal
Critically analysed the topic and QI proposal incorporating primary research, national and international policy documents, guidelines and literature?
Provided sound rationale for the QI proposal?

Supported with use range of evidence?

The Proposal and summary of key evidence
Identified the topic / problem being proposed for quality improvement and the desired outcome?
Explain the quality improvement proposal using the structured framework based on PDSA?
Clear plan to carry out the project (who what where, when)?
Clear plan for measuring the effects of the change (before and after implementation)?
Summary of key evidence to support your QI (based on part 4 literature)?

A critical analysis of leadership and change management
Critically analysed leadership and change management theories?
Discussed potential barriers and enablers?

Applied this to how you would plan implementation of the quality improvement proposal?
Supported with use range of evidence?

Feedback, SNOB and action plan
Completed feedback summaries and SNOB?

Reflection on individual learning
Reflected on key learning from completing portfolio and developing quality improvement proposal?
Considered feedback from tutor, peer and practice?

References
Included a range of academic sources of evidence and policy documents?
Have you used APA7th accurately in your text citations and reference list?
Structure and presentation
Well-structured sentences and paragraphs with a logical flow?
Have you followed portfolio guidance/structure?

Carefully proof read portfolio AND/OR someone else proof read portfolio?
Have you remained within the word count
(7,000 +/- 10%)?
Have you formatted correctly?
• Line spacing: 1.5
• Font type: Arial
• Font size: 12
 
PART 2: Introduction
NOTES (delete on your final document for submission)
• Introduce the topic or the problem.
• Introduce the area of practice where you plan to implement the proposal (eg: a ward, community, clinic, care home.) Please don’t specifically name the hospital, ward or community setting, but give us enough detail that we understand the context of your proposal e.g. a busy surgical ward in a large a teaching hospital.
• Give an overview of quality improvement idea, tell us why it is important (e.g. it’s an issue that affects many patients/it’s an issue that can have serious implications for patients/it increases healthcare costs, etc.)
• Introduces portfolio and guides reader to what is to follow. Tell us briefly what’s in your portfolio e.g. “In the following sections, I will….”
• Link and support this with evidence and policy, using references appropriately where required.
• You could write in the 1st or the 3rd person for this short section, pick one approach.
PART 3: Search strategy (for part 4)
NOTES (delete on your final document for submission)
• You can fill this is as you go as soon as you start searching for evidence.
• Use the library databases to search for appropriate literature
• When searching for evidence, make sure you use simple, appropriate search terms
• See the example in the Assessment section of Moodle
• If you are really struggling, ask the subject librarian for help.
Aspect Search terms
Setting: the place where care is being delivered. It could be a hospital, part of a hospital, general practice or somewhere else in the community.
Outcome: the thing that you are investigating or measuring in some way.
Factor: something that might influence the thing you are measuring.
People: the group of healthcare professionals, patients, family members or otherwise that you are interested in.
Study Design: the type of research you want to find.
Search terms to exclude from search
Age / gender

Publication Date
Language

Geography

Databases used
Number of articles returned:
PART 4: Critical analysis of the background and drivers for the quality improvement proposal
NOTES (delete on your final document for submission)
• Critically analyse the topic and QI proposal incorporating primary research, national and international policy documents, guidelines and literature. Most importantly, include primary research evidence which provides evidence that there is a problem which might benefit from a quality improvement proposal.
• Provide a sound rationale for the QI proposal based on the evidence. Justify your QI plan here. Start with the clinical context and the bare bones of what you want to do and why.
• Relate this briefly to your experience or observations in practice.
• Support your discussion with a range of evidence. Tell us about any policy documents that are relevant to your proposal: e.g. local NHS policies, best practice guidelines, NICE, etc, etc. Be sure to reference them appropriately. We don’t expect you to know these documents in minute detail, but we’d like to know that you’ve read them in enough detail that you can tell us why they’re relevant. Have the most recent “best practice” guidelines been supported or contradicted by research, for example?
• Acknowledge and discuss any different points of view in the evidence you have gathered, debate pros and cons and argue your point of view based on the evidence.
• Don’t worry too much if you’ve briefly said some of this already in your introduction.
• We’d expect this section to be written in the 3rd person, and referenced throughout.
 
PART 5: The proposal and summary of key evidence
NOTES (delete on your final document for submission) When you seek feedback in practice, this section could be used to share/present your plan as it also includes the key evidence to convince people in practice that this is a useful QI.
Quality Improvement Proposal Plan
PLAN
What is the topic or the problem?
What is your overall desired outcome: improved patient experience, continuity of care, etc?
DO
What is you are planning to do or change (who, what, where and when)?
Be specific and keep it simple
STUDY
What is your plan for measuring the effect of the change?
How will you know a change has happened? Remember that you’ll need a baseline measurement as well as measuring after the proposal is implemented. This might be an audit, a before-and-after quiz or feedback form, etc. Try to keep it simple.
Briefly summarise the key evidence to support your QI proposal.
Use your research from part 4, choose evidence that is compelling and convincing and reference it. Think about what is really important. Consider what will convince people in practice that this QI proposal is worthwhile. You can use bullet points.
 
PART 6: A critical analysis of leadership and change management approaches applied to the planned implementation of the quality improvement proposal, considering barriers and enablers
NOTES (delete on your final document for submission)
In this section you should critically analyse the role of leadership and change management in the development of this proposal.
• You should consider the leadership and change management approaches that are applicable to this small QI project.
• Tell us about 2-3 leadership styles and 2-3 change management approaches, look at the Moodle materials on Leadership and Change management for guidance. Explain using evidence:
• What are they?
• What are the pros and cons for each?
• Why they might or might not be appropriate or effective in your proposal?
• Tell us why you’ve chosen the approaches you have, in preference to these others.
• Explain how you might apply these (theoretically) in your project.
• Consider the enablers and barriers you might encounter when implementing this QI proposal in practice.
• How would you leadership and change management approach help you manage enablers and barriers?
• We’d expect this to be written in the third person, and referenced throughout, though when you are discussing the application to practice you might prefer to use the first person for a short section.
 
PART 7: Feedback, SNOB and action plan
Notes – delete for submission: You should record the feedback you have received at formative opportunities you have had the opportunity to engage in. Thereafter complete the SNOB Analysis (Strengths, Needs, Opportunities and Barriers) as introduced in the tutorials. Use the information in your SNOB analysis to consider a personal action plan to support you moving forward to the summative assessment. If you did not do the formative work for any reason, just write “not applicable”, you do not have to explain personal details in here.
Formative Feedback 1A
Draft QI proposal. Summarise the feedback provided. Ensure you consider the feedforward comments provided.
Formative Feedback 1B
Draft 700 words. Summarise the feedback provided. Ensure you consider the feedforward comments provided.
Feedback from Practice
Ask staff in placement for feedback or comments on your theoretical QI proposal, do they think this will be a useful QI? Can they think of any enablers or barriers to implementing it? Summarise the feedback and consider the comments provided.
 
SNOB Analysis
Strengths
Things that you did well and can continue to do well.
Opportunities
Things that you got wrong or missed. Or could include to make your work better.
Needs
Extra things you need to do before the next assessment.
Barriers
Things that could make it difficult to do things you think are necessary.
Personal Action Plan
Based on your SNOB analysis what do you need to do to improve your work before the summative submission?
 
Record of other discussions & feedback
Please summarise any relevant additional discussions with peers or tutors, SNOB analysis and action plan, you can use bullet points.
 
PART 8: Reflection on individual learning
NOTES (delete on your final document for submission)
Use the NMC template, or another reflection model if you prefer. Reference if using a different model and use appropriate headings to structure.
Tell us about your key learning from developing the proposal and portfolio using the reflective tool structure.
Consider your feedback and action plan.
Have you identified any strengths or areas for development? Examples might be: time management, academic skills, finding or using evidence, communication, leadership and change management skills.
You can write this in the 1st person, and we’d expect this to be appropriately referenced where needed, for example when using the NMC code.
Reflective Account
Adapted from: http://revalidation(dot)nmc(dot)org(dot)uk/download-resources/forms-and-templates.html
What was the nature of the activity and/or practice-related feedback and/or event or experience in your practice?
What did you learn from the activity and/or feedback and/or event or experience in your practice?
How did you and/or will you change or improve your practice as a result?
How is this relevant to the Code?
Select one or more themes: Prioritise people – Practise effectively – Preserve safety – Promote professionalism and trust
PART 9: References
Use APA7th – see library website for referencing guidance
 
Appendix for supporting evidence (if required)